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HIV/AIDS in South Africa

HIV/AIDS and corporations: Meeting human rights and social responsibility APRM - Submission to Parliament Fatima Hassan 1 December 2005. HIV/AIDS in South Africa. About 5.2 million people living with HIV/AIDS in 2005 (ASSA2003 Model) (5.8 by 2010) www.assa.org.za

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HIV/AIDS in South Africa

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  1. HIV/AIDS and corporations: Meeting human rights and social responsibilityAPRM - Submission to Parliament Fatima Hassan 1 December 2005

  2. HIV/AIDS in South Africa • About 5.2 million people living with HIV/AIDS in 2005 (ASSA2003 Model) (5.8 by 2010) www.assa.org.za • 530 000 new HIV infections mid 2004 to mid 2005 • 340 000 AIDS related deaths in same period • Estimated 520 000 untreated • Only about 80 000 in public sector and 70 000 in private sector (includes not for profit) with very few children (end October 2005) • Massive challenge ahead, need to scale up fast • Business has duty to respond effectively

  3. The early years… • Characterised by exclusion, unfair discrimination, mandatory testing • SADC Code of Good Practice mid-1990s coupled with lobbying started to force change • Challenges to corporate conduct included on disclosure, dismissal, testing, access to benefits (SAA, Old Mutual) • Seeking protection through EEA (1998) and NEDLAC

  4. About turn … bottom line or social responsibility or both ? • Legal, context, government’s delay forced social responsibility into action • Workplace policies premised on non-discrimination • Testing phased out • Better access to benefits (because of MSA) • No public sector treatment programme until Nov. 2003 • Medical Scheme coverage unaffordable SO: Private unfunded sector forced to rely on business • Announcement of treatment programmes before Operational Plan • Few companies • Costs • Choice of drugs, generics, licences

  5. SABCOHA / BER 2005 • Mining, transport, financial services and manufacturing sectors have heaviest impact: • But compared to other sectors dealing with AIDS in integrated manner • Anglo Platinum and De Beers now embarking upon external initiatives to support local communities (this is the exception) • Seeing strong public/private partnerships in the provision of treatment to employees, spouses and their children • BUT: Building and construction, retail and wholesale sectors response has been poor • Most companies unaware of the internal and external impact of HIV on their companies

  6. SABCOHA contd. • Small and medium size enterprises slow in responding to the epidemic • ESKOM, VW, and DaimlerChrysler - supply chain development programmes to unlock capacity for SMEs • Large companies moving towards making an HIV workplace programme a procurement requirement • Emphasis shifting from an internal focus, to a focus upon the community. • Broader policy unclear • Efficacy of SANAC • Barriers to foreign funding for private sectors projects

  7. How does the private sector fare? • 44% indicated that the private sector’s response has been either lacking or completely inadequate • 28% feel that the private sector’s response has been satisfactory or “more than adequate” • Large companies (with more than 500 employees) appear to be relatively more frustrated with the response to the epidemic • 60% rated the private sector’s response as lacking or completely inadequate

  8. The legal framework • Constitution • Equality, security of person, privacy • Employment Equity Act (EEA) • Prohibits non-voluntary HIV testing, outlaws unfair discrimination • Labour Relations Act (LRA) • Governs automatic unfair dismissals, access to benefits, reas. accom. • Equality Act • Prohibits unfair discrimination based on HIV/AIDS in Insurance services as prohibited practice • Medical Schemes Act • Prohibits unfair discrimination on basis of HIV status and risk rating, • Now guarantees prevention and treatment benefits as a PMB

  9. Legal framework … • Occupational Health and Safety Act (OHSA) – • Duty on employers to minimise risk of HIV (equipment and other) and ensure safe working environment • Compensation for Occupational Injuries and Diseases Act (COIDA) • Governs compensation for infections during course/ scope of employment • Basic Conditions of Employment Act (BCEA) • Governs sick leave and other leave

  10. Employment Equity Act • First piece of employment legislation that refers explicitly to HIV/AIDS • Specifically prohibits unfair discrimination on the basis of HIV status- section 6(1) • Prohibits testing of an employee or job applicant for HIV status - section 7(2) UNLESS Labour Court determines such testing justifiable - section 50(4) • Anonymous and voluntary testing is allowed • Compulsory testing must be approved by the Labour Court

  11. Code of Good Practice on HIV/AIDS and Employment • Provides guidelines for employers, employees and trade unions on how to manage HIV/AIDS in the workplace • Promotes the development of workplace HIV policies and programmes • Emphasizes the need to base any programmes and policies on the principle on non-discrimination

  12. Meeting legal obligations and social responsibility – a scorecard • Testing • Still occurs though infrequently • Confusion unnecessarily created around voluntary and compulsory • Discrimination • Still high levels of stigma and non-disclosure evident in low take up of medical treatment • Still occurs through greater awareness • Disclosure • Still low in the workplace – climate of trust for historical reason does not exist …

  13. Meeting legal obligations and social responsibility – a scorecard … • Access to information • About who has programmes, lessons learnt, data, numbers • Central coordinating authority needed • Requires coordination with government to address long term sustainability and compliance with norms and standards • Working conditions that create vulnerability and susceptibility • Hostels, migrant work, long distance travelling, sexual harassment • Multinationals • Pharmaceutical companies in particular • Competing claims – patent protection v patient protection • PMA, patent defiance, forced voluntary licences • Civil society forced lower prices and less patent protection • Though still camouflaged as ‘donations’

  14. Scorecard … • Access to benefits • Still complaints about access to housing , pension and death benefits – particularly mining companies • Many employers still do not treat partners/ dependants • Migrant workers (cross border) often have no access • High TB co-infection (due to poor working conditions) • Private care unaffordable, inefficient, highly subsidised • Abuses my medical schemes (many are corporate businesses) • Waiting periods imposed • Exclusions imposed • Indirect cherry picking (‘cheap movie tickets but no hospital cover syndrome’) • Using MSA’s to fund PMBs and limiting PMBs illegally

  15. Contact details AIDS LAW PROJECT • hassanf@law.wits.ac.za • 021 422 1490 • 083 27 999 62 • www.alp.org.za • www.tac.org.za

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