Shedding light on the tuberculosis (TB) epidemic that continues to pervade the global mining industry, international nonprofit biotechnology company Aeras, which is on a mission to develop TB vaccines, released a documentary highlighting the need for governments, mining companies, unions, health officials and other industry stakeholders to work together to find a permanent solution to the prevalence of TB in South African gold mines.

Aeras strategic communications manager Matthew Feldman tells Mining Weekly that Undermined: An epidemic in South Africa’s gold mines, which debuted in June, portrays the difficulties that mineworkers and their families face in the battle against TB.

It highlights the plight of widows and children who have to find the means to financially support themselves after their husbands and fathers die from TB contracted in the mines.

The film showcases how, because of the local mining industry’s reliance on migrant workers, TB spreads from host areas that surround mining operations to townships and villages in other parts of Southern Africa.

Undermined portrays how mineworkers who repeatedly contract TB after treatment may eventually become drug-resistant and die from the disease.

It further highlights that the biggest difference between TB and other mining-related ailments is that TB treatment does not immunise mineworkers against the disease, leaving them vulnerable to recontract TB.

“The movie aims to present the crisis as an opportunity to find new ways of doing something about the spread and prevention of TB,” says Feldman.

He tells Mining Weekly that there is an increase in the prevalence of drug-resistant TB, which is more deadly and even more expensive to treat than other type of TB.

Feldman explains that, because there is no known effective TB vaccine to protect mineworkers, industry stakeholders need to work together to find a vaccine combination that will eliminate the pandemic.

He also points out that eradicating the disease is not the sole responsibility of government or mining companies, as the problem is too big and complex for just one stakeholder. “We all have roles to play in developing new tools to help stop this global epidemic,” he says.

A Starting Point
Feldman believes that efforts by South African civil society organisation Aurum Institute are a step in the right direction.

He cites the Aurum Institute’s initiatives as a positive example of researchers and academics partnering with the mining industry to produce the biggest study on TB in South African gold mines. The ‘Thibela TB’ – which means ‘prevent TB’ in seSotho – report was published in the New England Journal of Medicine in February.

“We were not involved in the Thibela study, but we want to build on that, do further studies, ask more questions and get more stakeholders involved,” Feldman explains.

He highlights that Aeras wants to partner with other organisations to find ways of lowering the costs of creating TB awareness and to design prevention programmes.

The Thibela report found that mineworkers in sub-Saharan Africa have the highest TB rate in the world, with more than 760 000 new mining-related cases a year.

The study revealed that the South African government and the mining industry spend more than $360-million a year on TB treatment. Further, owing to the country’s escalating TB contraction rates, the mining industry loses an additional $570-million in productivity costs, while miners lose $320-million a year in lost wages.

The Aurum Institute study involved eight gold mines, each with a staff complement of between 1 000 and 10 0000 mineworkers, who were screened for active TB. Those diagnosed with active TB were referred for treatment while those whose results were negative were offered TB preventive therapy.

An inexpensive drug called isoniazid preventive therapy (IPT) was offered to those without TB over a nine-month period. This was the largest clinical trial of IPT, during which 23 659 people were treated.

Feldman concludes that the fight against TB requires mining industry stakeholders to work together to ask the right questions and find new solutions.