As the COVID-19 pandemic sweeps into South Africa, the decades the country has spent fighting the world’s worst combined epidemic of tuberculosis (TB) and HIV could give it an advantage. But those infections could also worsen the pandemic’s impact.

By 6 April, South Africa had 1686 confirmed COVID-19 infections, the highest number on the continent—and that is almost certainly an undercount. At the same time, one in every five people aged 15 to 49 is HIV positive and two to three people die every hour from TB. South African scientists hope the resources and health networks built to fight those diseases will help them battle the new pandemic. “The COVID-19 response draws on the same skills as TB and HIV,” says Gavin Churchyard, director of the Aurum Institute, a Johannesburg-based research and health care nonprofit.

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