Tuesday May 31 2011
Business Investing in Malaria Control: Economic Returns and a Healthy Workforce for Africa, the sixth report in the Roll Back Malaria Progress & Impact Series, examines how private sector investment in malaria control has improved cost effectiveness at companies operating in malariaendemic regions in Africa. Companies in Equatorial Guinea, Ghana, Mozambique, and Zambia have worked to prevent malaria among their workers and workers' dependents and have seen an excellent return on investment, with significant reductions in malaria-related illnesses and deaths, worker absenteeism, and malaria-related spending.
A summary of key messages
- Malaria is bad for business: the disease is responsible for decreased productivity, employee absenteeism, increased health care spending, and can negatively impact a company's reputation. A 2006 report found that nearly three-quarters of companies in the Africa region reported that malaria was negatively affecting their business.
- Malaria infection in company employees can impact the local economy because the overall labor force is weakened by sickness and absenteeism, savings are lost, commerce is slowed, investments and tax revenues are reduced and public health budgets are diminished.
- Companies have been able to scale up malaria control quickly and have seen a rapid return on investment. Malaria-related spending at three company clinics in Zambia decreased by more than 75%, and a very conservative estimate showed that the companies gained an annualized rate of return of 28%.1
- Strong models exist for businesses to take leadership roles in controlling malaria, protecting their workers and their families, strengthening their businesses, and extending programmes into communities.
- The private sector is a critical partner and can collaborate with and complement national programmes to resource and implement effective malaria control. The benefits reaped by malaria control efforts in the business context are fragile and can be temporary unless durable investments are made to ensure continued success.
Malaria hurts business
A report published in 2006 found that nearly three-quarters of companies in sub-Saharan Africa reported that malaria was negatively impacting their business, with 39% perceiving the impact to be serious. Varying reports estimate that during a typical malaria episode, a worker misses between one and ten days of work and often return to the workplace exhausted and less productive. Many companies provide healthcare for their employees and bear the cost of medical expenses when employees or their family members are ill. In addition to affecting individual workers, malaria can also damage the economic environment in which businesses operate, impacting the availability of local resources and public health budgets, and slowing economic growth.
The companies profiled in this report have demonstrated that the private sector is a powerful partner, capable of implementing effective malaria prevention programmes to quickly reduce malaria-related health-care expenditures, worker absenteeism, and illnesses and deaths.
Investing in malaria control pays off
Involvement in the fight against malaria helped build these companies' reputations for social responsibility and good corporate citizenship. It also had a significant leveragig effect. These companies used their diverse competencies and infrastructure to attract partners and resources, securing funding from external donors and jumpstarting scale-up interventions that otherwise would not have taken place.
Strong models now exist for the involvement of the private sector in malaria control:
- Three companies in Zambia 3 Mopani Copper Mines, Konkola Copper Mines, and Zambia Sugar—have made dramatic progress in a ten-year period. The number of malaria cases in company clinics dropped 94%, from 27 925 per year to 1631 and the number of malaria-related lost work days also dropped 94%, from 19 392 per year to 1133 (see Figure 1).
- In 2004, in the Ghanaian community of Obuasi, gold producer AngloGold Ashanti was seeing as many as 6800 malaria patients per month at the company's hospital, out of a total workforce of 8000 people. AngloGold partnered with Ghana's National Malaria Control Programme, among others, to implement indoor residual spraying, distribution of bednets, and rapid diagnosis and treatment. By 2009, only 1100 patients were visiting the hospital each month and monthly malaria medication costs at the company had fallen from US$ 550 000 to US$ 9800.
- In Bioko Island, Equatorial Guinea, Marathon Oil partnered with business partners and the Guinean Government to develop a five-year US$ 15.8 million initiative that increased the percentage of young children protected by bednets or indoor spraying of insecticides from 4% to 95% and reduced malaria parasite prevalence in children by 57% in just four years. The project, which won several high-profile awards for social responsibility and good citizenship, was extended through 2013 to develop local capacity and enable the programme to reach the mainland.
- During the first two years aluminum smelter BHP Billiton was operating in Mozambique, the company reported 6000 malaria cases, 300 medical evacuations, 13 fatalities, and incurred US$ 2.7 million in malaria costs while it was being built. The company partnered with the Lubombo Spatial Development Initiative to help reduce malaria infections from 625 cases per 1000 population to fewer than 200 cases per 1000 in the Maputo Province of Mozambique. In addition to savings from absenteeism and health care costs averted, the initiative's success helped secure two grants totalling US$ 47 million from the Global Fund for regional control of malaria.
Malaria control is a cost-effective business investment that offers a rapid rate of return. Both small and large businesses have proven to be critical contributors in the fight against the malaria, whether they work independently or partner with national governments. Supporting malaria control is a contribution that the private sector can and should make; strengthening their businesses while savings lives.
Yearly malaria cases reported in company health clinics for Zambia Sugar, Mopani Copper Mines and Konkola Copper Mines, Zambia, 2001–2009 The number of malaria cases dropped dramatically in each of the company health clinics between 2001 and 2009. This figure includes malaria cases of employees and dependents. Where possible, other non-employee and family cases are excluded.
Sources: Company data from Zambia Sugar, Mopani Copper Mines (MCM) and Konkola Copper Mines (KCM).
1 Internal rate of return (IRR) measures and compares the profitability of different investments; the higher the IRR, the more desirable it is to undertake the project.
Tim France is the P&I Series Project Manager at the RBM Secretariat in Geneva. Hard copies of the report are available on request.