TB, HIV/AIDS, Malaria in mining – ICMM good practice guidance released

Mining companies can play an important part in the control of the world’s top three communicable diseases.

LONDON - 

Across the world, Tuberculosis (TB), HIV/AIDS and malaria are generally agreed to be the major causes of mortality related to communicable diseases.

In its 2007 World Health Report, the World Health Organisation highlighted the fact that such diseases are spreading more rapidly than ever before, exacerbated by increased air travel, and the emergence of drug-resistant disease strains.

The mining and metals industry is in a strong position to influence the course of these diseases, since it works in regions where they constitute a serious problem. The business case for doing so is strong, centred round employee well-being and positive financial impacts for companies.

A new publication by the International Council on Mining and Metals - ICMM Good Practice Guidance on HIV/AIDS, TB and Malaria - outlines that business case, and provides mining and metals company managers with the practical information they need to guide effective action in the workplace, and to seek technical expertise where necessary.

The Guidance stresses the need for an integrated approach to the three diseases, and highlights the new links between them emerging in recent research. It also highlights the need for collaboration between mining and metals companies, communities, and local and international institutions and organisations.

But how urgently is such action really required?

Causes for concern

The most recent United Nations update on progress towards the Millennium Development goals shows that the targets for halting and reversing the spread of HIV/AIDS, malaria and TB are not close to being met anywhere in the world.

According to Business for Social Responsibility, some US companies have estimated costs between $3,500 and $6,000 per year for each worker with HIV/AIDS. Studies of South African firms indicate that cost savings from investment in prevention and education programs are as high as 3.5-7.5 times the cost of the intervention.

TB, reportedly leads to a decline in worker productivity of around $12 billion annually, even though healthy people with latent infection have only a 10% chance of suffering active TB over their lifetime (this rises if HIV is also present).

Nearly half the world's population is at risk from malaria. Although found mainly in the tropics, the disease can also occur further north and south on the Asian, African and American continents.

International SOS has reported that each uncomplicated episode of malaria results in an estimated 2-5 days sick leave for semi-immune workers, and more among those suffering chronic health effects from repeated malaria infections. There are an estimated 30,000 malaria cases annually in travellers and expatriates, with the average cost per medical evacuation for a case of severe malaria being around $50,000 in 2007.

Mining and metals companies are among those under the spotlight in relation to communicable diseases, because the environments in which their operations tend to be located are often at risk. The nature of the mining industry means that mining companies operate in resource-rich locations, where disease can be prevalent. Major projects often attract high levels of migration into the area. Community housing can be informal and crowded, which assists the spread of disease. Workers may be at risk of exposure to dust containing silica (a contributor in the spread of TB, made worse by the presence of HIV/AIDS). The increase in working age men in an area is usually accompanied by an increase in commercial sex workers (with associated HIV infection risks). Environmental disruption caused by projects can also contribute to the spread of malaria.

For all these reasons, mining and metal companies need a comprehensive strategy for management of the risks that these diseases pose.

Business case for action

As well as simply being the right thing to do, a proactive approach to the management of these diseases can have a direct positive impact on the financial performance of a company.

Moreover, a range of quantitative and qualitative data suggest that companies addressing the three diseases in the workplace, through preventive and treatment measures, gain a variety of bottom-line benefits.

Improvements can be seen in employee morale, in company reputation, and in the business's licence to operate. Employee turnover rates are lowered, as is employer liability. Profitability rises due to increased productivity and decreased costs of health care. The business benefits from workforce diversity that reflects a range of age groups, sexes, talents and skills.

Improving operational competencies

The new ICMM Good Practice Guidance on HIV/AIDS, Tuberculosis and Malaria sets out to improve company competencies in dealing with these issues at an operational, day-to-day level.

Aimed at managers and health practitioners, it seeks to increase their understanding of the individual diseases, and also their links, in a non-technical way. The Guidance explains the characteristics of each disease - the stages, signs and symptoms, spread, diagnosis and treatment. The uniquely different prevention, treatment and control mechanisms of the three diseases are recognised.

A systematic management process is described, comprising nine generic steps to determine the type and level of intervention required for HIV/AIDS, TB and malaria - culminating, where appropriate, in the implementation of a health programme with associated monitoring and evaluation.

The process is relevant for existing projects that have not yet adequately addressed the risks of the three diseases; and also for new projects, where it is likely to be linked to environmental and social impact assessment and the associated health baseline and impact components. Managers are equipped with the questions they need to ask to ensure the right action, with the right partners, to the right extent.

Essential collaboration

Mining and metals companies cannot, on their own, beat the "big 3" diseases.

Experience has demonstrated that sustained effort, on many levels and through many channels, is needed to bring about the social and behavioural changes that will lead to the long-term sustainability of any health programme.

Any mining or metals project has a finite lifespan. When an operation closes, company interventions will diminish. So long-term improvement in the quality of life for a local workforce and their families depends on establishing partnerships with local organizations, and often international agencies as well.

Experience also shows that the benefits of extending company health programs into the community significantly outweigh the costs.

Improved community health increases the productivity of both employees and their families and friends in the local area. More cost-effective community health programs, combined with strategic partnerships, make it possible to engage in larger investments that have wider reach, and also help to ensure the programs' impact is sustained beyond the life of a mine. Effective community outreach programs build positive, constructive relationships with local groups and influencers, providing reassurance for company shareholders and prospective investors.

The ICMM Guidance strongly recommends an integrated, community-based approach to health care and disease management. And it provides insights into improving the effectiveness of implementation - and the sustainability of results - through working with external partners including funders, contractors, service providers and suppliers.

* ICMM Chief Operating Officer

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