Private Sector

Unpacking HIV and AIDS Policy Implementation

In our November 2004 issue of share the Durban Chamber Foundation representative, Mr Amar Sooklal, outlined some of the key elements of a successful HIV and AIDS workplace policy. Top of his list were the need:

? For workplace programmes to be driven by CEOs of companies;
? For a workplace forum where all employees, at all levels, can be equally involved and openly engaged in HIV and AIDS related planning and implementation;
? To reduce and regularise the costs and quality of training provided by consultants so that SMMEs could afford to train, and
? For mutually beneficial partnerships around HIV.

He said that this would enable and encourage SMME?s to develop workplace HIV and AIDS programmes, as a major stumbling block for most small businesses is the lack of capacity and resources necessary to implement such programmes.

HIVAN decided to see for itself how this advice has translated into practice in some of the leading companies in South Africa. This opportunity presented itself when a HIVAN representative attended a recent think tank on development and implementation of HIV Policies for the Workplace. Case Studies were presented by De Beers Consolidated Mines, Roche Products (Pty) Ltd, Rand Water and Eskom. The AIDS Consortium then provided some useful reflections on how HIV and AIDS is viewed at the community level.

While development of an HIV and AIDS policy has become something of a buzz word in the sector, its important to be clear on what we mean by ?policy? and what the core elements of such a policy would be. Firstly, there is an important distinction to be made between a policy and a law. Policies and codes of good practice are the SPIRIT of the law (Rajesh Latchman, AIDS Consortium). They are not prescriptive, but embody a commitment on the part of the organisation and its staffing to conduct themselves in a particular manner. Policies only become law once courts have used them as a basis for their decision-making. Second, policies can be fairly short documents that lay out particular codes of conduct, or they can be fairly lengthy, and encompass goals, outputs, plans and timeframes for implementation of the policy.

Lessons from the companies:

Space constraints prevent us from sharing the full stories of each of the companies that presented. As a result, we have focused on two diverse case studies from De Beers (mining) and Roche (pharmaceuticals).

A recent survey conducted by SABCOHA (South African Business Coalition on HIV/AIDS) found that HIV and AIDS-related illness and death is threatening the productivity and profits of the mining sector, with over 60% of mines reporting lower profits. Brad Mears, CEO of SABCOHA commented that amongst the sectors surveyed, the mining and manufacturing sectors were by far the worst affected (UN Integrated Regional Information Network, 26 Nov 2004, www.allafrica.com). It is encouraging therefore to hear from De Beers, how HIV and AIDS is being proactively planned for at all levels within the company.


De Beers has a Southern Africa focus, with mining interests in South Africa, Botswana and Namibia. In South Africa there are 10 000 employees and prevalence is estimated at 10%. AIDS has been identified as one of the 5 key risks to the company, and as such has been integrated into the everyday business process. Tracey Peterson, HIV/AIDS Manager outlined the 5 key elements of the De Beers Strategy as (1) Saving lives (2) Living with HIV and AIDS (3) Minimising the economic impact for De Beers (4) Communications strategies specific to each mine and local community (5) Stakeholder involvement / Partnerships.

Peer education has been the foundation of their programme to save lives. The programme has extended well beyond education and awareness-raising, and encompasses both the mine, all mining contractors, and the surrounding community. Being a peer educator involves a serious personal commitment for employees involved. Peer education is built into the key performance areas of employees trained as peer educators. They are expected to work closely with the AIDS Programme to develop monthly campaign themes, materials and programmes relevant to the needs of the mining community, and they present regularly on HIV and AIDS to their fellow employees at shift meetings. Peer educators are offered incentives, rather than a monetary reward for their efforts, and are given time off within their shift to carry out these activities.

De Beers runs a wellbeing programme for all employees that involves a comprehensive treatment programme (run by Aid for AIDS) and TB management on site. Since August 2002, treatment has been extended beyond the employee to their ?life partner? where this can be provided in a responsible and sustainable manner. Costs are fully subsidised by De Beers. They also provide management training and address issues of stigma and discrimination in the workplace. Monitoring and evaluation is ongoing to ensure that De Beers does all it can to minimise and plan for the impact of HIV on the company. This process has included review of business practices, processes and policies, a cost impact analysis, two sero-prevalence surveys, KAP (Knowledge, Attitudes, Practices) surveys and the use of balanced scorecards.

Roche Products (Pty) Ltd

The impetus to develop the Roche Pharmaceuticals HIV and AIDS policy came from the CEO who attended the World AIDS Conference in 2000. Roche aimed to integrate HIV into the core business of the company and ensure the sustainability of their HIV programme. Meaningful employee involvement in the development and implementation of the HIV policy was provided through the establishment of a representative task force, elected from its 500 staff. Partnership with GTZ provided essential technical and practical training and assistance in development of the policy and implementation. This was however on the understanding that the Roche task force would be able to take these efforts beyond their three year partnership with GTZ. The task force wrote the policy between January and September 2002, and required examination of a number of internal issues at Roche so that the policy best met the needs of Roche as an organisation.

The final document was short and easy to read. All employees were given a copy and made aware of where help was available in the company and how to access this. Confidentiality was assured. The Roche spokesperson, Faith Masilo, commented that employees learnt to cope and work through their own fears, and so were able to lead this effort for the company.

Key to the success of the policy and its implementation has been good communication on the policy within Roche. For example, managers are aware which of their employees form part of the task force and receive minutes of these meetings so that they can accommodate the additional workload and responsibilities that these employees carry. This helps to avoid frustrations that might otherwise arise from having employees away from their workstations.
Roche is confident in the policy and its implementation within the company. Milestones include a prevalence study (saliva tests) conducted in March 2003 in which 99% of employees participated. Prevalence was 8%. A VCT campaign followed in September 2003, with 31% participation. An occupational health clinic on the premises continues to offer VCT daily. Aid for AIDS (AFA) has been contracted to provide HIV/AIDS related assistance to all HIV-positive employees. As this programme is not linked to Roche Human Resources Department, confidentiality is ensured and employees can use the system with confidence. At this stage, the service is not extended to family members.

Roche will be concentrating for the near future on (1) providing managers with appropriate training to manage HIV related discussions with employees and (2) assisting employees to manage their VCT results (3) the integration of chronic illnesses into the programme, and (4) developing a monitoring and evaluation system.

Aid for AIDS provides a network of HIV and AIDS trained medical practitioners, private doctors and mine doctors and will source doctors where no local doctor is available. Many companies choose to use Aid for AIDS to support a comprehensive treatment programme for their employees. Aid for AIDS works in collaboration with company medical aid schemes, but as all administration is separate from that of the company, confidentiality is ensured. Aid for AID provides general guidelines to companies on uptake but will not divulge the category of employee or any personal details of patients to the company. Contact Stephen Laverack, Education and Awareness Manager, Aid for AIDS on Tel: (021) 514 1700 Fax: (02) 514 1771; Email: a[email protected]

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