Managing health issues

Occupational and community health

Our context

In line with our values, we believe that we cannot accept ill health as a natural consequence of our business operations, and that our employees must be able to go home fit and well at the end of each working day. Our definition of good health is a state of complete physical, social, mental and spiritual wellbeing and not merely the absence of disease and ill health.

We also subscribe to the value that ‘communities in which we operate will be better off for us having been there’, which implies that our approach to health encompasses community health issues.

In many areas of operation, we have found that employee and community health issues are inseparable, and integrated strategies are required. Approaches to malaria, HIV/AIDS and TB, for example, require community-level interventions as well as employee-level interventions to be successful.

The diagram below shows the model that we aim to adopt in analysing and managing health issues in the workplace, and the potential health exposures that employees face. These are significant, particularly in South Africa where we encounter many of our most pressing health risks.

AngloGold Ashanti’s global approach to wellness in the workplace

Our most material health risks relate to:

Failure to manage these issues adequately poses risks to the business in terms of increased potential for injuries and accidents, decreased productivity, fatigue, poor morale, increased medical and medical compensation costs and poor stakeholder relations, all of which can threaten the social and legal licence of the company to operate.

Our health strategy

AngloGold Ashanti is a global company which operates in a diverse range of settings. Health exposure risks therefore differ between regions and according to the type of mining operation undertaken. The company has not implemented a global health strategy or management system in the past and the management of health and wellbeing issues has not therefore always been consistent.

In 2011, we intend to move towards a structured approach to managing health issues, through the development and implementation of a global health strategy and health management system, thus improving the organisation’s ability to learn from the experience of different regions and to replicate good practice across the group.

The health strategy that we have developed has the following objectives:

A health management system will be designed and implemented which will be compatible with the best practice standards on occupational health and safety already in use at our operations and integrated with our broader business systems. These include key organisational change initiatives such as Project ONE as well as duty of care policies and practices, knowledge and information management systems, risk management systems and community relations strategies.

Standards and guidelines are being developed on key health issues such as health impact assessments, specific disease management and pre-placement medical examinations.

Health impact assessments will be conducted at operations over the next 18 months and health risk assessments will be updated or put in place where they do not already exist. They will also serve as a benchmark for new operations, which in future will be assessed at the feasibility stage.

Health targets for 2011 and 2012

We intend to take forward implementation of our health strategy and management system within the following time frames:

We have set the following goals relating to wellness and occupational environment:

Health performance in 2010

In 2009, we committed to a number of targets relating to health issues, as set out below. All of them are centred on South Africa, where the need for progress has been most acute. This is due to the large numbers of people employed by the company in South Africa, as well as the incidence of silicosis, HIV/AIDS, NIHL and TB among this workforce. This section sets out progress against these targets as well as on addressing malaria at our African operations.


Our target is the elimination, by 2013, of new cases of silicosis among employees in South Africa who were not occupationally exposed prior to January 2008 (using present diagnostic techniques).

This target is the industry milestone, set at the 2003 Health and Safety Summit. However, it is still too early to provide a meaningful assessment of the group of employees exposed after January 2008 due to the latency period of the disease. Current diagnostic techniques do not allow us to make a meaningful assessment of performance at this stage.

We therefore measure current performance with reference to the occupational hygiene aspects of the industry milestones. These state that no more than 5% of samples measuring exposure should be above the occupational exposure limit of 0.1mg/m3 for respirable crystalline silica.

A continued focus on filtration strategies and footwall treatment has enabled us to continue reducing silica dust exposure and achieve compliance with the industry milestone. We are still maintaining a downward trend of dust exposure on an annual basis. We also maintained significantly higher sampling rates than those prescribed by legislation, increasing our confidence in the data collected and enabling us to manage the issue of silica exposure more closely.

We have now set ourselves a lower benchmark for dust readings for analysis than the industry milestone and investigate the root cause of all dust readings exceeding this benchmark. We are also in the process of defining a new baseline for dust readings by sampling all employees. This will enable us to evaluate high risk areas and occupations so that strategies can be adapted accordingly.

A former employee, Mr Thembekile Mankayi, instituted a legal action against AngloGold Ashanti in October 2006, claiming approximately $360,000 for damages allegedly suffered as a result of silicosis. AngloGold Ashanti learnt of the death of Mr Mankayi on 3 March 2011 and wishes to offer condolences to his family and friends.

