Collaborative push to address TB crisis on mines

After a century of failed tuberculosis control strategies on South Africa’s mines, and three major but ineffective enquiries and commissions, a government-led ‘TB in Mines Task Team’ is being set up to address the deepening HIV-driven crisis. This was revealed by Professor Gavin Churchyard, CEO of the Aurum Institute for Health Research, a not-for-profit public benefit organisation with roots in the mining industry. He was addressing the annual Investigators Meeting of the international Consortium to Respond Effectively to the AIDS/TB Epidemic (CREATE) in Cape Town in mid-October. Churchyard revealed that the HIV-fuelled TB epidemic, compounded by rising drug resistance, is now estimated at 3 500 per 100 000 mine workers, with 40% of all autopsies on men who die working on the mines revealing they had TB. Migration from rural areas throughout southern Africa to Gauteng and surrounding industrial areas to work in the mining, building and other dominant sectors is a major driver of the rampant TB epidemic. Dr Lindiwe Mvusi, Director of TB Control and Management in the national department of health and chairperson of the new ‘TB in Mines Task Team’, said because the pandemic embraced all South Africa’s neighbouring countries it demanded a regional, multi-stakeholder response. A third delegate at the meeting, an ‘anxious and concerned’ Deputy Health Minister, Dr Molefi Sefularo, said national TB prevalence had increased nearly threefold in the past decade. South Africa was now among the 10 worst performing countries on TB control, and Statistics SA had found that for every 100 deaths in 2006, 13 were from TB, making it the leading cause of death. Churchyard said less than 1% of all HIV-infected individuals in this country were accessing proven safe and effective isoniazid preventive TB therapy (IPT), a situation he calls ‘inexcusable’