South Africa wants to test hundreds of thousands of miners for tuberculosis and ensure sufferers get treatment over the next year, a government health official said Tuesday.
Dr. David Mametja, head of the government's TB fighting program, said the government is concerned the high prevalence of the disease among miners is holding an entire region back in the fight against TB.
He said it may be impossible to reach the nearly 600,000 miners in South Africa in one year, even those at highest risk in the gold industry, but that setting an ambitious targets is a way to show "it's not business as usual."
Mametja spoke to reporters at a workshop organized by the Stop TB Partnership, which brings together the U.N.'s World Health Organization and some 1,000 governments and private groups around the world to fight the disease. The partnership says that Africa is the only region in the world likely to miss the U.N. Millennium Development Goal of halving TB deaths by 2015, and that the high numbers of miners with TB is driving the crisis. Gold mining is of particular concern because it has been linked to silicosis, an incurable lung disease that increases vulnerability to TB.
South Africa's mining industry draws workers from neighboring countries and beyond. Dr. Llang Maama-Maime, a government TB expert from Lesotho who joined Tuesday's workshop, described some of the challenges that presents. Some 33,000 Lesotho citizens are working in South African mines, she said. Those among them diagnosed with TB might start treatment in South Africa, and not follow up at home. Stopping treatment increases the chances a TB case will grow resistance to drugs.
Maama-Maime added that workers diagnosed at home may start treatment, then, pushed by poverty, return to work in South Africa before completing a course. More than half Lesotho's citizens live below the poverty line.
Mametja said estimates of the prevalence of miners with TB vary. But even the lowest estimate, 5 percent, was well above the figure of 1 percent for the general population, he said. He said the problem should be taken as seriously as accidents that cause mining deaths.
"There's a silent kind of accident happening, which is called TB," he said.
The problem is particularly worrying given South Africa's high rate of HIV infection. TB is the biggest killer of HIV-positive South Africans, whose resistance to disease is lowered.
Some fear a testing campaign will overwhelm the health system with new TB patients, Mametja said. But given that an infected person who is untreated can infect 10-15 other people in a year, and that late-stage TB is much more difficult and expensive to treat, Mametja said testing was crucial.
"The truth is, doing nothing only overwhelms the system more," he said.
Mametja could not put a price on his testing campaign. He said the government was counting on mining companies, the largest of which have clinics and hospitals, to help.
Dr. Thuthula Balfour-Kaipa, a health adviser to the Chamber of Mines, the main industry group for mining companies, said Tuesday that the industry welcomed the government's focus on testing.