In June 2008, judgement on an application was given in the company’s favour on the basis that mine employers are indemnified against claims by employees for damages relating to diseases compensated under existing legislation. An appeal by Mr Mankayi was dismissed by the Supreme Court of Appeal. In August 2010, the Constitutional Court of South Africa heard Mr Mankayi’s application for leave to appeal to the Constitutional Court. On 3 March 2011 the Constitutional Court granted the leave to appeal and simultaneously granted the Appeal. The effect thereof is that the executor of Mr Mankayi’s estate may return to the High Court to recover common law damages from AngloGold Ashanti and that they are not barred by legislation from doing so. AngloGold Ashanti has several defences available to it, and it will continue to defend the action.

Noise-induced hearing loss (NIHL)

Our target on NIHL is to achieve the industry milestone of no deterioration in hearing greater than 10% amongst occupationally-exposed individuals at South African operations. Audiograms are conducted on all occupationallyexposed employees in South Africa when they join the company and annually thereafter. The baseline for the target is the routine audiogram performed during 2009 or, for employees who joined the company after 1‑January 2009, the audiogram performed at the start of their employment.

Due to the lag between noise exposure and NIHL, we are not yet able to give a meaningful assessment of performance against this target. In the meantime, however, we continue compliance with noise targets (the industry milestone states that by December 2013, the total noise emitted by all equipment installed in any workplace must not exceed 110dB(A) at any location in that workplace). We have been in compliance with this hygiene target since 2008 and have now set a lower internal benchmark.

HIV/AIDS, voluntary counselling and testing (VCT) and wellness programmes

Our targets in this area for 2010 were:

We were not able to achieve these targets. The uptake of VCT has been falling since 2008 and in 2010 it was 74%. We treated over 4,000 patients at wellness centres during the year but have not been able to measure retention on the programmes. Measuring retention is challenging because of the constant change in the number of patients, and the many reasons for not returning to the programme. These losses include resignation and voluntary and ill-health separations but are not always recorded as such.

The number of employees presenting themselves for VCT is declining. Testing and counselling programmes, which have been in place at AngloGold Ashanti since 2000, have helped curb the epidemic but do not appear to have resulted in a step change in prevalence, for which a major advance in treatment such as a cure or vaccine would be required.

Notwithstanding this situation, communications and awareness programmes have continued and are now conducted on a one-on-one basis as well as through mass media communication channels. Particular attention is given to VCT at induction.

A major advance in 2010 has been the introduction of linked testing, which enables follow up with affected employees and will also form the basis for a better estimate of the incidence of HIV/AIDS among our workforce. Anti-retroviral therapy (ART) continues to be supplied to approximately 2,500 employees for whom this treatment is clinically indicated.

Tuberculosis (TB)

We have met targets on occupational tuberculosis for 2010, which were to:

Occupational TB incidence in 2010 was reduced to 2.64% in 2010 and more than 90% of cases were successfully treated in 2009. Data for successful outcomes of TB cases treated in 2010 is not yet available as treatment programmes last between six and eight months. Prevalence of this disease among employees in South Africa is closely linked to HIV prevalence.


Downward trends in malaria cases continued in 2010, as shown in the table below.

Number of malaria cases in affected countries (2007 – 2010)

  2010 2009 2008 2007
Ghana 3,219 5,085* 4,947 7,786
Tanzania 218 447 1,557 3,212
Guinea 783 664 756 633
Mali 268 204 216 434
Total 4,488 6,400 7,476 12,065

* The number of cases of malaria in Ghana was incorrectly stated in our 2009 report as 5,075.

In 2009, AngloGold Ashanti was nominated as the principal recipient of a grant of $138 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. The project will cover 40 districts in Ghana and will be based on the integrated malaria control model implemented at Obuasi. It is anticipated that this will run for five years and create approximately 3,800 jobs. Work on the project is scheduled to begin in the first quarter of 2011 following successful resolution with the Ghanaian authorities on taxation issues relating to the grant.

Starting in 2011, we intend to roll out the highly successful integrated model undertaken at Obuasi in Ghana to other malaria-affected areas where AngloGold Ashanti operates.

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