South Africa’s TB Snake and Its Tail Wreaking Havoc in Lesotho

This reporting project by Billy Ntaote of the MNN Centre for Investigative Journalism exposes how Lesotho continues to suffer from the scourge of tuberculosis (TB) and silicosis, a devastating legacy of decades spent working in South African gold mines. It reveals how Basotho miners, past and present, endure life-threatening lung disease, an opaque and inaccessible compensation system, and a healthcare infrastructure stretched beyond capacity.

The series traces the human cost of silica dust exposure and silicosis, showing how migrant labour drained the health of Lesotho’s men even as it fueled South Africa’s economy and multinational companies. It also exposes how chronic underfunding, donor pullback, and opaque compensation schemes leave many TB patients untreated and dying. Policy shifts under U.S. President Donald Trump on global health aid disrupted life-saving TB and HIV programs that Lesotho relied upon, forcing local authorities to scale back community health interventions.

The project further explores how TB is spreading through entire families of ex-miners who are impoverished and rely on food parcels to adhere to treatment. Through first-hand interviews with ex-miners, policymakers, and health workers, the reporting connects historical labour exploitation to today’s public health crisis and calls for accountability, reform, and justice for those who carried the burden underground.