Learn: TB, HIV, and South African Gold Mining

This section will provide you with plenty of data and information, but first we wanted to make the sure severity of the issue of TB in the South African mines is absolutely clear.

TB is a deadly airborne disease. TB incidence rate is the number of new cases of TB acquired in a population in a given time period, in this instance, per year. The diameter of these circles represent the TB incidence in the respective populations. The United States and other high income countries have around 5 new cases per 100,000 people per year (the U.S.’s is 3.2/100,000). The World Health Organization (WHO) declares an emergency when TB incidence rates reach 250 per 100,000 population. To our knowledge, at up to 7,000 per 100,000 population, the South African gold mines have the highest recorded incidence rate in the world: 28 times a declared TB emergency.

(Sources: US TB Rate: CDC; Emergency Threshold: AIDSMap; TB rate in mines: South Africa Ministry of Health).

What is TB?

TB is a deadly airborne bacteria the primarily infects the lungs, but understanding TB from only one angle is simply not enough. If you are just getting to know the disease, or if you only know one aspect of TB, we invite you to learn more by clicking below.



TB in the South African Mining Industry

The issue of TB in the mines is highly complex and there is no simple solution (nor is there a simple solution to the general globalized TB epidemic). In this section, we try our best to break it down. But be prepared, we’re going to throw a lot at you!

The Overview

The issue of TB in the South African mining industry is so extremely complicated that it is difficult to know where to start. So how do you eat an elephant? One bite at a time. So we have broken it down into three large groups to start:

  1. High exposure to TB risk factors at the mine.
    Migrant miners are exposed to high rates of TB at the mine primarily due to silica dust exposure, HIV risk factors, and cramped, squalid living conditions.
  2. Migration bridges these disease ‘hotspots’ with the general population. Most miners are “oscillating migrants,” meaning they travel to and from their rural homes to the urban mines.
  3. Poor access to care, compensation, and legal rights. Once they leave the mine, there is poor access to care and legal rights, making continuation of care and acquisition of workers compensation very difficult.

All of this together means that this population is highly mobile and highly infectious, traveling from an area of high concentration of disease to low concentration of disease. Because of this, the South African gold mines have been referred to as a “TB factory,” and “a river of disease” by leading public health experts, and mining is the largest driver of TB on the African continent aside from HIV.