World TB Day is commemorated on the 24th of March, and as part of the celebration, the South African Ministry of Health is planning to launch a campaign to test and treat hundreds of thousands of miners for TB over the next year.

Some fear a testing campaign will overwhelm the health system with new TB patients. Mametja, however, said that doing nothing would only worsen the situation as an infected person who is not on treatment can infect 10 to 15 others in a year, and that late stage TB is much more difficult and expensive to treat.

In a recent interview, Health Minister Dr Aaron Motsoaledi compared the country’€™s TB burden to a snake, and said that TB among mineworkers the fangs of the snake. Speaking at a briefing earlier this week, Mametja also emphasised government’€™s concern about the high prevalence of the disease among miners, and said that it is holding an entire region back in the fight against TB.

Health risks for miners

The TB situation among mineworkers is aggravated by the migratory nature of employment in this industry, which contributes to the spread of this highly infectious disease among miners, their families and communities and in the wider population.

The fact that mineworkers are often separated from their families and live in all-male hostels also mean that they are at high risk of contracting HIV, which further increases TB vulnerability. Tuberculosis is the main cause of death in HIV-positive people, whose immune systems are weakened by HIV.

Gold mining has also been linked to silicosis, an incurable lung disease caused by dust inhalation which increases vulnerability to TB.

Another unique challenge is that many mineworkers are cross-border migrants, which makes it difficult to track TB patients and ensure treatment continuity, which increases the threat of multi drug-resistant (MDR) TB and extensively drug-resistant (XDR) TB. This is compounded by the fact that mineworkers generally have limited medical benefits and compensation and often struggle to access health facilities because mines are usually in remote areas.

 Declaration to tackle TB in miners

In response to this, the Southern Africa Development Community, in partnership with the International Organisation for Migration, Stop TB Partnership and the World Bank hosted a regional stakeholders consultation meeting in Johannesburg to draft a Declaration and Code of Conduct on regional collaboration to deal with cross-border TB issues in the mining sector. The Declaration aims to ensure commitment and accountability by member states to improve the lives of those affected.

The draft Declaration and Code of Conduct on TB in Mines resulting from this consultation will be endorsed by Health Ministers in April this year and tabled at an upcoming SADC Heads of State Summit taking place later in August, for adoption by affected countries.