Managing crystalline silica dust to intensify the fight against TB a regional approach



The Southern Africa Tuberculosis and Health Systems Support (SATBHSS) Project is a regional initiative implemented in four countries, namely, Lesotho, Malawi, Mozambique, and Zambia. The project aims to improve the coverage and quality of key tuberculosis (TB) control and occupational lung disease services in targeted geographic areas of the participating countries, and to strengthen regional capacity to tackle the burden of TB and occupational diseases. The interventions are being implemented through three overarching components: (i) innovative prevention, detection, and treatment of TB; (ii) regional capacity for disease surveillance, diagnostics, and management of TB and occupational lung diseases; and (iii) regional learning and innovation, and project management.1

The project targets underserved populations with high TB and/or TB/HIV burdens, including mining communities, labour-sending areas, transport corridors, and cross-border areas.1 The project strengthens efforts to achieve goals set in the United Nations (UN) Sustainable Development Goals (SDGs), the Southern African Development Community (SADC) Protocol on Health, the African Union (AU) Catalytic Framework to End AIDS, TB and Eliminate Malaria in Africa by 2030, the SADC Mining Protocol, and the AU Mining Vision. The project has adopted a regional multi-stakeholder and multi-sectoral approach to respond to TB. The New Partnership for Africa’s Development (NEPAD) Agency and Eastern Central and Southern Africa Health Community (ECSA-HC) are collaborating to provide technical support to project countries, and enhance regional coordination. The project is funded by the World Bank (WB).

To ensure mutual capacity strengthening and knowledge-sharing, the project countries have taken leadership in various thematic areas where they have a comparative advantage in tackling the scourge of TB. Leadership responsibilities for the various technical areas are as follows: Zambia (mining regulation and occupational health); Malawi (continuum of care); Mozambique (economics of TB/sustainable financing of laboratories and surveillance) and Lesotho (monitoring and evaluation, and research).



Workers’ exposure to crystalline silica dust and other hazardous substances results in silicosis, other lung diseases, and cancer which are, at times, incurable diseases, and lead to increased risks of contracting TB.2 Prevention of workers’ exposure to hazardous dust is limited by the availability of comprehensive regulations, which is a huge challenge in the SADC region. This, especially, is with regards to the management, monitoring, and control of hazardous airborne dust in mining workplaces.3



The project has so far identified critical occupational health and safety (OHS) gaps, which include inadequate infrastructure, inadequate policies and regulations, limited occupational health monitoring and evaluation equipment, insufficient quality improvement systems, and inadequate human capacity and competencies to address occupational health adequately. Solving these challenges requires a collaborative and coordinated multi-stakeholder approach. There is an urgent need for strategic partnerships, and regional multi-sectoral and multi-disciplinary engagements, to curb the scourge of TB and silicosis in southern Africa. Just like the 2018 World TB Day theme ‘Wanted: Leaders for a TB-Free World’, partners are needed to solve this regional challenge.



Use these platforms to get updates of project activities:







1. World Bank. International Development Association Project Appraisal Document on the Proposed Grant/Credit to Lesotho, Malawi, Mozambique, and Zambia. Project Number: PAD 1716; 2016. p. 10.

2. Ngosa K, Naidoo RN. The risk of pulmonary tuberculosis in underground copper miners in Zambia exposed to respirable silica: a cross-sectional study. BMC Public Health. 2016: 16:855: DOI 10.1186/s12889-016-3547-2.

3. SATBHSS. Report of the first meeting of the community of practice on mine regulation and occupational health. NEPAD agency. Project number: P155658; 2017. p. 8.


Report by:

Norman Khoza: Senior Programme Officer: OHS Specialist: SAIOH Members:


Chimwemwe Chamdimba: Principal Programme Officer: Policy Specialist


Hlazo Mkandawire: Communication Specialist: New Partnership for Africa’s Development (NEPAD Agency)


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