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| Introduction |
| Impact of HIV on Business |
| Response from the Business
Sector |
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| Introduction
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| AIDS is a workplace issue not only because it affects
labour and productivity, but also because the workplace
has a vital role to play in the wider struggles to limit
the spread and effects of the epidemic. |
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| HIV/AIDS threatens the livelihoods of many workers
and those who depend on them - families, communities and
enterprises. In doing so, it also weakens national economies.
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| Over 40 million people are living with HIV/AIDS in
the world. Nine out of every ten are adults in their productive
and reproductive prime. At least 26 million are workers
aged 15 to 49, in the prime of their working lives. Discrimination
and stigmatisation against women and men with HIV threaten
fundamental principles and rights at work, and undermine
efforts for prevention and care. |
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| The effects are felt by enterprises and national economies
as well as workers and their families. The epidemic strikes
hard at the most vulnerable groups in society including
the poorest of the poor, women and children, exacerbating
existing problems of inadequate social protection, gender
inequalities, and child labour. |
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| Four main factors make young workers particularly vulnerable
to HIV/AIDS: the lack of opportunities for decent work,
discrimination, lack of influence and representation,
and poor social protection. These 'decent work deficits'
increase the likelihood of infection among young workers,
and deepen the social and economic impact of HIV/AIDS.
Young people typically face a higher level of insecurity
than other workers. They will often be the last hired
and the first fired, and may be subject to unacceptable
working conditions and very low pay. Young people are
almost three times as likely to be unemployed as adults
and make up the majority of those who are in informal
work. |
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| Many societies accord a subordinate status to young
people and have little respect for their rights; young
workers themselves are often unaware of their rights,
or lack procedures to redress grievances - for example,
discrimination on the basis of HIV status. They are therefore
at a disadvantage when it comes to identifying and confronting
bullying or sexual harassment in the workplace. |
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| Of the 1.2 billion young women and men who will enter
the labour force over the next decade, many will be affected
by HIV/AIDS, directly or indirectly. In heavily hit countries,
the loss of household income puts pressure on children,
particularly girls, to discontinue schooling in order
to help supplement family income or to care for the sick.
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| Furthermore, the world of work will have to adjust
to the approximately 14 million orphans affected by AIDS,
many of them deprived of schooling or adult mentoring,
and who will reach working age in the next decade. |
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| Impact on businesses |
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| After about two decades of the epidemic, the link between
HIV and business is no longer conceptual. Areas worst
hit by the epidemic, provide myriad examples of loss of
productivity at the industry, business sector and country
levels. |
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| 1. The population structure of a country
can change into hitherto unknown patterns. |
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| The usual population structure has a 'pyramidal pattern'
with the maximum number of individuals in infancy and
the number coming down gradually as the age rises. |
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| When there is a major HIV/AIDS epidemic, large sections
of infants could die due to Mother to Child Transmission.
This combined with high mortality rate in the reproductive
age group and unchanged mortality pattern among the elderly
produces a 'chimney pattern'. |
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| 2. AIDS related costs |
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| The business sector where management of costs has a
critical role is faced with increasing levels of AIDS-related
costs. |
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| AIDS related illnesses and deaths of workers affect
employers by increasing their costs and reducing revenues.
They have to spend more in areas such as health care,
funeral, training and recruitment of replacement employees.
Revenues may be decreased because of absenteeism due to
illness or attendance at funerals as well as time spent
on training. Labour turnover can lead to a less experienced
and therefore less productive work force. However, the
relationship between HIV/AIDS and the costs and revenue
of employers has rarely been examined systematically up
to now. Moreover, little data is available on enterprises.
Overall there is bound to be a reduction in profits if
companies do not take early measures to prevent the impact
of HIV/AIDS. |
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| Employers are unlikely to be affected significantly
by HIV/AIDS where those employees who have to leave the
labour force can be replaced without loss of productivity.
