How the mining industry is dealing with the fight against TB


South Africa’s mining industry is conscious that, for a range of reasons, tuberculosis (TB) and HIV-Aids are a special challenge for our members and their employees.

The industry has taken on the challenge in the fight to control and eventually eradicate these diseases. With that imperative as motivation, the industry has put considerable time and resources into supporting government’s fight against TB and HIV-Aids.

In 2016, TB incidence in the South African mining industry was 900 cases per 100 000 of the workforce, down from 1 200 cases per 100 000 in 2013.

This is still higher than South Africa’s general TB incidence rate which was 781 cases per 100 000 people in 2016.

The industry has set itself the target of being at or below the South African TB incidence by 2024.

This target looks possible at current rates of reduction of TB in the industry.

TB is a major global health challenge. Around the world, 30 countries – including South Africa (as well as Russia, India, China and Brazil, among others) – have been identified by the World Health Organisation (WHO) as dealing with very high TB and drug-resistant TB disease burdens.

Collectively, these countries account for 80% of the global TB disease burden.

According to the 2017 WHO Global TB Report, 10.4 million people around the world contracted TB in 2016, and nearly 1.7 million of them died – including nearly 400 000 people who had HIV-associated TB.

The WHO report also notes that 438 000 South Africans contracted TB, and 124 000 died from it – 81% of them being HIV positive.

Globally and nationally, TB is the leading killer of people with HIV.

South Africa faces a number of challenges which exacerbate the TB situation and which make both prevention and treatment far harder – the central challenges being poverty and HIV-Aids prevalence.

The South African mining industry faces not only these challenges, but also the mining-specific challenge of exposure to silica dust, which is known to be associated with individuals contracting TB. Silica dust exposure is a declining problem as dust prevention and control methods become ever more precise and effective.

However, those exposed at any stage of their mining careers will remain vulnerable.

In facing the TB challenge, the industry has been focussing on the ‘social determinants’ of TB – the factors that play a pivotal role in predisposing an individual to TB.

For us, these factors are dust control; HIV-AIDS and TB prevention and treatment; improvements in employee housing; and collaboration with key stakeholders involved in the fight against TB.

In late 2015, as part of a broader national TB testing campaign launched earlier that year by then deputy president Cyril Ramaphosa, the South African mining industry, in partnership with government and organised labour, launched the Masoyise iTB initiative as a major TB screening campaign for the industry.

Masoyise iTB’s aim is to have a meaningful impact on South Africa’s TB challenge by reducing the current high incidence rate, while ultimately seeking to eliminate TB altogether.

The focus has been to offer all employees in the mining sector TB screening and HIV counselling and testing annually (over an initial period from 2016 to 2018), and the numbers suggest that the industry has bought into the initiative with enthusiasm and commitment.

In 2016, the mining industry tested 296 400 out of 352 857 employees for TB.

In 2017 this number was 388 460 out of 431 622 sector employees – 90%.

We expect that percentage to continue to rise for 2018.

On 26th September, the United Nations General Assembly (UNGA) will for the first time hold a high-level meeting focussing solely on the global health challenge posed by TB.

Under the theme “United to end Tuberculosis: an urgent global response to a global epidemic”, the hope is that this meeting will provide critical impetus to combatting the disease – much as similar meetings did for the fight against HIV/Aids and against malaria.

African Union countries have played a central role in leading the call for increased global cooperation on TB.

In August 2016, ministers of health from the Africa region were the first regional group to call for a UN High-Level Meeting on TB.

Our own Health Minister Dr Aaron Motsoaledi is credited with leading this bold initiative.

The experience of the South African mining industry is that success in reducing TB and HIV is possible and sustainable when based on addressing the determinants of health, preventing dust exposure and improving access to comprehensive health services.

Improvements in salaries, housing and living conditions for employees in the mining industry have also contributed to reductions in TB incidence.

The industry offers social protection for those that suffer from TB in the form of employer and labour agreements that provide for 140 days fully paid leave and up to 183 days partially paid leave, whilst employees undergo TB treatment.

The Minerals Council will be attending the UNGA session as part of the official South African delegation.

We will reiterate the mining industry’s commitment to eradicating TB, and to supporting government and civil society initiatives in this regard.

There is no doubt that, working together, TB can be beaten.

*Andile Sangqu is Chairperson of the Masoyise iTB initiative and Vice President of the Minerals Council South Africa

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