The AIDS and Rights Alliance for Southern Africa (ARASA) has proposed a united call of action reiterating that tuberculosis is particularly acute in South Africa and four of its labour-sending neighbours, namely, Lesotho, Mozambique, Swaziland and Zimbabwe, which all have a high per capita TB occurence.
Lynette Mabote from ARASA presented her report on the mining sector at the joint session of SADC-PF regional standing committees for capacity strengthening on HIV criminalisation and stigmatisation. The meeting that ended on Thursday was attended by parliamentarians from Namibia, Swaziland, Lesotho, Malawi, Tanzania, DRC, Mauritius, Seychelles, South Africa and Zimbabwe.
Mabote stated that southern Africa remains the epicentre of the HIV epidemic and that HIV infection dramatically increases susceptibility to TB in South Africa, where 60 percent of TB patients are HIV-positive. The labour-receiving country and its four labour-sending neighbours have all reported cases of multi-drug resistance TB (MDR-TB) and extra drug resistance TB (XDR-TB), she added.
Public health disaster
Mabote quoted a Milner Commission Report of as early as 1903 as having stated, “The extent to which miners’ phthisis (TB) prevails at the present time is so great that preventative measures are an urgent necessity, and that such a large number of sufferers in our midst is a matter of keen regret.”
She noted that regrettably more than a century later after the Milner report was released the status quo with regard to TB remains the same and that, “The failure to control tuberculosis in the mining industry must be a matter for grave concern.”
Quoting Dr Aaron Motsoaledi, the minister of health of South Africa, Mabote noted, “The western world conquered its TB by the 1960s, thanks to socio-economic improvements as well as antibiotics and other drugs. But South Africa, the wealthiest country in the African continent, quadrupled its TB rate from 1990 to 2007.”
She also referred to Motsoaledi as having said at a TB conference that, “If TB and HIV are a snake in southern Africa, the head of the snake is here in South Africa. People come from all over the Southern African Development Community to work in our mines – and export TB and HIV along with their earnings. It we want to kill a snake we need to hit it on its head.”
Mabote said South Africa’s 500 000 mineworkers have the highest rate of TB in the world, estimated to be 3 000 to 7 000 cases in each 100 000 most of whom are also HIV positive, some with silicosis. She noted that in 2010/2011 eleven percent of South Africa’s gold sector miners were infected with TB compared to an industry average of five percent.
She said gold mines in South Africa have limited TB and HIV services with only 56 percent of gold mines having TB and HIV services, compared to 78 percent for platinum mines.
“Unlike platinum mines, most gold mines were built a long time ago, some as far back as the early 20th century and therefore have compromised infrastructure that breeds TB,” she stated.
Coordinated regional response
“TB is an increasing occupational hazard for South African miners … [and] mining companies need to accept responsibility for the consequences of unsafe working and living conditions in South African mines, including the high risk of HIV infection in migrant workers.”
In 2010 SADC health ministers committed to address this regional health crisis with urgency and this was backed by an extraordinary ministerial meeting on TB in mines, which took place in April 2012, and the end result was the 2012 declaration signed by SADC heads of state in August 2012, she said.