This may happen in countries with high unemployment and
underemployment rates. However, in view of the expected
impact of HIV/AIDS on the composition of the available
workforce, there is likely to be a mismatch of human resources
and labour requirements in terms of qualifications, training
and experience. Other significant impacts may include
a loss of markets where the purchasing power of the population
declines. |
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| In view of these factors, some companies have already
begun to hire or train two or three employees for the
same position, if it is feared that employees in key positions
may be lost due to AIDS. Employees can also be replaced
by importing labour from neighbouring countries, at the
risk of creating a bigger immigrant sub-population, which
is often more vulnerable to HIV infection. |
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| HIV/AIDS has led to increased demands for spending
for health and social welfare, and the cost of insurance
benefits for households, companies and governments has
increased. Some companies have reported a doubling of
medical expenses over a five year period, while employees
who fall ill have to divert their savings into medical
care. Greater claims are being made on group life insurance
and health schemes. |
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| 3. Loss of skilled human resource: |
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| Some of the specific skills needed for business are
even now available in limited supply. Shortage of a specific
skill translates as high cost of hiring. HIV could deplete
the already limited supply of these skills and push the
cost of hiring up. This would increase the cost of production
and decrease competitiveness. |
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| 4. Decreased availability of capital:
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| Shifting of government spending to social sector harm
mitigation and lower private savings because of decreased
earning power and higher spending on HIV lead to decreased
availability of capital for the business sector. |
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| 5. Sectoral impacts in business: |
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| Within the business sector, there are certain sectors,
which are more vulnerable than the others. These are typically
sectors, which require the workers to stay away from their
homes for long periods of time. Examples in this category
would include transport, mining and fishing sectors. Sectors,
which rely on seasonsal and short-term workers, such as
agriculture construction and tourism, are also particularly
vulnerable to the impact of HIV/AIDS. Moreover, sectors
which rely on highly trained personnel, are also in danger
of being adversely affected by HIV/AIDS because the loss
of even a small number of specialists can place entire
systems and significant investments at risk. |
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| 6. Issues in the informal sector:
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| While information and experience of addressing HIV/AIDS
in large scale formal enterprises is beginning to be accumulated,
the same cannot be said of the informal sector or small
enterprises, where majority of the workers are to be found.
Given the very high percentage of employment found in
these enterprises, there is an urgent need to amass knowledge
of the situation of HIV/AIDS in these enterprises, identify
best practices on how to address the problem and develop
practical and innovative approaches and tools to prevent
HIV/AIDS and mitigate its impact in these sectors. One
approach, which should undoubtedly be investigated more
thoroughly, is the development of prevention and care
programmes in the context of the mutual health funds,
which are being established for small enterprises and
informal sector operators in many countries. |
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| Response from
the business sector |
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| Business houses in some countries have shown encouraging
responses in protecting their human capital. |
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| The response from business have included
the following approaches |
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- Ongoing formal and informal discussion and education
on HIV/AIDS for all staff
- An equitable set of policies that are communicated
to all staff and properly implemented, including protection
of rights at work and protection against any discrimination
at work
- The availability of condoms
- Prevention and rehabilitation programmes on drugs
and alcohol
- Diagnosis, treatment and management of sexually
transmitted diseases, for employees and their sex
partners and
- Voluntary HIV.AIDS testing, counselling, care and
support services for employees and their families
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| In addition to these innovative initiatives have been
launched by business houses. In India, Apollo a major
tyre manufacturer has set up health clinics on high ways.
The response from the truck drivers to this programme
has been very encouraging. |
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| In a growing number of countries, employers have formed
business coalitions on HIV/AIDS to pool resources and
improve their response to the crisis in their workplaces
and communities. Such business coalitions facilitate the
inter-country and even inter-regional exchange of experience. |
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| Special measures by health insurance providers: Certain
health insurance providers have also established facilities
specifically designed for persons with HIV infections,
which guarantee and at the same time cap payments for
HIV related treatment. These schemes currently provide
enough benefits to cover a significant share of the cost
of treatment, but employers are already worried that,
as the proportion of HIV infected workers rises, they
will not be able to maintain benefits at these levels.
Often more radical changes in the way that insurance schemes
work are needed. |
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| Business realizes the disadvantages of HIV/AIDS testing:
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| With a view to anticipating loss of workers due to
HIV/AIDS, many companies would like to know the proportion
of the workforce they are likely to lose through AIDS.
However, increasingly, employers are beginning to recognize
the tremendous negative impact of pre-employment and on
the job HIV screening. Testing the existing workforce
is not only unethical, but leads to great hostility and
is incompatible with effective HIV/AIDS prevention and
care programmes at the workplace. Companies are beginning
to find that, by abandoning testing requirements, a conducive
climate can be created for workplace prevention programmes.
A steadily increasing number of employers in the worst
affected countries are reaching the conclusion that prevention
is much more cost effective than HIV screening in the
long term, and that respect for the rights of workers
is a powerful tool in its own right. |
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| Challenges before the business community:
Employers urgently need assistance in developing tools
to calculate the cost of HIV/AIDS for their enterprises.
Work is also needed to adapt existing prevention programmes
to the needs and circumstances of specific enterprises
and sectors, with emphasis on especially vulnerable sectors.
Employers also need to be encouraged to work through their
organizations to exert pressure for action at the national
level, pool resources and knowledge for company programmes,
and develop means and tools to reach out to small businesses
and the informal sector. |
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| Links and key sources |
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