Strategies to Tackle Social and Labour Implications of HIV/AIDS

Organized by
The International Labour Office (ILO)
In collaboration with
The Joint United Nations Programme on HIV/AIDS (UNAIDS)
Windhoek, Namibia, 11 - 13 October 1999

http://www-ilo-mirror.cornell.edu/public/english/protection/trav/aids/publ/windhoee.htm

SOCIAL AND LABOUR IMPLICATIONS OF HIV/AIDS

A background document

I. THE PROBLEM

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.
Women 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.

II. SOCIAL AND ECONOMIC IMPLICATIONS

AIDS, business and the economy

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 education.

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.

Gender dimension

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 children

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 raging.

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.

Discrimination, social 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 the virus.

III. 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.

Combating discrimination

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:

Protection 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:

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 strategy.

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;

(d) evaluated for their effectiveness.

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 employers.

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:

providing 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 education;
protection in jobs where there are risks of exposure to infection;
preventing drug and alcohol abuse leading to intoxication and risky behaviour (violence, unprotected sex, sharing of contaminated needles);
specific support for groups at high risk, such as migrant and transport workers.

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.

Social security

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 countries.

Statistics

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.

The 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.
The determination of appropriate methods for generating occupation-industry specific HIV/AIDS incidence rates.
The 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.
The 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 international organizations.

IV. CONCLUDING REMARKS

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.

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A N N E X

Report of proceedings

I. BACKGROUND

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 this report.

II. OPENING CEREMONY

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 their representatives.

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.

III. ELECTION OF OFFICERS

The following persons were elected to the Bureau:

Chairperson: Mr. C. Schletwein, Namibia

Vice Chairperson (Workers): Mr. F. Abena Fouda, Cameroon

Vice Chairperson (Employers): Dr J. P. Murphy, South Africa

Rapporteur: Mr. Solomon Tatah, Cameroon

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 control.

IV. FIGHTING THE CULTURE OF DENIAL

Plenary Session 1:

HIV/AIDS Pandemic and Decent Work

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 local level.

Ms. Odhiambo, (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 AIDS.

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.

V. 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 combat HIV/AIDS.

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;
several 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;
several activities had been well implemented on sensitization; it was now time for action and for focussing on protection and care at enterprise level.

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 enterprises;
document and disseminate best practices regionally and to continue to reinforce the good work already being done;
continue and expand efforts to mainstream AIDS in all activities. This was applicable to all players;
prepare national strategic and resource mobilization plans to ensure focused and consistent action;
capitalize on the presence of all the agencies present to achieve concrete results;
coordinate and integrate these actions towards one common objective.

Plenary Session 2:

National Experiences

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 infected workers.

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 perceptions.

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 areas.

VI. 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.

VII. DISCUSSION AND ADOPTION OF THE DRAFT PLATFORM OF ACTION AND WORKSHOP REPORT

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.

VIII. CLOSING CEREMONY

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.

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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.

DRAFT PLATFORM OF ACTION ON HIV/AIDS

IN THE CONTEXT OF THE WORLD OF WORK IN AFRICA

I. PREAMBLE

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 levels.

The Meeting called upon all African governments to declare HIV/AIDS a national disaster requiring urgent attention and mobilisation of resources.

II. COMMON VALUES

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 comparative advantage.

III. GOALS

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.

IV. ACTIONS

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 information systems;

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 HIV/AIDS;

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 for all;

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 allocations;

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 of AIDS;

15. effectively mobilizing resources;

16. improving availability and affordability of drugs;

17. incorporating HIV/AIDS in collective bargaining agreements.

V. PARTNERSHIPS

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.

VI. ROLE 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 UNAIDS.

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 developed

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 civil society.

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 enterprise levels.

11. The ILO should consider submitting this draft Platform of Action on HIV/AIDS in Africa to the 9^th African Regional Meeting (Abidjan, 8-11 December 1999) for its consideration and formal adoption.

A 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 SPEECHES

Opening speech by Ms. Mary Chinery-Hesse,

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 of work.

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 especially worrying.

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.

Secondly, 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.

Thirdly, 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.

Fourthly, 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.

Fifthly, 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 beneficiaries.

