HIV & Business Overview

man-walkingHIV/AIDS is impacting on economic activity and social progress around the world. Only now are the hidden costs of HIV/AIDS to business coming to light. Besides the costs to individual companies, HIV/AIDS is hampering human resource development, undermining the skills base and driving away foreign investment. The benefits of a proactive approach far outweigh the costs of doing nothing.


Why is HIV my business?

Over 90 percent of people with HIV/AIDS are in the most productive period of their lives – be they workers, managers or employers. According to the International Labour Organisation as many as 36 million of the 39 million people living with HIV are in some form of productive activity. There is no doubt then that HIV/AIDS affects business – causing costs to escalate and markets to contract. While many would argue that business has a moral responsibility to help tackle the worst health crisis the world has seen in 700 years, there is also the matter of the bottom line.

Research shows that if companies invest in prevention and treatment programmes, the savings outweigh the costs. Providing care and treatment for HIV-positive employees can reduce the financial burden of HIV/AIDS by as much as 40 percent. For more information see a presentation by Sydney Rosen. Daimler Chrysler showed that the savings from preventing a new infection in its South African workforce ranged from $25 000 to $280 000, depending on the job level.

How badly is my company affected?

For anyone doing business in South Africa, 10 – 40 percent of the workforce is likely to be infected with HIV. But the impact and potential impact of HIV/AIDS varies from one company to the next. Labour and capital-intensive industries, as well as those with a high mobility of labour, are most affected. Research in South Africa shows that the mining, metals processing, agribusiness and transport sectors are most affected by the pandemic, with more than 23 percent of employees infected with HIV/AIDS and with prevalence rates two to three times higher among skilled and unskilled workers than among supervisors and managers.

What are the direct consequences of HIV/AIDS on companies?

Companies are directly affected by lower productivity, greater absenteeism, vacant posts, the need to retrain and rehire workers, reduced productivity due to staff inexperience or illness, loss of morale among employees, poor labour relations, less reliable supply chains and distribution channels … the list is endless. Other direct costs to companies depend on whether they offer employment benefits, funeral cover, pensions and in-house medical facilities.

On a general level, HIV/AIDS is affecting business by increasing poverty and therefore lessening the demand for goods and services. It is also increasing demands for state spending, placing strain on the government’s capacity to deliver health and welfare services. When breadwinners die or lose their jobs due to illness, poverty spreads. When students and school children drop out of learning institutions because they or their family members are ill, the skills base is continuously eroded. Years of development, skills building and intellectual knowledge are undermined by the loss of productive members of our economy.

Why is business perfectly positioned to get involved?

Business has direct access to those most affected – the productive members of our society. The workplace is the ideal environment for tackling the epidemic as employers and employees group together regularly in an environment where communication systems to disseminate information and undertake education programmes exist.

Business is good at making things happen: with its focus on problem-solving, target-setting and speedy delivery, programmes can be run effectively and efficiently. Core skills of business – such as media, marketing or training – can also be harnessed for in-house programmes or to support community or NGO initiatives.

What are the benefits of involvement for my company?

There is no doubt that HIV/AIDS has an effect on the markets generally and on consumer behaviour. A healthier labour force generates more spending power and a more vibrant economy generally. And besides the moral imperative to save lives and the direct financial savings to the company resulting from more productive employees whose health and lives are prolonged with ARVs, there are other direct benefits too:

  • Some companies have achieved recognition and accolades around the world for their involvement in combating HIV/AIDS.
  • Companies risk falling behind as others take the lead in the fight against HIV/AIDS.
  • Sound programmes have been shown to boost staff morale and improve labour/employer relations.
  • With the business sector now facing growing pressure from organised labour to do their bit, proactive measures can head off the potential for industrial conflict.
  • The public/private partnerships being forged to strengthen HIV/AIDS programmes can result in mutually beneficial co-operation in other areas.

What should my company be doing?

Every company should have an HIV/AIDS policy and a programme in place, with four key elements:

  • prevention
  • care and support
  • protection of infected or affected employees from stigma and discrimination
  • monitoring and evaluation of the programme.

Whether services are offered in the company or by partnering institutions or organisations depends on the nature and size of the company. Putting policies and programmes in place can involve costs, time and other resources that smaller companies just don’t have. But there is help at hand. See our Case Studies to find out what others are doing. SABCOHA’s toolkit gives step-by-step guidance on how to tailor-make a programme to suit the needs and budget of your company. For very small businesses, SABCOHA runs BizAIDS, a programme to empower businesses with 10 or fewer employees to protect themselves against HIV/AIDS.

What are other companies in the country doing?

