Inherent in our core values and business principles is a commitment on the part of AngloGold Ashanti as an employer, to ease the burden for employees in the face of debilitating regional health threats and to ensure that the company has addressed the resulting impact on the company.
During the year under review four regional health threats have been identified, unchanged from 2007. They are:
The management of HIV/AIDS and malaria is undertaken directly at an operational level between mine management and the occupational health and healthcare service professionals contracted to perform these tasks. The exact nature of the services provided differs from site to site, depending on specific circumstances and requirements. Further details are provided below and in the operation- and country-specific reports.
Experts within the company, such as James Steele who heads the HIV/AIDS programme in South Africa, and Steve Knowles, who manages the malaria programme at Obuasi, provide guidance to other operations as this is required.
The company’s response to HIV/AIDS in South Africa, where the disease is of pandemic proportions, is underpinned by the company’s Board-approved HIV/AIDS policy, and supported by an HIV/AIDS agreement between the company and various unions. Arrangements at an operational level provide for joint management/union HIV/AIDS committees that oversee the mine-based programmes.
In South Africa, oversight and implementation of the HIV/AIDS programmes is undertaken by AngloGold Ashanti Health, a wholly-owned subsidiary of AngloGold Ashanti, in association with the business units and their HIV/AIDS committees.
HIV/AIDS and 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 issues are also considered during the company’s risk management process.
During the year, the company’s group internal audit, in conjunction with external consultant, developed plans and a toolkit to manage and ensure the continuity of business operations in the event of a catastrophe with a long-term outlook such as an influenza pandemic. In 2006, the potential for avian flu was considered by a group task force in the light of the World Health Organization’s positioning of such an outbreak as a serious global health threat.
A formal plan or code of practice is being developed for each site and a number of simulation exercises have been undertaken. The exercise has proved to be very useful: AngloGold Ashanti’s operations have a track record in managing immediate crises, but have had less experience in managing those of a longer-term nature. (See the case study in the Report to Society 2006 AngloGold Ashanti establishes avian flu task force and Business continuity management – an update).
In 2007 AngloGold Ashanti was recognised by a number of independent entities, NGOs and conferences for its work in delivering sustainable healthcare solutions in the communities in which it operates.
HIV/AIDS remains an issue of concern in the African countries in which we operate, with the most significant affected areas in Sub-Saharan Africa. Generally, the estimated prevalence levels at our operations are in line with similar demographically segmented portions (that is, predominantly males of working age) in the general population.
It is estimated that the HIV/AIDS prevalence levels amongst employees at the South African operations in 2007 remained stable, at around 30% of the workforce.
Prevalence levels are estimated at around 8% at Navachab in Namibia, at between 15% and 20% at Geita in Tanzania, at between 3% and 4% at Sadiola/Yatela and Morila in Mali, at 3% in Ghana, and at 4.5% at Siguiri in Guinea. While the prevalence level at Geita is far higher than the estimated Tanzanian national average of around 9%, the prevalence rate at the mine is consistent with the level in Mwanza Province in which the mine is located. The same applies to Siguiri mine in Guinea, where the prevalence level in the province and at the mine is higher than the national prevalence level of 1.5%.
The group’s HIV/AIDS programme in South Africa is the most comprehensive as this is where the disease has had its greatest impact, and additionally, where the company has the greatest number of employees. For this reason, the performance that is covered below relates primarily to the South African operations.
The key objectives of the group programme are: minimising the risk of HIV/AIDS on the company and its employees by reducing and ultimately eliminating new infections; efficiently managing those infected and supporting those with advanced AIDS.
AngloGold Ashanti’s HIV/AIDS programme is grouped into three areas:
Extensive education and awareness programmes are in place at various operations in an effort to halt the spread of the disease and to reduce and eliminate the stigma associated with it. (See case studies: success in recruiting peer educators at Great Noligwa mine in South Africa and the launch of the HIV/AIDS programme at Iduapriem).
Voluntary Counselling and Testing (VCT) forms a cornerstone of every HIV/AIDS programme and is available, directly or through nearby facilities, at every operation. All our African operations encourage VCT in a strictly controlled anonymous environment that provides not only for further options in terms of treatment but guarantees confidentiality and support by the company.
A great deal of emphasis is placed on VCT at the South African operations, with VCT targets being an important part of performance management at senior levels. In 2007, 33,435 VCT encounters were recorded and, assuming single testing, this represents around 102% of the South African workforce (2006: 75%). Of those tested, 65% have had a single test during the year, while 35% had two or more tests. Of those tested during the year, 20% were HIV positive and 80% HIV negative.
At a number of the African operations outside of South Africa VCT is undertaken by third parties (such as state hospitals or jointly-funded centres). Not all the statistics are available to the company and hence cannot be meaningfully reported. At some operations, where VCT is offered to dependants and community members, statistics are captured for all VCT encounters and not for employees alone.
Two significant achievements during the year were the successes achieved in promoting VCT: at Siguiri mine in Guinea more than 1,000 community members participated in VCT during the year; similarly, at Iduapriem in Ghana, a new state/mine partnership saw the rapid growth in VCT in the second half of the year, with 41% of employees participating in a programme that was also extended to dependents and contractors.
