Presentation to Portfolio Committee 25 September 2002

1. Presentation to Portfolio Committee 25 September 2002 RESPONDING TO THE THREAT OF HIV/AIDS IN THE PUBLIC SERVICE

2. PRESENTATION OVERVIEW • How is HIV/AIDS likely to impact on the Public Service? • How are we responding to this threat? • What can we do to improve this response?

3. IMPACT OF HIV/AIDS ON THE PUBLIC SERVICE • HIV/AIDS likely to result in: • Increased demand for services (particularly in health and welfare) • Decreased ability to render these services because of impact on our employees • HIV/AIDS likely to impact differently on various sectors and departments based on the risk profile of their workforce • Skilled and highly skilled employees appear to have the highest risk of infection - this includes groups such as teachers, nurses & social workers

4. IMPACT OF HIV/AIDS ON THE PUBLIC SERVICE (cont) • But even for low risk groups the impact will still be serious… • All workplaces that already have high workloads & over-extended capacity will be particularly vulnerable. This includes services in remote areas & disadvantaged communities. It also applies to functions that rely on scarce skills… • This requires of all departments to identify vulnerable services and to introduce effective workplace programmes

5. IMPACT OF HIV/AIDS ON THE WORKPLACE More employees who are sick More employees who die • Higher rates of absenteeism • Higher no of employees who require medical treatment = additional costs • Additional strain & workload on those who remain • Lower productivity • Higher turnover rates • Higher recruitment & HRD costs • Higher pension costs • Lower morale

6. DPSA RESPONSE • DPSA response grounded in National HI/AIDS Strategic Plan (2000 - 2005). This plan requires of different sectors of the state & society to play their part in countering the threat of HIV/AIDS in their particular sectors - a number of goals are of particular relevance from a workplace perspective: • Goal Nr 1: Promote safe & healthy sexual behaviour • Goal Nr 6: Improve access to voluntary counseling & testing • Goal Nr 15: Develop an appropriate legal & policy environment • Programme of Action developed in April 2001 - focused on putting in place the required policy frameworks and systems • All of the activities guided by the mission of sustaining service delivery and promoting the health and well-being of public servants & their families • Key focal areas: • Policy review & development • Review of conditions of service • Capacity building

7. POLICY DEVELOPMENT • In Resolution 8 of 2001 employer and employee parties to the PSCBC expressed support for HIV/AIDS and STD workplace programmes aimed at - • prevention; • counselling and support for those infected and affected; • education; • resources and leadership to implement HIV/AIDS and STD workplace programmes; • creation of a non-discriminatory environment; and • protection of confidentiality of those who voluntary disclose their HIV status • PSCBC Resolution expressed support for management of HIV/AIDS as part of broader wellness management programmes • So what have we done to translate policy intentions into reality?

8. POLICY DEVELOPMENT (cont) • Thorough policy & legislation review completed in order to - • identify key principles upon which workplace programmes should be based; • analyse existing legal framework of Public Service to assess the extent to which this supports/contradicts the key principles • Key conclusion: Although legal framework doesn’t expressly violate any of these principles, also doesn’t provide an enabling environment… • Hence two policy options developed & widely consulted • Option that was favoured sets out minimum standards underpinning workplace policies & programmes - recognises the fact that departments are at different stages of developing & implementing their policies & programmes & that their needs differ • These minimum standards have been included in the PSR & communicated to all departments

9. POLICY DEVELOPMENT(cont) • Good Practice Manual has been developed to complement the Regulations and serve as a guide for depts to develop workplace programmes - will be launched during Public Service AIDS Indaba to be held in Oct 2002 • The Regulations indicate what departments have to do and the Manual how • Key elements of regulations(these are part of the provisions relating to the work environment and health/safety): • Every dept to introduce an education, awareness and prevention programme focusing on HIV/Aids and other sexually transmitted diseases • This programme preferably to be integrated with broader programmes that promote the health & well-being of employees (e.g. EAP) • Create mechanisms to encourage openness, acceptance, care and support for HIV-positive employees

