SADC survey shows increased business confidence, but Aids hurting

A new survey shows that the business climate in the Southern African Development Community (SADC) is improving, but there are also strong indications that HIV/Aids is taking a material toll on companies operating in the region.

The survey was taken from 541 companies operating in the manufacturing, primary and services sector, in the SADC region.

Speaking at the third results survey presentation held in Johannesburg on Wednesday, Zambian Chamber of Commerce CEO Justin Chisulo said that it appeared that SADC was becoming more regionally integrated and that there was increasing optimism about the year ahead. However, Chisulo also acknowledged that Aids was an increasing challenge. In 2005, only 29% of respondents indicated that HIV/Aids had an impact on their business, compared to 40% in 2006.

But he said that thesurvey also found more companies were coming to terms with the impact of HIV/Aids. Some 58% of respondents had an HIV/Aids programme in place, while 65% recognised the pandemic’s impact on their organisations.

“There are a greater number of companies embarking on a HIIV/Aids workplace programme,” he stated, adding that as of 2005, HIV/Aids was included in the survey.

According to Malawian Chamber of Commerce and Industry CEO Chancellor Kaferapanjira, increased HIV/Aids awareness had seen the infection rate decrease from 15% to 12%, in the last year, in Malawi. (from Engineering news on line)

DRC, not ABC

JOHANNESBURG, 14 August (PLUSNEWS) - In the fight against HIV/AIDS, think 'DRC' and not 'ABC', a new Southern African Development Community (SADC) report says.

The report, released on Monday, said the old model of controlling the lethal virus through a programme of ABC (Abstinence, Being faithful and Condom use) should be replaced by 'DRC' - Delaying sex, Reducing partners and continued Condom use.

The SADC said a "lethal cocktail" of low condom use by people with multiple sexual partners, combined with low levels of male circumcision, were the key factors driving the soaring rates of HIV/AIDS in Southern Africa, the epicentre of the global epidemic, and urged the new approach.

Casting doubt on long-held beliefs about how the disease spreads in countries such as South Africa, Swaziland and Botswana, the report said that high-risk activities such as casual sex and intercourse with sex workers were no longer the principal causes of new infections.

Instead, individuals with many concurrent sexual relationships, without consistently using condoms, were fuelling the spread of the virus, while traditional high-risk groups such as prostitutes, mineworkers and truckdrivers were, in fact, better protecting themselves from infection.

The report found that in Uganda, Kenya, and Zimbabwe - countries where the incidence of new HIV infections has recently slowed - the essential factor behind successfully controlling the spread of the disease was a reduction in the number of sexual partners an individual had at the same time.

"Without knowing it, if many individuals [or their partners] have only one additional longer-term sexual partner, huge numbers of people may be at risk of HIV infection if only one person in the sexual network is newly infected. This is in part because in the few weeks after infection [the window period], the infected person is much more likely to transmit HIV to his/her sexual partners," the report said.

The SADC report said that abstinence - long touted as the best and easiest way to slow the spread of HIV - was not a panacea. "While a focus on abstinence may result in delays in young people starting sex, this does not have a large impact on their lifetime risk of HIV infection once they start being sexually active, if they engage in multiple partnerships, etc."

The study also commented that "voluntary counselling and testing (VCT) has not been shown to date to have as strong an impact on behaviour change as previously hoped. Counselling and testing is still very important, however, as an entry point for care and treatment".

According to the SADC, the HIV prevalence rate among those aged 15-49 in Southern Africa is 11 percent, compared to only 1 percent globally. Approximately 40 percent of the world's HIV-positive people were in the region, which was also the source of 37 percent of all new infections in 2005.

The stubbornly high numbers worry anti-AIDS campaigners, many of whom denounce Southern African governments for doing too little, too late to stop the spread of the virus. The number of adults living with HIV in South Africa - the continent's richest country - was estimated at 5.3 million in 2003 - or about one in five of those aged 15-49.

