In January 2016, Minerals Council South Africa launched the Masoyise iTB project as a three-year, multistakeholder mining industry project to tackle HIV/Aids and tuberculosis (TB). Participants in the project included the Minerals Council, the South African Business Coalition on Health and Aids, and the four main trade unions, namely the National Union of Mineworkers, Solidarity, the Association of Mineworkers and Construction Union and United Association of South Africa..

The departments of Health and Mineral Resources and Energy, the Mine Health and Safety Council, the National Health Laboratory Service, the National Institute of Occupational Health, the International Labour Organisation, UNAids and the World Health Organisation (WHO) were also involved.

Anglo American South Africa executive head Andile Sangqu (see personality profile on page 38) is the convenor of the Masoyise Health Programme.

Anglo American notes that, from inception, the project took as its starting point the 2024 milestone targets set by the tripartite Mine Health and Safety Council: 100% of employees should be offered HIV counselling and testing yearly and those found to infected should be linked to an antiretroviral therapy programme; 100% of employees must be screened for TB yearly, and the TB incidence in the mining sector must be reduced to or below the South African rate by 2024.

Both the Department of Mineral Resources and Energy and the Minerals Council monitor these set targets. Reporting by companies to the Minerals Council has gone very well, illustrating the priority given by companies to the exercise. In 2018, companies reported on a total of 370 223 employees – representing 81% of the industry’s workforce.

Meanwhile, 84% of employees were counselled for HIV in 2018, compared with 71% in 2016.

Screening for TB stood at 90.3% in 2018, slightly above the 90% in 2016. Although both targets of 100% were not achieved, it is encouraging that there has been a marked increase over the past three years in HIV counselling, while the TB screening rates are high and can be a proxy for the Global Plan to End TB by 2020 target. This global initiative aspires to 90% of all people who need TB treatment being diagnosed and receiving appropriate therapy as required.

The most encouraging trends can be seen in respect of TB incidence rates, where it appears very real progress is being made in reducing the incidence to a level at or below the South African rate.

The TB incidence for the South African general population in 2017 was 567 cases per 100 000 of the population. The Minerals Council numbers show 545 cases per 100 000 population in 2017 – falling further to 435 cases per 100 000 in 2018. These rates vary across commodities. This seems to indicate that the mining industry is on track to meet the target of reducing TB incidence to below the South African TB incidence rate.

A further step initiated by the project, which will be expanded into the future, is the practice of contact tracing. This involves tracing individuals who are contacts of mineworkers diagnosed with TB and then screening them for TB, and, where necessary, establishing if they have contracted TB and providing treatment in order to limit the spread of this highly contagious disease, Anglo American points out.

Contact tracing pilot schemes were initiated around the West Rand gold mines and in Bojanala on the platinum belt. The WHO provided invaluable support for this initiative, and many lessons were learned that are currently being applied in the coal sector.

As part of the partnership, the National Institute for Occupational Health monitored TB treatment outcomes in eight companies over the period 2015 to 2017. Their results showed an improvement from 76% in terms of treatment completed in 2015 to 80% in 2017. The global average is 82%, while the WHO target is 85%. The industry is committed to meeting this target, Anglo American avers.

The project’s work will continue through a new and even more ambitious initiative called the Masoyise Health Programme, which will have a broader wellness approach that incorporates, in addition to TB and HIV, noncommunicable diseases such as diabetes, hypertension and mental health ailments, as well as occupational lung diseases, including silicosis and coal worker’s pneumoconiosis, among others.

This Masoyise Health Programme will run to 2021. “We hope this programme will do even more to make a difference in the industry and its communities as a whole.”

Anglo American believes that the industry can, “with renewed commitment and with careful performance monitoring”, contribute to eliminating TB and HIV from the sector and ultimately make a significant contribution to the improvement of public health in South Africa.