Malaria

AngloGold Ashanti’s malaria control programme has proven so successful at Obuasi, Ghana that it is being adopted as the model for a Global Fund Proposal by the country’s government. The National Malaria Control Department has also rolled out the programme to 40 districts in Ghana. The “Obuasi model” has also been implemented at AngloGold Ashanti’s Siguiri mine in Guinea.

Malaria is the most significant public health threat in West Africa. It was therefore imperative that AngloGold Ashanti develop methods to counteract the scourge within its own workforces and surrounding communities. See case study: Obuasi malaria control programme: a model for Africa

In 2005 AngloGold Ashanti implemented an integrated malaria control programme at Obuasi and for its associated communities, which has led to extremely impressive results in curbing malaria in the area. The programme’s initial objective was to achieve a 50% reduction in the incidence of malaria within two years, beginning in January 2005. By October 2008, reported malaria cases had declined by 74% from an average of 68,000 cases per month in 2005 to 1,200 in 2008.

“We have also completed the planning and preparation for the rollout of the model at Iduapriem mine in Ghana, and they are due to start the programme next year,” said Steve Knowles, AngloGold Ashanti’s Manager: Malaria Control Programme. Planning has been completed to upgrade the malaria control programme in Mali and Tanzania but implementation at these sites has been postponed until 2009 due to logistical factors.

In an example of public and private partnership, the government of Ghana has applied to the Global Fund (a donor fund headquartered in Geneva and funded by governments and large foundations; which is dedicated to funding programmes fighting HIV, Malaria and TB) for $160 million to roll out the programme in that country, enlisting AngloGold Ashanti as the implementers of the project.

A provisional approval of the proposal by the Global Fund committee in Geneva was received in January 2009 – AngloGold Ashanti will be the principal recipient and the implementer of the Indoor Residual Spraying programme including responsibility for the disbursement of funds and the implementation of the programme.

A contributing factor to the success of the project was ensuring that the processes used were based on sound scientific principles and followed World Health Organisation (WHO) guidelines. Recognised authority in the field, Prof Maureen Coetzee of the South African National Institute for Communicable Diseases and Prof Richard Hunt, a specialist entomologist, were retained to consult on the development of the project and to conduct the initial baseline research. Previous studies and surveys conducted by the Ghanaian Health Services and the University of Ghana’s Malaria Unit were also used.

“First and foremost, it was imperative that AngloGold Ashanti do the proper groundwork for this project: we ensured that the community was involved at all levels; we had to make them understand why it was important to get rid of stagnant water and clear blocked drains - areas where mosquitoes typically breed,” explains Knowles.

This was not an easy task as there are long-standing myths in the communities about what causes malaria. It was essential therefore, that AngloGold Ashanti provided ongoing malaria education.

Accurate information regarding the anti-malaria campaign is provided at regular committee meetings, social gatherings, media articles, and during a weekly slot on the local radio. One-on-one interaction with community leaders is used to get feedback.

“We now have total commitment from the community; we have a large number of community members phoning in to ask questions during the radio talk shows, and we also provide feedback on the effectiveness of the campaign in their areas,” says Knowles.

Engagement with the community was imperative as the essential component of any anti-malaria programme is indoor residual spraying, which has been shown to have the greatest impact on malaria vector populations and malaria incidence reduction. The community was forewarned about the unpleasant odour of the initial insecticide used although the new insecticide introduced in the second year has no odour. The changing of insecticides on a regular basis is the keystone of the insecticide resistance management programme - to prevent resistance build-up of the vector mosquito. The community was also informed of the added benefits of spraying, such as the elimination of ants, cockroaches and other insects, not only mosquitoes.

Steve Knowles concludes, “Malaria control as a Corporate Social Responsibility programme is a win-win situation. The community benefits with respite from the burden of the disease; the company benefits from decreased absenteeism and lost man days; increased production and a major reduction in the costs of medication (in 2005 malaria medication costs for AngloGold Ashanti in Obuasi was $55,000 – in 2008 it was $12,000). In addition the reduction in patients has lessened the pressure on the doctors and medical facilities.”