Battling Aids in mining

16th May 2003 By: Joanne Delaurentis

The government, labour and the South African mining industry have takendecisive steps to end the war against each other over the HIV/Aids epidemic facing the industry, and to turn their fighting efforts towards the epidemic.

This industry cooperation follows a number of years of divided efforts and duplicated programmes undertaken by individual stakeholdersin the fight against HIV/Aids.

The new partnership between the three stakeholders aims to pioneer successful best practice in the prevention, treatment, and research of theepidemic, that can be modelled by other industries in their fight against the disease.

The first HIV/Aids Mining Summit, attended by top representatives from the Department of Health, the Department of Minerals and Energy, the Department of Labour and the office of the Presidency, as well as the National Union of Mine Workers (NUM) and local mining companies, was held in Midrand at the end of last month.

The summit came as a result of the mining industry recognising that the many complex issues surrounding the rapid spread of the epidemic inthe local mining industry could not be tackled without a comprehensive strategy involving all concerned.

These sentiments were echoed by World Health Organisation DG Dr Gro Harlem Brundland, who pointed out that no constituency can act alone to change the face of the epidemic, whether from national governments or international agencies,associations of people living with HIV, the private sector, academic institutions, community organis-ations, or public interest groups.

The summit aimed to examine what various parties are doing in the fight against HIV/Aids, and to share lessons of best practice regarding what works at ground level.

The summit also aimed to strengthen partnerships between the three main stakeholders involved in the South African mining industry, for each of these three to commit to a set of achievable goals necessary to curb the prevalence of thedisease, and to agree on a system for monitoring and evaluating the performance of the threepartners over the next few years. Mining and mining operations in South Africa present a unique set of characteristics that make the industry susceptible to the rapid spread of HIV/Aids.

These include an already large percentage ofinfected people in the 600 000 South Africanmining industry labour force.

The epidemic mainly affects the young, black, sexually-active and economically-poor in society – which represents the majority of mineworkers in South Africa.

The industry is largely dependent on local and regional migrant workers, and operates from inhospitable locations, resulting in family separation, andisolation.

Also, mining in South Africa favours single, male migrants that require limitedinfrastructure costs, hence the preference for hostel accommodation at most oper-ations.

Mining operations are often located in communities which are sources ofaccess to excessive alcohol intake, the use of commercial sex workers, multiple sexual partners and unprotected sex by migrant workers, resulting in the rapid spread of sexually-transmitted diseases (STD), such as HIV/Aids.

The occupational hazards and un-pleasant living conditions of mostmining operations favour a host ofdiseases, including nutritional stresses that increase susceptibility to HIV infection and faster progression to Aids.

This complex set of circumstances, it is hoped, will set the stage for the development of a com-prehensive strategy, backed by all in the industry, that will alleviate the suffering among those who are infected and affected by the epidemic, andaddress the economic, social and politicalchallenges that will contribute towards a viable mining industry in South Africa and the subregion.

In 2000 government launched the five-year HIV/Aids and STD strategic plan, focused onthe four main pillars of prevention, treatment, human rights and research, designed to guide the country’s response to the epidemic.

Since then, private companies in the miningindustry have developed HIV/Aids policiesinfluenced by best practices on fighting theepidemic from various parts of the world.

They have developed in-house models toprovide workplace prevention, informed consent voluntary counselling and testing, care andtreatment programmes, and have introducedreview and monitoring mechanisms to evaluatethe effectiveness of the programmes introduced.

Also, each mining company has developed budgets for workplace and community inter-vention programmes, spending between R220and R480 a year per employee on workplaceHIV/Aids programmes.

AngloGold alone will spend R25,8-million on HIV/Aids programmes this year, up from R16,18-million in 2002.

The company has budgeted some R2 000/mineworker/month for its antiretroviral treatment (ART) programme, currently being rolled out,reports HIV/Aids manager Dr Petra Kruger.

