Strategies to Tackle Social and Labour Implications of HIV/AIDS
The International Labour Office (ILO)
In collaboration with
The Joint United Nations Programme on HIV/AIDS (UNAIDS)
Windhoek, Namibia, 11 - 13 October 1999
AND LABOUR IMPLICATIONS OF HIV/AIDS
A background document
HIV/AIDS is undoubtedly the single
most important and daunting health problem facing Africa. Globally
too, this is one of the most serious health, medical and social
preoccupations of our time. The figures from UNAIDS and the WHO
provide a grim picture.
- Since the
first cases of AIDS and HIV were recorded about two decades ago,
nearly 50 million people have been infected.
- The Joint
United Nations Programme on HIV/AIDS (UNAIDS) and the World Health
Organization estimated that, by the end of 1998, the number of
people living with HIV/AIDS would have grown to 33.4 million and
the number of deaths to about 2.5 million.
- About 95
per cent of all HIV-infected people live in the developing world.
The majority of the victims are young adults who, if not sick,
would be at the peak of their productive and reproductive years.
- The total
number of children living with HIV/AIDS stands at 1.2 million.
account for 43 per cent of all people over 15 who are living with
HIV and AIDS.
The true cost of this pandemic is
almost incalculable and its repercussions in terms of deteriorating
child survival, diminishing life expectancy rates, overburdened
health care systems, increasing orphanhoods and substantial
financial losses in the business world are enormous.
For Africa, HIV/AIDS is perhaps the
single most important obstacle to social and economic progress. AIDS
is no longer a health problem. It is a development problem with
potentially ominous consequences. At least two-thirds of the world's
HIV/AIDS population - 22.5 million - live in this subregion.
Countries like Botswana, Namibia, Swaziland and Zimbabwe have been
among the hardest hit nations. Between 20 and 26 per cent of people
aged 15 to 49 in these countries are living with HIV/AIDS. AIDS is
expected to be the cause of death of two million Africans this year.
According to the International Labour Organization's East Africa
Multidisciplinary Advisory Team, AIDS has surpassed malaria as
Africa's number one killer.
And the rate of new infections is
not slowing. In 1998, nine of out every ten newly diagnosed people
were African, and at least 95 per cent of all AIDS orphans are
African. Even sub-Saharan countries that had lower infection rates
than their neighbours just a few years ago seem to be catching up.
South Africa, which at the beginning of the 1990s trailed the other
nations in the region, now accounts for one in seven new infections.
In Zimbabwe, where there are 25 surveillance sites in which blood is
taken from pregnant women and tested anonymously, only two of the
sites had HIV-positive results below 10 per cent. The remaining 23
sites reported infection rates between 20 and 50 per cent.
SOCIAL AND ECONOMIC IMPLICATIONS
AIDS, business and the
Because HIV/AIDS cuts into the size
and quality of the workforce, it is of fundamental concern to
business and economic policy makers. It is estimated, for example,
that in South Africa's mining sector as many as one out of five
workers are HIV-positive. Data collected by the ILO in May 1999 on
the labour force in Rwanda, United Republic of Tanzania, Zambia and
Uganda revealed that 80 per cent of the persons infected in those
countries were between 20 and 49 years old. In other words, AIDS is
affecting, and ultimately killing, the most productive labour force
within the formal sector. Many are experienced and skilled workers
in both blue collar and white collar jobs. In Zambia, for instance,
96.8 per cent of all deaths in the 18 firms covered occurred among
workers aged 15 to 40.
Between 1984 and 1992, mortality
had risen fivefold, with AIDS-related illness accounting for 56 per
cent of the deaths among general workers, 71 per cent among lower
level workers, 57 per cent among middle level workers, and 62 per
cent among the top level managerial workers. Employers naturally are
concerned about the backbone of their businesses - their employees -
and the effect the pandemic could have on their businesses. HIV/AIDS
makes the cost of doing business more expensive, while at the same
time lowers worker's productivity and decreases overall demand for
goods and services. It decimates management and the skilled labour
force. Finding qualified top management and skilled line workers to
replace those who die or can no longer work can be extremely
difficult. Productivity suffers; it takes time to replace workers,
particularly skilled or senior workers. There are other costs as
well. In Mauritius, AIDS resulted in increased health care costs,
medical insurance costs, death benefits and disability and pension
payments. In Zimbabwe, life insurance premiums quadrupled in just
two years because of AIDS-related deaths. Other countries also
reported that their health bills had doubled. In the United Republic
of Tanzania and in Zambia, large companies reported that AIDS
illness and heath costs surpassed their total annual profits. In
Botswana, companies estimated that AIDS-related costs will increase
from under 1 per cent of salary costs to 5 per cent in only six
years due to the rapid rise in infections in the last several years.
At the national level, the effect could be even more serious. For
example in the United Republic of Tanzania, the World Bank predicted
a 15 to 25 per cent drop in the Gross Domestic Product because of
the AIDS crisis.
Employers face daunting challenges.
Many fear that addressing AIDS in the workplace could be too costly,
while others are concerned that they do not know how best to
approach the issue. Surveys reveal that few companies have
established comprehensive prevention, care and support interventions
in their workplace. A study of Kenyan companies done by UNAIDS
showed that while most managers believed HIV/AIDS would have some
effect on their business, only one-half of them provided HIV/AIDS
In the informal sector, where many
unsuccessful aspirants or retrenched workers surface alongside those
who are without adequate education and skills, AIDS has also had a
considerable impact. Many in this sector, especially women, trade in
perishable goods such as vegetables, fish, fruit and cooked foods.
But many of the HIV-positive or AIDS-infected workers in this sector
are forced to forfeit their stalls in the market, causing their
businesses to collapse. If there is a period of remission or
recovery, it is often difficult to resume in the market because
personal savings may have depleted.
Women are especially vulnerable.
Young women of childbearing age - ages 15 to 24 - are twice as
likely to be infected as males in the same age group. The most
common route of transmission is through heterosexual sex. Widely
held cultural practices that accept multiple partnering by males,
the lower socio-economic status of women, and the greater efficiency
of male to female transmission all make women particularly
vulnerable to the disease. Wartime conditions are also fertile
breeding grounds for HIV/AIDS. In Rwanda, for instance, rapes during
that country's armed conflict earlier this decade is blamed in no
small part for spreading the virus there.
According to USAID, four out of
five HIV-positive women live in Africa. In many of African
countries, where women are generally responsible for running the
household and caring for family members, the death of the wife can
make it difficult for the others who then have to take on
responsibilities. Regardless of the gender of the deceased, the
death of a family member because of AIDS, leads to a reduction in
savings and retirement benefits.
Impact of HIV/AIDS on
For children, HIV/AIDS means hard
labour and diminished life expectancy. Zimbabwe illustrates the
frightening prospect of orphanhood, where more than 25 per cent of
the adult population is HIV-positive, the Government is estimating
that within two years, 2,400 Zimbabweans a week will die from AIDS.
With most of these deaths concentrated in young families, this means
a considerable increase in the number of orphans.
When a child is thrust into this
position or forced to become the head of a household, he/she has to
quickly find a way to provide for more needy siblings. Many end up
becoming delinquent, drifts, onto the streets, or into prostitution.
Orphaned boys often turn to the armed forces, or paramilitary
forces, for comfort and camaraderie. A constant supply of young
soldiers thus helps keep the internal armed battles in Africa
According to UNAIDS and WHO reports
of sexual abuse of girls, have risen rapidly in recent years in
Zimbabwe. In a single rural district of Zimbabwe, one study recorded
nearly 400 cases of child sexual abuse, in which at least 25 per
cent of them were girls under the age of 12, and at least 10 per
cent of them were orphans. Studies have shown that girls who face
sexual abuse are more likely to drift into prostitution, which
itself carries a sizeable risk of infection.
exclusion and the culture of silence
The stigma and shame associated
with HIV/AIDS could actually foster the spread of the disease and is
a very real obstacle to both prevention and care. In many of the
hardest hit countries, government officials and ordinary citizens,
including those most affected by the epidemic, often continue to
look the other way because of the rejection, discrimination and
shame attached to it.
Stigma and the fear it engenders
fuel the spread of HIV, since those with risky behaviour in the past
may be reluctant to change that behaviour in case the change is
interpreted as an admission of infection. Fear of acknowledging HIV
infection can stop a married man from raising the subject of condom
use with his wife. Fear of advertising her HIV status may prevent an
infected woman from giving her baby replacement feeding to avoid
transmitting the virus through breast milk.
The stigma attached to HIV affects
both sexes. However, the consequences may be more severe for women,
who risk being beaten and even thrown out of their house if their
status is revealed. This may still be the case even when the husband
was the source of the woman's infection. An HIV-infected woman may
be blamed for the death of her children, and be deprived of care.
Many people simply do not want to
know if they are HIV-positive, even when counselling and testing are
offered. The culture of silence can continue to reign even when
people with HIV are ill and dying. Since AIDS is the name for a
cluster of diseases that immune deficient people develop, patients
and their care-givers can simply choose to view their illness as
just tuberculosis or diarrhoea or pneumonia. A report by UNAIDS and
WHO cited an instance from southern Africa where, in a study of
home-based care schemes, fewer than one in ten people who were
caring for HIV-infected patients acknowledged that their patients
were suffering from HIV or AIDS. Patients themselves were only
slightly more likely to acknowledge their status, and several told
researchers that they had not disclosed their status to anyone,
including the person caring for them. The self-imposed silence is
hard on the patient, and it can also be hard on care-givers,
particularly when they are children or adolescents.
In some countries, leaders have
spoken out loudly, clearly and repeatedly about AIDS, and have
sought to demystify it by encouraging discussions about safe sex
everywhere - from the classrooms to the boardrooms. It is in such
countries, Uganda for example, that most progress has been made not
only in keeping the number of new infections down, but also in
ensuring the well-being of those people who are already living with
SOME THOUGHTS ON FUTURE ACTION
Much of the work in the ILO in the
past was concerned with rights and discrimination issues. It is now
obvious that the AIDS pandemic is more than a health or rights
problem. It affects the very social fabric of communities and the
future of the economy. HIV/AIDS could well be the single most
important impediment to social and economic progress in Africa; it
can therefore be best described as a development crisis.
This frightening reality has
prompted the ILO constituents to seek assistance to address this
problem. For example, during the 1994 African Regional Meeting in
Mauritius, the ILO was requested to provide technical assistance and
include activities aimed at helping governments and employers' and
workers' organizations to respond to the threat posed by the high
incidence of HIV/AIDS infection. A similar request was made at the
last OAU Labour and Social Affairs Commission Meeting at Windhoek,
Namibia. The ILO's tripartite structure and extensive collaborative
work with governments, employers and workers on social, labour and
employment policy puts it in a somewhat unique position to assist
member countries deal with what is certainly an exceptionally
daunting humanitarian challenge. The problem of HIV/AIDS is
multi-faceted. The approach to deal with it would inevitably have to
be multi-dimensional. Here though, we will emphasize two particular
lines of action: the prevention of the disease and the protection
and well-being of those affected by it.
In 1988, the WHO and ILO issued a
major statement on AIDS and the workplace (see Annex), which serves
as a point of reference at the international level concerning the
principle of non-discrimination. It encompasses the essential
elements of the policy to be followed on AIDS at the workplace; and
these are stated as follows:
of the human rights and dignity of HIV-infected persons, including
persons with AIDS, is essential to the prevention and control of
HIV/AIDS. Workers with HIV infection who are healthy should be
treated the same as any other worker. Workers with HIV-related
illness, including AIDS, should be treated the same as any other
worker with an illness.
- Most people
with HIV/AIDS want to continue working, which enhances their
physical and mental well-being and they should be entitled to do
so. They should be enabled to contribute their creativity and
productivity in a supportive occupational setting.
