Over the past few years, advances in malaria prevention and treatment have resulted in dramatic reductions in malaria deaths in Africa. To keep this momentum going, Senegal Sugar Company (Compagnie Sucrière Sénégalaise or CSS), in close partnership with the Senegal National Malaria Control Program (NMCP) and the international organization Path, set a more ambitious goal: zero local transmission of malaria in Richard-Toll district of northern Senegal.
Producing over 100,000 tonnes of sugar per year and with a turnover of $140m, CSS has confirmed itself as a leader in the sugar industry in West Africa. Now a household name, the company provides an important source of foreign exchange for Senegal and, critically, provides jobs to more than 7,000 people in its base city, Richard-Toll, making it the country's second largest employer.
Most company directors will state that their first responsibility is to their shareholders. It is in this fiduciary capacity that the decision was made three years ago to contribute to the malaria elimination program.
Focusing on malaria creates many benefits for the company, its employees, and the community. During decades spent as members of the Richard-Toll community, CSS realised the importance of good employee health to our business model. Its inhouse medical team has been treating employees for malaria for many years, but beginning in 2012 CSS decided to be more aggressive with the disease and joined with partners in adopting the vision of a malaria free district.
CSS needed data to develop an effective malaria elimination strategy. So, in collaboration with partners and especially the district health team, the company sent researchers into the community to take a baseline survey. The data convinced us that we should focus on malaria testing and appropriate treatment, case monitoring, community education, and health commodity distribution.
CSS interventions include:
• Mosquito net distribution to all CSS employees and their families
• Malaria awareness sessions on correct and consistent use of bed nets
• Confirmation of all suspected malaria cases with rapid diagnostic tests (RDTs) as recommended by the country's case management policy
• Testing of the rest of the family along with other households surrounding each positive index case
• Immediate use of artemisinin-based combination therapy (ACT) for confirmed malaria cases
• Systematic documentation of all malaria cases
Before entering into this partnership, on average, 20 cases of malaria were recorded per day. Six months after beginning the interventions, we were only seeing four cases per month. The costs associated with treating the disease have rapidly declined as well. Whereas costs used to reach $23,000 per year to treat employee malaria, they have now been reduced to $300.
But that is not the entire story. In addition to dramatically reducing some of our health care costs, the project has also had a great impact on our productivity. Now workers need less recovery time because the disease is treated as soon as the diagnosis is confirmed. They are therefore able to return to work more quickly and reduce absenteeism. There also is decreased burden on our microscopy lab (because diagnosis is now being done with RDTs) and an increase in our employees' disposable income.
Elimination offers long-term benefits to the entire nation as well. Malaria costs the government of Senegal millions in prevention and treatment each year, and more in lost worker productivity. Malaria elimination could free national resources for education and workforce development, as opposed to spending money on prevention and treatment.
Based on the results of the Richard-Toll project, CSS is more committed than ever to the elimination initiative and remains a proud, key partner to the National Malaria Control Program as it leads our nation to a malaria free future.
André Froissard is managing director of Senegal Sugar Company. Dr Mady Ba is manager of Senegal National Malaria Control Programme.
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