Those industries most hard-hit by the epidemic, such as the mining, manufacturing, transport and financial sectors, are further down the road than others like the building, construction, retail and wholesale sectors. Some, like De Beers and Anglo Platinum, have developed fully-fledged workplace HIV programmes that have now evolved into broader wellness programmes.

The latest research shows that between 60 – 80 percent of mining, manufacturing, financial services and transport companies have implemented HIV and AIDS awareness programmes. SMME’s, overwhelmed by the challenge and hampered by resource shortages, are lagging far behind the bigger companies in tackling the epidemic in the workplace. For more information see the Bureau for Economic Research’s 2005 Survey on “The Impact of HIV/AIDS on Selected Business Sectors in South Africa”.

Where do I start?

SABCOHA offers a Workplace HIV/AIDS Toolkit, which is a comprehensive, step-by-step guide to implementing a workplace HIV/AIDS programme. Produced in partnership with Unilever and Standard Bank the toolkit is aimed at small and medium-sized businesses. However, it is also of relevance to bigger businesses whose supply chains are threatened by HIV/AIDS. The toolkit enables bigger companies to help their smaller partners and associates by providing them with an easy-to-use workplace guide. To buy a toolkit, click here .

Also look at the experiences of other companies for guidance on what works – or doesn’t work – in our Case Studies section. But remember, there is no “one size fits all” for workplace HIV/AIDS programmes, as each company has unique characteristics and challenges that call for a range of different responses. The most effective programmes integrate the key components of non-discrimination, prevention, testing and treatment, and monitoring and evaluation.

What will it cost my company?

Although companies should aim to establish a budget for an HIV/AIDS programme or for specific HIV/AIDS-related activities, some interventions can be implemented at little or no cost. Collaboration is the key word: avoid duplication and reinventing the wheel by doing some preliminary research to see who is doing what. Look at our Case Study section for examples of best practice and what to avoid. Smaller companies can team up to share costs; resources, services and expertise may be found in the community or business environment itself. St Leger and Viney (click – story in Case Study folder) is an example of a small company that has created a programme using public resources. SABCOHA also helps companies to access funding.

Doing a “risk assessment”

Assessing the extent of the threat posed by HIV/AIDS to your company is usually the first step towards setting up an HIV/AIDS workplace programme. This can entail: finding out existing levels of HIV/AIDs infection among employees and/or surrounding communities (some companies do anonymous testing to find out prevalence rates in the company), calculating the cost to company of HIV/AIDS-related employee absence, low productivity, hospitalisation or death, and calculating the costs of implementing a programme. Some companies use KAP studies (assessing Knowledge, Attitudes and Practices) to assess the level and extent of intervention required.

The ins-and-outs of VCT

VCT programmes must be part of a broader HIV/AIDS programme that enables the employee to access HIV prevention, care and – if necessary treatment. VCT should also be part of a broader health service delivery for employees so that they don’t view the initiative as an attempt to “screen” them. And unless a VCT programme is run in a climate of confidentiality and non-discrimination, it will fail.

VCT campaigns in the workplace have been shown to be only partly successful, with uptake rates seldom more than 45 percent, due to stigma, denial, fear and ignorance. This means that uptake for treatment– even if offered free by the company – is also low. Many South African companies and medical aids report low uptake of treatment.

Research shows that compulsory counselling and voluntary testing ensures better testing rates among employees. Also, campaigns led by senior management and characterised by short, intensive “know your status” drives, have significantly increased uptake rates. Some companies now use the HIV saliva test, which is quick, accurate and easy to use.

Treatment programmes

Employers can prolong the health and productivity of employees living with HIV/AIDS by offering care, treatment and support services – either in the company or by partnering with health care providers in the private or public sector. Research shows there are large savings to be made regarding a reduction in death, disability and sick leave costs as well as human resource and medical costs. A service – whether in-house or not – needs to include the treatment of other sexually transmitted diseases, opportunistic infections, particularly TB (less costly than ARVs), counselling support, ARVs, home-based and palliative care.

Due to partnerships with government, medical aids, international donors and NGOs, ARVs are now far cheaper and easier to access.

Community Outreach

Successful interventions seldom operate in isolation and many companies implementing HIV/AIDS workplace programmes soon see their initiatives impacting on a broader community: the employee who goes home to a family; the community living near the workplace; the consumers who buy products …

Forging partnerships with other organisations in the surrounding community generates new awareness about community needs and offerings. Read our Case Studies for inspirational examples of HIV/AIDS initiatives that have evolved into fully-fledged outreach programmes. Anglo PlatinumDe Beers and Daimler Chrysler South Africa are excellent examples.

Where can I find more information on setting up an HIV/AIDS Workplace Programme?