- The World
Health Assembly resolution (WHA41.24) entitled, "Avoidance of
discrimination in relation to HIV-infected people and people with
AIDS" urges Member States:
-"...(1) to foster a spirit of understanding and compassion
for HIV-infected people and people with AIDS...;
- -(2) to
protect the human rights and dignity of HIV-infected people
and people with AIDS ... and to avoid discriminatory action
against, and stigmatization of them in the provision of
services, employment and travel;
- -(3) to
ensure the confidentiality of HIV testing and to promote the
availability of confidential counselling and other support
The approach taken to HIV/AIDS and
the workplace must take into account the existing social and legal
context, as well as national health policies and the Global AIDS
Consistent policies and procedures
should be developed at national and enterprise levels through
consultations between workers, employers and their organizations,
and where appropriate, governmental agencies and other
organizations. It is recommended that such policies be developed and
implemented before HIV-related questions arise in the workplace.
Policy development and
implementation is a dynamic process, not a static event. Therefore,
HIV/AIDS workplace policies should be:
(a) communicated to all concerned;
(b) continually reviewed in the
light of epidemiological and other scientific information;
(c) monitored for their successful
(d) evaluated for their
These WHO/ILO principles should
provide a good basis for the development of suitable legislative
framework, collective agreements and codes of practice. The ILO
could and should mobilize the social partners and civil society to
develop and apply these principles and to disseminate them widely as
a basis for training jurists, counsellors, doctors, workers and
Prevention and assistance
Though protecting the human rights
of affected workers and combating discrimination against them remain
important, action against HIV/AIDS should give particular importance
to prevention and assistance. A coherent labour management policy is
needed to ensure that all aspects of the problem are addressed in a
mutually supportive manner. The willingness of employers and workers
to take action should be enshrined in multi-sectoral national
policies to combat AIDS. It is necessary to promote private sector
initiatives on an urgent basis and to undertake AIDS training
(prevention and community assistance) at the workplace. It is also
indispensable for the public sector, which is still the major
provider of salaried employment in developing countries, to develop
the resource structures for the dissemination of a permanent message
of solidarity among public employees. For activities of this
magnitude and urgency, major political awareness and commitment are
vital. Important also is a multi-media and information campaign.
Such a campaign should cover the following areas:
information about the facts and myths concerning HIV/AIDS,
emphasizing that it is an illness and not a punishment, while
promoting a health lifestyle and avoiding risky behaviour;
- safe sex
in jobs where there are risks of exposure to infection;
drug and alcohol abuse leading to intoxication and risky behaviour
(violence, unprotected sex, sharing of contaminated needles);
support for groups at high risk, such as migrant and transport
Information and training materials
need to be developed to enable industry, employers' and workers'
organizations to conduct training activities. Attention should also
be given to the large number of workers (hospital and health-care
personnel, firefighters, police etc.) who are at risk of becoming
infected with HIV because they come in contact with blood, semen, or
body fluids containing blood. Guidelines should be elaborated and
implemented systematically through appropriate educational and
ongoing programmes in the workplace.
The ILO has initiated work on the
impact of AIDS on the future structure of the population. A
long-term model has been built to assess the demographic impact of
AIDS. This model is an important tool for actuarial work on social
insurance schemes in countries with high AIDS prevalence, notably in
southern and eastern Africa. This basic tool will be further
improved and completed in order to simulate the medium- to long-term
impact of AIDS on labour supply, employment, productivity, growth
and poverty levels. It will make possible a projection of various
social expenditures such as health, education and social services,
as well as cash benefits in formal sector social insurance schemes.
It will then establish the links between social expenditure and the
government budget by estimating changes in government social
expenditure and revenues over time. In addition, the combination of
an AIDS mortality model and a social budget model will permit cost
benefit analysis of different degrees and intensities of early
awareness campaigns. The model assumes that early awareness will
reduce infection rates, morbidity and mortality and thus avoid a
major part of later negative impacts on government spending and
income and economic growth. The ILO is prepared to collaborate in
the application of the model and share experiences with African
Statistics are important for
advocacy and public awareness campaigns and to develop policies and
programmes to mitigate the adverse effects of this epidemic. With
this is in mind, the ILO will undertake the following kinds of
activities to assist member States and non-governmental and
international organizations in documenting and revealing the nature,
magnitude and extent of the problems.
development of HIV/AIDS-sensitive projections of the labour force
in order to determine the potential areas of major shortfalls in
the future supply of labour.
determination of appropriate methods for generating
occupation-industry specific HIV/AIDS incidence rates.
provision of data on and statistical analysis of the impact of
HIV/AIDS on the economy at the enterprise and national levels
taking into account the pattern of distribution of the epidemic
across workers in different sectors as well as the differential
experiences in each category.
incorporation of economic characteristics in the existing data
collection instruments and mechanisms relating to HIV/AIDS cases,
for example the sentinel sites and HIV testing centres, through
adequate networking with relevant national, non-governmental and
It has been said many times before,
but needs to be said again, that HIV/AIDS is probably the most
serious humanitarian challenge of our time, especially here in
Africa. HIV/AIDS does not discriminate; it can infect persons of any
race, age and sex. It has no cure. It is transmitted in only a few
specific ways: sexual contact, blood-to-blood contact and
mother-to-baby. In other words, it can be prevented.
The world labour force is estimated
at close to 3 billion workers. They are all vulnerable. But they can
all serve as agents of change, an enormous work force which can be
deployed in the cause of a healthier, safer and longer life and a
better world. What is needed is to provide it with the awareness
essential for action and commitment and the assistance to effect
prevention and protection. The challenge therefore for the ILO and
the member States is to develop a programme of action of prevention
and protection that encompasses: statistics to document the problem
and make it more visible and amenable to action; a multi-media
information and education campaign and direct assistance to industry
and communities to stimulate and support action at all levels; the
promotion of a culture of fairness and ethics that can embrace the
weak, vulnerable and diseased; a legal and social security system
that can provide some measure of legal and real protection to
victims and society at large.
ILO, WHO: Consensus Statement
From the Consultation on AIDS and Seafarers, Global Programme
on AIDS, October 1989.
ILO: Role of the Organized
Sector in Reproductive Health and AIDS Prevention, Report of a
Tripartite Workshop for Anglophone Africa Held in Kampala, Uganda,"
ILO: Decent Work, Report
of the Director-General, International Labour Conference, 87th
ILO: HIV/AIDS Impact on the
Labour Force, East Africa Multidisciplinary Team, May 1999.
ILO: Regional Training and
Sensitisation Workshop on HIV/AIDS and its Social and Labour Impact
in Africa, Summary Report, September 1999.
ILO: Social Protection Sector,
Social Security Department, Financial Actuarial and Statistical
Branch, September 1999.
ILO: AIDS and the Workplace,
Spotlight, Newsletter of the Labour and Population Programme
Development Policies, September 1999.
ILO: Regional Tripartite
Workshop on Strategies to Tackle Social and Labour Implications of
HIV/AIDS in Africa, October 1999.
Joint United Nations Programme on
HIV/AIDS (UNAIDS): HIV/AIDS and the Workplace: Forging
Innovative Business Responses, July 1998.
UNAIDS, WHO: AIDS Epidemic
Update, December 1998.
Mehra-Kerpelman, Kiran: The
Organized Sector Mobilizes Against AIDS, World of Work,
N'Daba, Louis: HIV/AIDS and
Discrimination in the Workplace: The ILO Perspective, ILO,
N'Daba, Louis, and Hodges-Aeberhard,
Jane: HIV/AIDS and Employment, ILO, 1998.
United States Bureau of the Census:
Recent HIV Seroprevalence Levels by Country, Health Studies
Branch, International Programs Center, Population Division, July
USAID: Economic Impact of AIDS
in Africa, USAID Global Bureau, Office of Health and Nutrition,
Division of HIV/AIDS, 15 March 1999.
USAID: Regional Overview of
AIDS in Africa, USAID Global Bureau, Office of Health and
Nutrition, Division of HIV/AIDS, 15 March 1999.
Young, A.S.: Some Statistical
Issues, Social and Labour Implication of HIV/AIDS in Africa,
Bureau of Statistics, ILO, 1999.
A N N E X
The African Regional Tripartite
Workshop on Strategies to Tackle Social and Labour Implications of
HIV/AIDS was held in Windhoek, Namibia, from 11 to 13 October 1999.
It was organized by the International Labour Office (ILO) in
collaboration with the Joint United Nations Programme on HIV/AIDS (UNAIDS).
The meeting was organized in response to the request of the members
of the OAU Labour and Social Affairs Commission at its last session
in Windhoek in April 1999, for the ILO to be more involved in the
fight against HIV/AIDS in Africa.
Fifty-four governments', employers'
and workers' participants from twenty African countries attended the
Workshop. Observers from donor, scientific, regional and
international organizations concerned with and involved in combating
HIV/AIDS also participated at the meeting. The list of participants
and observers is included at the end of this report.
The aims of the Workshop were to
exchange views and experiences and to promote action against
HIV/AIDS at and through the world of work. It was also expected to
lead to an African Platform of Action which could eventually be
adopted at the ILO's African Regional Labour Conference to be held
in December, 1999, in Abidjan, Côte d'Ivoire.
The meeting was a first step in a
series of activities to be carried out at national and regional
levels, in collaboration with the ILO and other concerned
international organizations and donor agencies.
The programme included plenary
sessions with presentations and discussions as well as group work.
An ILO background document entitled Social and labour implications
of HIV/AIDS was distributed to the participants and forms part of
Honourable Walter Kemba, Deputy
Minister of Labour of Namibia, was the Chairperson for the opening
ceremony. He stressed the importance of this Workshop not only for
Namibia but also for Africa as a whole given the extent to which
HIV/AIDS was ravaging through the continent. This intervention of
the ILO was therefore particularly timely. Mr. Kemba welcomed the
participants to Namibia and challenged everyone to work hard at
finding solutions during the Workshop.
Ms. Mary Chinery-Hesse, Executive
Director, Social Protection Sector, ILO, welcomed the participants
and spoke extensively on the extent, magnitude and consequences of
the problem and the need for the constituents to combat the ravages
of this terrible pandemic affecting the world of work. She
highlighted the issues of greatest concern to the ILO which could
provide opportunities or entry points for intervention:
discrimination against HIV/AIDS-infected persons in employment; the
impact on child labour; the impact on the quality of labour and
productivity and its negative effects on the growth of small
enterprises and the informal sector; the differential impact of
HIV/AIDS on men and women; the linkages with migration and the
adverse consequences on social security, for example the
implications for government expenditure and social services.
She pointed out that the ILO was
prepared to assist in slowing the spread of HIV/AIDS through a wide
range of interventions. These could include sensitising employers
and encouraging them to make HIV/AIDS a corporate priority,
emphasising the collective responsibility of workers through the ILO
workers' education programme and sensitising governments to the
impact of the problem on development efforts. She expected the
Workshop to help the ILO define an integrated and coherent approach,
which would enable it to make a difference, and a realistic Platform
of Action, which would provide a basis for cooperation. She
concluded by saying that "while the whole world is waiting for a
vaccine in the medical field to prevent HIV/AIDS, let us make use of
ILO facilities and values such as tripartism, equality and social
justice, to effectively develop a social vaccine".
The representative of the workers'
participants, Mr. M. Besha of the Organization of African Trade
Union Unity (OATUU), noted that the Workshop was long overdue. He
noted that the ILO had taken certain initiatives, and that his
organization had also organised many workshops, undertaken research
and studies, run training of trainers and of workplace level
unionists. He noted that the impact of HIV/AIDS in the workplace was
alarming. To what extent had the ILO really attacked the problem of
this killer disease? He hoped that this Workshop would lead to the
development of effective strategies that would include workers and
The representative of the
employers' participants, Mr. R. Iacona of the Ethiopian Federation
of Employers, endorsed the support given to this important Workshop
by the workers, stressing that employers could not fight HIV/AIDS in
the world of work alone. Action was required by all social partners.
This Workshop should help arrive at strategies not only covering
prevention but also protection of already infected persons.
