A formative evaluation of the TB Think Tank’s role and influence on TB policy in South Africa

Abstract

Tuberculosis (TB) remains one of the leading causes of death globally, despite being both preventable and treatable. South Africa continues to experience a high burden, with an estimated 56,000 TB-related deaths recorded in 2023. In response to this public health crisis, the TB Think Tank (TB TT) was established in 2014 to strengthen the government’s programmatic response to TB. This formative evaluation examines the activities, processes, and outputs through which the TB TT has influenced TB policy between 2021 and 2024, identifies areas for improvement, and provides actionable recommendations to enhance its impact. To conceptualise the TB TT as a Knowledge Translation Platform, Bennett and Jessani’s (2011) framework was applied, focusing on knowledge generation, dialogue, and capacity building. Data were collected through 14 in-depth interviews with key stakeholders, a survey of 65 TB TT members conducted between June and July 2024, document review, and observational data to provide contextual insight; survey data were analysed using descriptive statistics, while qualitative data were analysed using inductive thematic analysis. Findings indicate that the TB TT has played a significant role in shaping South Africa’s TB response, with 97% of survey respondents affirming its effectiveness in advising the National Department of Health on policy. Key strengths include diverse membership, strong leadership, and alignment with national priorities, which have supported influential outputs such as the TB Strategic Plan 2023–2028. However, several challenges persist, including delays in the approval of recommendations, underrepresentation of key stakeholders such as district and provincial practitioners and other government sectors, limited monitoring mechanisms, and broader systemic constraints such as bureaucratic processes, competing priorities, and data access issues. Overall, the TB TT has made a substantial contribution to South Africa’s public health landscape and remains well positioned to advance the national TB agenda by strengthening evidence-informed decision-making and promoting equitable care.