The company is a manufacturing and distribution group operating in the construction industry with a total of 1 450 employees. The primary factory employing one-third of the staff is located in the North West Province while the balance of the employees are nationally distributed in 60 locations around South Africa, with significant clustering in the major metropolitan areas.

During 1999 and 2000 a number of employees in the North West factory started presenting with HIV/AIDS-related symptomatic conditions at the company’s on-site clinic. The company began to consider the consequences of HIV/AIDS into the future and believed from literature and various sources that the HIV/AIDS prevalence rates in their area in the North West Province, could be as high as 25%. The scenario of managing such a large number of infected employees and the social responsibility in the community around its factory were both of real concern.

A further factor in the evaluation was that the company had made attempts to have certain employees (who were often unfit for duty) boarded out in terms of the permanent disability insurance procedures. A number of these applications had proved unsuccessful as the HIV/AIDS sufferers displayed erratic periods of being unfit for duty resulting in insufficient evidence to qualify for permanent disability.

The initial strategy

A strategy was formulated for the main factory workers, where the prevalence was considered to be highest in the company, with three main components:

•    A "shadow workforce" would need to be trained and multi skilled based on projections to replace lost employees.

•    An unused facility would be converted into family living units and the surrounding area would be cultivated into suitable land for subsistence farming. This new facility was to function as a hospice for employees once they became unable to work. A trust was to be created to sponsor and support the facility.

•    All employees would be educated on lifestyle changes, nutrition and other matters relating to the disease.

The strategy was a defensive one, and prior to implementation the company believed it should review the assumed prevalence rates that were driving this strategy, and develop a reliable risk assessment.

The need for a revised strategy

It was decided to conduct anonymous prevalence saliva tests in the workforce initially in the North West Province and in the Western Cape. The results were found to be considerably lower than expectations. The North West site tested 7.8% HIV-positive on 80% of this workforce, while the Western Cape sites tested 7,1% on 95% of this workforce that volunteered.

With the lower prevalence rates, the company believed that a number of different proactive strategies were now financially viable and practical. A new HIV/AIDS policy is being formulated with the co-operation of the unions, and includes a comprehensive ill-health policy with clear grievance procedures to protect the HIV positive employees in the workplace.

The company has adopted a policy that provides for an ex gratia retrenchment package to AIDS-disabled workers who do not qualify for permanent disability insurance. The policy further provides that these employees and dependants have access to the company medical facilities for one year.

Following the results in the first two regions, the unions in other regions are not only supporting the initiative but are also requesting saliva testing. A decision to provide anti-retroviral medication will be considered once the saliva test results have been received from all locations in the country. Knowledge attitude and practices (KAP) studies are being commissioned for a number of regions to measure HIV/AIDS pointers and provide guidance for education programmes.