The representative of the Joint
United Nations Programme on HIV/AIDS (UNAIDS), Mr. A. Sy, Director
of the Subregional Southern African Programme, recalled that
throughout history, societies had been affected by epidemics and
other natural catastrophes, and individuals, families, communities
and nations had mobilised and developed responses to them. That kind
of mobilisation was now needed for HIV/AIDS. As the pandemic
threatened Africa's gains in health and socio-economic development,
the UN family had recognised the need to address its multiple facets
by creating UNAIDS which coordinated and facilitated the responses
of the whole UN family. UNAIDS wanted to be partners with the
participants present at this Workshop and looked forward to the
strategies that would be worked out for action at the international,
regional, sub-regional and national levels.
The Opening Speech on behalf of his
Excellency, President Sam Nujoma, President of the Republic of
Namibia, was delivered by the Minister of Health and Social
Services, the Honourable Dr. L. Amathila. Recalling the frightening
spread of HIV/AIDS especially in Africa, he noted that the biggest
impact had been on the labour force and overall economic performance
in African countries. The President had already warned, at the April
1999 meeting of the Organization of African Unity Labour and Social
Affairs Commission, that Africa was not taking HIV/AIDS seriously.
This Workshop was a concrete follow up to that warning, and he
thanked the ILO and participants for taking that call seriously. The
Workshop should advise on comprehensive information-sharing
strategies and on successes in tackling the pandemic. SADC had a
Code on HIV/AIDS and Employment, and Namibia had adopted a National
Code on HIV/AIDS and Employment in 1998. That Code had, no doubt,
seen both negative and positive experiences in its implementation,
and other countries may have had similar experiences. Therefore
collective exchanges in this field would enrich the discussions
here. Another area for exchange was how far to go medically and
otherwise in making HIV/AIDS a reportable disease.
In giving the Vote of Thanks, Mr.
E. K. Andoh, Director ILO Office, Pretoriathanked the participants
for making the time to attend the Workshop. He also expressed his
thanks to the Honourable Minister, Dr. Amathila, and all dignitaries
who had graced the Opening Session with their presence and their
speeches. Mr. Andoh assured the speakers that, during their
deliberations, the Workshop's participants would take seriously the
challenges thrown at them.
ELECTION OF OFFICERS
The following persons were elected
to the Bureau:
Chairperson: Mr. C. Schletwein,
Vice Chairperson (Workers): Mr. F.
Abena Fouda, Cameroon
Vice Chairperson (Employers): Dr J.
P. Murphy, South Africa
Rapporteur: Mr. Solomon Tatah,
The Chairperson and Vice
Chairpersons gave brief statements thanking the participants for the
confidence in their leadership and called on the Workshop to take
the opportunity to exchange experiences and make proposals for
practical strategies to fight HIV/AIDS especially for prevention and
FIGHTING THE CULTURE OF DENIAL
Plenary Session 1:
HIV/AIDS Pandemic and Decent
Dr. B. Alli (Labour Protection
Department, ILO) examined the impact of HIV/AIDS on the world of
work. He singled out women as particularly affected because, in
addition to vulnerability to infection, the burden for caring for
the sick had also fallen mainly on them. Dr. Alli demonstrated that
HIV/AIDS was impacting negatively on the ILO's goal to promote
decent work for all, in which rights were protected, incomes
adequate, social protection available and all had access to income
generating opportunities. There was discrimination at the work place
and victimization of persons living with HIV/AIDS through various
pretexts, including retrenchment.
In addition to the adverse impact
on the quality of labour, meagre national funds had to be diverted
to this problem to the detriment of other social programmes and
services. Other important areas affected by HIV/AIDS were
productivity, social protection and social security. He cited social
dialogue as the niche where ILO had a comparative advantage based on
its tripartite structure. Four key issues were to be considered,
especially for people living with AIDS: security (social and
economic), participation by all, income and solidarity.
The Extent of HIV/AIDS Pandemic
in Africa and its Implications on the World of Work
Mr. Sy (UNAIDS) began his
presentation by providing statistics to underline the gravity of the
HIV/AIDS scourge in Africa. He noted that while Africa made up only
10% of the world population, at the end of 1998, 70% of those
suffering from HIV/AIDS (22.5 million people) were to be found in
Africa, out of a world total of 33.4 million. This compared
unfavourably with 1.4 million people in Latin America and 6.7
million in south and south east Asia. HIV/AIDS infection was
associated with substantial decline in life expectancy at birth,
which had eroded the gains that had been achieved after such great
effort. Citing the cases of Botswana and Malawi, he noted that the
life expectancy at birth had fallen from 60 to 50 years in the
former and from 40 to 35 years in the latter. There was a large
variation in infection rates among countries and also within regions
in the same countries.
He stressed that the mode of
transmission was known, i.e. through heterosexual sex, blood
transfusion and from mother to child. While the number of infections
was declining in other regions it was rising in Africa. The
socio-economic impact was very negative given the age of those
affected (i.e. 20 - 49 years), the most productive age group. While
a better understanding of the factors fueling the pandemic was
crucial, real behavioral change was critical, i.e. change in
attitudes at the work environment. Stigma and discrimination led to
denial at the individual level and further led to collective denial
which, in turn, led to more and more infection.
Mr. Sy pointed out that some groups
were more vulnerable than others. This was especially true of
immigrant labour in southern Africa. The vulnerability did not arise
from immigration per se, but from their way of living (e.g.
single men), the culture and their needs. Migrants traveled through
long distances paved with risks before arriving in southern African
mines. Moreover, further risks were entailed in their work in the
mines. Hence their notion of risks from HIV/AIDS may differ from the
perception of risks by other groups.
Poverty was another important
dimension of the vulnerability of groups to HIV/AIDS. Among the
poor, it was those who were better off who were more vulnerable. The
most vulnerable were not necessarily the poorest. It was thus
critical that there was a deeper understanding of the pandemic and
the structural factors fuelling it in order to develop an adequate
response. Responses would be needed at different levels - individual
personal behavior, people living with AIDS, the work place and at
the national level. It was critical to mobilize different sectors to
support an expanded response. It was also critical to support
individuals and communities to minimize impacts among individuals,
families and society. Openness rather than denial had been shown to
lead to good practice - as in Uganda and Zambia - in the type of
response of communities and the country. Finally, it was critical to
build partnerships and alliances to share information and resources.
Panel Session 1:
Impact of HIV/AIDS on the
labour force, enterprise and the economy in Africa
The Session, moderated by Mr. K.
Andoh (Director, ILO Office Pretoria), concentrated on the impact of
the pandemic on socio-economic factors relating to individuals,
enterprises and governments.
Dr. D. Ogaram (Government
of Uganda) said that the workplace deserved
particular attention with respect to HIV/AIDS as people spent 8 -10
hours of their time everyday there and social interactions relevant
to HIV/AIDS took place there. Therefore, correspondingly, preventive
material assistance and advocacy services were required there. These
should be extended to all workers, including management, since all
participated in social interactions and were equally exposed to
HIV/AIDS and so have equal risk. Dr. Ogaram used the equation:
Risk = Constant X Hazard X Exposure
to demonstrate that the only doable
way of reducing the HIV/AIDS risk was to reduce exposure. He
proposed that workplace-based strategy should include a
multisectoral, multidisciplinary, and participatory approach taking
into account legitimate interests. Dr. Ogaram confirmed that the
strategy worked as the experience of Uganda had shown.
Dr. J.P. Murphy (Business South
Africa - BSA) described the experiences of AIDS programmes in the
workplace stating that large organizations in South Africa such as
Eskom, Anglo American Barlows, and SAB had instituted AIDS
prevention programmes during the 1980's and 1990's. He outlined the
characteristics of successful HIV/AIDS programmes of organizations
as follows: AIDS was considered as a strategic business issue; there
was commitment from the top; they were participative, i.e. involved
unions and their representatives; they had a strategic plan. He
further elaborated that these programmes included both prevention
and help to HIV/AIDS infected people to cope with the disease. The
preventive programmes, which included information and education,
condom distribution and syndromic management of STD's, were extended
to families and communities of the workers.
Ms. Steele (South Africa Workers)
elaborated on the activities of the labour movement on HIV/AIDS. She
reported that the three major labour federations i.e. COSATU, NACTU
and FEDUSA had put together a Labour Movement Draft Workplace
Policy. The objective of this policy, which was to be implemented in
all workplaces by October 2000, was to reduce the number of new
infections among employees and their families and to ensure that the
rights of employees with HIV were fully respected. The policy
covered all employers and employees. She further talked about the
partnership that had been forged against HIV/AIDS, bringing together
the government, trade unions, and business, women and youth. Success
stories included HIV/AIDS projects in mining, transport and
manufacturing sectors. Concerns highlighted included fear of
disclosure of HIV/AIDS status in the absence of a conducive
environment, and the need to decentralize HIV/AIDS programmes to the
(Women Fighting AIDS in Kenya - WOFAK), dealt with the impact of
HIV/AIDS on individual women in the workplace especially regarding
psychological manifestations such as anger, depression, fear of
unknown, panic, blame, demoralization and loss of direction, Denial
and sometimes suicidal tendencies resulting from extreme stress.
These impacted negatively on productivity at the workplace.
Ms. Odhiambo informed the Workshop that her organization
had initiated a work place intervention programme that targeted
HIV-infected working women. It provided psychological support in the
form of counseling and education and helped the women to cope and
continue to be productive. Follow-up on the women living with HIV at
their work places had revealed that women who had received support
coped very well both at work place and at household level. WOFAK's
intervention had proved valuable for the usually neglected
psychological manifestation for which appropriate programmes needed
to be developed at the workplace.
Mr. Young, (Bureau of Statistics,
ILO), presented some statistical issues relating to HIV/AIDS. He
explained that existing statistics on HIV/AIDS were mainly
demographic and health related and that statistics on the economic
characteristics of HIV/AIDS individuals came largely from case
studies, anecdotal evidence, circumstantial arguments and logical
interrelationships. These latter statistics were however necessary
for both the long-term objectives of reducing the incidence of
HIV/AIDS and the medium-/short term objectives of developing
strategies for coping with, and mitigating the adverse consequences
for individuals and their households, enterprises and their workers
and governments and their citizens. Using an example of an African
country, he illustrated some analysis that could be done on the
impact on projections of the labour force and the sectoral price
differential for labour.
Mr. Young stressed that appropriate
methods for generating occupation-industry specific HIV/AIDS
incidence rates were required in order to take compensatory action
in the fields of training, wages policy, etc. In the medium to long
term, specialized household/enterprise surveys on labour force
characteristics and HIV/AIDS status of household members and/or
economic characteristics of household enterprises were the best
source for generating these kinds of data. In the short-term
however, we could incorporate economic characteristics in the
existing data collection instruments and mechanisms relating to
HIV/AIDS cases, for example the sentinel sites and HIV testing
centres, through adequate networking with relevant national,
non-governmental and international organizations.
Mr. Pierre Plamondon, (Social
Security Department, ILO), presented the ILO long-term model on
HIV/AIDS and social security that had been built to assess the
demographic impact of AIDS. As such, this model was an important
tool for actuarial work on social insurance schemes in countries
with high AIDS prevalence, notably in southern and eastern Africa.
When finalized, this basic tool would allow for the projection of
various social expenditures such as health, education and social
services, as well as cash benefits in formal sector social insurance
schemes. This would be followed by links between social expenditure
and the government budget by the estimation of changes in government
social expenditure and changes in government revenues over time. In
addition, the combination of an AIDS mortality model and a social
budget model would permit cost benefit analysis of different degrees
and intensities of early awareness campaigns. Such early awareness
would reduce infection rates, morbidity and mortality and thus avoid
a major part of later negative impacts on government spending and
income and economic growth.
In questions and observations from
the floor, the view was expressed that the negative impact of AIDS
was compounded by the impact of Structural Adjustment Programmes (SAPs)
which had increased unemployment through retrenchments, loss of
income, weakening of families and labour unions and their power to
negotiate and bargain collectively. Concern was expressed about the
difficulty in reconciling between confidentiality and the need for
employers to support infected workers who were normally breadwinners
for a large number of dependants. A suggestion was made that action
be taken to counter the taboo around sexually transmitted diseases.
