Business and AIDS: Lots of concern, little cash

Business and AIDS:  Lots of concern, little cash"We are burying about three truck drivers a day because of AIDS, and at this rate we will have no drivers left by 2003," says Paul Matthew, acting chief executive office of the Road Freight Association'€™s training board. But even though forecasts for the trucking industry are dire, Matthew says it'€™s a "slow process" getting employers to put money into fighting the epidemic.

“We are burying about three truck drivers a day because of AIDS, and at this rate we will have no drivers left by 2003,” says Paul Matthew, acting chief executive office of the Road Freight Association’€™s training board. But even though forecasts for the trucking industry are dire, Matthew says it’€™s a “slow process” getting employers to put money into fighting the epidemic.

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“Trucking Against AIDS”, which educates truck drivers about the epidemic, was only launched in June once transport companies had digested what the disease would soon do to their businesses.

Logically, the RFA should be training more drivers than they need currently, given the gap that will soon need to be filled. But many “see training as a burden”, says Matthew.

This seems to be the theme song of many businesses’€™ response to HIV/AIDS. They express concern, but few will invest hard cash in managing the disease.

Big companies who are aware of the risk ‘€“ such as Old Mutual, Anglo American and SA Breweries — are aggressively pursuing overseas interests.

But many furniture and clothing retailers, who have lured customers with generous credit, seem to be playing a waiting game — despite the fact that forecasts show that their target market will have 20 percent less income in five years’€™ time.

Mineworkers, like truck drivers, are in the HIV/AIDS high-risk bracket. Most still live in single-sex hostels far from their families, and use the services of sex workers.

Chamber of Mines health adviser Dr Lettie le Grange says the mining industry has been involved in “AIDS education, information and awareness” since the mid-1980s.

But she adds that while “97 percent of our mineworkers are fully informed about HIV/AIDS, there has not been a change in behaviour. People will only start to change once they see people dying.”

But few mineworkers die on the mines. When they start to get sick, they are retrenched or medically boarded and sent home to die.

Anglo American’€™s Marion Brower says the corporation’€™s first HIV positive employee was diagnosed in 1986, and since then it has “developed and implemented a comprehensive AIDS prevention policy”.

Anglo says it has put “millions of rands” into AIDS prevention and caring for people with HIV and AIDS. But critics say that mining houses have not done enough for the workers who have built their industry at great personal cost.

For example, in Carletonville, the biggest gold-producing town in the country, the CSIR has set up a successful project to manage HIV/AIDS. But while Anglogold and Goldfields benefit from the project, neither contribute a cent to it.

Dr Brian Williams, who heads the CSIR project, says the mines have a “history of externalising the long-term costs of occupational diseases and they have found that they can continue to do this with HIV”.

As HIV is a “slow disease” that takes about five years to manifest itself, the mining houses can “get five productive years out of mineworkers, then get rid of them when they start to get sick”, says Williams.

But AIDS consultant Dr Clive Evian, who has been in the field for over 10 years, is more benevolent in his assessment of business. He believes that “there’€™s more happening in business than anywhere else”.

“Once companies do a risk analysis and see what it’€™s going to do to their profits, they get a wake-up call,” says Evian.

But he says that the only way for a company to assess its risk is to test staff anonymously, and unions often refuse to allow members to be tested.

One company that recently managed to conduct tests with union blessing is Eskom. The parastatal, which employs 38 000 people, is widely considered to have a good HIV/AIDS policy, which it started to develop in 1993.

This year alone, Eskom will spend R4.6-million on its HIV/AIDS policy, says AIDS education and training officer Thomas Tshabalala.

Eskom’€™s commitment to fighting the epidemic is shown by the fact that it ranks the implementation of its AIDS policy as a key performance area for it business units, alongside other core functions.

But even though Eskom started planning earlier than most companies, it has had to drastically cut back on medical aid benefits to HIV positive staff. This is partly because its 1995 risk analysis was based on national HIV prevalence figures, rather than on the infection rate of Eskom staff.

In 1997, the company offered an HIV positive staff member and partner R100 000 a year for treatment. Last year, it slashed this figure to R15 000 as “the queue for the HIV treatment was longer than we expected and there was a danger that our medical aid would go down the drain,” says Tshabalala.

Old Mutual is widely complimented for its community HIV/AIDS work. In the past year, it has spent R1-million training school students as AIDS educators. It also co-sponsors the TV series, Soul City, and two centres for HIV positive people.

Sadly, Old Mutual’€™s reputation is somewhat tarnished by the fact that its own HIV positive staff are excluded from the company’€™s medical aid. However, AIDS consultant Zinzi Mgolodela says limited cover will be probably be offered next year.

While the costs of HIV/AIDS can be measured in human terms ‘€“ about 2 000 people dying each day in five years’€™ time ‘€“ it is far more difficult to say how this will affect the country’€™s gross national product (GNP).

Many of the dead or infected are low wage earners or unemployed, so they contribute little to the GNP. At the same time, wealthier people can afford antiretroviral drugs to slow down the transition of their HIV infection to AIDS, thus prolonging their economically productive years.

Professor Alan Whiteside, who heads Natal University’€™s Health Economics and HIV/AIDS Research Division, says businesses (other than those in service industries) may well adapt to lessen the impact of sick or dead staff.

“They may, for example, decide to move towards capital intensification or outsourcing of non-core business functions,” says Whiteside. Or they could opt for “multi-skilling of staff so that there is more job flexibility. Or they could employ extra staff.”

What business doesn’€™t understand, says Whiteside, is that government does not have this flexibility. It cannot easily replace sick officials and government’€™s lack of capacity is going to affect business badly ‘€“ from fewer Home Affairs officials to process work permits to fewer police officers to fight crime.

The Partnership against AIDS, launched by government last year, is beginning to draw government and business together. But national guidelines on how business should manage the epidemic are needed urgently so that everyone is pulling in the same direction. ‘€“ Health-e news service.