Finally, 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 labour impact.

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 efforts.

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 future.

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.

Thank you.

Opening speech by His Excellency Sam Nujoma,
President of Republic of Namibia,
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
Honourable Ministers Representatives of various Governments taking part in this workshop
Leaders of Employers' and Workers' groups
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 19April 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 Namibia seriously.

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 discussions.

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 co-sponsoring agencies.

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 workshop.

Opening speech by Michael P. Besha, Assistant Secretary General,
OATUU on behalf of workers' organizations

Honorouble Dr. Libertine Amathila, Minister of Health and Social services, Namibia,
Ms. Chinery-Hesse, Executive Director, ILO,
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,
invited guests,
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 workshop.

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
Identify 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:

The identification of workers', employers' and governments needs for a more effective execution policy and a workplace based programme of action.

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 have included:

Education and sensitization of the workers and their families on the prevention of HIV/AIDS;
Development of study materials, posters, etc. For the same purpose;
Carried some research which has been instrumental in the formulation of national and even subregional policies and programmes to combat the pandemic.

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 and monitoring;
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 Africans.

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 workshop.

♥

♥

Opening speech by Mr. Roberto Iacona,
President of Ethiopian Employers' Federation,
Representative of Employers' Participants

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 problem.

The ILO support is very important to help the employers in creating awareness and helping the already affected workers.

Therefore, I wish a successful meeting to deliberate a platform of action plan.

Thank you.

CLOSING SPEECHES

Closing speech by Dr. F. Fall,
Representative of Employers' Organization

Your Excellency,
Madam, Executive Director of the ILO,
ladies, gentlemen, representatives of international or government institutions,
dear friends,

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 national level.

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 welcome.

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. Makoffu, ICFTU-AFRO
Representative of Workers'Organization

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 HIV/AIDS pandemic.

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 attention.

Closing speech by Mr. As Sy,
Representative of UNAIDS

Honorable Minister,
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 work.

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 pandemic.

Words of thanks (Minister, ILO, participants).

Closing speech by Mr. Toivo Ya Toivo
the Minister of Labour of Namibia,

Mr. Chairman,
ILO Executive Director for Social Protection,
The Executive Director of UNAIDS,
worker's Representatives,
employer's Representatives,
distinguished guests,
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.

PROGRAMME

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 ceremony

10.30 - 11.00 a.m. Refreshment

11.00 - 12.30 a.m. Nomination of officers for the workshop

FIGHTING THE CULTURE OF DENIAL

Introduction to the workshop: 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

General discussion

12.30 - 13.30 p.m. Lunch

1.30 - 3.00 p.m. Panel Discussion:

Impact of HIV/AIDS on the labour force, enterprise and the economy in Africa

Moderator: Mr. Ken Andoh (ILO)

Panelists: Representatives of Governments, Employers' and Workers' Organizations; Ms. Zemenay Lakew (UNSIA), Ms. Dorothy Odhiambo (WOFAK),

Mr. Pierre Plamondon (ILO)

Discussant: 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 SECURITY

3.30 - 5.00 p.m. Panel Discussion:

Analysis of country and regional strategies in place to fight HIV/AIDS in the world of work

Moderator: Mr. Assefa Bequele (ILO)

Panelists: Ms. Jane Hodges (ILO)

Ms. Renee Saunders (CDC)

Ms. Alice Hamer (ADB)

Dr. Roland Msiska (UNDP, AIDS Project)

UNAIDS

WHO

Discussant: Ms. Rie Vejs-Laursen (ILO

TUESDAY 12 OCTOBER

7.30- 8.30 a.m. Group meeting

8.30 - 10.00 a.m. Plenary:

National Experiences

Governments

Employers

Workers

10.00 - 10.30 a.m. Refreshment

10.30 -11.30 p..m. Gender sensitive national and workplace policies on HIV/AIDS

Moderator: Mr. Ahmar Toure

Panelists: Ms. Aurorita Mendoza (UNAIDS)

Ms. Judica Amri-Makhetha

General Discussion

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 (cont'd)

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 Committee

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 closing by:

Dr. F. Fall, Representative of Employers' Organizations

Ms. M. Makoffu, Representative of Workers' Organizations;

Mr. As Sy, Representative of UNAIDS,

Ms. Mary Chinery-Hesse, Representative of the ILO,

The Honourable Minister of Labour Namibia, Andimba Toivo Ya Toivo.

