World Tuberculosis Day is observed on 24 March each year and was designed to build public awareness about the global epidemic of tuberculosis and efforts to eliminate the disease. The Minerals Council South Africa says that the South African mining industry has made significant inroads into addressing tuberculosis (TB) since 2017, by beating its 10-year target to reduce the incidence rate among mineworkers to below national levels.

The Minerals Council South Africa Logo

In 2014, the Mine Health and Safety Council set the milestone of achieving a TB incidence rate for the sector of below the national average by 2024. In 2015, the mining industry’s TB incidence rate was more than 1 060 per 100 000 employees, according to Minerals Council data, compared to a national average of 834 per 100 000 people.

By 2022, the latest year for which the Minerals Council has verified data, the incidence rate was 278 per 100 000 – well below the 537 per 100 000 national rate.

“The mining industry’s biggest achievement in healthcare was reaching the TB incidence rate in 2017 and sustainably keeping it well below the national level every year since then,” says Dr Thuthula Balfour, Head of Health at the Minerals Council.

TB is an infectious bacterial disease that generally affects the lungs. At the peak of the TB epidemic in the early 2000s, incidence rates in the mining industry were about seven times the rates in the general population.

In 2003, a total of 8 400 cases of TB were diagnosed in the industry, translating to a rate of 1 928 per 100 000 in the population. The national TB incidence rate that year was 245 per 100 000. The mining sector was at the epicentre of the epidemic.

The mining industry’s fight against TB has been a long one, with 2003 having been a seminal year for the industry as the first milestones were set for improving health and safety, including HIV – which is a driver for TB.

TB infections worsened with HIV infections in the 1990s. HIV infection increases the risk of TB by up to a factor of four and migrancy – which was common in the mining industry.

In 2001, a tripartite HIV/AIDS committee for the mining industry was established between government, labour and mining companies in South Africa. In 2003 the Mining Industry Tripartite HIV and AIDS signed a declaration on HIV/AIDS.

Resolutions included:

  • Every workplace will have workplace HIV/AIDS policies and programmes in place by the end of 2004.
  • Prevalence survey results will be shared within a national databank framework.
  • Measures will be implemented to improve the standard of housing for mineworkers.

The Minerals Council-led Masoyise Health Programme was launched in 2015 as Masoyise iTB, an initiative for the testing of mineworkers for TB and HIV.

Masoyise is a multistakeholder initiative that includes – among others – the departments of Health and of Mineral Resources and Energy, the five mining unions, and the UN organisations, the International Labour Organisation, the World Health Organisation and UNAIDS.

Key interventions through Masoyise iTB and Masoyise Health Programme are:

  • A data reporting and monitoring system. The Minerals Council established a Milestone Reporting System in 2015 which has managed to track industry performance since 2015 to date. The system is open to all mines, not only Minerals Council members.
  • Regular reporting to leadership forums and the board ensured that the performance of the industry was tracked at the highest level.
  • The analysis of the Masoyise data is done by the National Institute for Occupational Health and this gives credibility to the data collected and reported on.  
  • Dissemination of best practices and knowledge transfer through seminars and workshops: companies learn a lot from best practices within and outside the industry and through collaboration with other stakeholders led by expert advice.
  • Contact tracing initiatives for all cases of TB were prioritised and meant that the contacts of those with TB, at work and in the community were identified, tested and treated where required.
  • Information, education and communication materials are developed for the industry with common, simple messaging for employees. 
  • The TB in Gold Mines Working Group (TBGWG) was established in 2023 to specifically advise on how TB can be reduced in the sector. The programme addresses the key drivers of the epidemic, HIV, latent TB and silica dust. It is envisioned that TB rates in the gold sector will be significantly reduced over the next two years.
  • Since 2019, the Masoyise Health Programme has adopted a comprehensive approach to health and moved beyond HIV and TB to incorporate occupational lung diseases, non-communicable diseases and mental health. This is in line with an aging workforce where diseases of lifestyle are becoming more prevalent.

Source: Supplied by the Minerals Council South Africa