It was lamented that women were bearing more than
their share in coping with the disease. They had to care for ill
family members often abandoning their jobs, and that had a negative
impact on food production. The issue of confidentiality was singled
out and it was suggested that a mechanism for disclosure to the
spouse would avoid future orphans. Issues relating to stigma and
pre-employment tests as well as to implications on training of
infected employees were mentioned. AIDS should be part of a
corporate policy, including counseling, but the culture of denial
and confidentiality was a stumbling block. ILO assistance in this
field was requested. The importance and sustainability of voluntary
programmes such as those used by the Zimbabwe Farmers Union were
underlined. Finally the difficulty in counseling at company level
given the premise of confidentiality was highlighted.
The discussant Mr. George Ruigu, (ILO
East Africa Multidisciplinary Team), based his summary of the
session on the findings of the study on "The impact of HIV/AIDS
on the productive Labour force in Africa (1994)" which covered
Rwanda, United Republic of Tanzania, Uganda and Zambia. The study
examined the impact of HIV/AIDS on both formal and informal sectors,
plantation workers and training institutions. The negative impacts
were underlined as loss in productivity, erosion of skills,
increased training costs, increased costs of health services and
collapse of micro and small enterprises. At national level, it was
noted that HIV/AIDS had exacerbated the already weak performance of
the African economies, which were implementing Structural Adjustment
Programmes. The retrenchment of workers tended to mitigate the
negative impacts of HIV/AIDS at the firm level, by providing a ready
pool of labour that could be used to replace those who were dying
from AIDS, especially among the unskilled level categories. In the
agricultural sector, the substitution of low value crops for high
value crops was stressed as negatively impacting on national
economies. The increased burden on women as health care providers
further reduced supply of agricultural labour. In parallel, child
labour was also increased by the death deaths of parents caused by
In concluding, the discussant noted
that ILO needed to give continuous and greater attention to the
impact of HIV/AIDS on employment. Since many activities which could
assist in combating the scourge fell outside its mandate, ILO should
establish institutional linkages with UNAIDS and other existing
programmes through networks to facilitate the exchange of
information among countries.
COMBATING HIV/AIDS IN THE WORLD OF WORK TO PROTECT LIVES AND PROMOTE
SOCIAL AND ECONOMIC SECURITY
Panel Session 2:
Analysis of Country and
Regional Strategies in place to Fight HIV/AIDS in the World of Work
The focus of the session, moderated
by Mr. Assefa Bequele, (Director, Labour Protection Department, ILO),
was on strategies and actions and lessons drawn from the
fight against HIV/AIDS in the world of work. These fell under:
1. concrete actions undertaken and
lessons learned from them;
2. opportunities the organizations
see for future action.
Ms. J. Hodges, (ILO Southern Africa
Multidisciplinary Team), introduced ILO's work on HIV/AIDS in the
world of work which had knowledge, service and advocacy as its axis.
In the field of research and dissemination of knowledge, the ILO had
undertaken specific studies in the area of the impact on employment
in four eastern African countries, published various manuals for
explaining the disease, contracted research on legal frameworks and
enterprise policies which were summarized in a volume and organized
meetings intermittently over the last decade. In the area of
services, the ILO had developed the model for plotting the social
security cost of HIV/AIDS to assist governments in their assessment
of current AIDS strategies; projects existed to develop income
generating activities for persons living with and affected by AIDS
provided technical assistance to SADC in the adoption and
implementation of its Code of Practice on HIV/AIDS and employment.
In the area of advocacy, the ILO was active in national country
teams of the United Nations (UNDAF).
According to Mr. As Sy, (UNAIDS),
UNAIDS worked at the country level with people with HIV/AIDS and
collaborated with interested parties (mainly business, organized
labour, NGOs etc.) by providing funding for innovative activities
aimed at fighting HIV/AIDS. It was involved in identifying best
practices in the world of work.
Dr. Roland Msiska, Chief Technical
Adviser of the UNDP regional project on HIV/AIDS, indicated that the
project collaborated with organizations working in the area of
HIV/AIDS prevention. Emphasis was placed on the private sector,
especially the informal and the small-scale enterprises sector,
which it had identified as a marginalized area in the fight against
HIV/AIDS. The project looked forward to the possibility of future
co-operation with the ILO in this sector.
The Representative of the UN
System-wide Special Initiative on Africa (UNSIA), Ms. Zemenay Lakew,
stated that UNSIA is a unique collaborative arrangement with
clustering of Africa-determined priorities under the leadership of
agencies such as the Bretton Woods institutions. It facilitated
working together to create synergy among the efforts of various
agencies through joint formulation of programmes and implementation
strategies, as well as monitoring and reporting of progress. At the
country level, it worked through the UN country team and as such it
could support the work of UNAIDS through expansion of agency
participation and facilitating the mainstreaming of HIV/AIDS into
other clusters such as education and governance. Following the
decision of the First UN Regional Coordination meeting held in
Nairobi in March 1999, it could also facilitate coordination work at
the sub-regional and regional level.
According to its Representative,
Ms. Alice Hamer, the African Development Bank (ADB), worked closely
with African govemments. Since 1990, it had made credit resources
available to 12 countries in Africa to finance HIV/AIDS activities
under wider health projects. This had been in the areas of drug
procurement, training of health personnel, information, education
and communication in HIV/AIDS prevention, blood safety, and
institutional strengthening of national HIV/AIDS programmes.
Recently, the ADB had made attempts to mainstream HIV/AIDS in other
projects it financed in diverse areas such as transport, education
and micro-credit. The ADB welcomed partnerships with UN agencies to
Ms. Reneé Saunders, who represented
the Office of National Aids Policy of the White House and the
Centers for Disease Control and Prevention (CDC) referred to some of
their activities in collaborating with business and trade unions in
the fight against HIV/AIDS in the workplace. In the African region
CDC had developed co-operation with the three trade union
federations in South Africa, namely, COSATU, NACTU and FEDUSA. With
funds provided by USAID, the project provided education and training
to all levels of trade union leaders. It assisted trade unions to
develop HIV/AIDS workplace policy. Technical support and grants were
provided to help the trade unions to implement HIV/AIDS programmes.
The President of the United States had launched an initiative
targeting 14 African countries in a bid to fight HIV/AIDS. The
components of this initiative were as follows: prevention,
assistance to HIV/AIDS orphans, home- and community-based care,
capacity building and surveillance.
In comments and questions from the
floor, some participants declared that they would prefer to see the
direct impact of the interventions of regional and international
organizations at the field level. They expressed concern that the
institutional approach of meetings and workshops might not have
sufficient impact on the ground.
In reply to this, it was pointed
out that in order to have a coordinated action between all
organizations involved, and to have a medium-term vision, these
exchanges of information were essential. It was however conceded
that there was a need for a better monitoring of these actions.
On the actions conducted in the
informal and small enterprise sector, it was mentioned that, unlike
large enterprises, this was a difficult sector because of the very
nature of this environment.
In summarizing the discussions, Ms.
R. Vejs-Laursen (Job Creation and Enterprise Department, ILO),
pointed out that we should all keep in mind the complex nature of
the HIV/AIDS problem. Not only did the impact manifest itself on the
individual, family, community and society levels, it also had
dimensions that were both quantifiable and non-quantifiable. Among
the lessons learned so far, we had:
- a lot of
activities had been implemented for the formal sector, so we were
not starting from scratch;
- the nature
of the problem was complex and multi-disciplinary. The response
would also have to be multi-disciplinary;
- SADC code
was an important reference for present "best practice" in labour
law reform and how to address discrimination at the workplace;
partnerships and strategic alliances between different ministries,
UN agencies, other organizations and civil society were essential;
organizations were active and willing to continue addressing this
issue and all recognized it as a priority area;
- there was a
need to be focused, realistic and yet patient as shown by the
experience from the United States;
activities had been well implemented on sensitization; it was now
time for action and for focussing on protection and care at
As opportunities for further
action, it was necessary to:
- address the
situation in the informal sector and for micro and small
enterprises, which catered for the majority of employment, in
addition to the work that had so far been done with large
and disseminate best practices regionally and to continue to
reinforce the good work already being done;
and expand efforts to mainstream AIDS in all activities. This was
applicable to all players;
national strategic and resource mobilization plans to ensure
focused and consistent action;
on the presence of all the agencies present to achieve concrete
and integrate these actions towards one common objective.
Plenary Session 2:
Twelve presentations were made
comprising of four from governments, four from employers'
organizations and four from workers' organizations.
According to these presentations,
national structures for the prevention and control of HIV/AIDS were
in place and had embarked on activities to create awareness about
the HIV/AIDS pandemic. Increasingly the focus of attention was being
shifted to the impact of HIV/AIDS at the workplace. This could be
attributed to the active involvement of the social partners in the
fight against HIV/AIDS.
The workers' and employers'
organizations at the national levels had embarked on many activities
in the areas of awareness creation, formulation and implementation
of work place policies on HIV/AIDS and distribution of condoms at
the work place etc.
Although the social partners had
realized the need to go beyond sensitization of their general
membership they had been constrained by lack of funds and technical
expertise in expanding their activities. Activities carried out so
far had been dependent on donor funding. The other major constraint
had been lack of legislation to protect the rights of workers with
HIV/AIDS, and where legislation existed, lack of proper
implementation on the ground. The complexity of the HIV/AIDS issue
necessitated the need for concerted effort by the social partners in
an integrated manner instead of the current one-off activities being
implemented by employers' and workers' organizations.
Attempts by the social partners in
fighting HIV/AIDS had been limited to the formal sector workforce
despite the fact that the majority of the working people were found
in the urban informal and rural sectors. Given the financial
constraints faced by employers and workers organizations, the
sustainability of the activities being implemented by them to fight
HIV/AIDS was very much uncertain in the medium- to long-term.
Request for ILO's assistance in the areas of financial support for
educational activities and, most importantly, technical support for
mainstreaming HIV/AIDS in the work of employers' and workers'
organizations were strongly put across.
A specific request for ILO's
assistance in setting up health insurance schemes which would cover
both formal and informal sector workers and thus would help them to
meet their medical expenses was put forward. The issue of enhancing
capabilities of the social partners to address HIV/AIDS concerns in
the workplace through collective bargaining was also raised, as well
as the enactment and enforcement of legislation to protect HIV/AIDS
The political will as well as the
commitment of the public authorities towards HIV/AIDS prevention
came out as critical issues which would go a long way to determine
the success of HIV/AIDS initiatives taken by concerned
organizations, such as the employers and workers organizations.
Panel Session 3:
Gender Sensitive National and
Workplace Policies on HIV/AIDS
Mr. Touré, (Deputy Regional
Director, ILO Regional Office, Abidjan), was the moderator for the
session. He pointed out the necessity to conceptualize the "social
vaccine" that was required to cope with the impact of AIDS.
Furthermore, he underlined that it was not only a question of having
a social vaccine but also to ensure access by all to the vaccine.
Emphasizing the particular vulnerability of women, he gave the floor
to the two panelists.
Ms. Mendoza, (UNAIDS, Geneva),
presented five primary gender-linked trends of the epidemic and then
shared with the participants the 10 major lessons learned from
UNAIDS work globally. These were as follows:
1. Social norms created economic,
social and cultural gaps between women and men.
2. Risk and vulnerability occurred
at all levels.
3. Transformation of roles, norms
and social structures were needed.
4. Social gate-keepers and civic
society had to be involved.
5. Interventions should place
people in the context of relationships.
6. Interventions were more
effective if infections-education was provided.
7. Girls should be kept in schools.
8. Transformation of men and their
9. Gender sensitive interventions
for the workplace.
10. Empowering the socially,
culturally, politically, economically poor.
The second panelist, Ms.
