A CHALLENGE TO A KEY SOUTHERN AFRICAN ECONOMIC SECTOR
BAD FOR COMMUNITIES, BAD FOR THE ECONOMY
In addition to the human toll, TB in the mining sector results in huge healthcare costs and greatly reduced productivity. The current cost of the TB epidemic in the South African mining sector is estimated at US$ 886 million per year. However, implementing activities to tackle TB in mines would eliminate these costs and bring about increased productivity, resulting in a total financial benefit of US$ 783 million per year. (See section
Why invest in TB and mining
on the next page.)Mine workers in South Africa have the highest rate of tuberculosis (TB) in the world, with an estimated 3 to 7 percent of miners becoming ill with the disease each year. The issue is regional. The mining industry in South Africa is heavily dependent on migrant workers from surrounding countries, particularly Lesotho, Mozam-bique, Swaziland and Zimbabwe. Each migrant worker who returns home with TB spreads the disease to an estimated 15 people in their community. An estimated one third of TB infections in sub-Saharan Africa are linked to mining activities.
Implementing best practice interventions could yield a financial benefit of
US$ 783 million a year
for mines and miners
Tuberculosis and mining
Photo: David Rochkind/International Reporting Project
WHY INVEST IN TB AND MINING?
THE COST OF TB*
Annual cost of the TB epidemic in the South African mining sector $886 million Annual cost of implementing best-practice interventions $570 million
WHAT IMPLEMENTATION OF BEST PRACTICE INTERVENTIONS COULD SAVE SOUTH AFRICA
Annual savings as a result of implementing best-practice interventions $316 million Annual productivity increase from implementing interventions $467 million Total annual benefit $783millio
*Source: preliminary analysis performed on behalf of SADC.
For more information, please contact Judith Mandelbaum-Schmid: schmidj@who.int
WHAT DRIVES THE TB EPIDEMIC IN MINES?
The TB epidemic in South African mines is driven by high levels of HIV-infection in mining communities—people living with HIV are 20-30 times more likely to develop TB—crowded living conditions and exposure to silica dust, which can lead to silicosis and a three-times greater chance of becoming ill with TB. Men travelling to work in the mines from neighbouring countries are at the greatest risk of getting TB, but their partners, children and friends are also at risk when these miners travel back and forth to work, often many times a year.
ELIMINATING TB FROM THE MINING SECTOR
The issue of TB and mining crosses national boundaries and affects both the public and private sector. To free mine workers and their communities from TB, govern-ments across Southern Africa need to work together with private companies, civil society, labour unions and mineworkers themselves. World Bank analysis on the South African mining sector identifies five interventions required to address TB among mine work-ers, former mine workers, their families, and communities:
• Improve TB detection – actively nd
people with TB and provide them with treatment early
• Eliminate the factors which lead to high
rates of TB in the mines
• Improve TB treatment• Actively seek former mine workers who
could have developed TB and silicosis
• Create a legal and regulatory framework
that provides appropriate compensation for occupational disease
BUILDING POLITICAL MOMENTUM FOR CHANGE: FROM PROBLEMS TO SOLUTIONS
The Ministers of Health for Lesotho, South Africa and Swaziland - who also serve as ministerial TB champions on the Stop TB Partnership Coordinating Board - have shown extraordinary leadership in putting the issue of TB and mining on both the regional and global agenda. The three ministers raised the issue of TB and mining to the Southern African De-velopment Community agenda (SADC) in November 2011. In March 2012, SADC con-vened a stakeholders meeting in Johannes-burg. The meeting, which was supported by the Stop TB Partnership, World Bank, the International Organization for Migration and other partners, allowed representa-tives from governments, trade unions, the private sector, nongovernmental organiza-tions and donors to provide their input to a declaration and code of conduct on TB in the mining sector. This declaration was endorsed by SADC health and labour min-isters in April 2012 in Luanda, Angola. The ministers also agreed on the need for:
• The development of a regional action
plan to implement the declaration
• The development of a single unied em
-ployment database and health information system to record workers, enable patient tracking and to improve cross-border medical referral
• Further economic analysis of TB in the
mining sector across the 15 SADC states
The 15 SADC countries
NEXT STEPS
To maintain momentum, SADC countries need support to deliver the three priority tasks identified above. In addition, it is clear
that action will require strong public–pri
-vate partnerships which welcome the corporate sector as a key partner, and a coordinated response across sectors.
Photo: Stephenie Hollyman