TB IN THE MINING SECTOR IN SOUTHERN AFRICA Southern Africa Regional Coordinating Mechanism TB IN THE MINING SECTOR IN SOUTHERN AFRICA John Mkandawire, PhD, MPH Wits Health Consortium August 29, 2016

Contents Background of the TIMS Grant Goals and Objectives About the Principal Recipient (PR) TIMS Grant Background of the TIMS Grant Goals and Objectives Target Populations High – level Modules and Interventions Community Systems Strengthening

About the PR Wits Health Consortium (Pty) Limited was appointed by the Regional Coordinating Mechanism (RCM) as the Principal Recipient (PR) for a Global Fund grant to contribute to the reduction of the tuberculosis burden in the mining sector in 10 Southern African countries WHC was selected through a transparent and documented process WHC has extensive experience in managing complicated sponsors and commercially funded contracts and activities. Manages in excess of 300 active contracts and grants each year Primary role of WHC is to provide the governance, legal framework, human resource management and financial or grant management for the research and service entities of the University Wits Health Consortium (Pty) Limited (WHC) was appointed by the Regional Coordinating Mechanism (RCM) as the Principal Recipient (PR) for a grant from the Global Fund to contribute to the reduction of the tuberculosis (TB) burden in the mining sector in ten Southern African countries (TIMS). WHC is wholly owned company of the University of the Witwatersrand, Johannesburg, South Africa WHC was selected through a transparent and documented process Has extensive experience in managing complicated sponsors and commercially funded contracts and activities and manages in excess of 300 active contracts and grants each year  Primary role of the WHC is to provide the governance, legal framework, human resource management and financial or grant management for the research and service entities of the University

Goal and Objectives TIMS Goal and Objectives Goal: Objectives: To contribute towards the reduction of the TB burden in the mining sector in Southern Africa countries Objectives: To increase TB case finding among the key populations in the mining sector in Southern Africa To increase the proportion of key populations on TB treatment that complete their treatment To increase the proportion of key populations with TB that are tested for HIV and enrolled for ART

Target Populations Key Populations Current Miner Workers Size of these population are not fully known. Mapping studies for 3 of the 10 countries estimate: 498,384 miners in SA, most are migrants from Lesotho, Swaziland and Mozambique and 2 million ex-miners. Ex-Miner Workers Current Miner Workers Families of both current & ex-mine workers Communities around the mines & communities in labour sending areas

High Level Modules and Interventions TB Care and Prevention Develop and Implementation of TB surveillance system Expansion of occupational health service delivery Improving TB prevention, care and treatment behaviour Health Information Systems and M&E Conduct surveys: Geospatial Mapping and Epidemiological surveys Strengthen continuity of TB care and treatment Policy and Governance Policy, planning, coordination and management Removing Legal Barriers to Access Legal and policy environment assessment and law reform Community Systems Strengthening Improved Access to TB, silicosis and HIV services by key populations

Human Rights and Gender Objective Improve provision of TB services at community level Key Intervention Activities Review existing work in the region focusing on human rights and gender barriers in the key population to understand human rights and gender barriers impacting on access to TB services Develop a strategy to address human rights and gender barriers based on the review Develop a community-based program on human rights and gender barriers customized to the 10 countries Develop a communication strategy for use by CSOs when implementing programmes and train CSOs in content Deliver community-based programs by conducting workshops, undertaking awareness training for women and vulnerable populations