Issue 4: Introduction
In 2012 we celebrate ten years since the Constitutional Court delivered a landmark judgment obliging the state to provide treatment for prevention of mother-to-child transmission of HIV.
The court case, which has come to be known as the Treatment Action Campaign (TAC) case, followed a bitter political battle between TAC and the government. In the end, it was the constitution’s guarantee of the right to health that determined the legal outcome. Yet, although ten years have passed since that ruling, TAC and other civil society organisations still find themselves going to court to defend the very same constitutionally-guaranteed right to health.
We are now fighting for the rights of prisoners detained in communal cells that often hold up to twice as many people as the legal maximum. Such conditions place both inmates and prison officers at a significantly higher risk of contracting tuberculosis (TB) or drug-resistant TB. Research has found that inmates of Pollsmoor Prison near Cape Town have a roughly 90% risk of contracting TB over a one-year period. But that is not where it ends – prisoners and warders return to their communities carrying these active infections, which then spread to the wider population.
Research shows that the risk of TB transmission can be greatly reduced by implementing national or international cell occupancy standards and active TB case detection. The Department of Correctional Services however has not taken the necessary steps to implement such measures, which could reduce TB transmission risk by up to 94%.
TAC has joined as amicus curiae (friend of the court) in the case of Dudley Lee, who contracted TB while awaiting trial in Pollsmoor. John Stephens writes about this important case in more detail starting on the next page.
Apart from prisons, other arenas notable for TB-related human rights violations are our mines, which employ approximately half a million workers. In 2010/2011, 11% of South Africa’s gold mine workers were infected with TB compared to a national industry average of 5%. TB is the number one cause of death in South Africa, particularly for people with HIV.
Whereas our 2009 National TB Management Guidelines do not mention mineworkers specifically in regard to the disease, the National Strategic Plan 2012-2016 (NSP) clearly identifies them as a key population at high risk of infection or re-infection.
The NSP sets out specific interventions to target this key population for maximum impact: “The private sector, all employers and labour unions should ensure that all…employees are tested and screened annually and have equitable access to prevention, treatment and wellness services. Special attention should be given to high-risk workplaces and trades e.g. mines and truck drivers.” In addition to the NSP, the 15 member states of the Southern African Development Community (SADC) signed a Declaration on TB in the Mining Sector* in August 2012. The document identifies areas in need of urgent prioritisation.
But the NSP and the SADC declaration* are only starting points. We need to transform these high ideals into successful TB programmes in our prisons and mines. TAC will continue to campaign for this and hold government to account.
The only way to beat TB is to address the human rights violations that fuel its spread. These abuses undermine our ability to meet the NSP targets of eliminating new TB infections and stemming the tide of TB-related deaths.
Vuyiseka Dubula, TAC General Secretary
* For more on the declaration click here