The World Bank is set to release the first tranche of its $120-million contribution to the fight against tuberculosis (TB) in Southern Africa’s mining sector during the first quarter of this year.
The funds will initially be directed to assist current and former mineworkers in Mozambique, Lesotho, Malawi and South Africa who are living with TB.
The disease has plagued the South African mining industry for over 100 years. However, over the past five years, the World Bank, in collaboration with the governments of Swaziland, Lesotho, Mozambique and South Africa; mining companies and trade unions; ex-mineworker associations; civil society organis-ations; and development partners have joined forces to address the challenge of TB in Southern Africa.
“Our global partners have therefore also set aside $20-million to support the campaign against TB,” says World Bank healthy societies global lead Dr Patrick Osewe.
He adds that mining companies will also support this initiative either through the South African Chamber of Mines – which is currently supporting several TB prevention and treatment programmes – or directly by providing health services for their employees.
Osewe highlights that there has recently been a lot of innovation by mining companies in addressing the TB challenge, such as through instituting health programmes for their employees.
However, he notes that the challenge of TB cannot end at the mine gate, which is why there is currently a concerted effort by Southern African countries’ health Ministries to provide TB treatment programmes for communities where mine-workers reside.
“This is assisting in ensuring that the disease is detected early and that it is treated effectively,” Osewe states.
He points out that South Africa has taken the lead to ensure that 100% of mineworkers are tested for TB and, if the disease is detected, they can start treatment immediately.
Mining is one of the major business sectors in Southern Africa that have driven economic growth. However, Osewe points out that the number of people infected with TB in the mining sector is almost three times the level of the rest of the population.
“In the mining industry, there is a TB infection rate of about 3 000 people for every 100 000 in the area, compared with the general population, which has a rate of about 1 000 for every 100 000 in the surrounding area,” he states.
Osewe highlights that the World Health Organisation (WHO) emergency threshold for an epidemic is 250 infections per 100 000 people. Therefore, he says “it is safe to say there is an epidemic of TB in Southern Africa, particularly in the mining sector”.
He lauds the ongoing efforts of South African Health Minister Dr Aaron Motsoaledi to combat the spread of TB in Southern Africa. In 2014, Motsoaledi spear-headed the campaign to establish a framework for the harmonised management of TB in the region.
The system aims to track, refer and treat infected miners in a standardised manner throughout Lesotho, Mozambique, South Africa and Swaziland.
“In the whole region, we share labour, we share communities, and we share labour-sending areas. But we have not had a clear programme for how to work together. That is why we brought the issue to the Stop TB Partnership, the World Bank and the WHO to help us bring the issue to all countries in the region,” Motsoaledi explained during a Ministerial meeting on harmonising the response to TB in the mining sector in 2014.
Meanwhile, World Bank senior health economist Thulani Matsebula notes that analysis undertaken by the World Bank in 2014 found that testing and treating all
current mineworkers in South Africa (about 500 000 in total) would cost about R330-million.
“There is about a 40:1 benefit-cost ratio for undertaking this programme, as the benefits to society of this investment would be in excess of R13-billion,” he highlights.
Matsebula points out that the foremost benefit of the programme would be a reduction in deaths caused by TB and a reduced TB incidence among mineworkers and their communities.
He says the WHO estimates that about 3 000 lives could be saved over a 15-year period between 2015 and 2030, if the testing and treatment programme was effectively implemented.