excerpt from India's journal Combat Law

Combat Law, Vol. 5, Issue 2 - According to International Labour Organisation (ILO) estimates, at least 26 million workers are living with HIV/AIDS globally. This constitutes 65% of the global population of people living with HIV/AIDS. In the coming years, it is bound to adversely affect their families, enterprises, and national economies. Moreover, HIV/AIDS hits the productive age group the hardest. Within affected households, the illness of a family member means loss of income, increasing medical expenses and the diversion of other family members from work or school to caring for the patient. Women in particular have to take on the additional burden of care and work.

Intolerance at Workplace

The shame and discrimination attached to HIV/AIDS is at times harder to cope with than HIV itself. In an ILO study conducted in four Indian states, undertaken by the Networks of People Living With HIV/AIDS (PLWHA), about 70% respondents had faced discrimination at work. Maximum prejudice was reported from within the family (33.33%), followed by health care settings (32.5%). Nearly 18.3% people faced prejudice from neighbours and 9% from community, educational institutes or relatives. Discrimination at the workplace could be higher than the reported 6.1% considering that many PLWHA do not disclose their status fearing losing the job. Positive people are compelled to leave their job on account of harassment such as denial of promotion, being forced to take voluntary retirement or being ostracised by co-workers.

The study also revealed that there was a decrease in expenditure on education in affected families. About 35 per cent children were denied basic amenities and about 17 per cent had to take up petty jobs to meet the growing monetary needs of the family. This indicates that HIV can worsen the child labour situation in India.

Responsibility of employers

Enterprises in the most seriously affected countries report increases in absenteeism, labour turnover, and cost of recruitment, training and staff welfare due to HIV/AIDS. The ILO India conducted a study on the Singareni Collieries Company Limited (SCCL), Andhra Pradesh in 2005. The study revealed that the company spent Rs. 65 lakh (approx US$ 144,444) on disbursement of terminal benefits to 29 employees declared unfit, due to HIV/AIDS related illnesses, during the last five years. The study brings out evidence of rising costs, increased absenteeism and loss of manpower due to HIV/AIDS. The company has 311 employees living with HIV and if all of them reach the stage of being unfit to work and are given compensation as per the SCCL rules, it will cost Rs.9.33 crore (approx US$ 2.1 million) in the coming years. It needs to be emphasized that provision of Anti Retroviral Treatment to these employees for a period of ten years would cost the company much less - Rs.5.59 crore (approx US$ 1.24 million). And this will enhance the working life of infected employees, reduce absenteeism, and also help them sustain their families.

Workers' Welfare and Rights

Enterprises need to commit themselves to prevention as well as care and treatment. The ILO Code of Practice on HIV/AIDS lays down guidelines for action against HIV/AIDS in the world of work. It recommends that HIV/AIDS should be treated like any other illness at the workplace and employers should support their employees and their families with the available treatment. Employers' organizations and trade unions have a crucial role to play in the fight against HIV/AIDS. The International Organization of Employers (IOE) and International Conference of Free Trade unions (ICFTU) have joined hands to undertake projects in eight African countries. Trade unions need to work closely with management and governments on issues related to welfare and rights of workers affected by HIV/AIDS.

Lessons from Industry

There are some crucial lessons to be learnt from the experiences of enterprise-based responses. These lessons are:

1. The foremost factor in the success of a workplace programme is the management's commitment. This commitment is reflected in:
   - HIV/AIDS being a staff responsibility
   - Presence of a non- discriminatory HIV/AIDS policy statement
   - Management's participation in key events to mobilize technical support from other agencies

2. The initiation of HIV/AIDS prevention programmes does not mean that the company has HIV-infected employees. It shows that the company is concerned about its employees, knows the importance of human capital, is aware of the threat of HIV and takes timely action. Such proactive companies stand to benefit as they then enjoy an improved public image.

3. HIV/AIDS prevention programmes do not require a big investment but call for mobilizing technical resources from NGOs, the government and international agencies.

4. HIV/AIDS need not be a standalone programme at the workplace but should be integrated with other welfare programmes so that it is sustainable and costeffective.

5. Special education for trade unions and human resource personnel is an effective tool to create an enabling environment at the workplace.

6. Employers' organizations can provide a forum for sharing experiences on HIV/AIDS and develop a coordinated response.

7. It is necessary to develop a cadre of peer educators within the enterprise for long-term HIV prevention projects. Selected workers, trade unions representatives or supervisors can be trained for the purpose.

8. Creation of a non-discriminatory environment for HIV positive people including counselling of co-workers and families would result in a friendlier workplace. People living with HIV/AIDS need to be kept in employment as long as they can work. To quote an HIV positive person who said in the ILO project's advocacy film, "We can work. We pose no risk to our co-workers. If you take away our jobs, you will kill us faster than the HIV virus".

Migrant workers out of reach

Reaching these programmes to workers in the informal economy is another challenge. Generally, these workers have low access to health care facilities, low health seeking behaviour and few social protection benefits. Any absence from work means loss of that day's earning. The vulnerability increases in case of migrant workers, as they are away from home for long durations. Several approaches are being tried out to take HIV/AIDS programmes to unorganised labour. NGOs are playing a vital role in implementing targeted interventions among migrant workers.

Integration of HIV/AIDS in existing programmes of ministries of labour, agriculture, transport, railways, etc. can be a good way of expanding the programme. Trade unions have an extensive reach. There are sectoral unions like the postal workers unions, taxi and auto drivers unions, etc. which can be involved. The corporate sector can expand the scope of its programmes to cover contract workers and workers in ancillary units. The corporate sector can also sponsor an NGO to implement HIV/AIDS programmes in nearby communities. There are good models of corporate- NGO partnerships that can be replicated. The response to HIV/AIDS cannot be left to the Health Ministry alone, but has to be a multi-dimensional response with active participation of industrialists. Since an HIV/AIDS epidemic in India is only a matter of time there is no room for complacency.

S. Mohd Afsar
Combat Law, Volume 5, Issue 2
(published 07 May 2006 in India Together)

The author is Technical Specialist (HIV/AIDS), South Asia and National Programme Coordinator, ILO, Sub-regional Office, New Delhi.