HCT in the mining industry

Chamber of Mines

Khanyile Baloyi

12 October 2011

1.Introduction

2.TB and HIV Stats

3.Health Management Model

4.Challenges

5. Conclusion

Contents

Food for thought

“If TB and HIV are a snake in the SADC Region, the head of the snake is here in South Africa in the mines. People come from all over the SADC Region to work in our mines and export TB and HIV, along with their earnings. If we want to kill a snake, we need to hit it on its head”.Dr Aaron Motsoaledi, South African Health Minister, June 2010

Paula Akugizibwe of the Aids and Rights Alliance for Southern Africa (ARASA) stressed that the mining sector, which she referred to as a ‘TB factory’, was over a century behind schedule in its response to TB.

Introduction

Country All cases Per 100,000 population

India 2,000,000 167China 1,300,000 97South Africa 490,000 978Nigeria 460,000 297Indonesia 430,000 187Pakistan 420,000 232Bangladesh 360,000 222Ethiopia 300,000 362Philippines 260,000 283DR Congo 250,000 379Myanmar 200,000 400Viet Nam 180,000 204Russian Fed. 150,000 106Kenya 120,000 301Uganda 96,000 293Mozambique 94,000 411Zimbabwe 93,000 743Thailand 93,000 137Brazil 87,000 45Tanzania 80,000 183Cambodia 65,000 439Afghanistan 53,000 188Global total 9,400,000 138

WHO Global Report 2010

Countries All cases

South Africa 490000

Zimbabwe 93000Cambodia 65000

Mozambique 94000

Myanmar 200000

DR Congo 250000

Ethiopia 300000

Per 100,000 population

978

743439

411

400

379

362

Mining industry 500 000

COM Members 450 000 (90%)

COM Members that submitted 349 562 (78%)

Number of test done 262 048 (75%)

Factors determining the incidence of TB in a mining community

11

Referral Systems

Monitor effectiveness of controls

TB & HIV Disease Prevention, treatment, care & support

Disclosure & clinical assessment

Fitness to work assessments

Disease Management provided by treating doctors

- Treatment protocol - Determine severity and prognosis of the

condition with proper referral systems

Prevention- Education(induction, posters etc.)- Condom distribution

Legal obligationLegal obligation Legal /VoluntaryLegal /VoluntaryVoluntaryVoluntary

Health Policy Committee Decisions

HPC Meeting May 2010Support the National HCT CampaignStrengthening of company HCT campaignsIntegration of TB and HIV CareTest 100% workforce Promote access to HIV/AIDS prevention and treatment services for employees, their spouses, family members and the surrounding communities.Submit data to Nerve centres and SABCOHAAnnual Industry surveys on HCT contribution.

Not intervening will cost the companies more

Intervening too late has opportunity costs that cannot be recovered

Savings only happen ‘at scale’ (because of overhead costs)

Externalized benefits accrue with high levels of uptake & if ‘done properly’

Sustainability depends on the design and approach (a human development process!)

HIV/AIDS Intervention Strategy – Business Review – Impact Analysis

Corporate image (e.g. GBC awards)

Transformed workplace culture & highly motivated employees on treatment

Improved relationships in workplace

Safe working environment

Mining Charter obligations fulfilled

Public-private partnership with Government

Other ‘externalized’ benefits

Roadmap Towards a “Blue-chip” Response to HIV/AIDS

Given the challenges we have with respect to data, we appreciate the initiative by

SABCOHA for establishing the web based date tool.

Business need to be organized to ensure a coordinated response to the epidemics.

Today’s workshop acknowledges the important role of engaging in such a

multi-sectoral approach.

The availability of data enable the sector to do effective advocacy and beyond.

Take Home message

Two hands clap and there is a sound. What is the

sound of one hand clapping?