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A CHALLENGE TO A KEYSOUTHERN AFRICANECONOMIC SECTOR

BAD FOR COMMUNITIES, BAD FORTHE ECONOMY

In addition to the human toll, TB in the

mining sector results in huge healthcare

costs and greatly reduced productivity.

The current cost o the TB epidemic in the

South Arican 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 nancial benet o

US$ 783 million per year. (See section Why

invest in TB and miningon the next page.)

Mine workers in South Arica have the

highest rate o tuberculosis (TB) in the

world, with an estimated 3 to 7 percent

o miners becoming ill with the disease

each year.

The issue is regional. The mining industry

in South Arica is heavily dependent

on migrant workers rom 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 o TB inections in subSaharan

Arica are linked to mining activities.

Implementing bestpractice interventionscould yield a fnancialbeneft oUS$ 783

million a year or mines

and miners

Tuberculosis and mining

Photo: David Rochkind/International Reporting Project

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WHY INVEST IN TBAND MINING?

THE COST OF TB*

Annual cost o the TB epidemic in the

South Arican mining sector $886 million

Annual cost o implementing best

practice interventions $570 million

WHAT IMPLEMENTATION OF BEST-PRACTICE INTERVENTIONS COULDSAVE SOUTH AFRICA

Annual savings as a result o

implementing bestpractice

interventions $316 million

Annual productivity increase rom

implementing interventions $467 million

Total annual benet $783millio

*Source: preliminary analysis perormed on behal o SADC.

For more inormation, please contact

Judith MandelbaumSchmid:

schmidj@who.int

WHAT DRIVES THE TB EPIDEMIC IN MINES?

The TB epidemic in South Arican mines is driven by high levels o HIVinection in mining

communitiespeople living with HIV are 2030 times more likely to develop TBcrowded

living conditions and exposure to silica dust, which can lead to silicosis and a threetimes

greater chance o becoming ill with TB. Men travelling to work in the mines rom neighbouring

countries are at the greatest risk o getting TB, but their partners, children and riends are also at

risk when these miners travel back and orth to work, oten many times a year.

ELIMINATING TB FROM THEMINING SECTOR

The issue o TB and mining crosses national

boundaries and afects both the public

and private sector. To ree mine workers

and their communities rom TB, govern

ments across Southern Arica need to work

together with private companies, civil

society, labour unions and mineworkers

themselves.

World Bank analysis on the South Arican

mining sector identies ve interventions

required to address TB among mine work

ers, ormer mine workers, their amilies,

and communities:

Improve TB detection actively nd

people with TB and provide them with

treatment early

Eliminate the factors which lead to high

rates o 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

or occupational disease

BUILDING POLITICAL MOMENTUMFOR CHANGE: FROM PROBLEMS TOSOLUTIONS

The Ministers o Health or Lesotho, South

Arica and Swaziland who also serve as

ministerial TB champions on the Stop TB

Partnership Coordinating Board have

shown extraordinary leadership in putting

the issue o TB and mining on both the

regional and global agenda.

The three ministers raised the issue o TB

and mining to the Southern Arican 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 or Migration

and other partners, allowed representa

tives rom governments, trade unions, the

private sector, nongovernmental organizations and donors to provide their input to

a declaration and code o 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 or:

The development of a regional action

plan to implement the declaration

The development of a single unied em

ployment database and health inormation

system to record workers, enable patient

tracking and to improve crossborder

medical reerral

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 identied above. In addition, it is clear

that action will require strong publicpri

vate partnerships which welcome the

corporate sector as a key partner, and a

coordinated response across sectors.

Photo: Stephenie Hollyman