We can finally ensure 500,000 miners are paid out for silicosis and TB — here’s the problem

Nearly half a million miners are owed compensation for silicosis and tuberculosis claims but getting the money to them and their families is still a hard journey.

Fidelis Hove leads Genesis Analytics’ social protection work, helping governments spend more and better through expenditure reviews, fiscal-space analyses and digital transformation. He holds a PhD in economics from the University of Cape Town.

The migrant labour system that built South Africa’s gold economy was a machine for moving value in one direction. It pulled men into the Witwatersrand goldfields from the Eastern Cape, Lesotho, Mozambique, Malawi and Zimbabwe, took their working years underground and sent them home when their lungs failed. Wages left as remittances. Silica dust stayed in their chests. And the compensation they were owed stayed stranded on the wrong side of a border.

The system had every rail it needed to carry labour in. It never laid the one to carry justice back out. That missing rail is the unfinished business of the goldfields, and for the first time the tools to build it exist.

Six years ago it looked as though that was finally being fixed. The 2019 class-action settlement with six gold mining companies created the Tshiamiso Trust and roughly R5-billion to pay silicosis and tuberculosis claims. By February 2026 the Trust had paid out about R2.5-billion across six countries. That is halfway through the money, and roughly halfway through the time it has to spend it.

The people are nowhere near halfway. Advocates count something in the order of 500,000 potential claimants. About 23,000 have been paid. In Lesotho alone, 5,464 men diagnosed since 1965 cannot be traced. Behind the Trust sits an older backlog: the Compensation Commissioner for Occupational Diseases recorded more than 107,000 unpaid claims as far back as 2017, under the century-old Occupational Diseases in Mines and Works Act (ODMWA). When the Trust’s mandate ends, whatever it has not paid does not roll over. It lapses.

A working return rail needs four things: a law that recognises the claim, institutions that cooperate, records that mean the same thing across systems and technology that can move them. This is the anatomy of portability set out in a recent Digital Convergence Initiative report on cross-border social security. South Africa can now build three of them. Identity, data exchange and payment, the institutional and technical track, are being laid as we speak. The fourth is the legal segment, and it is the one we have left unbuilt.

The Trust’s own chairperson has acknowledged that strict ODMWA criteria rendered more than 70% of 83,810 certified claims ineligible. Read that again. These are men who presented themselves, submitted to a medical examination and were certified. Then they failed a legal test.

They fail it for reasons that have almost nothing to do with whether their lungs are damaged and almost everything to do with paperwork. Service records that the mines were supposed to keep and did not. Medical histories interrupted by decades and borders. Post-mortem evidence that was never collected because nobody told the family it mattered.