On the occasion of the World Economic Forum Africa Summit, a new effort to protect the health of millions of workers was launched today by the World Health Organization (WHO) and the International Labour Organization (ILO), with the release of guidelines for TB control activities in the workplace.
The guidelines describe cost-effective steps to protect workforce productivity in the face of this disease: TB infects 8 million and kills an estimated 2 million people each year – the equivalent of 5000 deaths per day. The toll is even more alarming because three-quarters of TB victims are in the most economically productive age group of 15-54 years.
Effective treatment, however, under the internationally recommended DOTS(1) strategy, can prevent avoidable deaths and allow sick workers to return to productive work sooner.
The guidelines draw on the practical experience of employers and workers and the technical expertise of WHO and ILO. They are the first comprehensive approach to workplace TB control. The information in the guidelines is targeted at employers, employees and their associations, and health workers, all of whom can play a significant role in their implementation.
In a foreword to the guidelines, WHO Director-General, Dr Gro Harlem Brundtland, and ILO Director-General Mr Juan Somavia write: "TB is a workplace issue because health is essential not only to the well-being of individuals but the functioning of economies. Poor health among working people is a threat to the viability of enterprises and the national stock of human capital. The productivity of the workplace, in particular, is weakened by the loss of skills and experience, absenteeism, disrupted production and escalating costs."
Urging businesses and all key partners to use these guidelines in making their contribution to the global movement to stop TB, Dr Gro Harlem Brundtland and Mr Juan Somavia have argued that: "For private and parastatal business, and for the public sector, TB control represents a win-win situation. Employers benefit from investment in a healthier workforce and the demonstration of corporate social responsibility. The community in general stands to benefit from improved TB control resulting from the contribution of workplace TB control to overall TB programme activities in a particular country."
The 74-page booklet gives authoritative information on TB, how it spreads, and what can do done to control the disease. It also includes current information on the treatment of people who are co-infected with TB and HIV, and for people who have multidrug- resistant TB, which is far more difficult and expensive to treat than normal TB.
Inviting business leaders to join the global effort to prevent the needless economic and human destruction caused by TB, Mr George Soros, Chairman of the Open Society Institute, has given the workplace guidelines his full backing: "As a philanthropist, I believe that corporations can be powerful advocates for health. As a businessman, I believe that implementation of the guidelines is one of the best investments companies can make."
The internationally recommended DOTS strategy for curing and controlling TB is hailed by the World Bank as one of the most cost-effective of all health interventions. A number of illustrative case studies included in the workplace guidelines show how a variety of businesses are now reaping the rewards of their TB control activities.
One case study looks at the large South African mining company, AngloGold, which employs more than 50 000 people, in a high TB prevalence business sector and country. The local high HIV prevalence further contributed to the increase in the incidence of active TB in the workforce. Before implementing a TB control strategy, the cost to the company per TB case was calculated at US$ 2775, with an additional cost of US$ 410 per case, in lost shifts among lower-level employees. With the introduction of a comprehensive TB control programme for their workforce, the company is now spending only about US$ 90 per employee each year, and saving US$ 150 through the prevention of active TB among HIV-positive employees.
Another case is Youngone Industries, a Korean manufacturer of sports goods located in Chittagong, Bangladesh, with a workforce of 22,000. After committing itself to tackling TB, the company formed a successful partnership with the national TB programme. Sustained high-level management and company commitment resulted in a successful plan for prevention and control of TB among employees.
The WHO–ILO guidelines for workplace TB control activities are expected to play a key role in strengthening public/private partnership, between the TB community and the business sector, which is of great importance in achieving the goals of the global effort to stop TB.
(1) The DOTS control strategy consists of 5 elements: (i) government commitment to sustained TB control; (ii) case detection using sputum smear microscopy among symptomatic patients reporting to the health services; (iii) standardized short-course chemotherapy under proper case management conditions, including direct observation of treatment; (iv) a proper drug supply system; (v) a standardized recording and reporting system.
For more information contact: Glenn Thomas, Communications Officer, Stop TB Department, WHO, Tel: 41 22 791 3983; email: thomasg@who.int.