Resetting the sights

Resetting the sights

Covid-19 has taken the world, and 2020, by storm. But there are many other crucial health conditions that the mining industry shouldn’t lose sight of …

In an online seminar held by the Masoyise Health Programme in October 2020, local and international experts heard that the critical battles against HIV, tuberculosis (TB) and noncommunicable diseases (NCDs) in mining should no longer be sidelined by the Covid-19 pandemic.

The Masoyise Health Programme was originally launched in 2016 after a call by then-Deputy President Cyril Ramaphosa on government, organised labour and the Minerals Council South Africa to intensify the battle against HIV and TB in the mining industry. Its work has expanded to deal also with hypertension, diabetes and other noncommunicable diseases prevalent in the industry.

Minerals Council vice president and Masoyise Health Programme chair Zanele Matlala said that there is an opportunity to draw from the innovative work done by the industry to counter Covid-19 and use it to manage HIV, TB and NCDs.

In his opening address, Health Minister Dr Zweli Mkhize quoted published research which states that the diversions away from other medical priorities because of Covid-19 could lead to an increase in deaths worldwide due to HIV, TB and malaria in low- and middle-income countries by up to 10%, 20%, and 36%, respectively.

Minister Mkhize added that NCD screening and testing has fallen by half during 2020 for the same reason.

Dr Lucica Ditiu, executive director of the Geneva-based Stop TB Partnership, said her organisation had carried out a study in May 2020 which showed that the global response to Covid-19 could lead to more than 6 million additional cases of TB and 1,4 million additional deaths from the disease between 2020 and 2025.

“For the past five years TB has remained the biggest infection disease killer because the ‘TB agenda’ consistently became less visible in front of other priorities,” she pointed out in an article on the medical news site Healio. “Today, governments face a torturous path, navigating between the imminent disaster of Covid-19 and the long-running plague of TB. But choosing to ignore TB again would erase at least half a decade of hard-earned progress against the world’s most deadly infection and make millions more people sick.”

“The reason we’re seeing this ballooning TB burden is because, during the lockdown period, there have been missed opportunities for diagnosis – people haven’t been able to present for care,” explained Nimalan Arinaminpathy, a reader in mathematical epidemiology at Imperial College London, during a press briefing on the study’s analysis. “We have normal TB diagnostic tools being repurposed for coronavirus and now you have this wider pool of potentially infectious people.”

The local Stop TB programme, which has been running since 2012, had performed particularly well in 2018/19. Unfortunately, though, the lockdown (and other factors) led to a drop of 30% to 40% in TB screening and testing.

This will, sadly, lead to an increase in TB incidence during 2021 and reduce the strides that have been made, thus far …

According to the latest figures published by Department of Mineral Resources and Energy (DMRE) in its annual report for the 2018/2019 financial year – which covers the entire South African mining industry including mining companies that are not members of the Minerals Council and which may be accessed on the department’s website – in 2018, 474 429 employees out of a total of 493 054 employees were screened for TB and 2 066 cases were diagnosed. This translates into a case finding rate of 0,4% or 400 cases per 100 000 population.

These findings are aligned to the Minerals Council’s own reporting system for members where, since 2016, TB incidence rates have been in decline as follows:

• 750 cases/100 000 in 2016;

• 548 cases/100 000 in 2017;

• 415 cases/100 000 in 2018; and

• 301 cases/100 000 in 2019.

“TB screening and prevention needs urgently to be restored to previous levels,” Ditiu said.

Dr Shannon Hader, deputy executive director at UNAids, applauded SA’s leadership for its management of the pandemic. She added that the Masoyise initiative had shown how the private sector can contribute to tackling public health challenges.

The World Health Organization’s representative to SA, Dr Owen Kaluwa, said building resilient health systems is critical to address the HIV, TB and NCD challenges. This means that “government stewardship and longer-term investments in the health sector are needed now more than ever”.

The SADC’s Dr Willy Amisi also congratulated SA for its management of the pandemic. “It gives the rest of SADC hope we can suppress the pandemic,” he said.

It, however, remains paramount that the mining sector and the world as a whole don’t lose sight of the culprits that have been plaguing the industry for decades and that we all apply the lessons learned during these trying times.

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