Amri-Makhetha, (ILO Area Office, Pretoria), emphasized in her
presentation that both men and women were vulnerable to this
pandemic. Nevertheless, women were particularly vulnerable and this
was the reason for focusing on a gender component. The panelist
referred to the ILO mandate; the need to have short-, medium- and
long-term strategies, and the need to incorporate AIDS in technical
programmes. Therefore, the panelist presented ideas and
recommendations on how the ILO should introduce the AIDS component
in its various capacity building programmes.
During the discussions, several
comments were made on what should be the specific gender policies.
It was pointed out that women would have to participate fully in the
decision-making processes. An intervention pointed out that, given
the current economic circumstances in many countries, the
international labour standards and conventions were too expensive to
implement. In general, the concerns were on how best to reach out to
the informal part of the economy and to those enterprises in rural
GROUP WORK: DRAFT PLATFORM OF ACTION
Four working groups focused on the
social and labour issues of HIV/AIDS, possible responses and
strategies, roles of governments, employers and workers, expected
ILO assistance on the pandemic. Group work resulted in the drafting
of a draft Platform of Action.
DISCUSSION AND ADOPTION OF THE DRAFT PLATFORM OF ACTION AND WORKSHOP
The draft Platform of Action was
discussed at length and then adopted as amended by the participants.
The Workshop Report was also adopted by the participants with
amendments in writing to be incorporated later.
In her closing remarks, Dr. F.
Fall, the Representative of the participating employers'
organizations praised the cordial atmosphere with which
deliberations had taken place during the Workshop. The adoption of
the draft Platform of Action was only the beginning in the fight
against this pandemic which was threatening the already fragile
African economies and the productivity of African businesses.
Participants on return to their countries should bring to the
attention of their member organizations the conclusions reached and
should continue to strengthen the tripartite dialogue started during
the Workshop. She thanked His Excellency, President Sam Nujoma, for
his interest in the prevention of HIV/AIDS and also the people of
Namibia for their warm welcome. Dr. Fall expressed the gratitude of
the participating employers' organizations to the ILO for organising
this Workshop and looked forward to the immediate implementation of
the Platform of Action.
Ms. M. Makoffu, the Representative
of the participating workers' organizations, stressed on the
importance of the draft Platform of Action in guiding the work of
all stakeholders in HIV/AIDS, when making her closing remarks. She
stated that the workplace was ideally suited for combatting this
pandemic which had to be fought at all levels and by everyone
through the forging and building of partnerships and alliances. The
draft Platform of Action should now be translated into concrete
action by all participants on their return home. Ms. Makoffu thanked
the ILO for its continued interest in responding to the needs of the
working people of Africa as demonstrated by the organization of this
Workshop in collaboration with UNAIDS.
Dr Sy, the representative of UNAIDS,
exhorted participants to engage in a journey of real partnership and
collaboration "from fear and despair to hope, from denial to
openness, from stigma and discrimination to compassion, from
exclusion to inclusion (no more them and us, but WE)." He expressed
the commitinent of UNAIDS to work with the ILO to respond to this
pandemic through support for activities in the world of work. Dr Sy
thanked everyone for the hard work done during the Workshop.
Ms. Chinery-Hesse, Executive
Director, Social Protection Sector, ILO, thanked the Honourable
Minister of Labour, Mr. A. Toivo Ya Toivo, for gracing the occasion
with his presence and agreeing to formally close the Workshop. She
emphasised. that given the spirit with which all participants had
worked during the Workshop, we were all now friends-for-a-cause, the
eradication of HIV/AIDS in Africa. Ms. Chinery-Hesse expressed her
thanks to the participants as well as all those who had contributed
tirelessly to the organization and implementation of the Workshop.
Finally, she thanked His Excellency, President Sam Nujoma, and the
people of Namibia for agreeing to host the Workshop and receiving
all of us so warmly in their country.
Honourable Andima Toivo Ya Toivo,
the Minister of Labour of Namibia, reminded the Workshop of the
concerns of all African countries about the threat of the HIV/AIDS
pandemic. Not only were the most productive skilled section of the
population dying but also innocent children were dying or being
orphaned. He expressed the hope that the sharing of experiences in
the fight against this pandemic during the Workshop had led to
concrete strategies being proposed. The implememation of these
strategies, he asserted, was the responsibility primarily of
govemments and their social partners. While thanking the ILO for
their efforts in this regard, the Honourable Minister stressed that
it was up to Member States to inform the organization of the help
they desire and to ensure that this help was properly utilised. He
expressed his appreciation to UNAIDS and UNDP for their help and
requested all participants to implement the conclusions reached on
their return home. The Honourable Minister then declared the
Workshop officially closed.
PLATFORM OF ACTION ON HIV/AIDS
CONTEXT OF THE WORLD OF WORK IN AFRICA
AIDS threatens every man, woman and
child in Africa today. The pandemic is the most serious social,
labour and humanitarian challenge of our time. Since its start two
decades ago, AIDS and HIV have taken a catastrophic toll in Africa,
decimating its population, tearing apart the very social fabric of
its societies and threatening its economies. Its toll of
debilitating illness, widespread and indiscriminate death,
deteriorating quality of life and life expectancy, threatens to
reverse the hard won social and economic gains of African countries
and ultimately, the very future of the continent.
AIDS is rapidly becoming the single
most serious threat to social and economic progress in Africa today.
The true cost of the pandemic is almost incalculable. Its impact is
aggravated by the overall economic, political and social context, as
well as some cultural practices, dominated by a weak economic base,
high unemployment, pervasive poverty, and the negative consequences
of structural adjustment, all of which further undermine Africa's
ability to compete in the global market.
The pandemic has manifested itself
in the world of work - the area of the ILO's mandate - in the
following ways: discrimination in employment, social exclusion of
persons living with HIV/AIDS (PLWHA), additional distortion of
gender inequalities, increased numbers of AIDS orphans, and
increased incidence of child labour. It has also disrupted the
performance of the informal sector and small and medium enterprises
(SMEs). Other manifestations are low productivity, depleted human
capital, challenged social security systems and threatened
occupational safety and health, especially among certain groups at
risk such as migrant workers and their communities and workers in
the medical and transport sectors.
Clearly, AIDS is no longer just a
health problem. It is a developmental crisis with potentially
ominous consequences for Africa and the world. Yet, a culture of
silence, fear and denial continues to reign and prevent action. The
stigma and the fear engendered by AIDS fuels discrimination,
persecution and ignorance. Despite this, the spread of AIDS can
be prevented. A multi-dimensional response to AIDS is needed to
prevent its spread and protect those who live with its consequences.
In the absence of a cure, what is needed is a "social vaccine" that
includes such elements as social inclusion, income and job security,
social security and solidarity.
In search of awareness, action and
commitment, participants from 20 African countries, meeting in
Windhoek from 11 to 13 October 1999, in tripartite delegations,
adopted the following Platform for Action to respond to this crisis
at workplace, community, national, regional and international
The Meeting called upon all African
governments to declare HIV/AIDS a national disaster requiring urgent
attention and mobilisation of resources.
It was agreed that the following
would form a set of overall principles, which should guide the
formulation of policies and programmes:
1. Tripartism, allied with civil
society, NGOs and other stakeholders.
2. Social justice and compassion
for People Living with HIV/AIDS (PWLHA).
3. A sense of shared responsibility
among all actors.
4. Good governance, transparency
and accountability for results.
5. Partnerships among international
and national agencies to complement one another on the basis of
It was agreed that, while awaiting
a medical vaccine, the aim should be to apply a "social vaccine" for
prevention and protection which would include elements such as:
social inclusion, income and job security, social security,
solidarity and optimal use of treatment.
In order to achieve these goals,
action backed by strong African political, religious, traditional
and community leadership and commitment should focus on:
1. Fighting the culture of denial;
2. raising national awareness of
the incidence and impact of the pandemic through, among other
things, information, education and communication;
3. eliminating the stigma and
discrimination attached to HIV/AIDS by adopting and applying ILO's
international labour standards and national labour legislation;
4. documenting and disseminating
information and statistical data through effective labour market
5. strengthening the capacity of
the social partners to address the pandemic;
6. empowering women economically,
socially and politically in order to reduce their vulnerability to
7. promoting the transformation of
gender roles, norms and social structures;
8. integrating HIV/AIDS in existing
social security schemes and developing new ones to ensure coverage
9. building capacity to address the
dilemma facing AIDS orphans and children exposed to infection or
forced into child labour;
10. incorporating HIV/AIDS
considerations into the national development agenda and budget
11. creating a rapid response
mechanism to mitigate against the implications of the pandemic;
12. promoting income and employment
opportunities for PLWHA and their families through, for example,
informal sector and small enterprise development;
13. strengthening occupational
safety and health systems to protect groups at risk;
14. formulating and implementing
social and labour policies and programmes that mitigate the effect
15. effectively mobilizing
16. improving availability and
affordability of drugs;
17. incorporating HIV/AIDS in
collective bargaining agreements.
In order to mount an effective
response to the HIV/AIDS crisis and address its many faceted
implications, national level partnerships should be built rapidly
among all the key actors: governments, employers' and workers'
organizations, NGOs and other civil society groups, including
religious and traditional leaders. Partnerships should also be
forged among and with bilateral and multilateral agencies, as well
as regional organizations and UN agencies through among others,
joint planning, collection, dissemination and exchange of
information on good practice and ensuring synergy in programmes.
OF THE ILO
The ILO should strengthen its
activities in fighting HIV/AIDS in the Region through improved
knowledge, vigorous advocacy, and expanded services. The ILO
tripartite structure provides a unique mechanism for intensifying
the response to HIV/AIDS.
1. In order to avoid duplication of
efforts, the ILO should collaborate with concerned international
organizations, participate in the decision-making process regarding
HIV/AIDS at the global level, and consider becoming a co-sponsor of
2. The on labour and social issues
for responding to the design of research and programmes on HIV/AIDS.
ILO should adapt and apply concepts, methods and tools it has
3. The ILO should expand its
capacity to deal with HIV/AIDS, especially in its multidisciplinary
teams, through, for example, training, resource mobilization and
secondment of experts from UNAIDS.
4. The ILO should undertake
research and surveys to determine the implications of HIV/AIDS for
the world of work, including its effects on the growth of the labour
force and participation rates, women, child labour, union
membership, productivity and competitiveness, informal sector and
small enterprise development.
5. The ILO should document and
disseminate through all appropriate means information on national
experiences including best practices.
6. The ILO should engage in
advocacy and training on HIV/AIDS and the world of work targeting
the political leadership, workers' and employers' organizations and
7. The ILO should include HIV/AIDS
in its regional meetings and consider organizing a special session
on the subject at the International Labour Conference.
8. The ILO should integrate
HIV/AIDS issues and gender components in all its programmes and
technical cooperation projects in the region.
9. The ILO should develop a policy,
programme and structure to address the issue of HIV/AIDS and the
world of work.
10. The ILO should strengthen the
capacity of its social partners to formulate and effectively
implement policies, programmes and activities at the national and
11. The ILO should consider
submitting this draft Platform of Action on HIV/AIDS in Africa to
the 9th African Regional Meeting (Abidjan, 8-11 December
1999) for its consideration and formal adoption.
CALL FOR IMMEDIATE ACTION
Action against HIV/AIDS is
primarily a national responsibility. The enormity and exceptional
nature of the problem require exceptional measures. Member States
are therefore urged to adopt and implement this Platform of Action
on an urgent, immediate and continuous basis.
Opening speech by Ms. Mary
Executive Director, Social
Protection Sector, ILO
It gives me a great pleasure to
participate in this important Tripartite Workshop on Strategies to
Tackle the Social and Labour Implications of HIV/AIDS in Africa. On
behalf of the Director-General of the International Labour Office,
Mr. Juan Somavia, I welcome you all most warmly.
This workshop is convened as a
result of the strong representation made to the Director-General by
the OAU Labour and Social Affairs Committee Meeting which convened
here in Windhoek in April this year, for the ILO to assume its
responsibility of assisting its African tripartite constituents to
combat the ravages of this terrible pandemic as it affects the world
I would like to emphasize here that
our intervention in this matter is only relevant if it brings added
value to the international effort to contain the HIV pandemic. With
so many players in the field, even as we cooperate and coordinate
our interventions with other partners, it is important that we
maintain our focus. This is why we welcome our collaboration with
the Joint United Nations Programme on HIV/AIDS (UNAIDS), who are
co-sponsoring this meeting, and who have an overview role in these
matters, and can thus assist us in identifying and promoting our
special niche and comparative advantage amid the myriad of
initiatives on this subject.