List of Participants

BOTSWANA

Government:

Mr. Mothusi Bruce Rabasha PALAI
Commissioner of Labour
Department of Labour and Social Security
Gaborone - Botswana

Employers:

Mr. Elias DEWAH
Executive Director
BOCCIM
Gaborone - Botswana

Workers:

Mr. Amos TLHOOLEBE
Regional Chairperson (OHS)
Botswana Federation of Trade Unions
Gaborone - Botswana

BURUNDI

Government:

M. Terence MBONABUCA
Conseiller au Cabinet
Ministère Travail, Fonction publique et Formation professionnelle
Bujumbura - Burundi

Employers:

M. François NTAREME
Directeur Polyclinique Saint Stephane
Association des employeurs du Burundi
Bujumbura - Burundi

Workers:

M. Celestin NSAVYIMANA
Président Bureau exécutif
Confédération des Syndicats du Burundi (COSYBU)
Bujumbura - Burundi

CAMEROON

Government:

M. Solomon TATAH
Diplomat
Ministère des relations extérieures
Yaounde - Cameroon

Employers:

M. Charles Christian NGOULE
GICAM
Yaounde - Cameroon

Workers:

M. Félix ABENA FOUDA
CSTC
Cameroon

CENTRAL AFRICAN REPUBLIC

Government:

Dr. Aristide REGANGUERE
Médecin - Inspecteur médical du travail
Direction générale du travail
Bangui - République centrafricaine

Employers:

M. Rigobert YOMBO
Président
Union nationale du patronat centrafricain
Bangui - République centrafricaine

COTE D'IVOIRE

Government:

Dr. Coulibaly KOUNANDI
Directeur - Médecine du travail
Ministère emploi, fonction publique
et prévoyance sociale
Abidjan - Côte d'Ivoire

Employers:

M. Bah YAO
Membre de la Commission sociale
Conseil national du patronat ivoirien (CNPI)
Abidjan - Côte d'Ivoire

Workers:

M. Sai Pascal GOUE
Secrétaire national chargé de la santé
Union Générale des travailleurs de Côte d'Ivoire
Abidjan - Côte d'Ivoire

DJIBOUTI

Government:

M. Hassan ALI Mohamed
Conseiller technique
Ministère de l'Emploi et de la Solidarité nationale
Djibouti - République de Djibouti

ETHIOPIA

Employers:

Mr. Roberto IACONA
President
Ethiopian Employers' Federation
Addis Ababa - Ethiopia

Workers:

Mr. Wubneh GEBREEGYIABHER
General Secretary
The Confederation of Ethiopian Trade Unions (CETU)
Addis Ababa - Ethiopia

GHANA

Government:

Mr. Felix Kwami TSAMEYE
Deputy Director
Ministry of Employment and Social Welfare
Accra - Ghana

Employers:

Dr. Daniel Aryee ANUM
Senior Medical Officer
Ghana Ports and Harbours Authority
Tema - Ghana

Workers:

Mr. Daniel Owusu BOATEY
Health and Safety Officer
Trade Union Congress (TUC)
Accra - Ghana

KENYA

Government:

Dr. W.D.O. SAKARI
Director of Occupational Health
Ministry of Health and Manpower
Nairobi - Kenya

Employers:

Mr. Samso Ebarasi LWAKI
Training Consultant
Federation of Kenya Employers
Nairobi - Kenya

Workers:

Mr. Joseph BOLO AWACH
Executive Board Member
Central Organization of Trade Unions (COTU)
Nairobi - Kenya

NAMIBIA

Government:

Mr. Calle SCHLETTWEIN
Permanent Secretary of the Ministry of Labour
Windhoek - Namibia

Employers:

Ms. Simone SHIHEPO
Chamber of Mines
Windhoek - Namibia

Workers:

National Union of Namibian Workers
Windhoek - Namibia

NIGERIA

Government:

Ms. Helen Gladys NKECHI ADABA
Deputy Director
Federal Ministry of Labour
Abuja - Nigeria

