1. HCT in the mining industry
Chamber of Mines
Khanyile Baloyi
12 October 2011

2. Contents Introduction TB and HIV Stats Health Management Model
Challenges
5. Conclusion

3. Introduction 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.

4. Perception out there: Highest TB and HIV rates
We export TB/HIV to the SADC Region
Referred to as the TB factory
We are over a century behind schedule in our response to TB /HIV.

5. WHO Global Report 2010 India 2,000,000 167 China 1,300,000 97
Country
All cases
Per 100,000 population
India
2,000,000
167
China
1,300,000 97
South Africa
490,000
978
Nigeria
460,000
297
Indonesia
430,000
187
Pakistan
420,000
232
Bangladesh
360,000
222
Ethiopia
300,000
362
Philippines
260,000
283
DR Congo
250,000
379
Myanmar
200,000
400
Viet Nam
180,000
204
Russian Fed.
150,000
106
Kenya
120,000
301
Uganda
96,000
293
Mozambique
94,000
411
Zimbabwe
93,000
743
Thailand
137
Brazil
87,000 45
Tanzania
80,000
183
Cambodia
65,000
439
Afghanistan
53,000
188
Global total
9,400,000
138
WHO Global Report 2010

6. Per 100,000 population
978
743
439
411
400
379
362
Countries
All cases
South Africa
490000
Zimbabwe
93000
Cambodia
65000
Mozambique
94000
Myanmar
200000
DR Congo
250000
Ethiopia
300000

9. Mining industry
COM Members
(90%)
COM Members that submitted
(78%)
Number of test done
(75%)

10. Factors determining the incidence of TB in a mining community

11. (Provider initiated CT) Disease Management
Legal obligation
Voluntary
Legal /Voluntary
TB and HIV Programmes
Wellness Campaigns
Awareness, education, nutrition, Testing
Medical Surveillance
(Provider initiated CT)
Disease Management
PHC, Secondary & Tertiary
Referral Systems
Fitness to work assessments
Disclosure & clinical assessment
Monitor effectiveness of controls
TB & HIV Disease Prevention, treatment, care & support
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

12. Health Policy Committee Decisions
HPC Meeting May 2010
Support the National HCT Campaign
Strengthening of company HCT campaigns
Integration of TB and HIV Care
Test 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 SABCOHA
Annual Industry surveys on HCT contribution.

13. HIV/AIDS Intervention Strategy – Business Review – Impact Analysis
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!)

14. Other ‘externalized’ benefits
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

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

16. Take Home message
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.

17. Two hands clap and there is a sound
Two hands clap and there is a sound. What is the sound of one hand clapping?