In the coming days, there will be
many presentations which will clearly justify the pressure of our
constituents on the ILO to be involved in this area of work. These
selected facts demonstrate the devastation this pandemic continues
to wreak; and why our constituents are alarmed.
The HIV pandemic in Africa, despite
efforts to contain it, still continues to pose major challenges in
the world of work and to society as a whole. Worldwide, nearly 34
million people are currently living with HIV/AIDS, and one-third of
these are young people between the ages of 10 and 24. Sub-Saharan
Africa is the most affected. More than 11 million Africans have
already died, and another 22 million are now living with HIV/AIDS.
Nearly 10 million more deaths are expected by 2005. In many of the
21 countries identified as having the highest HIV prevalence in
Africa, one in four adults is infected.
Furthermore, in at least 10 other
African countries, the prevalence rates among adults exceed 10 per
cent. In 1998, at least 4 million people were newly infected with
the virus. Among HIV infected globally, six out of ten men, eight
out of ten women, and nine out of ten children live in Africa. As
many as 650,000 African babies are estimated to be born with HIV
this year. The erosion in the improvement in life expectancy rates
in Africa constitutes a cause for concern.
The disease kills both old and
young, but mainly strikes people in their prime years. The current
pattern of the disease is that it hits people hardest in their
productive years. Over 80 per cent of AIDS deaths have been in the
age group of 20 to 49 years old. Consequently it profoundly disrupts
the economic and social bases of families.
What is more alarming is the report
recently released by the World Bank that the world has witnessed
only 10 per cent of the illness and death that this pandemic will
bring. The forecast is that the real impact on people, communities,
economies is still to come. Quite a frightening picture.
The primary goal of the ILO, which
is to promote opportunities for women and men to obtain decent and
productive work, in conditions of freedom, equity, security and
human dignity is obviously being adversely affected by this HIV/AIDS
pandemic, which hangs over Africa's accelerated development efforts
like a sword of Damocles. The loss of income and output is
HIV/AIDS has many aspects, and as I
have stated earlier, the ILO has to be careful to address those
matters which fall within the area of its mandate. So, what are the
issues of greatest concern to the ILO which should constitute our
entry point for intervention? I can mention the following:
- The first
relates to discrimination in respect of employment and occupation.
I do not think anybody can challenge the fact that people living
with HIV/AIDS tend to be discriminated against.
HIV/AIDS has created a situation where children are being pulled
out of school to take care of a sick relative. It has also created
a large number of orphans who are sometimes forced to find a way
to provide for themselves and their siblings, taking the place of
dead parents or relatives. This situation can lead to exacerbation
of the problem of child labour which the ILO is vigorously
fighting to eliminate.
HIV/AIDS also impacts negatively on employment. The adverse effect
on business and enterprise is well-documented, and will be
reported upon later. Small and medium-sized enterprises (SME) and
the informal sector are currently regarded as spearheading growth
in many African countries. More than half of Africa's private
sector is made up of informal/SME sector. HIV/AIDS has devastated
this sector with very undesirable consequences.
HIV/AIDS also affects the quality of labour. As I stated earlier,
it tends to disproportionately afflict working age persons. The
experienced labour force continues to be taken out by the disease,
thus negating all the investment made in skills training, and
draining enterprises of crucial brain and manpower, not to talk of
the additional resources necessary for training of new recruits to
fill places vacated through these deaths. The negative impact on
productivity is clear due to factors such as absenteeism and
reduction in performance and cognitive ability. Additional
resources have also to be applied for health care, thus siphoning
away funds which might be better used for investments purposes.
according to a 1999 USAID review, four out of five HIV-positive
women live in Africa. The report further adds that young women of
child bearing age - ages 15 to 24 - are twice as likely to be
infected as males in the same age group. The impact of this state
of affairs on families in terms of the burden African women now
carry, in many cases, as heads of households and sole
bread-winners, need no further expansion. There is a gender
component to HIV/AIDS in Africa which cannot be ignored.
- Further, we
have concluded that HIV/AIDS may ultimately drive the social
security schemes in many countries in Africa into bankruptcy,
since it decreases contributions, while accelerating payments to
labour migration has been identified as a culprit for the spread
of the disease; and migration is an important theme for the ILO.
Of course, what I have listed is by
no means exhaustive.
The ILO has not been completely
dormant these past years in confronting this daunting health
problem. For example, we have attempted to sensitize member States
to the fact that a number of ILO core Conventions and other
International Labour Standards contain provisions that enable
governments, employers' and workers' organizations to deal with
issues of discrimination and human rights, as well as occupational
safety and health. The ILO Social Security Department has developed
a model, which aims at assisting member countries to assess the
impact of HIV/AIDS on their social security and health schemes. This
model will be presented to you at this workshop.
I would not want to take any more
time by enumerating our past, current and planned activities in this
area. My colleagues of the ILO will do that in the coming days more
effectively. I would just like to say that we are convinced that
because of our tripartite structure and our extensive experience in
the promotion of rights at work, social protection, employment and
income generation and social cohesion through dialogue and human
resource development, the ILO is definitely positioned to assist in
slowing the spread of HIV/AIDS, and in mitigating its social and
We can play an important part in
the improvement needed in the workplace to created an atmosphere
conducive to the welfare of workers and the safeguarding of the
productive capacity of African countries. We can achieve this by
emphasizing the collective responsibility of workers in this fight
through our workers' education programmes, by sensitizing employers
to make HIV/AIDS a corporate priority, and by increasing the
recognition of Governments of its negative impact on development
Our expectation is that this
workshop will help to define the appropriate response of the ILO in
face of this terrible scourge, and help us to map out an integrated
and coherent approach which will enable us to make a difference in
the shortest possible time. Beyond the rhetoric, we expect no less
from you than a realistic platform of action on "Strategies to
Tackle the Social and Labour Implications of HIV/AIDS". This will
then provide us with an agreed basis for our cooperation for the
Finally, while the whole world is
waiting for a vaccine, in the medical field, to prevent HIV/AIDS,
let us make use of what we presently have - ILO traditions and
values such as tripartism, equality, and social justice, to
effectively develop, shall I say, a social vaccine?
I cannot end without extending our
gratitude to our gracious hosts, the Government and people of
Namibia, and to you Sir, for agreeing to grace this function.
Opening speech by His
Excellency Sam Nujoma,
President of Republic of
read by Hon (Dr.) L.
Amathila, Minister of Health and Social Services, Namibia
Master of Ceremony
Mrs. Chinery-Hesse, Executive
Director for Social Protection at the ILO
Representatives of various Governments taking part in this workshop
Leaders of Employers' and Workers'
Members of the Diplomatic Corps
Ladies and Gentlemen
It gives me a great pleasure to
welcome you all to this workshop.
It is gratifying to see
representatives of employers, of workers and of Governments coming
together in an attempt to develop regional strategies to tackle
social and labour implications of HIV/AIDS.
I am informed that 20 countries are
participating in this very important workshop. This makes our
deliberations twenty times richer, and perhaps many times more,
considering the potential input of representatives of international
development agencies present here.
On behalf of the people and the
Government of the Republic of Namibia, I would like to welcome you
all to this very important workshop. I would particularly like to
thank the ILO for choosing Namibia to be the venue of this very
important workshop, the Regional Tripartite Workshop aimed at
tackling social and labour implications of HIV/AIDS.
The UNAIDS Fact Sheet of May 1996
informed us that by that year, HIV prevalence was highest among 20
to 30 year old women and 30 to 40 year old men. The same source
informed us that if that pandemic trend continued through to the end
of the decade, between 30 and 40 million adults worldwide will have
been infected with HIV by the year 2000.
The predilection has proven to be
correct and by now 30 million people are infected. Already in 1998,
the Namibia Human Development Report by the UNDP informs us that a
total of 21.5 million African men, women and children were said to
be living with HIV/AIDS, which forms 69 per cent of the world's
total infected persons.
This is a frightening trend, is it
not unfortunate that because of its nature of transmission, HIV/AIDS
tend to strike those in their most economically productive years;
the result being that illness and death have most impacted on the
labour force and overall economic performance of our countries.
On the 19 April this
year, I stood before 380 delegates from various member States of the
Organization of African Unity, development partners and
international development agencies who gathered here in Windhoek, to
discuss labour and social issues, within the framework of the 22nd
Session of the OAU Labour and Social Affairs Commission. I recall
noting to these audiences my observation that the threat of HIV/AIDS
infection and its impacts on labour, employment and social issues
was not taken up seriously in the agenda of that Session. I also
noted that unless Africa was prepared and ready to tackle this
deadly disease effectively and openly our efforts will be in vain.
I am informed ladies and gentlemen,
that you are here to make a concrete follow up on that observation
and I thank the ILO sincerely for taking me and the people of
You would definitely share with me
the undeniable facts, that skilled and productive people are being
lost every day, children are orphaned, families are robbed of their
breadwinners, employers are robbed of their most productive skilled
workers, nations and societies are losing their most productive
labour force. The performance of most workers is negatively impacted
by the HIV/AIDS pandemic.
One of the recommendations of the
22nd Session of the OAU Labour and Social Affairs Commission was
that the situation of HIV/AIDS should be an agenda item in all the
relevant meetings regarding social and economic affairs.
This workshop should therefore
advise on the best procedures that we member States can follow to
ensure comprehensive information sharing regarding successes in
developing strategies to tackle HIV/AIDS pandemic and its impacts on
our socio-economic development.
I am aware that some efforts have
been made at the sub-regional level of the Southern African
Development Community, SADC, that of developing the SADC Code on
HIV/AIDS and Employment. My Government, through the Ministry of
Labour in conjunction with the Ministry of Health and Social
Services and the Labour Advisory Council has developed a National
Code on HIV/AIDS and Employment in 1998.
The Code is an integral part of the
Government's commitment to address most of the major issues related
to the prevention of new infections and the provision of optimal
care and support for the work force. The development of such a Code
was primarily brought about by the gravity and impact of the
pandemic as well as the potential for discrimination at workplaces.
I am sure that there has been both
negative and positive experiences regarding the introduction of that
Code and its application. I also hope that Namibia is not alone
regarding such development. I am therefore hoping that our
collective experience in this field would help to enrich your
Finally, I would like to request
this workshop to take up the challenge of deliberating on how far we
should go medically and otherwise to make HIV/AIDS a reportable
disease, to take the disease out in the open, so that those affected
must get all necessary support.
I thank you.
Opening speech by Mr. As Sy,
Representative of UNAIDS
"I don't have a problem with the
virus but with us people. I have learned to be clear with myself,
and this epidemic has taught me one thing: that is I want to fight,
and on your side".
Those were the words of Dr. Rieux,
the hero of the Albert Camus novel "The Plague."
Throughout history, societies have
been affected by epidemics and other natural catastrophes and
individuals, families, communities and nations have mobilized and
developed responses to those challenges.
More than ever before that
mobilization is needed: HIV/AIDS is calling for it!
There is a pandemic jeopardizing
our hard won gains in health and socio-economic development, and
threatening the human resource, our most valuable resource.
The involvement of the ILO in
responding to HIV/AIDS and addressing the different challenges posed
by the pandemic is a natural dynamic.
The United Nations family
recognized the necessity of addressing the multiple facets of the
AIDS pandemic, and established UNAIDS, the Joint United Nations
Program on HIV/AIDS.
The program is coordinating and
facilitating the response of the whole UN family, beyond the
Let's remember that we are dealing
with an evolving pandemic, and that the response that also be an
evolving one. And UNAIDS will continue to evolve by including new
and more co-sponsors. It will be curious to know who's next.