Employers:

Mr. Poly ASONGO
Senior Executive Officer
Nigeria Employers Consultative Association (NECA)
Lagos - Nigeria

Workers:

Mr. Iliya KAFFOI
General Secretary
National Association of Nigeria Nurses and Midwives
Nigeria Labour Congress
Lagos - Nigeria

RWANDA

Government:

M. Jean-Baptiste RULINDAMANYWA
Chef de division - Inspection nationale du travail
Ministère de la Fonction publique et du Travail
Kigali - Rwanda

Workers:

M. Alphonse NDATEBWA
Vice-président
Syndicat du personnel de santé
Kigali - Rwanda

SENEGAL

Government:

M. Cheikh FAYE
Chef du Bureau Médecine
Ministère du Travail et de l'Emploi
Dakar - Sénégal

Employers:

Dr. Fatma Sarr FALL
Médecin - Représentante du président du Conseil national
Conseil National du Patronat (CNP)
Dakar - Sénégal

Workers:

M. Aliou TALL
Responsable syndical de la section de la santé de Pikine
Syndicat national des travailleurs de la santé publique
Dakar - Sénégal

SOUTH AFRICA

Government:

Ms. L. SEFTEL
Chief Director, Labour Relations
Department of Labour
Pretoria - South Africa

Employers:

Dr. James MURPHY
Medical Adviser
Barlow Limited
Sanoton - South Africa

Workers:

Ms. Theodora STEELE
COSATU
South Africa

SWAZILAND

Government:

Mr. Erickson L.B. DLAMINI
Assistant Commissioner
Department of Labour
Mbabane - Swaziland

Employers:

Dr. Tyrone David LAPIDOS
Swazi Medical Dental Association
Simunye - Swaziland

Workers:

Ms. Valentine Gugu PHUNGWAYO
Reconciliation Controller
Mbabane - Swaziland

UNITED REPUBLIC OF TANZANIA

Government:

Mr. Ludovick John MWANANZILA
Assistant Commissioner of Labour Workers
Ministry of Labour and Youth Development
Dar es Salaam - United Republic of Tanzania

Employers:

Mr. Jones SIKIRA
Association of Tanzanian Employers (ATE)
Dar es Salaam - United Republic of Tanzania

Workers:

Ms. Christine Nyanjiga NYAGIRO
Project Manager
Tanzanian Federation of Free Trade
Dar es Salaam - United Republic of Tanzania

UGANDA

Government:

Dr. David OGARAM
Commissioner for Labour
Ministry of Gender, Labour and Social Development
Kampala - Uganda

Employers:

Mr. Moses THENGE
Federation of Ugandan Employers (FUE)
Kampala - Uganda

Workers:

Mr. Justus Odiba CABRIBO
General Secretary, Education Union
National Organisation of Trade Unions (NOTU)
Kampala - Uganda

ZAMBIA

Government:

Mr. Christopher Chanda PASOMBA
Assistant Labour Commissioner
Ministry of Labour
Lusaka - Zambia

Employers:

Mr. Sylvester MPILA
Manager
Zambia Federation of Employers
Lusaka - Zambia

Workers:

Mr. Japhet Chibulo MOONDE
Deputy President
Zambia Congress of Trade Unions
Kitwe - Zambia

ZIMBABWE

Government:

Dr. Joseph Nicholas GUTSA
Under-secretary
Ministry of Public Service, Labour and Social Welfare
Harare - Zimbabwe

Employers:

Mr. Joan Zuichaguma MTUKWA
Human Resources manager
Employers' Confederation of Zimbabwe (EMCOZ)
Harare - Zimbabwe

Workers:

Mrs. Clementine DEHWE
Health and Safety Trainer
Zimbabwe Congress of Trade Unions (ZCTU)
Harare - Zimbabwe

Observers

Mr. Michael P. BESHA
Assistant Secretary-General
Organisation of African Trade Union Unity (OATUU)
Accra - Ghana

Ms. Alice HAMER
Human Resources Development Division
African Development Bank
Abidjan - Côte d'Ivoire

Mr. Christo HORN
Control Labour Relations Officer
Ministry of Labour
Windhoek - Namibia

