South African health minister: Canada should join us to fight TB in mines – by Aaron Motoaledi (Globe and Mail – July 11, 2013)

The Globe and Mail is Canada’s national newspaper with the second largest broadsheet circulation in the country. It has enormous influence on Canada’s political and business elite.

As South Africa’s Minister for Health, it may be surprising that many of the meetings I will have during my visit to Canada this week are not with health officials or medical personnel, but with representatives from mining companies.

Our mining industry has recently been the subject of intense international and national media scrutiny due to industrial unrest. As government, we have placed a high premium on returning stability to the industry and our deputy president has been tasked with managing this process. It is important that we succeed because mining is one of the driving forces of the South African economy, contributing around 20 per cent of the country’s gross domestic product and being a major employer.

What is less well known, and so far has not been subject to the same degree of media attention, is the devastation caused to miners and their families by tuberculosis (TB). The disease, which was the number one killer of Canadians in the early 20th century, remains the leading cause of death in South Africa today. It is an airborne disease, spreading through the air when people who have it cough or sneeze, and is often fatal if left untreated.

In our mines, as many as one in every 15 miners gets sick with TB, the highest rate among any working population in the world. High HIV-infection rates, cramped living conditions and exposure to silica dust that damages the lungs of miners create a perfect breeding ground for the disease.

The effects are devastating not only for the many miners who die from TB and their families, but also for communities, companies and governments. The disease dents productivity, puts a drain on health budgets and spreads far into the rural areas that miners migrate from.

Migration means that the problem is not exclusive to South Africa. As I have often remarked, TB is like a snake, with its fangs buried in the mines of South Africa and its tail sweeping across the southern part of the African continent. One of the results is that Sub-Saharan Africa is not on track to meet the target of reducing deaths from TB by half by the time that the Millennium Development Goals expire in 2015.

This is part of a troubling global picture. TB is curable with drugs that cost as little as $25 a person. But global underinvestment and indifference mean that the disease killed an estimated 1.4 million people globally in 2011. The failure to deal decisively with TB has allowed drug-resistant strains of this airborne disease to develop. These are much more difficult and significantly more expensive to treat.

How do we respond? Some are keen to point the finger at the mining companies –including Canadian ones – with operations around the world, and particularly in Africa. But my message is that these companies are an essential part of the solution.

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