Durban, South Africa

The disease burden in South Africa is challenging and complex. It is a stark example of the inequities that exist in access to care and care delivery globally and reflects how histories of globalization and colonization have serious implications for the quality of life of certain individuals today. For instance, the incidence of tuberculosis (TB) in South Africa is one of the highest in the world; in 2019, there were 615 cases per 100,000 population, which is nearly five times higher than the global incidence that same year. Moreover, South Africa is a notable contributor to the global burden of multidrug- and rifampicin-resistant TB, having had 14,000 cases in 2019. 
Our goal is to build care delivery capacity and integrate the care of multiple diseases to effectively combat the multiplicity of burdens faced by people in this country. We've developed programs that integrate TB screening with other screening efforts for noncommunicable diseases, like diabetes and heart diesease, and established systems that link individuals to the appropriate forms of care. We've also engaged in research to better understand the dynamics of drug use in different South African cities and how these dynamics lead to different outcomes, like increased rates of heptatis C and overdoses. 
Within the city of Durban, we've collaborated to establish the Bellhaven Harm Reduction Centre, which was developed at the beginning of the COVID-19 pandemic in order to reduce the risks associated with severe withdrawal. The Bellhaven Harm Reduction Centre uses evidence-based practices to help homeless individuals manage forced withdrawals during the COVID-19 Lockdown and is staffed by clinical and public health professionals to ensure the safety and well-being of everyone who utilizes the services at the Centre. Efforts like these function to encourage the flourishing of all individuals and create a healthier city.