South Africa has the sixth highest prevalence of HIV in the world, with 18.8% of the population estimated to be infected. The UNAIDS 2006 Global Report, estimated that 320.000 people died of AIDS related deaths in South Africa during 2005. South Africa is regarded as having the most severe HIV epidemic in the world. New infections are still increasing with no signs of reaching a natural limit.

Efforts to stem the tide of new infections have only had limited success, as behaviour change and social change are long-term processes, and the factors that predispose people to infection – such as poverty, illiteracy, and gender inequalities – cannot be addressed in the short term.

Tuberculosis is also a major public heath problem in South Africa. In 2006, the World Health Organization ranked South Africa fifth among the world’s 22 high-burden TB countries. Despite South Africa’s investments in TB control, progress toward reaching program objectives has been slow. Treatment success remains low compared with other African countries with high HIV/AIDS prevalence and considerably fewer resources.

The TB epidemic in South Africa is likely to be further exacerbated over the next few years due to HIV/AIDS. TB-HIV co-infection rates are high, with as many as 60 percent of adult TB patients being HIV-positive. Multidrug-resistant TB (MDRTB), largely caused by non-adherence to drug regimens or inappropriate drug regimens, is further exacerbating the epidemic (source: www.usaid.gov).