As commodity prices tumble, South African miners with HIV stand to lose access to treatment should they be made redundant in recently announced job cuts.
The South African government has received notice that several mining companies plan to cut as many as 11,700 jobs, triggered by revenue losses on the back of falling prices.
Companies who have announced major cuts include Lonmin, Anglo American Platinum, and Glencore. All provide antiretroviral medication to their employees with HIV.
The prevalence rate in South Africa is the highest in the world at 18 percent of the population, with incidence among miners running 15 percent higher than the average population. Prevalence runs up to 40 percent in the Kwazulu Natal region.
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While HIV treatment is technically free in South Africa, many of the workers who lose their jobs will return to their rural communities which may not have adequate healthcare systems in place. They could lose access to antiretroviral therapy, said Maja Mphahlele, parliamentary head of South Africa’s National Union of Mineworkers (NUM).
“Should a miner with HIV lose his job and return home, he could be as far aways as 200km from a clinic,” Ms Mphahlele says. “There are no alternative provisions in place. This is a serious life-and-death situation for patients. It is very devastating.”
NUM said it is engaging with the companies on the issue.
South African mining jobs stand to be the latest casualties of a global economy roiled by plummeting commodity prices and slowing demand from China. Within the country, fierce union politics and rolling strikes have cut into profits and unnerved investors.
Tuberculosis is also a problem in the mines, and those with HIV/Aids are especially susceptible to the bacterial infection according to Marcus Low, a researcher at the South African NGO Treatment Action Campaign.
“These miners, who are often very sick, get sent home to rural areas with poor healthcare facilities,” he points out. “The duty of care then falls on the family, severely impacting the patient’s health and family’s income.”
South Africa’s largest iron miner, Kumba Iron Ore, has already begun the process of shutting its Thabazimbi mine. The closure will affect 800 employees and 360 contractors. However, it will endeavour to to provide antiretroviral therapy for HIV positive workers who lose their jobs.
“All employees that leave the organisation will be referred to their primary healthcare provider of choice,” said a spokesperson for Anglo American Platinum, the majority shareholder of Kumba.
Anglo American Platinum has announced intentions to reduce its South African headcount by 6,000 during its 2015 interim results. Glencore’s Optimum Coal, meanwhile, unit has been placed into business rescue proceedings after taking a hit from an unfavourable supply deal with troubled power utility Eskom. Some 380 jobs are at risk. The company will close the Eland Platinum mine, which will trigger around 1,000 job losses.
Glencore did not respond to questions from This is Africa as to whether it would continue to offer healthcare to workers it makes redundant. A spokesperson did, however, say: “In everything we do we respect the human rights of our people, host communities and partners.”
Lonmin, who have announced plans to slash 6,000 jobs, says it provides antiretroviral therapy for life, and former employees can still receive treatment from its facilities. It has 3,666 employees taking antiretrovirals under its healthcare scheme.
“If it is not logistically possible for former workers to access the Lonmin Medical Services, they are given a referral letter to collect ART from their provincial clinic or hospital,” a company spokesperson said.
But following up with the patients who return to their home villages to ensure they have access to treatment will be difficult, said Julia Baabua, NUM’s health and safety secretary for the Matlosana region.
“It is a very controversial issue. We will not get the names of the HIV patients who have lost their jobs, just the numbers,” she said. “We need to find out how do we deal with this, we cannot just let them go home.”
Discrimination based on HIV status is not legal, Dr Thuthula Balfour-Kaipa, health advisor at the Chamber of Mines of South Africa, emphasises.
Bearish commodity markets have thrown South African mines into turmoil. The market price for platinum is hovering around a six-year low. Iron has halved in price in the last year, and gold has slumped towards five-year lows.
Copper has also sunk to 2009 levels. The sector has also been hit by rising operating costs, depressed oil prices, China’s economic slowdown and the strong US dollar.