Meanwhile, Harmony Gold estimates R1 000/mineworker/month, or R600 000 a month in total for its ART programme.

Harmony Gold currently spends R3,8-million a month on Aids-related illnesses, a number that will hopefully decrease in the future with the introduction of the ART programme, says CE Bernard Swanepoel.

“Overall, the South African mining industry has created one of the most progressive and far-sighted policy and legislative frameworks for dealing with HIV/Aids in the world,” says Chamber of Mines of South Africa CEO Mzolisi Diliza.

“However, despite this, the prevalence of the disease continues to increase,” he stresses.

“This indicates that these policies and laws have not been adequately implemented and have not impacted significantly on the ground.” Speaking at the summit last month, Health Minister Dr Manto Tshabalala-Msimang urged mining houses, under the ambit of the Chamberof Mines, to harmonise their strategies and the manner in which they respond to the Aidsepidemic.

“Ideally, the mining industry should adopt a charter, a set of basic principles or a statement of intent, that seeks to promote a basic framework for responding to the Aids epidemic that cuts across the industry, she said.

“This agreement should outline a set ofprinciples that commit to a partnership withbusiness, labour and government, to provide a basic set of interventions that are necessary to halt HIV infection and address Aids-related diseases among those already affected, within the contextof the HIV/Aids and STD strategic plan,” said Tshabalala-Msimang.

The mining summit offered an opportunity for the beginnings of these suggestions to be reached.

By the end of the one-day event, government, labour and mining companies had signed adeclaration of intent containing their jointcommitment to address these issues in the fight against HIV/Aids.

In the declaration, parties committed toimplement and review the strategic plan in acoordinated and comprehensive manner, and to strengthen the healthcare infrastructure to provide necessary care for the infected.

They also committed that, by the end of 2004, every workplace in the industry will have HIV/Aids policies and programmes in place. Those at the summit also committed toconducting periodic incidence, prevalence and other necessary surveys of HIV/Aids, and toshare the information within a national databank framework.

One of the main socioeconomic commitments of mining companies was the establishment of measures to improve the standard of housing for mineworkers, including the upgrading of hostels, conversion of hostels into family units and thepromotion of home ownership for all employees.

This issue has been one of the main arguments of the NUM of South Africa, which has stressed that each mineworker should have access to decent housing with the options of social housing, rented housing and home ownership, within the next ten years.

“Stopping new infections remains a pipe dream as long as more than 70% of mineworkers stay in single-sex hostels.

“The commitment of the mining industry must go hand-in-glove with the commitment to move with the necessary speed towards availing family accommodation to mineworkers,” stressed NUM President Senzeni Zokwana.

“An aggressive programme for the provisionof family accommodation, and integration ofmining communities will normalise the lives of mineworkers, instead of trying to deal with a crisis within an abnormal situation as we are at present,” he said.

The NUM also stressed the contribution of poverty and the lack of nutritional content in food to the accelerated decline of the immune system.

“Every mining company should be heldresponsible for the nutritional content of thecatering provided to mineworkers on their oper-ations, regardless of whether catering is out-sourced or not,” said Zokwana.

He also stressed the need for all mineworkers to have access to antiretroviral drugs and supplements directed at boosting the immune system.

Thus far only Anglo American has committed itself to giving workers these drugs, while other mining companies have given limited commitment to date.

The mine labour force in South Africa isestimated at over 600 000 or about 4,5% of the formally employed, the majority of whom are young, sexually-active males.

The prevalence of HIV/Aids in South Africahas increased rapidly over the past decade, from almost zero in 1990, to about five million peopleinfected in 2001.

By the end of that year some 334 000 people were sick with Aids, and this number is expected to treble to 1,4-million by 2009.

About 20% of the South African population is HIV infected, with mineworker infections closer to 30% of the workforce.

The largest number of HIV infections aresituated in mining provinces, with the Free State, Gauteng, Mpumalanga and Kwazulu-Natal filling the top four places.