At an operational level, malaria is managed by mine management and the occupational health and health care service professionals contracted to perform these tasks. Given the concentration of malaria in East and West Africa, a great deal of co-ordination is undertaken between sites located here, with the malaria control team at Obuasi in Ghana providing specific guidance to the other operations. However, the facilities and programmes provided by the group differ from site to site, depending on specific circumstances and requirements. Further details are provided in the country and operational reports.
Malaria programme performance and statistics are reported to the regional management of AngloGold Ashanti on a monthly basis and to the Safety, Health and Sustainable Development Committee of the Board every quarter. The issue is also considered during the companys risk management process.
Not only does the disease result in death, illness and absenteeism among employees, it also is a major cause of death in young children and pregnant women, with an obvious impact on employees families and communities.
AngloGold Ashantis malaria programmes and protocols are based on World Health Organisation (WHO) standards and guidelines. As malaria is something that affects whole communities, and not just employees of the company, a holistic approach must be taken. Regionally, the group is involved with initiatives by government and by non-governmental organisations (NGOs) to combat the disease, and national guidelines are applied and provide the context for the various programmes. Such national guidance includes the Tanzanian National Guidelines for Malaria Management and, in Mali, the National Policy Against Malaria (published in 2006). The Obuasi malaria control programme is run in accordance with the Ghana National Malaria Control Plan. The mine works closely with the national programme co-ordinators and the Obuasi Municipal Assembly, and company health management officials give credit for much of the success of the programme as due to this close cooperation.
Malaria remains an area of concern for AngloGold Ashantis operations in Ghana, Guinea, Mali and Tanzania, although employees at South African operations may contract the disease when travelling to their homes in malaria-infected areas in neighbouring states.
Key elements of the malaria control programme are depicted in the diagram below, and form part of the malaria control programmes at all operations. These components are:
In addition to monitoring the incidence of malaria cases diagnosed and the number of days lost as a result of the disease, the company has developed a Malaria Lost Time Injury Frequency Rate (MLTIFR). This is expressed as the number of cases (incidents) of malaria for every million hours worked, and allows the rate to be compared with the conventional LTIFR, which is a commonly used safety measure.
At Iduapriem in Ghana, a number of initiatives are in place to involve both employees and community members in a campaign to eradicate the disease. Key to this programme is education and training, with an emphasis on:
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An extensive integrated malaria control programme is in place at Obuasi, and the lessons learnt here are being applied elsewhere. Malaria rates have declined consistently over the past three years, from 6,700 cases per month in 2005 to 1,128 cases per month in 2008. See the case study: Update on malaria programme at Obuasi.
The vector control programme at Obuasi is the principal component of the programme, and covers the entire Obuasi municipal area (the mine, the town and surrounding villages). Three primary areas of attention have been identified:
The programme has achieved a high level of acceptance from the community. Surveys undertaken in the region show an increased level of awareness by community members of the causes of malaria, recognition of mosquito breeding sites, and increased understanding of sources of infection.
The mine spent some $1.4 million on the programme during the year and is expected to spend a similar amount in 2009. Based on the success of Obuasis Indoor Residual Spraying programme in the Obuasi District, a proposal for funding from the Global Fund to Fight HIV, TB and Malaria (GFATM) for $133 million, to scale up the Obuasi model to cover 40 districts in Ghana, has been approved. It is envisaged that Obuasi will become part of this new programme, and although AngloGold Ashanti will contribute to the implementation of the National GFATM programme, a cost reduction is anticipated.
As part of the mines malaria control programme, a comprehensive malaria control centre has been established at Obuasi. It has a sophisticated malaria information system (MIS) which measures and monitors the progress and quality of the programme. The centre has an insectary and laboratory, built to the specifications of and accredited by the South African National Institute for Communicable Diseases. Here research and surveillance is conducted with regard to vector resistance and insecticide susceptibility, which, in turn, dictates the selection of insecticide for subsequent rounds of spraying. The Noguchi Institute of Ghana collaborates with Obuasi on many of these programmes.
A substantial decline in malaria cases has been recorded at Geita in Tanzania 99 cases in the fourth quarter of 2008 (which is the rainy season) as opposed to 667 cases in the fourth quarter of 2007.
At Iduapriem in Ghana, the anticipated malaria control programme will be undertaken in conjunction with the local municipality and with four other mining companies in the area. The programme comprises health education, intermittent preventative treatment for pregnant women, encouraging malaria prophylaxis and prompt treatment of diagnosed cases. A vector survey was undertaken in 2007 and a pilot spraying programme will be launched during the second quarter of 2009.
Despite increased emphasis on malaria control at Siguiri in Guinea during 2008, the incidence of malaria did not decline as much as expected, given the significant decrease achieved in the previous year. This may, in part, be due to the fact that the region experienced a particularly heavy and extended rainy season, from May to November. The mines programme includes vector control, distribution of nets and mosquito repellants for night shift workers, and an intensive education and communication campaign.
At Sadiola and Yatela, rising malaria rates are believed to be related to high levels of rainfall.
Malaria affects not only employees, but entire communities in which the groups operations are located. Where possible, the group works closely with other stakeholders to address malaria in a holistic fashion and to develop programmes that may attract both government and donor funding.
Obuasi offers extensive assistance to other companies and to the government in the planning and execution of their programmes. During the year the mine trained spray operators for the US Presidents Malaria Initiative which is being rolled out in the north of Ghana.
At Geita a local steering committee has been formed to extend the mine programme to the region.
At Iduapriem the company is involved in the Roll Back Malaria Initiative as well as a regional malaria control programme. The latter will be implemented during 2009, with the aim of halving malaria rates in the region over a two-year period.
In Mali, at Sadiola and Yatela, bednets are available to community members at subsidised cost, and reimpregnation is carried out free of charge.
I provide accounting services, administer and monitor corporate costs, and monitor regional expenditures at AngloGold Ashanti. It is an occupation that requires the custodian to be accountable to the business. The value that says, We are accountable for our actions and undertake to deliver on our commitments, therefore resonates with me.
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ANGLOGOLD ASHANTI Report to Society 2008