|The Business Response to HIV/AIDS: Innovation & Partnership (UNAIDS, 1997, 60 p.)|
|Examples of Company Actions on HIV/AIDS|
A. THE ORGANISATION
Family Health International (FHI) is a non-profit organisation that has worked for 26 years to improve reproductive health around the world, particularly in developing countries. It provides assistance in research, programme development and management, policy and capacity building on all aspects of reproductive health. FHI has been active in more than 50 countries in Asia, Latin America/Caribbean, and Africa.
B. REASONS FOR ACTION ON HIV/AIDS
In addition to helping women and men obtain access to safe, effective, acceptable and affordable family planning methods and developing public health policies and programmes, FHI is committed to preventing the spread of HIV/AIDS and other sexually transmitted diseases (STDs). It has programmed at least US$ 200 million in family planning and more than US$ 250 million in HIV/AIDS prevention.
Across the developing world, governments are rethinking their roles and are encouraging public-private partnerships. Some of these partnerships involve utilising the comparative advantages of each sector to deal with mutual issues, such as drug distribution. Others include handing over to businesses functions once assumed to be the domain of governments, such as the running of medical centres, where the benefits of private sector attributes arising from competition, increased efficiency and cost containment have been recognised. As a result, many companies are finding it to their advantage to foster relationships with governments and to offer solutions to issues that governments are unable or unwilling to address.
FHI has used its analytical, planning and programme work in more than 50 countries to assist governments and private sector businesses to build on their complementary strengths for disease prevention and improved health. It has also helped business associations and unions in many countries to more effectively engage in strategic planning, refinement of key concerns and issues and advocacy.
C. EXAMPLE ACTIONS
Companies face multiple policy, financial and human resource issues as a result of HIV/AIDS. FHI has worked on many of these issues and has offered companies assistance in defining viable options. Over the past nine years, the organisation has designed and implemented more than 200 peer education programmes for companies, conducted financial impact assessments for more than 25 companies and business sectors, and developed business management training materials endorsed as "Best Practices" by UNAIDS.
Business managers often have three key concerns about HIV/AIDS prevention programmes in the workplace: do they work?, what do they cost? and how do we develop a prevention programme?
1. Do prevention programmes work? FHI's experience has demonstrated that these programmes have a measurable impact. For example, condom usage among men in Zimbabwe and Zambia increased from around 10% in 1990 to 70% in 1996 as information about HIV/AIDS/STDs reached them. (Recent evidence from FHI reinforces the public health finding that treatment of STDs can significantly slow the transmission of HIV.) In Zimbabwe, workplace peer education programmes in 40 factories reduced HIV incidence among employees by up to 30%.
Employees are anxious for and receptive to clear and concise information about the disease and about means to prevent transmission. In addition, they are willing to change their sexual behaviours and social relationships to protect themselves and their families. In a number of countries, FHI has documented that men are reducing the number of sexual partners, while women are seeking help to expand communication with their sexual partners.
2. What do such programmes cost? No single answer applies to all companies, other than "less than the likely losses from production disruptions and increased medical and termination benefits." In Kenya, for example, FHI's research with several businesses found that absenteeism due to HIV-related illnesses and medical and death benefits were the major costs to be expected. Losses from HIV/AIDS among employees were estimated to reach as high as 20% of profits by the year 2005 for some businesses. By contrast, comprehensive prevention programmes (education, STD treatment and condom distribution) for these companies were likely to cost 2% or less of business profits by 2005.
Even when families of employees are included in prevention programmes, the costs remain manageable for most large and medium-size companies. FHI has worked with companies to expand prevention efforts to communities "outside the gates" as a way to further protect employees and highlight their social responsibility. Additionally, numerous options exist for cost sharing between the private and public sectors, such as in condom distribution. Private sector businesses do not usually have to absorb the total costs for mounting prevention programmes.
3. How do we develop a prevention programme? FHI has developed a package of materials specifically for business managers. The Private Sector AIDS Policy kit offers guidance on preparing HIV/AIDS policies and prevention programmes, as well as detailed guidelines on developing or expanding prevention education, condom promotion, and STD treatment programmes. Two spreadsheets are included for businesses to assess the potential impact of HIV/AIDS on profits and the cost of mounting or expanding a prevention programme in the workplace. Programme monitoring allows FHI to regularly inform management about the impact of and savings from its prevention efforts.
D. FUTURE CHALLENGES
Other complex issues loom on the immediate horizon. Advances in costly drug therapy for people infected with HIV is raising expectations, with insufficient consideration of long-term costs. Even in the few countries where governments provide the drugs, numerous issues remain for businesses and employees. It is unclear, for example, if companies will be expected to supplement coverage provided by the government. FHI is conducting one of the few studies of innovative private sector approaches to increasing affordable STD drugs in countries with high STD and HIV prevalence.
Contact: Peter Benedict
Corporate Director for International Activities
Family Health International
PO Box 13950
Research Triangle Park
Durham, NC 27709
Tel: 1 919 544-7040 Ext 553
Fax: 1 919 544-7261