Events for ETI Members

ETI Members' Roundtable 3
Tackling HIV/AIDS in the workplace

TGWU, London
17th April 2002

• Background and purpose of roundtable
• Who participated?
• Key points from presentations
  1. Setting the scene
  2. Impact of HIV/AIDS on the workforce & business - a corporate perspective
  3. HIV/AIDS and children - experiences from Zimbabwe
  4. TU action on HIV/AIDS with a focus on the transport sector
  5. The ILO Code of Practice on HIV/AIDS
• Key discussion points
• Recommendations: what ETI can do
• Recommendations: first steps for companies to take
• For further information…
   
• Advance Flyer
   

 

Background and purpose of roundtable

At the ETI AGM in 2000, HIV/AIDS emerged as an issue of increasing importance to companies, particularly those with operations in Africa. It was clear that a greater awareness about the impact of the disease and how to deal with it in the workplace was required. This roundtable was organised by the ETI in conjunction with the Trades Union Congress (TUC) in response to this demand.

 

Who participated?

This was our most popular roundtable to date. Overall there were 27 participants from ETI member organisations, representing 9 companies, 3 NGOs, 4 trade union organisations and the International Labour Organisation (ILO).

 

Key points from presentations

1. Setting the scene

Introduction by Peter Brannen, Director of ILO London Office

The scale of the problem - headline figures

At a global level… 40 million people are estimated to be living with HIV/AIDS, 25 million of whom are of a working age (15-49 year-olds); by 2010 it is estimated that there will be 30 million AIDS orphans.

The poorest are the worst hit, in particular sub-Saharan Africa…two-thirds of the total world population with HIV/AIDS live in sub-Saharan Africa; 50% of teachers in Uganda have HIV/AIDS; and an estimated 60% of the national health budget in Uganda will be spent on HIV/AIDS in 2025.

Impact of HIV/AIDS

For the worst hit countries, HIV/AIDS not only has a tragic human/personal impact, it also has a devastating social, political and economic impact, including the following: it cuts the labour supply, cuts skills, creates recruitment problems, cuts productivity, can increase discrimination and the burden on women, cuts family income leading to increased child labour, cuts the tax take and hence the ability to meet increasing demand for health facilities and other support services, and leads to increased security problems - many young people who know they will die young, so they stop caring and get violent.

…but it can be tackled!

• Mozambique, Uganda and Brazil have managed to control HIV/AIDS (with money, high-level commitment & concerted action)
• Kofi Annan - estimates that $10 billion can solve the problem, globally
• Experience shows that the workplace is an important and effective place for fighting back against HIV/AIDS
   

2. Impact of HIV/AIDS on the workforce & business - a corporate perspective

Presentation by Michael Pennant-Jones, Premier Brands.
For full presentation notes, contact Adil (adil@eti.org.uk)

Example: In one southern African country, on a tea estate that Michael has visited, 65% of all persons have or have recently had a sexually transmitted disease (STD). The incidence of STDs are often used as an indicator of infection rates in high risk AIDS areas. On the same estate, 5 university graduates were taken on as management trainees. 5 years later only 1 of these trainees is still alive, and he too was close to death - all from AIDS.

This story is a human tragedy, but it is also an urgent warning signal for business. If you don't have a workforce, you don't have a business. HIV/AIDS affects all employees and transcends all boundaries - it affects managers and skilled workers as well as the unskilled.

Effects of HIV/AIDS on labour: shortfall of management and skilled staff, with direct operational consequences; greater reliance on casual labour leading to an unskilled workforce.

Effects on business operations: lower operating standards, lower quality and consistency of output, lower ability to maintain equipment. Quality and consistency of product are essential in the export market, so lower quality and consistency mean loss of competitiveness on the export market.

Effects on cost: rise in personnel costs (recruitment, training, welfare benefits), increased requirement for medical facilities, housing (increased demand to house casual workers, and dependants of workers suffering from AIDS). Such extra costs can make the difference between being profitable or not, especially in the low quality markets and for smaller producers.
 

3. HIV/AIDS and children - experiences from Zimbabwe

Presentation by Anne Heaton, Save the Children.
For copy of presentation slides contact Adil (adil@eti.org.uk),

Background

There is no doubt that HIV/AIDS is presenting the world with some enormous challenges. This presentation focused on just one of these challenges that Save the Children has particular experience of, one which Anne believes is the most important to business in the long run but which is often overlooked: how HIV/AIDS affects children, and what this means for business. By 2010, it is estimated that 30-40 million children will be orphaned by HIV/AIDS, 95% of whom will be in Africa…and all of them will somehow need to earn their keep.

Child labour is an effect of HIV/AIDS, but it can also be a cause. Children affected by HIV/AIDS are likely to be pushed into work as their sick parents are unable to earn, as medical costs absorb the family income, and even as the family budget is stretched to cover children of relatives who have died. At the same time children are more vulnerable to HIV infection in a working situation due to the risk of physical and emotional abuse: most obviously where the child becomes a sex worker, for example in areas attracting male migrant labourers e.g. mining, but also in other work situations where their junior rank and desperate need to earn is exploited by others.

