by Dr. Benjamin O. Alli ILO/AIDS Turin, July 2006

1. Expanding access to HIV/AIDS Treatment, Care and Support through Occupational Health Services and consolidation of public-private partnerships by Dr. Benjamin O. Alli ILO/AIDS Turin, July 2006

2. Essential Facts • 40 million adults live with HIV/AIDS • 70% are workers in their productive prime • They are essential to social safety nets and national development • The world of work can play a key role in the provision of treatment, care and support through OH services

3. Problem statement • Health systems of many African countries are unable to cope with the rapid increase of AIDS patients • Time for OHS of larger enterprises to get involved in care, treatment and support of workers • Enterprises can also be effective in prevention and psycho-social support

4. Relevance of ILO instruments • The ILO Code of Practice on HIV/AIDS and the world of work • The Manual: ‘Implementing the ILO Code of Practice on HIV/AIDS and the world of work: an education and training manual’ • Occupational Health Services Convention, 1985 (No. 161) and accompanying Recommendation

5. Occupational health services Convention, 1985 (No. 161) Occupational health services are responsible for advising the employer, the workers and their representatives on: • The requirements for establishing and maintaining a safe and health working environment to facilitate optimal physical and mental health; • The adaptation of work to the capabilities of workers in the light of their state of physical and mental health.

6. ILO Code of Practice • 5.1 (e) “In countries where employers assume a primary responsibility for providing direct health-care services to workers, governments should offer guidelines to assist employers in the care and clinical management of HIV/AIDS. These guidelines should take account of existing services”. • 9.3 (a) “Some employers may be in a position to assist their workers with access to antiretroviral drugs. Where health services exist at the workplace these should offer, in cooperation with governments and all other stakeholders, the broadest range of health services possible to prevent and manage HIV/AIDS and assist workers living with HIV/AIDS”

7. Objectives • To extend treatment, care and support to the workplace through occupational health services as part of the efforts to scale up or accelerate access to treatment. • To promote Confidential Voluntary Counselling and Testing (CVCT) through “know your status” campaigns – when individuals know their HIV status they can be helped to live more healthily and take appropriate measures to prevent infection.

8. Objectives • To establish/promote community outreach programmes, including the use of mobile clinics to extend treatment, care and support to workers’ families. • To contribute to the management of the crisis of orphans through combined efforts to maintain the health of parents and the incomes of families and to prevent new HIV Infections. • To provide social protection which includes access to social security, medical benefits, health insurance schemes, and other decentralized insurance and income support schemes.

9. Treatment, Care and Support In the context of ILO, it should include • Access to comprehensive treatment • Information on living healthily • Psycho-social support for PLWHA • Access to community referral services • Adapted working conditions • Access to social protection services

10. UNAIDS/WHO 3 by 5 Initiative • Aims to provide 3 million PLWHA with ART by 2005 • Focuses on strengthening national health systems • ILO contribution will be to assist in strengthening OHS to make them effective ART access platforms

11. Focus of ILO action Technical cooperation project to: • Strengthen and organize OHS for effective contribution to national efforts • Strengthen continuum of care though promotion of public-private partnerships • Eliminate the causes of stigma and discrimination

12. Project goals and objectives • Extend treatment, care and support through OH services • Promote CVTC through ‘know your status’ campaigns • Promote creation of community outreach programmes • Create mechanisms to manage issues related to orphans • Improve social protection systems • Promote public-private partnerships

13. Main project activities • Collection of data on existing workplace based OHS and extent of services provided to workers (ongoing survey) • Selection of participating OH services • Creation of multidisciplinary occupational health care (OHC) teams, including mobile teams • Training & education of OHS personnel • Provision of services through a comprehensive care package

14. Achieving sustainable action • Give high priority to prevention • Focus on full integration of management tools and means • Respond to HIV/AIDS in development context, including vocational training and adapted income generating work • Explore creation of innovative social protection systems

15. Expected results • Enhanced capacity of OHS • Improved/expanded Community health care delivery and outreach networks • Enhanced and expanded prevention, CVCT and information programmes • Better Social protection services • Better working conditions and environment for infected workers • Reduction in AIDS related mortality and morbidity

16. International Cooperation Essential to achieve objectives and should include: • International organizations of Employers and Workers such as the IOE and the ICFTU, and their regional and national affiliates • The World Health Organization (WHO) and UNAIDS • Pharmaceutical companies • Donor agencies

17. THE END www.ilo.org/aids