HIV/AIDS - ISSUES FOR THE WORKPLACE PRINCIPLES, PLANNING, POLICY, PROGRAMMES AND PROJECT PARTICIPATION Rose Smart HIV/AIDS Consultant South Africa

Preamble Only fifteen years ago, if one had called business, labour, government and non government representatives together to discuss how to deal with the AIDS epidemic, most would not have even more than a fleeting idea of what it was, let alone why they should discuss it. Today, companies have lost top managers, workers have lost colleagues and huge amounts of time, energy and emotion have been spent pre-occupied with issues of illness and loss. Whole families have collapsed, while companies struggling against a background of chronic poverty have taken on deeper burdens of dependency

Statement of the problem AIDS causes illness, disability and death to workers and severe economic and emotional disruptions to their families. It also increases the cost of doing business. Disease prevention and health promotion are not commonly thought to be business concerns. The HIV/AIDS epidemic has forced a reconsideration of this position.

Ten Workplace Facts(1) Fact - The crisis is immense - AIDS is a real problem affecting workers and business operations - many companies are losing around 3% of their workers to AIDS each year Fact - 80% of HIV transmission in Southern Africa occurs due to heterosexual sex Fact - Young adults have the highest levels of infection and our nation’s economically active population, parents of young children and future leaders are at greatest risk Fact - AIDS will decrease life expectancy in South Africa by 20 years to about 40 by the year 2008 Fact - HIV has increased the burden of ill health and mortality in the 15 - 50 year age group two to three fold. According to the ILO, an average of 15 years of working life will be lost per employee due to AIDS

Ten Workplace Facts(2) Fact - The indirect costs of HIV/AIDS are greater than the direct costs. The costs of lost time have been consistently shown to be the most significant costs to companies Fact - HIV infected persons have 5 - 10 years on average of asymptomatic productive working life. This period can be lengthened by health promotion and stress management. Fact- Transmission of HIV poses little or no risk in most work settings Fact - Averting an HIV infection through prevention programmes yields a cost benefit ratio to companies of anything from 1:2 to 1:400 Fact - The workplace is an appropriate and important setting for AIDS programmes because workers spend a significant amount of time at work.

Ten Workplace Principles(1) The following principles apply to the workplace setting: Principle 1: Promote non-discrimination and openness around HIV/AIDS Principle 2:: Because AIDS is a preventable disease it makes sense to offer prevention education to all workers and to specifically invest in targeting situations of high risk Principle 3:: AIDS prevention works - we can change behaviour. But, information alone is not enough to change behaviour. Behaviour change is only possible if we reach solutions by developing our own responses and people need to be taught skills to enable them to put the information into practice

Ten Workplace Principles(2) Principle 4: Education needs to be complemented by supportive services Principle 5: AIDS programmes in the workplace can help control the epidemic and reduce the impact on businesses Principle 6: Effective AIDS prevention yields enormous savings in averted AIDS costs Principle 7: The most powerful change agents are our friends and peers Principle 8: The involvement of people living with HIV/AIDS is central to an effective workplace programme

Ten Workplace Principles(3) Principle 9: AIDS programmes must be simple, specific, concrete and verifiable. Use core management principles (simplicity, focus, precise targets, strong performance monitoring) and an explicit results chain (required inputs, outputs, outcomes and impacts) Principle 10: Strategies and projects in areas of economic and social development which address poverty, income inequality, the bargaining power of women, housing, migrancy and so on will address the underlying factors which fuel the epidemic

Planning A three-stage process is recommended to ensure optimal workplace HIV/AIDS/STD/TB policies and programmes Step One Identify factors related to your workplace which result in HIV infection i.e. put the epidemic in its social, economic and cultural context (i.e. who is infected or vulnerable to infection and why) by identifying what is known, what is not known and what information needs to be collected Collect information on: structural issues (demography of the workforce, migration, risk factors in the workplace), health issues (STDs, TB) and policy issues

Planning: Step Two Identify the obstacles and opportunities: (i) at worker level relating to the context within which people live and work in respect of the resources that they have access to in the choices that they are empowered to make (ii) at organisational level in respect of education and awareness in respect of health care in respect of social development in respect of impact analysis

Planning: Step Three Identify priorities for action which are realistic exploit inherent resources will receive support from management, workers, clients and community leaders Plans must encompass the three cornerstones of an effective response to HIV/AIDS, namely: Prevention, Care, Non-discrimination

Policy There are significant benefits to developing and adopting an HIV/AIDS/STD/TB workplace policy which: defines a company’s position sets a foundation for the HIV/AIDS programme provides a framework for consistency of practice expresses standards of behaviour expected of employees, supervisors and management sets standards for communication about AIDS lets employees know what assistance is available assures consistency with Government and international statutes

Characteristics of a Successful HIV/AIDS/STD/TB workplace policies are formulated around principles of non-discrimination, equity and confidentiality, rights and responsibilities are developed in consultation are based on current medical knowledge and scientific information are dynamic and able to adapt to changing situations are communicated to all existing and all new staff members

Programme The benefits of an HIV/AIDS/STD/TB workplace programme include: reducing STDs = reduction in risk behaviour = HIV infections prevented reducing absenteeism, morbidity and mortality creating a more tolerant and accepting attitude towards HIV infected workers producing positive effects on morale and productivity promoting the company’s image as a good corporate citizen

Successful HIV/AIDS/STD/TB programmes: have top management support are developed, implemented and monitored by bipartite committees are integrated into general health promotion programmes are backed by access to a company health service build environments for long-term behaviour change monitor impact through collection and review of company health, sick leave, turnover and productivity data provide training and information support to staff managing the programme have a forum to exchange experiences and ideas

Project participation: Among the many benefits of company participation in community HIV/AIDS/STD/TB projects are the following: increasing the capacity of communities to deal with HIV/AIDS allowing for the loaning of company resources and skills such as: marketing, advertising, public relations communications and publishing information technology market research employee volunteers training resources donation/loan of equipment distribution networks

Project participation: other benefits facilitating the establishment of partnerships improving inter-sectoral co-ordination and communication supporting socio-economic development

Successful project participation embraces the vision of the National AIDS Programme builds alliances with community based organisations facilitates the sharing of resources is responsive to cultural issues

Conclusion Employers of today find there are an ever increasing number of social burdens being placed on them. Although the law does not require an employer to develop a workplace AIDS policy and programme, to do so makes good business sense and makes for good labour relations. It gives a clear message to the workforce that the employer is committed to social issues, enables employees to protect themselves against possible infection, provides the employer with an opportunity to plan for the impact of HIV/AIDS and allows for the minimising of the impact of the epidemic