NUM proposes HIV/AIDS summit
The National Union of Mineworkers (NUM) has proposed that an HIV/AIDS summit for the mining sector be held next month to map out a common approach to the pandemic.
The NUM last week [subs: Oct 8-12] accused Anglo American of reneging on it’s plan to offer anti-retroviral (ARV) drugs to HIV positive mineworkers.
Mining experts believe 20% to 30% of workers on gold mines are living with the virus. Many workers are now becoming terminally ill.
‘There is a tendency for different groups in the industry to compete instead of developing an integrated approach to HIV/AIDS. But we are all partners. The issue affects all of us,’ said NUM’s publicity officer Moferefere Lekorotsoana.
‘We need a national HIV/AIDS summit for the entire mining industry to review all the different programmes, and begin to assess strengths and weaknesses then decide how to take forward the process with collective budget and a tighter programme.’
Anglo American’s Dr Brian Brink said last week that price was the main obstacle preventing his company from giving its workers the drugs.
However, the NUM accused Anglo American of ‘putting profits before people’, and said an earlier pronouncement by Anglo that it wanted to provide the drugs had simply been a ‘publicity stunt’.
Lekorotsoana said Anglo American’s decision not to offer antiretroviral drugs was ‘in contradiction to the recently signed NUM/Chamber agreement’ which promised HIV positive mineworkers access to drugs, nutritional food, physical training and hygienic conditions.
However, Brink emphasized that Anglo American had not ruled out the provision ARVs.
‘We are in negotiations with the drug companies about prices and I remain optimistic that we will be able to reach a point where we will be able to offer the drugs,’ said Brink.
Brink added that certain generic drug manufacturers based in India offered attractive prices, but their drugs still had to be registered with the Medicines Control Council and licensed for South Africa before Anglo could use them.
‘The subject of anti-retroviral drugs is very complex and difficult,’ said Brink. ‘We have to acknowledge that the drugs work. They’re getting better, easier to take with fewer side effects. ‘Once a person starts on the drugs, we have to be committed to seeing them through as long as they live. At this stage, it’s not clear how long a person’s going to live on these drugs but with good management, you are really talking about a chronic disease. ‘When you start adding up the lifetime cost of these drugs, this adds up to an intervention that is extremely costly. There are a lot of benefits to offset against the cost, in terms of reduced absenteeism, better productivity, better morale, reduced hospitalisation, not having to pay out pension benefits.
‘Our approach is that it’s something that we’d like to do. But we have to look at the feasibility and the only way to do this is to set up a feasibility study. I’ve been working on that for eight months but haven’t reached the stage where we are ready to begin the study.’
Some 13 682 Anglo American employees are already on ARVs paid for by their medical aid. However, Brink said these were generally office workers not mineworkers and that it was ‘absolute rubbish’ that they were senior managers only, as alleged by NUM. Almost a third of these employees earned less than R3 000 a month, while the majority earned less than R6 000, said Brink.
Given Anglo American’s diverse interests, any feasibility study would have to be run at multiple sites ranging from mines to forests to ‘establish if workers found the treatment tolerable in the different settings’, said Brink.
AngloGold’s HIV/AIDS manager, Dr Petra Kruger, points out that no research has been done on how workers in gold mines would cope with the drugs.
The working conditions underground are physically strenuous, the heat is intense and some of the side effects of the ARV drugs are nausea, dizziness and diarrhoea.
These conditions as well as the administration of ARV therapy are some of the issues that would have to be addressed by clinical trials, adds Kruger.
NUM’s Lekorotsoana acknowledges that a drug programme would need tight management. ‘If mineworkers are given tablets, they might go underground and forget to take them so the process needs to be monitored.’ However, he said the NUM would not tolerate mineworkers being treated as ‘guinea pigs’.
South Africa’s two other significant gold mining companies, Gold Fields and Harmony, are adopting a wait-and-see attitude to ARVs.
Stella Ntimbane, HIV/AIDS manager for Gold Fields, says her company offers ARV drugs to employees in three instances: to women employees who have been raped, to HIV positive pregnant women employees to prevent mother-to-child transmission, and to employees at risk after ‘occupational exposure’ (such as health workers who have had needle stick injuries).
‘We are still looking at ARV drugs for other HIV positive employees and we are following all the debates,’ said Ntimbane. ‘As soon as there is research out there that says it is safe to give ARV to workers in gold mines who work in hot conditions then we will look into that.’
Harmony’s manager of health Services, Dr Tony de Coito, says that while his company also offers ARVs to prevent mother-to-child transmission, ‘there’s a lot we need to get right before we see anti-retroviral drugs as the core issue’.
‘We need to get voluntary counselling and testing going more widely, the wellness clinics operating, vitamin supplementation, psychological support, prophylactic drugs to prevent opportunistic infections. We need to get all these right before we try to get anti-retrovirals right’.
‘ Health-e News Service.
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