The South African mining industry has made significant inroads into addressing tuberculosis (TB) since 2017 and has met its ten-year target to reduce the incidence rate among mineworkers to below national levels, industry body Minerals Council South Africa says.

In 2014, the Mine Health and Safety Council set the milestone of achieving a TB incidence rate for the sector of below the national average by 2024.

In 2015, the mining industry’s TB incidence rate was more than 1 060 per 100 000 employees, according to Minerals Council data, compared with a national average of 834 per 100 000 people.

By 2022, the latest year for which the Minerals Council has verified data, the incidence rate in the mining sector was 278 per 100 000, well below the 537 per 100 000 national rate, it points out.

“The mining industry’s biggest achievement in healthcare was reaching the TB incidence rate in 2017 and sustainably keeping it well below the national level every year since then,” says Minerals Council health head Dr Thuthula Balfour.

At the peak of the TB epidemic in the early 2000s, incidence rates in the mining industry were about seven times the rates in the general population, the Minerals Council notes.

TB is an infectious bacterial disease that generally affects the lungs.

In 2003, a total of 8 400 cases of TB were diagnosed in the industry, translating to a rate of 1 928 per 100 000. The national TB incidence rate that year was 245 per 100 000. The mining sector was at the epicentre of the epidemic, the Minerals Council explains.

The mining industry’s fight against TB has been a long one, with 2003 having been a seminal year for the industry as the first milestones were set for improving health and safety, including HIV, which is a driver for TB, the Minerals Council avers.

It explains that HIV infection increases the risk of TB by up to a factor of four, while migrancy, which is common in the mining industry, doubled the risk of contracting HIV.

In 2001, a tripartite HIV/Aids committee for the mining industry was established between government, labour and mining companies in South Africa. In 2003, the Mining Industry Tripartite HIV and Aids signed a declaration on HIV/Aids.

The Minerals Council-led Masoyise Health Programme was launched in 2015 as Masoyise iTB, an initiative for the testing of mineworkers for TB and HIV.

Masoyise is a multistakeholder initiative that includes, among others, the departments of Health and of Mineral Resources and Energy, mining unions, and United Nations agencies the International Labour Organisation and the World Health Organisation.

Key interventions through the Masoyise iTB and Masoyise Health Programme include a data reporting and monitoring system; dissemination of best practices and knowledge transfer; prioritisation of contact tracing initiatives for all cases of TB; and development of information, education and communication materials for the industry.

Moreover, the TB in Gold Mines Working Group was established last year to specifically advise on how TB can be reduced in the sector.

The programme addresses the key drivers of the epidemic, HIV, latent TB and silica dust. It is envisioned that TB rates in that sector will be significantly reduced over the next two years, the Minerals Council posits.

It adds that, since 2019, the Masoyise Health Programme has adopted a comprehensive approach to health and moved beyond HIV and TB to incorporate occupational lung diseases, noncommunicable diseases and mental health.

This is in line with an aging workforce where diseases of lifestyle are becoming more prevalent.

March 24 was World TB Day.