In line with the significant increase in VCT in South Africa, so there has been a similar rise in the participation in the wellness programme – as those who have tested positive are persuaded to understand and manage their health.
At the end of December 2007, there were a cumulative 4,610 participants in the wellness programme, with 1,182 people joining the programme for the first time. The comparative figures for the end of 2006 were a cumulative total of 3,554 patients, with 1,252 new enrolments during the year.
Anti-retroviral therapy (ART) is available to all employees at the African operations either directly from company facilities (South African operations, Navachab in Namibia, Obuasi in Ghana, Siguiri in Guinea), through company sponsored or funded facilities (such as Iduapriem in Ghana, Geita in Tanzania, and Morila in Mali) or through state facilities (Sadiola/Yatela in Mali).
In South Africa, a cumulative net total of 2,061 employees are being provided with ART, through AngloGold Ashanti Health in West Wits and Vaal River. A total of 189 patients previously receiving ART withdrew from the programme for a variety of reasons, including poor adherence, retirement, resignation and death. In 70% of these cases ART was no longer considered to be medically indicated for a variety of reasons. It should be noted that in South Africa ART is provided by the state and efforts are made to support the transition by referring employees on ART to state-run facilities. In 2006, the corresponding statistics were 1,467 patients on ART, with 617 new patients during the year.
In 2002, AngloGold Ashanti took a decision to provide ART to employees where this was medically indicated, in advance of the state-provided ART programme that followed in 2004. At that time the company was faced with either introducing what was deemed to be a high-cost intervention (in the form of ART) or face the reality of rising death rates (peaking at 14 people per 1,000 employees in 2004) and consequent impact on the company, employees and their communities. The loss of a breadwinner in the South African context could have an impact on more than 10 people, very often in rural and poverty-stricken areas of Southern Africa.
Over the past five years, however, drug access and affordability have improved and the cost implications have not been as significant as had originally been envisaged. Interventions with ART have increased both the physical and economic lifespan of those affected, and limited the social consequences associated with the loss of a breadwinner. In addition, outcomes to date indicate improved levels of absenteeism of affected individuals, lower costs of medical care and lower than expected recruitment costs.
In total, 763 employees in South Africa left the employment of the company as a result of ill-health in 2007. Although not all of these separations were as a result of AIDS it is likely that this was the reason behind some of the ill-health formal medical separations. In 2006, this figure was 993.
Approximately 285 people died because of illness while in the service of the company in South Africa in 2007 (2006: 305 people). It is estimated that AIDS was one of the main courses of these deaths. This figure has declined, largely as a result of the provision of ART. Statistics for operations outside of South Africa are not disclosed for reasons of confidentiality as the numbers are so low.
Total expenditure on the company’s HIV/AIDS programme in South Africa amounted to approximately R25.15 million in 2007 ($3.6 million) (2006: R21.5 million). This excludes medical care (for example admissions for opportunistic infections) and other costs associated with ill-health retirement, recruitment, training and productivity losses.
Malaria remains an area of concern for AngloGold Ashanti’s operations in Ghana, Guinea, Mali and Tanzania. Not only does the disease result in death, illness and absenteeism amongst employees, but the disease is a major cause of death in young children and pregnant women, with an obvious impact on employees’ families and communities.
Key elements of the malaria control programme are depicted in the diagram below:
An extensive malaria programme is in place at Obuasi and the lessons learnt here are being applied elsewhere (See case study Lessons learnt at Obuasi to lead other programmes). Malaria rates have declined consistently over the past three years –from 25% in the first quarter of 2005, to 15% in the first quarter of 2006 and then again to 7% in the first quarter of 2007. Because of seasonal changes in malaria incidence, it is appropriate to compare quarterly rates.
In 2007 the programme was audited by The National Institute of Communicable Diseases (South Africa) and the Noguchi Institute of Ghana, with an overall score of 95%.
A revised integrated malaria control programme was launched at Geita in Tanzania in September 2007, with indoor residual spraying of the Mchaura staff village and all mine vehicles. Spraying is being extended to Geita Town (a population of around 140,000 people) in 2008.
Work began during the year on the development of an integrated campaign at Siguri in Guinea, modelled on the programme at Obuasi. Professor Richard Hunt of the University of the Witwatersrand’s Department of Entomology, undertook a survey at the mine to identify the malaria vector (carrier) mosquito in the region, and possible insecticide resistance by these vectors. This has provided valuable insight into the malaria programme planned for 2008. (See case study on Study on Siguiri mosquitoes to inform malaria programme).
In addition to monitoring the incidence of malaria (that is known and diagnosed), the company has developed a malaria lost-time injury frequency rate (MLTIFR). This is expressed as the number of cases (incidents) due to malaria for every million man-hours worked, and allows the rate to be compared with the conventional LTIFR.
The incidence of malaria has continued to decline at Obuasi in Ghana following the third year of the integrated malaria control campaign, from 164 per 1,000 employees in 2006 to 61 in 2007.
At Iduapriem, the incidence of malaria decreased from 8.6% to 7.8% during the year. At Morila mine in Mali, the malaria incidence remained unchanged at around 2%.
AngloGold Ashanti Annual Report 2007 – Report to Society