Responding to the impact

The company is a multi-national one and operates in 13 countries across Africa. The company has not conducted formal prevalence assessments in any of the locations (including South Africa) but has launched its current HIV/AIDS policy and initiatives within the context of what it refers to as “responding to the impact”.

The impact period began in 1996 where the company started experiencing significantly increasing numbers of staff deaths believed to be AIDS-related, with considerable disruption to production and operations. Although up until 2001 certain countries responded with increased awareness and education programmes, these were having little effect on the losses. The company believed that its HIV/AIDS policy was limited in its effectiveness and too broad in its approach.

Initial response

Based on its experience of rising HIV/AIDS death rates, the company believed little value would be gained from prevalence testing. The company felt that a strategy to address the situation directly and immediately would yield the best operational results, and would contribute favourably towards employee morale and limiting further infections. The strategy identified three initial “drive levers” that could be implemented, to improve the workplace environment.

•    VCT as well as post VCT services for all staff in Africa.

•    Increase HIV/AIDS education intensity at all locations.

•    Increase access to ongoing HIV/AIDS counselling at all locations.

The breakthrough

A detailed cost-benefit analysis was commissioned to evaluate the full economic cost of the impact of HIV/AIDS on the African operations. The evaluation also assessed the cost of providing real care services to the employees that would reduce the direct and indirect costs associated with taking no action. A financial benefit was shown and the plan was implemented.

The package of benefits being provided to all staff in Africa include:

•    ARVs for the purposes of extending lifespan and optimising the productivity of each staff member with HIV/AIDS.

•    Psycho-emotional counselling to staff and dependants to address the impact of HIV/AIDS and a range of other emotional problems such as violence, financial hardship and substance abuse.

•    Anti-retroviral drugs to all registered dependants to limit the effects of “sharing drugs”, particularly where more than one family member is believed to be infected.

•    A lifestyle, education and nutritional programme for all staff whether they are infected or not, to improve wellbeing among all staff.

The core values associated with the decisions to implement the programme recognise the company’s responsibility to take a stand against HIV/AIDS, to understand the contribution that it can make to the psychological wellness of its workforce and to save lives and “buy time” in the African HIV/AIDS environment. The unique decision to provide ARVs to dependants as well, responds appropriately to the strong African culture of sharing. This immediately alleviates the problems of compliance to the dosages of the anti-retrovirals, and the moral dilemma for the company and family around the choice of which lives are to be preserved.