Combined workforce and community malaria control programme in Ghana

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Health is a leading measure of development failure or success and health improvements bring significant economic benefits. Significant progress has been made in recent decades to increase life expectancy and reduce child and maternal mortality, malaria, tuberculosis, polio and the spread of HIV/AIDS. Mine workers may be exposed to increased occupational health risks such as cardiovascular and respiratory diseases (such as silicosis), as well as communicable diseases like tuberculosis and HIV/AIDS. All ICMM members implement the 10 principles that underpin our Sustainable Development Framework. Principle 5 requires companies to continually improve health and safety performance with the ultimate goal of zero harm.

When the UN’s Sustainable Development Goals (SDGs) officially came into force in January 2016, the nations of the world committed to mobilise efforts to end poverty, fight inequalities and tackle climate change. Business has a significant part to play, alongside governments and civil society, in creating pathways for a greener, safer and sustainable future for us all. Metals and minerals are essential to almost all aspects of everyday life; they enable farming, healthcare, communications, construction, transport and energy and water supply. And they will arguably become more important as they help to deliver the infrastructure required for a low-carbon future. This is one of a series of case studies gathered from our members to highlight how companies are working to enhance their contribution to society and help industry to manage potential adverse impacts their activities may have on the realisation of some of the SDGs.

Malaria is a significant public health threat in a number of countries in which AngloGold Ashanti operates, including Ghana, Mali, Guinea and Tanzania. At AngloGoldAshanti’s Obuasi mine in southern Ghana, the company identified malaria as a leading cause of lost work time due to illness among its workforce.

In response, the company initiated a workforce malaria control programme, which also extended to the mine-affected communities around Obuasi. The company believes that a sound malaria control programme offers a good return on investment as it reduces the human consequences and costs of disease, and makes for better community relations.

Its malaria control programmes have evolved from in-house efforts focusing on employees to large scale community-based interventions whose design, planning and implementation is undertaken in partnership with governments, NGOs and the communities involved. The approach has attracted international funding and is now being replicated across Ghana.

For a company that relies on a local workforce, the health of the community is critical, and high rates of malaria among mine workers severely affected the business. In 2005, the Edwin Cade hospital in Obuasi, operated by AngloGold Ashanti and located near the mine treated an average of 6,800 malaria cases per month, of which 2,500 were mine employees.

That figure represented more than 30 percent of the workforce at the mine. Worker absenteeism and low productivity during recovery entailed serious costs. Beyond the direct effects of infection on the worker population, the disease also had secondary impacts on productivity, as mine workers often stayed home from work to care for sick family members.

Methodology

In 2005, the company set out to tackle malaria at the community level by implementing an integrated control programme. The company used the WHO-approved approach of indoor residual spraying, which recommends spraying of at least 80% of an area.

The spraying of mines, surrounding buildings, homes and then entire districts reached 92% of coverage. This meant that there were simply fewer mosquitoes that could spread malaria, to the benefit of all parts of the community, not just miners. People are spending less on malaria treatment, children are more likely to be healthy and attending school, and under-5s are less likely to die of the disease.

Care is also taken to avoid health risks among those who are sensitive to insecticide. For example, rooms used by people with asthma or allergies are not sprayed. There is the added advantage that other pests, such as cockroaches and bed bugs, are destroyed.

The company engages with partners for the planning and implementation of programmes wherever possible, and especially with local and national governments where its malaria control programmes fit into national strategic plans. Community engagement has been integral to the programme’s success.

The programme involves training local people to carry out the residual spraying and to involveall areas of the community. Through partnership with communities beyond Obuasi and with the national government of Ghana, the indoor residual spraying programme has created 3,800 jobs.

The programme also works in partnership with the President’s Malaria Initiative. The two initiatives frequently collaborate in areas such as training and community mobilisation, and share best practices in operations, timing and duration of spray rounds, entomological monitoring, spray quality, insecticide selection, and procurement.

Outcomes

The results have been significant. The Edwin Cade hospital received 6,711 cases of malaria in 2005, and the figure was down more than 85% to 973 by 2009. The programme has reduced the burden of malaria in the community, increased school attendance and strengthened relationships with the community. It has also reduced absenteeism at the mine, increased productivity and reduced the cost of malaria medication to mine employees and dependents. At corporate level it has brought a return on investment and has the backing of the shareholders.

The programme was so effective that, in 2011 AngloGold Ashanti was the primary recipient of the Global Fund grant for malaria in Ghana (totaling $138m over five years) and implementation started in mid-2011. By April 2014, 22 districts of Ghana had been treated. At the end of 2014, annual spraying was focused on 10 of the highest affected districts in Ghana. The programme continues to show good results in Upper West Region and Obuasi.

While the indoor residual spraying approach is more expensive than using bed nets, as well as being more complex to administer, the health outcomes have been far more significant than previous efforts. It contributes directly to the company’s ultimate social investment goal: to leave communities better off by responding to their most pressing needs.

ICMM members supporting the SDGs