On behalf of UNAIDS, welcome to the
Opening speech by Michael
P. Besha, Assistant Secretary General,
OATUU on behalf of workers'
Honorouble Dr. Libertine Amathila,
Minister of Health and Social services, Namibia,
Ms. Chinery-Hesse, Executive
Mr. As Sy, Representative of the
Joint United Nations Programme on HIV/AIDS (UNAIDS),
Mr. Ahmar Toure, Deputy Regional
Director ILO-activities in Africa,
officials from the ILO offices in
Geneva, Abidjan and Pretoria,
Government, employers' and workers'
representatives attending this workshop,
members of the press,
ladies and gentlemen,
It is my singular honour to take
this opportunity on behalf of the Organization of African Trade
Union Unity (OATUU), all its affiliates represented in this
workshop, and our colleagues of the ICFTU-AFRO to salute this
We would like to thank the
International Labour Organization (ILO) and the Joint United Nations
Programme on HIV/AIDS (UNAIDS), for organizing this workshop and
inviting us to attend.
We express our deep thanks to the
Government and people of Namibia for the wonderful reception we have
received since our arrival here.
Mr. Chairperson, the objectives of
this workshop stated in the letter of invitation are:
- To exchange
information on experiences and actions taken by Governments,
employers' and workers' organisations to deal with the problem of
HIV/AIDS at/and through the workplace, and
their needs for a more effective prevention policy and a workplace
based programme of action.
Chairperson, these objectives, in
particular the second one, are not only valid and timely, but may I
suggest, rather overdue so far as our ILO tripartite machinery is
concerned. I am saying so, Chairperson, because it was from 29
November to 1 December 1994 - five years ago, that we met in
Kampala, Uganda, in a tripartite workshop for anglophone Africa on
the role of the organized sector in reproductive health and aids
prevention. I do not know when a similar francophone or lusophone
workshop was held , and I am not sure whether there has been any
follow-up tripartite workshop after the one held in Kampala.
Chairperson, I am certain that many
of us here, will give a catalogue of meetings, seminars, and
workshops we have either attended or organized on HIV/AIDS. Indeed,
many will report of seminar, workshop or meeting conclusions,
resolutions and commitments to the prevention of HIV/AIDS. Some will
probably present case studies, interviews, recorded messages etc. as
evidence of their various experiences on the fight against the
killer disease. My organization OATUU for instance in collaboration
with some of our affiliates, have organized many seminars, workshops
and meetings, developed many study materials and research findings;
trained trainers and followed up the trained officers' activities at
workplaces - all in the struggle against HIV/AIDS and contributing
to the care for those living with AIDS.
Many worker representatives will, I
am certain, have similar experiences and actions to report.
Government and employers'
representatives, no doubt will also have a lot to say on what they
have done to combat the HIV/AIDS pandemic.
In spite of all our experiences and
actions, the HIV/AIDS situation in Africa is alarming. We are told
for instance that in 1998 alone, 2 million people died in Africa as
a result of AIDS and related diseases. It is also reported that in
South Africa, 1,500 new cases of HIV/AIDS are reported every day,
and that 20 per cent of the reproductive work force in the major
cities of Africa, are affected with the virus. Participants have, I
am certain experienced in one way or another, the trauma caused by
the loss of friends, relatives and fellow workers or the pains of
taking care of those living with AIDS.
It is for this reason that the
second objective of this seminar is crucial and that we spend more
time in realising it. This is:
identification of workers', employers' and governments needs for a
more effective execution policy and a workplace based programme of
In doing this, we shall have to
seriously ask ourselves several questions:
- How much
have we done to combat HIV/AIDS?. To what extent have the ILO,
Governments and employers collaborated with workers and
effectively involved them in the formulation, implementation and
monitoring of policies, strategies and programmes to combat
HIV/AIDS. What programmes have the ILO put in place to combat
AIDS? How are they monitored?
Workers' organizations have
structures at all levels-right up to the workplace. With the meagre
resources they have, many have initiated various programmes that
and sensitization of the workers and their families on the
prevention of HIV/AIDS;
of study materials, posters, etc. For the same purpose;
some research which has been instrumental in the formulation of
national and even subregional policies and programmes to combat
In short, Chairperson:
- The workers
and their organization structures are ready. They have already in
many places involved themselves in the struggle to combat the
pandemic. What they need are, among others:
- To be
effectively involved in all policy formulations, implementation
- To be
effectively assisted in terms of resources;
- To be
heard. There are for instance complaints of discrimination of
people living with AIDS. These are negative attitudes on the part
of some employers to the whole questions of HIV/AIDS. All these
must be addressed.
In our efforts to combat HIV/AIDS
no stone should be left unturned. It is essential to address
ourselves to the issues of unemployment, poverty alleviation,
problems connected with falling levels of education of health
delivery services - all of which contribute to the failure to stop
the spread of HIV/AIDS.
Workers and their organizations are
ready. It is time for the ILO and all of us to do more than ever
before to stop the spread of HIV/AIDS and to improve the care of
those living with aids. It is time that ILO committed itself firmly
and actively to play its role in combating HIV/AIDS.
We are all at stake, as
individuals, as families, as citizens of our nations and as
This workshop must not be a
talkshop. It must end with something tangible, workable - and one
that can be monitored, evaluated and remodelled to bring about
change and effectively stops the spread of the HIV/AIDS pandemic and
its effects on our people, our economies, our countries.
I wish all of us a very successful
Opening speech by Mr.
President of Ethiopian
The Employers' group is happy and
concerned to address this important issue which affected the
workplace by creating human and material damage to the society and
the business at all.
After the deliberations of this
two-day meeting, the employers are committed to implement it, and
this can be achieved if the social partners work hand in hand.
Specially, the Government has to put more and more efforts to tackle
The ILO support is very important
to help the employers in creating awareness and helping the already
Therefore, I wish a successful
meeting to deliberate a platform of action plan.
Closing speech by Dr. F.
Madam, Executive Director of the
ladies, gentlemen, representatives
of international or government institutions,
We are now almost at the end of
this Regional Tripartite Workshop on Strategies to tackle Social and
Labour Implications of HIV/AIDS. This choice of topic could not be
more apt at a time when various research carried out so far has
established the pandemic character of AIDS as well as the
devastating implications that this scourge can have on the level of
development of our fragile economies and on the productivity of our
enterprises. I would like to emphasize the intrinsically friendly
atmosphere that has prevailed throughout these 3 days we have spent
together. Such an atmosphere has favoured the institution of
exhaustive reflection and fruitful discussions which have enabled us
to establish a diagnosis of the situation prevailing in our
countries, to exchange our different national experiences and to
elaborate a platform of action.
I would like to draw your attention
to the fact that the work has only just begun and that the hardest
part is yet to be done. In fact, as soon as we return to our
respective homes, we have a duty to report on all the conclusions
that have arisen from our work together as members of the
organizations we represent. It is also a must that the tripartite
dialogue launched here be continued and further developed at the
I can not finish without addressing
our sincere thanks and deep gratitude on behalf of all the
Employers, to his Excellency Sam Nujoma for his special interest in
the prevention of HIV/AIDS in the work environment by accepting to
lend his support to this Workshop.
Our thanks also go to our brother
Namibian people for their sense of hospitality and their warm
We congratulate the ILO for giving
us the opportunity to discuss and to foresee the future together and
we express our desire to see all the conclusions drawn here put into
action as soon as possible.
Closing speech by Ms. M.
Permit me to first of all extend
the fraternal greetings of the ICFTU - AFRO General Secretary,
Brother Andrew Kailembo to this important gathering which is here
today to endorse a common agenda for action on HIV/AIDS. I know that
this is the result of three days of hard work and serious
deliberations. Allow me also on behalf of the working people of
Africa, to take this opportunity to sincerely thank the ILO for
their continued dedication and commitment to respond to the needs of
its constituents in drawing up effective strategies to combat the
Today marks the start of a new dawn
in terms of approach and in search for new and innovative strategies
to combat the AIDS pandemic. The Platform of Action which has been
endorsed by all of us is a significant document that will play a
major role in guiding our work and in providing principles for
policy development and in other places of work such as the informal
sector, small and medium business enterprises and the largely
unorganized small holder/plantation agricultural sector.
I do not want to repeat what we
have been deliberating on for the last three days in relation to the
social and labour impacts of the HIV/AIDS pandemic, but I need to
reiterate the magnitude of the HIV/AIDS problem in the African
context by restating the WHO statistics. Out of 33 million adults
and children infected by HIV/AIDS in the world, 22.5 million of them
are in sub-Saharan Africa. This therefore poses a big challenge to
our work in terms of resources (both human and material) our future
strategies and political will especially on the part of Governments.
There is an urgent need therefore for us to start forging and
building partnerships and alliances with donor agencies,
Governments, the employers, religious groups, the community we work
in and those we live in if we have to live up to the challenge that
is posed by AIDS.
Our ray of hope lies in the ability
of those who have recorded success by creating an open and enabling
environment to debate freely about the pandemic. The workplace is
and will still continue to be a particularly effective forum in
combating the pandemic for the following reasons:
1. First, large numbers of the age
group at risk (20-49 years) is brought together.
2. Many workplaces have facilities
that can be used for group discussions, the infrastructure in terms
of clinics and provision of condoms whilst privacy is ensured.
Workers take awareness more seriously if they associate their work
with economic security.
3. The work councils/health and
safety committees already existing within the enterprises
(comprising both management and workers) provide a good entry point
to HIV/AIDS awareness campaigns and educational programmes.
4. Organized workers are more
likely to accept change and thus through the contacts they retain
within their communities they can also be able to influence other
people outside the workplace.
Documented evidence in countries
such as Zimbabwe shows that having a well integrated HIV/AIDS
programme at the workplace that integrates into other areas of
social development such as reduction of poverty, strengthening the
bargaining power of women and development of empowerment strategies
for the vulnerable groups has more impact than one which is only
HIV/AIDS information oriented.
Counselling services and training
within enterprises and other places of work need to be given an
important emphasis in our future work. Data gathered from companies
offering good counselling services have shown that workers become
more open and friendly in dealing with sick leave issues, request
for voluntary HIV testing and also in sharing with others about
their HIV/AIDS status.
The AIDS pandemic must be fought by
everyone. At the enterprise-level, employers, union leaders, workers
and their families must be involved in sharing knowledge about a
safe sex life and should contribute to the prevention and control
measures at the workplace as well as complimenting national efforts.
Let us therefore as stakeholders
who stand to gain a lot in controlling the spread of the pandemic go
back to our countries to translate into action our new gospel - the
Platform of Action on HIV/AIDS.
On behalf of the workers' group,
OATUU and ICFTU-AFRO, I take this opportunity to once again thank
the ILO and UNAIDS for convening this important workshop. As we
enter the new millennium, we hereby affirm our determination as
workers to be the future Emergency Response Army in the prevention
and control of the HIV/AIDS pandemic.
I thank you all for your kind
Closing speech by Mr. As Sy,
Representative of UNAIDS
colleagues and friends,
ladies and gentlemen,
We shared views and broadened our
knowledge base, on HIV/AIDS and its implication in/with the world of
Let's now make a deal and engage in
a journey of real partnership and collaboration, a journey form fear
and despair to hope from denial to openness, form stigma and
discrimination to compassion, from exclusion to inclusion (no more
them and us, but WE).
This should indeed be the basis of
partnership and alliances at all levels, individually, family,
community, national and international. And the world of work cuts
across all these levels.
UNAIDS is committed to lend its
support to the world of work to respond effectively to challenges of
HIV/AIDS. And with ILO we hope to give an example of UN agencies
working together to support our constituencies to continue to learn
from each other, to support each other and to respond to the
Words of thanks (Minister, ILO,
Closing speech by Mr. Toivo
the Minister of Labour of
ILO Executive Director for Social
The Executive Director of UNAIDS,
members of the Media,
ladies and gentlemen,
First of all I would like to
welcome you all to Namibia although belatedly. I could not be with
you at the beginning of the workshop, as I had to attend to other
matters of equal importance.
