Carletonville, South Africa
Regulators are increasingly scrutinizing HIV and TB responses in South Africa's mining sector, which could lead to the industry being hit where it hurts - the bottom line.
Speaking to hundreds of mine workers and community members in the mining town of Carletonville on World TB Day, Deputy President Kgalema Motlanthe urged the mining industry to improve TB services by adopting the GeneXpert rapid TB test, upgrading health centers to allow for the treatment of drug-resistant TB, and by extending health services to those from surrounding communities and mines that may have limited access to healthcare.
At the same event, Mineral Resources Minister Susan Shabangu announced that mining companies, whose HIV, TB and workplace safety policies are being audited by her department, will have to submit their policies as a prerequisite for renewing their mining licenses.
As part of the deputy president's call for all mine workers to be screened for TB and HIV in the next year, World TB Day celebrations were accompanied by HIV and TB screenings, during which at least 1,220 people were examined for TB and 260 people were tested for HIV.
Going to ground
Before addressing the crowd, Motlanthe and Shabangu joined other officials, including Minister of Health Dr Aaron Motsoaledi and South African National AIDS Council deputy chairperson Mark Heywood at a community dialogue meeting with about 200 miners, who raised concerns like housing, compensation for their families if they should die, and unfair dismissal following TB diagnoses.
Mark Heywood, who also heads the human rights organization, Section 27, encouraged miners to report such dismissals.
"In South Africa it is illegal for anyone with HIV or TB to be dismissed or chased away from employment," Heywood told IRIN/PlusNews. "We encourage any mineworker who has been dismissed because of TB or HIV to report it - to overcome TB we have to protect human rights."
As in many countries in southern and East Africa, South Africa's high TB incidence is fuelled by a high HIV prevalence. Although many people carry TB, only 10 percent will ever develop the active disease, but because of their compromised immune systems, people living with HIV are up to 37 times more likely to develop active TB.
Miners are also at a higher risk of TB due to bad living conditions, often in the poorly ventilated, overcrowded single-sex hostels that have historically characterized mining in South Africa, and have facilitated TB transmission. Miners exposed to high levels of silica dust also often acquire a serious respiratory illness called silicosis, which increases their risk of developing active TB.
According to Shabangu, South Africa's mining sector sees three times as many cases of active TB as the general population, mostly in the gold mining sector, where studies have found that up to a quarter of all miners may have silicosis.
The Gold Fields mining company, which hosted the event, has already taken steps to address poor housing by building single-family homes on its mines, as well as helping others purchase their own homes, CEO Nick Holland told IRIN/PlusNews.
The company spends about R100 million on TB screening and treatment annually, and has managed to enroll around 3,500 miners in its HIV treatment program.
Motsoaledi will join fellow health ministers and mining representatives from the Southern African Development Community (SADC) at an April meeting in the Angolan capital, Luanda, to address the region's response to TB in the mining sector.
The gathering is expected to produce an SADC declaration on the issue by August 2012. A regional plan of action will inform future TB interventions, which may include the introduction of regional health passports for migrant workers and the harmonization of TB treatment policies and regimens.
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