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.