I have been told that the workshop
has been successful and that you have come up with a number of
strategies as to how we should tackle the social and labour
implications of the HIV/AIDS pandemic. Namibia like all other
African countries with high percentages of HIV/AIDS infections is
very much concerned about the threat of this dreadful disease. The
disease is robbing us of the most productive skilled section of our
population. Some of these workers we are loosing are people like
medical doctors, engineers who take years to educate and train. My
heart particularly goes to the children who are left behind as
orphans. Some of them die from AIDS because they were infected while
in the wombs of their mothers.
They are just innocent victims who
suffer because we the parents do not want to change our attitude and
sexual behaviours even though we known how deadly the consequences
of our actions could be.
In his opening speech, President
Nujoma informed you about the efforts which have been made at the
SADC subregional level to combat HIV/AIDS in employment.
I believe that the workshop has
made it possible for you, the participants to share experiences.
Your experiences and the measures you have taken to fight the
pandemic in your various work environment, can be very much
appreciate the holding of this workshop in Namibia.
I have been told that at the
beginning of this workshop you all vowed that the workshop should
not be a talkshop but a workshop in the real sense of the word -
where concrete strategies should have been mapped out. It is my hope
and trust that this workshop has been just that.
You will all agree with me that
ultimately, the responsibility for implementing these strategies
lies with Governments of member States and their social partners.
In conclusion ladies and gentlemen,
I would like to thank the ILO for the efforts they have been making
in assisting member States in this regard. I understand that we as
member States would like ILO to do more. It is however our task to
tell the organization how we want to be assisted. It is also our
task to see to it that the assistance we receive bears fruit. My
thanks and appreciation also go to UNAIDS and UNDP with whom we are
in contact on daily basis through their Resident representatives.
To our foreign guests, it is my
hope that you have enjoyed your short stay here in Namibia. Like
your Namibian colleagues here, I urge you to go back and implement
what you have learnt here.
I thank you.
MONDAY 11 OCTOBER
7.30 - 8.15 a.m. Group meeting
8.15 - 9.00 a.m. Registration
9.00 -10.30 a.m. Opening
10.30 - 11.00 a.m. Refreshment
11.00 - 12.30 a.m. Nomination of
officers for the workshop
FIGHTING THE CULTURE OF
Introduction to the
HIV/AIDS pandemic and decent work - Dr.B.O.Alli, ILO
Occupational Safety and Health Branch, Geneva
The extent of HIV/AIDS pandemic in
Africa and its implications on the world of work: Keynote speech by
Mr. As Sy, UNAIDS
12.30 - 13.30 p.m. Lunch
1.30 - 3.00 p.m. Panel
Impact of HIV/AIDS on the labour
force, enterprise and the economy in Africa
Mr. Ken Andoh (ILO)
Representatives of Governments, Employers' and Workers'
Organizations; Ms. Zemenay Lakew (UNSIA), Ms. Dorothy Odhiambo (WOFAK),
Mr. Pierre Plamondon (ILO)
Mr. George Ruigu (ILO)
3.00 - 3.30 p.m. Refreshment
COMBATING HIV/AIDS IN THE
WORLD OF WORK TO PROTECT LIVES AND PROMOTE SOCIAL AND ECONOMIC
3.30 - 5.00 p.m. Panel
Analysis of country and regional
strategies in place to fight HIV/AIDS in the world of work
Mr. Assefa Bequele (ILO)
Ms. Jane Hodges (ILO)
Ms. Renee Saunders (CDC)
Ms. Alice Hamer (ADB)
Dr. Roland Msiska (UNDP, AIDS
Ms. Rie Vejs-Laursen (ILO
TUESDAY 12 OCTOBER
7.30- 8.30 a.m. Group meeting
8.30 - 10.00 a.m. Plenary:
10.00 - 10.30 a.m. Refreshment
10.30 -11.30 p..m. Gender sensitive
national and workplace policies on HIV/AIDS
Mr. Ahmar Toure
Ms. Aurorita Mendoza (UNAIDS)
Ms. Judica Amri-Makhetha
11.30 - 1.00 p.m. Group
work on Platform of Action
1.00 - 2.00 p.m. Lunch
2.00 - 4.45 p.m. Group Work
4.45 - 5.00 p.m. Refreshment
5.00 - 6.00 p.m. Presentation and
discussion of the Group Work
WEDNESDAY 13 OCTOBER
BUILDING A PLATFORM OF
ACTION ON HIV/AIDS IN AFRICA
8.30 - 10.00 a.m. Drafting
10.00 - 12.00 a.m. Consultations
12.00 - 1.00 p.m. Lunch
1.00 - 2.00 p.m. Group meeting
3.00 - 4.00 p.m. Discussion &
adoption of Platform of Action and report on HIV/AIDS in Africa
4.00 - 5.00 p.m. Official
Dr. F. Fall, Representative of
Ms. M. Makoffu, Representative of
Mr. As Sy, Representative of UNAIDS,
Ms. Mary Chinery-Hesse,
Representative of the ILO,
The Honourable Minister of Labour
Namibia, Andimba Toivo Ya Toivo.
- Mr. Mothusi
Bruce Rabasha PALAI
Commissioner of Labour
of Labour and Social Security
- Gaborone -
- Mr. Elias
- Gaborone -
- Mr. Amos
Federation of Trade Unions
- Gaborone -
- M. Terence
Travail, Fonction publique et Formation professionnelle
- Bujumbura -
- M. François
Polyclinique Saint Stephane
des employeurs du Burundi
- Bujumbura -
- M. Celestin
Confédération des Syndicats du Burundi (COSYBU)
- Bujumbura -
- M. Solomon
des relations extérieures
- Yaounde -
- M. Charles
- Yaounde -
- M. Félix
CENTRAL AFRICAN REPUBLIC
- Médecin -
Inspecteur médical du travail
générale du travail
- Bangui -
- M. Rigobert
nationale du patronat centrafricain
- Bangui -
- Directeur -
Médecine du travail
emploi, fonction publique
- Abidjan -
- M. Bah YAO
- Membre de
la Commission sociale
national du patronat ivoirien (CNPI)
- Abidjan -
- M. Sai
national chargé de la santé
Générale des travailleurs de Côte d'Ivoire
- Abidjan -
- M. Hassan
de l'Emploi et de la Solidarité nationale
- Djibouti -
République de Djibouti
- Mr. Roberto
- Addis Ababa
- Mr. Wubneh
Confederation of Ethiopian Trade Unions (CETU)
- Addis Ababa
- Mr. Felix
- Ministry of
Employment and Social Welfare
- Accra -
- Dr. Daniel
- Ghana Ports
and Harbours Authority
- Tema -
- Mr. Daniel
- Health and
- Trade Union
- Accra -
- Dr. W.D.O.
- Director of
- Ministry of
Health and Manpower
- Nairobi -
- Mr. Samso
of Kenya Employers
- Nairobi -
- Mr. Joseph
Organization of Trade Unions (COTU)
- Nairobi -
- Mr. Calle
Secretary of the Ministry of Labour
- Windhoek -
- Ms. Simone
- Chamber of
- Windhoek -
Union of Namibian Workers
- Windhoek -
- Ms. Helen
Gladys NKECHI ADABA
Ministry of Labour
- Abuja -
- Mr. Poly
Employers Consultative Association (NECA)
- Lagos -
- Mr. Iliya
Association of Nigeria Nurses and Midwives
- Lagos -
- M. Jean-Baptiste
- Chef de
division - Inspection nationale du travail
de la Fonction publique et du Travail
- Kigali -
- M. Alphonse
- Syndicat du
personnel de santé
- Kigali -
- M. Cheikh
- Chef du
du Travail et de l'Emploi
- Dakar -
- Dr. Fatma
- Médecin -
Représentante du président du Conseil national
National du Patronat (CNP)
- Dakar -
- M. Aliou
syndical de la section de la santé de Pikine
national des travailleurs de la santé publique
- Dakar -
- Ms. L.
Director, Labour Relations
- Pretoria -
- Dr. James
- Sanoton -
Erickson L.B. DLAMINI
- Mbabane -
- Dr. Tyrone
Medical Dental Association
- Simunye -
Valentine Gugu PHUNGWAYO
- Mbabane -
UNITED REPUBLIC OF
Ludovick John MWANANZILA
Commissioner of Labour Workers
- Ministry of
Labour and Youth Development
- Dar es
Salaam - United Republic of Tanzania
- Mr. Jones
of Tanzanian Employers (ATE)
- Dar es
Salaam - United Republic of Tanzania
Christine Nyanjiga NYAGIRO
Federation of Free Trade
- Dar es
Salaam - United Republic of Tanzania
- Dr. David
Commissioner for Labour
- Ministry of
Gender, Labour and Social Development
- Kampala -
- Mr. Moses
of Ugandan Employers (FUE)
- Kampala -
- Mr. Justus
Secretary, Education Union
Organisation of Trade Unions (NOTU)
- Kampala -
Christopher Chanda PASOMBA
- Ministry of
- Lusaka -
Federation of Employers
- Lusaka -
- Mr. Japhet
Congress of Trade Unions
- Kitwe -
- Dr. Joseph
- Ministry of
Public Service, Labour and Social Welfare
- Harare -
- Mr. Joan
Confederation of Zimbabwe (EMCOZ)
- Harare -
- Health and
Congress of Trade Unions (ZCTU)
- Harare -
- Mr. Michael
Organisation of African Trade Union Unity (OATUU)
- Accra -
- Ms. Alice
Resources Development Division
- Abidjan -
- Mr. Christo
Labour Relations Officer
- Ministry of
- Windhoek -
- Ms. Katrina
- Director of
- Ministry of
- Windhoek -
- Dr. J.
- WHO - AIDS
- Windhoek -
- Ms. Kerry
- Harare -
- Ms. Nellie
States Agency for International Development (USAID) / SA
- Pretoria -
- Ms. Mary
- Head of
Gender and Equality Department
Regional Organisation (ICFTU-AFRO)
- Nairobi -
- Ministry of
Youth & Sport
- Windhoek -
- Director of
- Ministry of
- Windhoek -
- Mr. James
- The World
- Ms. Renée
- The Office
of National AIDS Policy,
- The White
House - Washington, D.C. USA
- and Centers
for Disease Control and Prevention (CDC)
Georgia - USA
- Mr. Fisseha
Center for International Labour Solidarity / SA
Braamfontein 2001- South Africa
- Ms. G. T.
Director for International Relations
- Ministry of
- Windhoek -
- Mr. Abner
Health Programme Officer
- Ministry of
Health and Social Affairs
- Windhoek -
- Ms. Mary
- ILO -
- Mr. Assefa
- ILO -
- Mr. Ahmar
Regional Office - Abidjan - Côte d'Ivoire
- Mr. Kenneth
- ILO Area
Office - Pretoria
- Ms. Judica
- ILO Area
Office - Pretoria
- Bureau of
- ILO -
Occupational Safety and Health Specialist
- ILO -
- Mr. Mpenga
Specialist, Small Enterprise Development
- ILO -
- Mr. Pierre
- ILO -
- Ms. Rie
Small Enterprise Development
Creation and Enterprise Department
- ILO -
- Mr. Alexio
- ILO -
Abidjan - Côte d'Ivoire
- Mr. George
Specialist, Labour Statistics
- ILO - Addis
Specialist, Workers Activities
- ILO -
- Ms. Jane
Specialist, International Labour Standards
- ILO -
- Mr. Tom
- ILO -
- ILO -
- Mr. As SY
- Team Leader
- Eastern &
Southern Africa UNAIDS
- Pretoria -
Promotion and Gender Adviser
- UNAIDS -
- Mr. Andrew
- Focal Point
- NACP -
- Ms. Dorothy
- Nairobi -
UNDP - Regional Project
- Dr. Roland
Regional Project on HIV/AIDS and Development
- Dakar -
- Ms. Zemenay
- UN Special
Initiatives on Africa
- New York,
N.Y. - USA
- Mr. Pierre
Project on HIV/AIDS
- Dakar -