SCF experience in Zimbabwe

SCF has been working to improve conditions for workers on commercial farms in Zimbabwe. Since 1995, SCF has worked with a local NGO, the Farm Orphan Support Trust (FOST), to develop sustainable community-based care for orphans on commercial farms.

Problems identified by SCF/FOST: rapid increase in problem - in 1995 1 orphan in every 2 farms, in 2001 on average 12 orphans on every farm. Majority of orphans live with a single parent, small number of child-headed households, remainder cared for by extended family members (likely to be the future trend). Problems faced by families caring for AIDS orphans: additional costs, leading to adults working more, children working, cutting back on food eaten, taking girls out of school to accommodate fostered boys; lack of skills and time to counsel orphans; vulnerability of eldest child in child-headed households.

Positive responses from farmers and communities: income generation e.g. establishment of farm welfare funds - each family pays an agreed amount into fund, distributed to foster families; food security & nutrition e.g. vegetable gardens and chickens at pre-school sites from which each child is fed at least one meal a day, farmer provision of land for foster families with labour contributed by other workers and their families; education e.g. farmers pay for children's primary school education, "learn and earn" schemes; tackling child exploitation e.g. awareness-raising for farmers and workers on child labour legislation, setting up child worker support groups (FOST, AEAAZ), farmers employing eldest sibling of child-headed households on part-time basis on pro rata adult salary; HIV training/awareness-raising for farmers, carers, children.

3 pointers for business

1. Wake up to HIV/AIDS! Do a risk assessment of HIV/AIDS in your supply chain, appoint a Board member to be responsible for HIV/AIDS, develop a policy, encourage others.
2. Recognise the child dimension to HIV/AIDS
3. Link workplace HIV/AIDS policies & programmes to community programmes - this is important to ensure effectiveness of interventions e.g. income-generating schemes for carers/spouses of employees with HIV/AIDS.
    

4. TU action on HIV/AIDS with a focus on the transport sector

Presentation by Bernhard Barth, International Transport Workers' Federation (ITF). For copy of presentation slides contact Adil (adil@eti.org.uk),

HIV/AIDS & the international trade union movement: TUs concerned about HIV/AIDS because of its economic & social impacts (as discussed in previous presentations), its implications for child labour & human rights (including stigma & discrimination leading to increased vulnerability & delayed treatment, unequal access to medication), & because good workplace policies can help address many of these problems. The international TU movement's responses include supporting action in the workplace (prevention, fighting against discrimination), putting pressure on pharmaceutical multinationals to lower the price of medicines essential for AIDS treatment, and lobbying WTO to change intellectual property agreements to allow production of cheaper generic drugs in poorer countries.

Focus on the transport sector: Transport workers are particularly vulnerable to HIV/AIDS due to: high level of mobility and frequent absences from home, insecurity and vulnerability to harassment, male-dominated/macho culture (truck drivers, sailors), limited access to health care (for treatment of STDs). The ITF intervenes by encouraging appropriate workplace policies (e.g. adapting work schedules to allow for more frequent home stays), practical interventions e.g. setting up STD/health clinics at truck-stops, incorporating HIV/AIDS issues into collective bargaining, lobbying, and raising awareness in co-operation with governments, NGOs and international organisations.
 

5. The ILO Code of Practice on HIV/AIDS

Presentation by Bernhard Barth, International Transport Workers' Federation. Bernhard was involved in preparing the ILO code. For copy of presentation slides contact Adil (adil@eti.org.uk). See also the ILO Code of Practice itself - details in "For Further Information", below.

Background: The Code is a set of guidelines for governments, employers & workers to help them develop concrete responses to HIV/AIDS at enterprise, community & national levels. Agreed by tripartite expert meeting, May 2001.

What the Code aims to achieve: To help workplace partners to prevent the spread of HIV, manage and mitigate the impact of HIV/AIDS, provide care and support for those infected and affected by HIV/AIDS, and combat the stigma and discrimination surrounding HIV/AIDS.

In particular, the Code can be used to develop a workplace policy & programme on HIV/AIDS: the Code encourages consultation and collaboration between employers and workers, sets out key principles to guide working terms and conditions, and sets out a programme of action for prevention, care and support.

Relevance to ETI corporate members - note from Secretariat: Although it is quite general in scope, the ILO Code could be a useful starting point for retailers to develop guidelines on managing HIV/AIDS in their supply chains. It could also be used as a basis for developing a checklist to be given to your suppliers in countries seriously affected by HIV/AIDS, to help them develop a work place policy and programme for addressing HIV/AIDS.

