Chamber of Mines’ response to the SADC

Declaration on TB in the Mines

MMPA Conference 30 August 2013

Dr Thuthula Balfour-KaipaHead: Health DepartmentChamber of Mines SA

Outline

• Need to act• SADC Declaration on TB in the Mining Industry• Analysis of declaration• Chamber response to declaration• Current initiatives• Conclusion

The need to act on TB

TB incidence in mining higher that normal SA population rate

Significant risks for TB in mining

2005 2006 2007 2008 2009 20100

1000

2000

3000

4000

Estimated TB Incidence Rate

SA Rate / 100 000All Commodities Rate / 100 000Gold Rate / 100 000

Rate

/ 10

0 00

0

Chamber approach to TB in mining

Risks for TB

Clinical management

Rehabilitation

Reduce migrancy

Living conditions

Nutrition

HIV

Dust control

Active case finding

Effective treatment

Contact tracing

Adequate referral

Compensation

MHSC Mining charterCompany level

MOSH

TB ReviewsMHSC TB Leading

Practices

Ex-Mineworker Project

Interventions

History of the SADC Declaration on TB in the Mines

Criticism of industry from 2007

Signing of SADC Declaration by Heads of State in August 2012

Elements of SADC Declaration on TB in Mining Industry

1. Accountability and coordination

2. Supportive policy and legislative environment

3. Strengthen programmatic interventions

4. Disease surveillance

5. Programme monitoring and evaluation

6. Financing

Chamber response to SADC Declaration

• Encapsulated in:

STRATEGIC FRAMEWORK FOR REDUCING TB, HIV AND SILICOSIS IN THE MINING SECTOR IN

THE SADC REGIONMay 2013

Analysis of requirements from declaration

SADC Declaration Priority Area

What exists Gaps

Strengthening accountability, coordination and collaboration for TB, HIV and silicosis at national and regional levels

• Ministerial Tripartite TB, HIV structures already exist for accountability, coordination and collaboration on TB, HIV and silicosis.

• Country level task teams that provide oversight do not exist.

• Independent office of complaints on health related matters in mining industry does not exist.

Analysis of requirements from declaration

SADC Declaration Priority Area

What exists Gaps

Promoting a supportive policy and legislative environment

-Supportive policy and legislative environment already exists.

-Legislation for compensation for occupational lung diseases is deficient.

Analysis of requirements from declaration

SADC Declaration Priority Area

What exists Gaps

Strengthening programmatic interventions for TB, HIV, silicosis and other occupational respiratory diseases control

-Programmes exist in companies

-Medical costs related to occupational lung diseases are not well regulated-lack of alignment between workplace wellness services provided to employees, services provided to contractors and health-related community initiatives.

Analysis of requirements from declaration

SADC Declaration Priority Area

What exists Gaps

Strengthening disease surveillance system for TB, HIV, silicosis and other occupational respiratory diseases control

-Industry meets all requirement

Analysis of requirements from declaration

SADC Declaration Priority Area

What exists Gaps

Strengthen programme monitoring and evaluation

- Industry meets most requirements

- There is no monitoring and evaluation of national budgeting, finance and spending on TB, HIV, silicosis and other.

Analysis of requirements from declaration

SADC Declaration Priority Area

What exists Gaps

Strengthening financing of TB, HIV, silicosis and other occupational respiratory disease interventions in the mines

- Companies currently finance interventions on these diseases.

- There are no national partnerships for resource mobilisation to support programmes on these disease.

Priority areas in Framework

• Surveillance and data

• Access to services for contractors, families and communities

• Referral systems

• Compensation

Approach to resource mobilisation in Framework

Recognition of the SA mining industry’s regulatory framework

Positive engagement with all stakeholders

Recognition of all contributions

Choice for companies

Linking internal capabilities to create external value

Co-designing with partners

Focus on systems strengthening

Current initiatives

Mine Health and Safety Council

Chamber

Collaborations among companies

Individual companies

MHSC• Integrated policy of TB, HIV, silicosis• Revision of DOH IPT policy to include silicosis• National repository of employee health

information• Employee awareness of Mining Charter

Summit Action PlanR15 m

• Collation of leading practices• Promotion/dissemination of practices

Promotion of TB Leading Practices

R2 m• Health impacts from dust emissions in

tailings• Reproducibility of digital X-rays

ResearchR7 m

Chamber

• Gold sector – 2011• Platinum sector – 2012• Coal sector - 2013External TB Reviews

• Benefit examination sites in Nongoma, Mthatha, North West, Free State

• Support to CCOD (DOH)• Socio-economic projects

Ex-Mineworker Project

R42m/6years

Collaborations among companies

• Intensified case finding in peri-mine communities

• 5 companies

Stop TB Reach ProjectR12 m

• Support to Mozambique health dept.• TB Pillar• 3 Mining companiesGBC Health

Initiatives

Conclusion

• Industry responding to the SADC Declaration on TB in Mining Sector.

• Progress being made on TB in mining.• Commitment from companies to improve and extend TB

services.• Collaboration is key to addressing TB in mining and the

region.