10. POLICY DEVELOPMENT (cont) • Designate a member of the SMS to be the champion of this programme and hold him/her accountable by way of his/her performance agreement • Allocate adequate resources to the development & implementation of the programme and form partnerships • Establish an HIV/AIDS committee for the dept, with representation of all stakeholders, including union reps • Ensure that the programme includes an effective internal communication strategy • Occupational exposure • Depts to identify units or employees at high risk of contracting HIV & related life threatening diseases and take reasonable steps to reduce risk • Facilitate access to VCT and post-exposure prophylaxis for those who have been exposed to HIV as a result of an occupational incident (e.g. needle prick injuries) • Assist employee to access compensation if he/she has become HIV + because of occupational injury

11. POLICY DEVELOPMENT(cont) • Non-discrimination • Depts to ensure that none of their employment policies and practices discriminate against employees on their HIV status or perceived HIV status • Take active steps to promote non-discrimination in the workplace • HIV testing • Depts to promote VCT, and wherever possible, promote access thereto • Not require HIV testing unless Labour Court authorisation has been obtained • Confidentiality • All employees to treat info on an employee’s HIV status as confidential and not disclose this to anybody else without the employee’s written consent

12. POLICY DEVELOPMENT(cont) • We have also developed a broader three year strategy that focuses on supporting departments as they develop and implement their own programmes • Three year strategy includes the piloting of workplace programmes and sharing the lessons with other departments • Communication campaign soon to be launched so as to sensitise departments and individual public servants on their roles and responsibilities & to communicate the policy framework and systems that have been put in place • Discussions held with OPSC on the monitoring of policy implementation - departments will be required to report on their departmental programmes…First report due end of this month

13. SYSTEMS DEVELOPMENT: EMPLOYEE HEALTH & WELL-BEING • It is clear that in years to come there will be a steady increase in the number of public servants affected by the pandemic • In this context access to a reasonable level of health care will be critical • Hence ways and means of broadening access to medical assistance being considered - State also to ensure that medical assistance includes effective disease management programmes • Another source of concern: Adequacy of pension benefits for public servants & their families… Most important gap in GEPF - minimal provision for children and orphans • To this end proposals under consideration on improved benefits • Research completed on management of ill-health in the Public Service • Draft new policy on incapacity management developed - provides for better health risk management and return-to-work strategies • Suggestion is that GEPF will play much more active role in assessment of incapacity through a Health Risk Manager

14. EMPLOYEE HEALTH & WELL-BEING (cont) • Efficiency of claims processing in Public Service is a major concern - indications are that delays occur at dept’al level and not at Pensions Administration. In the context of HIV/AIDS pandemic, this situation cannot continue • Hence proposals being considered to expedite this process • Guidelines developed on integrated HR planning since DPSA studies have shown that this is a critical weakness in the Public Service - have been made available to departments

15. CAPACITY DEVELOPMENT, TRAINING & SUPPORT • In line with training framework adopted by PSCBC, SAMDI has started with roll out of training programmes • Major service delivery departments targeted first • DPSA also collaborating with SANDF, SAPS and Education in roll out of their workplace programmes • DPSA closely involved in programmes of Dept of Health - in particular activities of IDC • Collaborated with Social Development in developing and implementing a course for Government planners • First ever HIV/AIDS Indaba held last year - is now an annual event • Several partnerships formed with business (e.g. Metropolitan and DaimlerChrysler) and donor community • DPSA presently strengthening its internal capacity to provide support to depts - will soon have four full-time members of staff focusing exclusively on HIV/AIDS

16. WAY FORWARD • Our view is that work done around policy & system development should assist considerably in developing a sustainable response. However the key challenge lies in the implementation process… • Specific concerns: • Lack of integration of HIV/AIDS policies & programmes into broader wellness initiatives & HR practices • Tendency of allocating HIV/AIDS responsibilities to junior officials with limited skills & influence • Limited data on HIV prevalence rates & impact of HIV/AIDS on the workplace • Inadequate understanding of specific workplace challenges such as existence of stereotypes & prejudices • Most depts have policies, but they are often in draft form

17. WAY FORWARD (CONT) • Strategies & implementation plans on e.g. training/development of staff & replacement of personnel often inadequate • Most programmes focus on awareness & prevention, with few focusing on sustaining service delivery and care/support • Lines of accountability & implementation monitoring often unclear • Major problems are being experienced around stigma - hence employees are reluctant to disclose their status & seek help • In view of these challenges, critical to assist depts in strengthening their internal capacity; analysing their risk profile; and getting tangible programmes off the ground to manage this risk • We believe that the planned communication campaign will be key to creating a climate conducive to non-discrimination; openness and support and that the pilot programmes will open the way to more comprehensive strategies