Ms. Katrina ITULA-LISWANI
Director of Labour
Ministry of Labour
Windhoek - Namibia

Dr. J. JACOBI
M.O. Reproductive Health
WHO - AIDS Programme
Windhoek - Namibia

Ms. Kerry KAY
Project Manager
Commercial Farmers' Union
Harare - Zimbabwe
Ms. Nellie MAKHAYE GWARU
HIV/AIDS Project Manager
United States Agency for International Development (USAID) / SA
Pretoria - South Africa

Ms. Mary MAKOFFU
Head of Gender and Equality Department
African Regional Organisation (ICFTU-AFRO)
Nairobi - Kenya

Mr. Albertus MULONDO
Youth Health Officer
Ministry of Youth & Sport
Windhoek - Namibia

Dr. Valentina MULONGENI,
Director of Labour
Ministry of Labour
Windhoek - Namibia

Mr. James SACKEY
The World Bank
Washington - USA

Ms. Renée SAUNDERS
Public Health Advisor
The Office of National AIDS Policy,
The White House - Washington, D.C. USA
and Centers for Disease Control and Prevention (CDC)
Atlanta, Georgia - USA

Mr. Fisseha T. TEKIE
Country Program Director
American Center for International Labour Solidarity / SA
Braamfontein 2001- South Africa

Ms. G. T. T. TULI
Deputy Director for International Relations
Ministry of Labour
Windhoek - Namibia

Mr. Abner XOAGUB
Chief Health Programme Officer
Ministry of Health and Social Affairs
Windhoek - Namibia

ILO

Ms. Mary CHINERY-HESSE
Executive Director
Social Protection Sector
ILO - Geneva

Mr. Assefa BEQUELE
Director
Labour Protection Department
ILO - Geneva

Mr. Ahmar TOURE
Deputy Regional Director
ILO Regional Office - Abidjan - Côte d'Ivoire

Mr. Kenneth ANDOH
Director
ILO Area Office - Pretoria

Ms. Judica AMRI-MAKHETHA,
Deputy Director
ILO Area Office - Pretoria

Mr. Sylvester YOUNG,
Senior Statistician
Bureau of Statistics
ILO - Geneva

Dr. Benjamin ALLI
Senior Occupational Safety and Health Specialist
SafeWork Programme
ILO - Geneva

Mr. Mpenga KABUNDI,
Senior Specialist, Small Enterprise Development
Employment Sector
ILO - Geneva

Mr. Pierre PLAMONDON,
Senior Actuary
Social Security Department
ILO - Geneva

Ms. Rie VEJS-LAURSEN,
Specialist, Small Enterprise Development
Job Creation and Enterprise Department
ILO - Geneva

Mr. Alexio MUSINDO,
Programme Officer
Multidisciplinary Team
ILO - Abidjan - Côte d'Ivoire

Mr. George RUIGU
Senior Specialist, Labour Statistics
ILO - Addis Ababa

Mr. Frederick PARRY
Senior Specialist, Workers Activities
ILO - Harare

Ms. Jane HODGES-AEBERHARD
Senior Specialist, International Labour Standards
ILO - Harare

Mr. Tom Netter
Press Officer
ILO - Geneva

Ms. Marie-Madeleine BOIRON
Administrative Assistant
ILO - Geneva

UNAIDS

Mr. As SY
Team Leader
Inter Country Team
Eastern & Southern Africa UNAIDS
Pretoria - South Africa

Ms. Aurorita MENDOZA
Health Promotion and Gender Adviser
UNAIDS - Geneva

Mr. Andrew TIMBE
Focal Point HIV/AIDS
NACP - Zimbabwe

Ms. Dorothy ODHIAMBO
WOFAK
Nairobi - Kenya

UNDP - Regional Project on HIV/AIDS

Dr. Roland MSISKA
CTA Regional Project on HIV/AIDS and Development
UNDP
Dakar - Sénégal

Ms. Zemenay LAKEW
UN Special Initiatives on Africa
UNSIA
New York, N.Y. - USA

Mr. Pierre ROBERT
Private Sector Adviser
Regional Project on HIV/AIDS
UNDP
Dakar - Sénégal