Wits Health Consortium TB in Mines Project Dr Riedawaan Pillay 05 September 2015

Context Mineworkers have a significantly higher risk of developing TB Related to: Silica exposure Living conditions Migrancy HIV In the South African context, incidence of TB (per 100 000) General population 860 Mine workers 1 200 Deep level mine workers 2 500

Southern African Incidence General Incidence

Strategic Dimensions As the current allocation of funds for this grant fall short of the full funding need, the grant will focus on key strategic aspects: Activities that have a regional dimension Innovating and scaling up interventions Funding catalytic interventions Addressing upstream risk factors Building synergies with national programmes Building institutional, governance and structural capacity Geographic Focus

Wits Health Consortium Wits Health Consortium (Pty) Ltd BOARD Dir. Com. REMCO Audit Com. Strat. Com. Sust. & Ethic Com. Acad. O. Com. Shared Services Centre Multidisciplinary Clinical Trial Sites E.g. - Ethics and CPD Faculty Support Secretariat RHRU Syndicates RHRU Syndicates RHRU RHRU RHRU RHRU RHRU RHRU RHRU RHRU RHRU Other Divisions / Syndicates (+/- 60) Syndicates RHRU RHRU RHRU Syndicates Syndicates RHRU Syndicates RHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU PHRU CHRU CHRU CHRU CHRU CHRU CHRU CHRU CHRU CHRU CHRU CHRU CHRU CHRU NICD NICD NICD NICD NICD NICD NICD NICD NICD ECHO ECHO ECHO ECHO ECHO ECHO ECHO ETC.. ETC.. ETC.. RHRU RHRU Contract Laboratory Services RHRU RHRU RHRU RHRU WRHI PHRU PHRU PHRU PHRU PHRU CHRU CHRU CHRU CHRU PHRU NICD NICD MatCH, CHRU, RMPRU And other GF divisions NICD Sites in Departments Clinical Trial ECHO ECHO ETC.. ETC.

Wits Health Consortium WHC governed by Board Dean – Chairman CEO 3 Faculty 2 Central University 4 independent 1 Syndicate nominee Sub-Committees Directors Affairs Remuneration & Transformation Audit & Risk Strategy & Investment Sustainability & Ethics Academic Oversight

Grant Modules TB in Mines Module 1: TB Care and Prevention Module 2: Health Information and M&E Module 3: Community Systems Strengthening Module 4: Policy and Governance

TB Care and Prevention Development of surveillance models Screening and active case finding Development of surveillance models Testing of models Social mobilisation of key populations Contact tracing at sentinel sites Prevention, Care and Treatment Behaviour KAP surveys Review national communication strategies Identify interventions Develop communications strategy Expansion of OH service delivery Review South African model for OH service centres Establish OHSC in participating countries IT system linking to compensation systems Support OH professionals in running centres Transition centres to national programmes

TB Care and Prevention Assessment of national referral systems Strengthening continuity of care and treatment Assessment of national referral systems Develop cross border referral systems Develop regional health information database Develop technology to support adherence Prevention of TB in the mines Legislative review of 10 countries – mine health and safety Opportunities to harmonise policy Disseminate recommendations via SADC technical and political structures

Health Information and M&E Conduct surveys Geospatial mapping studies in those countries that require Epidemiological baseline studies – regional These feed into the location and size of facilities and programmes in module 1 Monitoring of TB services Assess M&E systems in 10 countries wrt key populations Develop a regional M&E framework Support integration of M&E framework into national systems Co-ordinate with NTP regionally

Community Systems Strengthening Improve access to TB, silicosis and HIV services Review human rights and gender barriers to access for services Build organisational capacity to address barriers Focus at CSO level – technical, HR, operations, planning capacities

Strengthening high level co-ordination and partnerships Policy and Governance Strengthening high level co-ordination and partnerships Technical co-ordination with NTP managers Ministerial co-ordination on policy and programme harmonisation Policy advocacy agenda for the region Support compensation fund co-ordination

Next Steps High Level Process Jan 15 Mar 15 Apr–Sept 15 Oct-Nov 15 Concept Note formulation Acceptance with comments by TRP Grant making Grant signing Grant Implementation Jan 15 Mar 15 Apr–Sept 15 Oct-Nov 15 Jan 16 – Dec 17