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The critical role of the private sector in the battle against HIV and AIDS in the workplace was at the centre of discussions at the Second Private Sector Conference on HIV/Aids.

Three debates on the first day looked at broad issues around prevention, leadership and effective delivery of medical care, while the second day included sessions highlighting the private sector response to the pandemic in terms of medical, cultural and social factors.

It opened with the Johannesburg Work the Future road show, one of five Work the Future talks to have happened around the country. Organised by Metropolitan in collaboration with SABCOHA and Business Unity South Africa (BUSA), these talks were interactive sessions at which the private sector response to the National Strategic Plan for HIV and AIDS and STIs 2007-2011 (NSP) was explained to business leaders.

A Live the Future multimedia presentation explored how HIV/AIDS and our responses to it would shape the future of South Africa by 2025.

Following the road show, the SABCOHA chief executive, Brad Mears, who was the chairperson of the conference, spoke about a private sector strategy of zero tolerance to better respond to the pandemic. There should be zero tolerance for new infections, zero tolerance for AIDS deaths, zero tolerance for babies born with HIV, and zero tolerance for discrimination.

Starting off the debates were issues around HIV prevention; Pierre Brouard, the deputy director of the Centre for the Study of AIDS, based at the University of Pretoria, was a panelist.

"It was acknowledged that one reason why we are failing to lower infection rates is because while there has been strong emphasis on the medical and behavioural aspects of prevention, like telling people the importance of HIV-testing and having responsible sexual relations, not enough work has gone into addressing social and structural factors within communities to bring down infection rates," Brouard says.

These social issues include changing norms and beliefs which drive up HIV infections, and putting more laws and policies in place to counteract issues like discrimination, which stop people disclosing their status to their partners.

Panelists pointed out that health services and access to education needed to improve to prevent new infections. They noted that HIV prevention messages were too broad and simplistic and needed to be tailored to suit specific communities.

Mears was a panelist in the second debate, which focused on leadership. He says: "There was a call for leadership to be more vocal, visible and specific in addressing the epidemic. Leaders should remember to address their constituents on HIV/AIDS issues, rather than only addressing the country as a whole. They also need to become more lateral in their thinking."

In the third debate, which looked at effective delivery of medical care, Dr Kgosi Letlape, the executive director of The Tshepang Trust, was highly critical of the huge differences between the quality of private health care and that offered by the public health care sector.

"Not enough South Africans have access to quality health care," he stated. "Everyone deserves health care of a decent standard and we will achieve this through having greater solidarity. I want to see good treatment services for all who need it, not just for those who can afford it."

The trust is a South African Medical Association initiative that provides various HIV/AIDS services.

While Letlape appreciates the opportunity the conference gave him to express his views, he feels there were not enough representatives from the public health care sector on his panel. It should have included patients from the public and private health care sectors.

"We can't talk about patients without them being there ... We need to engage with those we support."

On the last day of the conference, Rachel Tau, a health and wellness peer educator at Pamodzigold Gold Mine in Springs, spoke about working with peer educators to identify and respond to risky sexual networks. "I highlighted the great need for peer educators to inform miners about the risks of having multiple sexual partnerships. Many miners work far from their families and find new girlfriends and wives in the vicinity of the mines, which drives the spread of HIV."

Not only are miners hit hard by HIV/AIDS, but so are the children left orphaned by the disease. Kim Feinberg, the chief executive of The Tomorrow Trust, spoke about the organisation's various initiatives, which include getting corporates to sponsor the education of orphaned young people and provide them with work experience once they graduate.

"The response to our work was excellent," says Feinberg. "It's great that the conference provided a platform to share and open people's eyes to what's happening, but I feel more CEOs should've attended as they make final decisions."

Offering an interesting mix of thoughts, themes and perspectives, the conference included Lee Sarkin, of the Actuarial Society of South Africa, who focused on the monitoring and evaluation (M&E) of access to and effectiveness of treatment in the private sector.

There was an urgent need to measure progress towards meeting international and national commitments that had been made by United Nations heads of state worldwide. These included the Millennium Development Goals, the 2001 Declaration of Commitment on HIV and AIDS, the 2006 Political Declaration, and the NSP-M&E framework.

He said these commitments contained time-bound targets which necessitated implementation of M&E frameworks to ensure that progress towards meeting them could be measured. To highlight the urgency, he pointed out that were half-way to the 2015 target for achieving the MDGs; the 2010 target for achieving universal access to HIV prevention, treatment, care and support was fast approaching; and the mid-term review of the NSP was scheduled for 2009.

SABCOHA, the Southern African HIV Clinician's Society, the AIDS Law Project and the Actuarial Society of South Africa are collaborating to support implementation of the M&E requirements of the NSP and the United Nations. An inaugural private sector M&E seminar for providers of HIV and AIDS treatment and care is being planned for early 2009.

Other sessions included exploring the connections between women's health, HIV and work; the integration of TB into workplace programmes; and investment by the private sector in public health care management.

On comparing this year's conference with the inaugural Private Sector Conference in April 2006, Mears says: "This conference was better attended and featured a wider range of topics than the previous one. The context of this year's conference was different as we now have a health minister who isn't in denial about our HIV/AIDS crisis and there has also been restructuring of the South African National Aids Council [SANAC]."

The Second Private Sector Conference on HIV/AIDS gave delegates greater knowledge and renewed enthusiasm and inspiration to continue the fight against the pandemic. By Thandiwe McCloy for SABCOHA

Click here to view all the presentations given at the conference:

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