 

Key discussion points

Role of companies in health care provision: Poor access to appropriate health facilities and treatment is a major constraint in tackling HIV/AIDS in poor countries. Can companies play a role in improving access? In East Africa, where corruption is rife in the public sector, often the best hospitals in rural areas are those provided by companies. This can have both positive and negative knock-on effects - sometimes this can galvanise governments to provide more facilities in rural areas, at other times the government may respond by "leaving it to the private sector". In some places companies providing health facilities compete with the government for scarce resources e.g. trained nurses. The best response in the long run is therefore to try and integrate/work with the national government health systems.

Child labour: One participant asked for further exploration of the link between HIV/AIDS and child labour and how this should be tackled. There seemed to be an underlying assumption that HIV/AIDS orphans should be supported to "work their way out of poverty". But isn't this a poorly conceived strategy? Studies show that in general child labour is associated with very low incomes and low productivity - so is this really any good for the child or for the company?

Different approaches required for men and women: HIV/AIDS doesn't always affect men and women in the same way - women are biologically more susceptible than men to contracting HIV, often higher social stigma attached to women with HIV/AIDS making it even more difficult for them to get help, women tend to be the ones lumbered with taking care of AIDS sufferers. Need to address these different needs when designing and implementing programmes.

 

Recommendations: what ETI can do

• Carry out risk assessment of the supply chains of ETI corporate members: find out which are high-risk locations, industries, for more focused activity. Doing this collectively will be more resource-efficient than each member carrying out their own risk assessment (?)
   
• Provide a library of HIV/AIDS expertise, resources and contacts… including region-specific information and contacts that retailers can give to their suppliers (farm/factory manager). Region-specific information likely to be most useful to suppliers.
   
• Promote partnership approach: ETI should promote a partnership/collaborative approach to tackling HIV/AIDS. This is seen to be important because getting to grip with HIV/AIDS requires a concerted effort - no-one can do it alone. ETI is in a good position to promote this given its tri-partite structure. Secretariat note: not sure if there was a specific recommendation here?

 

Recommendations: first steps for companies to take

The speakers were asked to propose first steps for companies in tacking HIV/AIDS in the supply chain, to help companies to prioritise given the scale of the problem. The recommendations were as follows:

• Risk assessment of supply chain - find out which are high-risk locations, industries, for more focused activity.
   
• Education and awareness, prevention - promote education and awareness of basic facts and preventative measures along the supply chain, encourage suppliers to raise awareness amongst their workforce.
   
• Non-discrimination - ensure policies/practice in place to prevent discrimination against workers with HIV/AIDS.
   
• Start the dialogue - HIV/AIDS is not going to be controlled overnight, but start the dialogue with suppliers, NGOs, worker representatives etc.

 

For further information…

There are several spare copies of the following documents at the ETI Secretariat…available on a first-come first-serve basis. Otherwise, copies are available as specified below:

An ILO code of practice on HIV/AIDS and the world of work. International Labour Organisation, 2001. See comments on the Code in the summary of the presentation on this subject, above. The code can be printed directly from the following
Website: http://www.ilo.org/aids (pdf format).
Alternatively, a hard copy can be ordered from the International Labour Office, Millbank Tower, 21-24 Millbank, London SW1P 4QP.

Overview of Private Sector, Labor and Government Response to HIV/AIDS Pandemic in Zimbabwe: a desk study. Prepared for Africa Now by Hope Chigudu and Associates, March 2002. The first 5 pages provide a useful summary of practical initiatives taken by companies to prevent and manage HIV/AIDS in the workplace, factors affecting a company's vulnerability to HIV/AIDS, and an analysis of costs of preventative measures. Copies available from Malcolm Ridout, Africa Now, 4 Rickett Street, London, SW6 1RU
email: mridout@africanow.org

Delivering the goods: HIV treatment for the poor. Insights Health No. 2 (March 2002). Provides tools and "good practice" examples of HIV/AIDS programmes around the world. Looks mainly at rural community-level and national/regional government programmes, but provides practical ideas that may be useful for the workplace setting. Copies available from ID21 at the Institute of Development Studies, University of Sussex, Brighton BN1 9RE, UK.
Phone: 01273 678 787
email: id21@ids.ac.uk
Web: www.id21.org

Work in progress….the following resources are currently being developed:

A workbook on AIDS, gender and child labour. Being developed by Traidcraft. Contact Gillian Mann, Traidcraft Exchange, Kingsway North, Gateshead, Tyne and Wear, NE11 0NE
Phone: 0191 491 0591.

A toolkit (for companies?) on managing HIV/AIDS. This is currently being piloted in South Africa. For further information and/or if you wish to take part in the pilot, please contact Fiona King, Save the Children, 66 South Lambeth Rd., London, SW8 1RL
email: f.king@scfuk.org.uk

Tools for managing HIV/AIDS in the workplace. This has just been completed (?) by the Global Business Council on AIDS.
(Sorry I don't have contact details here).

ILO/AIDS education handbook. This is being prepared by the ILO to accompany its Code of Practice on HIV/AIDS. It is being drafted with assistance from ETI member Stirling Smith, Labour & Society International. Drafts of six sections ready by mid-April. For more information contact Stirling Smith
email: stirlingsmith@lsi.org.uk