The SADC report pointed to underlying social and structural factors, such as high population mobility, disparity of wealth, cultural factors and gender inequality, which put young women particularly at risk, were driving the rapid spread of the disease across the region.

It recommended male circumcision as one important method of controlling the spread of HIV, citing a recent study that found the procedure had a 60 percent to 75 percent preventative effect on potential HIV transmissions. Evidence shows that the cells of the inner surface of the foreskin are particularly susceptible to infection.

"Male circumcision on its own is not enough to prevent HIV infection, and circumcised males must still use condoms and reduce their number of partners," the SADC said. "However, if a large number of males become circumcised, this could significantly reduce new HIV infections in the population as a whole."

Nevertheless, it urged caution on the efficacy of circumcision, saying more research was necessary.

AIDS, not overseas recruitment, stripping Zambian hospitals

AIDS is removing twice as many health professionals from the workforce from Zambia as overseas recruitment, according to a US-funded study published today in The Lancet, yet health care workers are not being prioritised for antiretroviral treatment. If the death rate of Zambian nurses could be cut by 60%, says the author, "Zambian health institutions would benefit more than they would from a total ban on recruitment to the UK."

Greater wealth, not poverty, associated with higher HIV prevalence in Africa, according to survey

Contrary to widespread belief, HIV is not disproportionately more common among the poor in Africa, according to a study by Dr. Vinod Mishra at the 2006 PEPFAR Implementers meeting held in Durban in mid-June. In fact, if anything, the reverse was true across several sub-Saharan African countries: “Even with all other factors controlled, in most countries, the weathier adults remain at least as likely as the poor to be HIV-infected, if not more,” said Dr. Mishra.

The study could have profound policy and programmatic implications, providing a rationale against funding poverty-reduction prevention programmes which Dr Mishra says are unlikely to have much of an impact on HIV prevention.

However, it may be a premature to base policy decisions entirely upon this cross-sectional survey because the relationship between poverty and HIV vulnerability is probably more complex, and as Dr. Mishra himself noted, the relationship could also be transitional. In other words, the economic opportunities that Africans have to get out of poverty come with increased HIV risks (such as sex work or intergenerational relationships with an economic component — sugar daddies) or place them in environments where HIV transmission is more likely (in urban settings, highway rest stops or the mines).

The relationship between socio-economic status and the HIV epidemic
Dr. Mishra began by pointing out that since South African President Thabo Mbeki’s speech at the World AIDS conference in Durban, there has been a growing tendency to associate poverty with HIV/AIDS. For example, in 2004, in a recent article in the Lancet, the author wrote that “poverty reduction will undoubtedly be at the core of a sustainable solution to HIV/AIDS,” (Fenton 2004).

There is some basis for making such statements, since across the globe, there is a positive correlation between HIV prevalence and poverty – as the poorer regions in the world have been the hardest hit by the HIV epidemic. This correlation has also been observed within a number of countries, such as in Brazil and within the US, where low socio-economic status has been clearly tied with higher risks of HIV both nation-wide and within specific communities (for example, such as among men who have sex with men in California) (Parker; Pechansky; Xia).

Poverty has also been associated with increased risk for other diseases, such as cholera and sexually transmitted diseases, and it has been postulated that malnutrition and access to healthcare that are associated with poverty could make individuals more susceptible to HIV infection. The poor are also less likely to have access to condoms and prevention information.

However, according to Dr Mishra, the associations between poverty and HIV break down when one looks at sub-Saharan Africa. For example, the wealthiest part of the continent (southern Africa, e.g., Botswana and South Africa) is where the HIV prevalence is the highest (although this argument fails to look at other factors that could be responsible for this difference).

Furthermore, studies in several sub-Saharan African countries have shown that HIV is actually more common among wealthier, better educated individuals. Although some have suggested that this pattern may change as the epidemic matures (Fenton), according to Dr. Mishra, data from several recent Demographic and Health Surveys and AIDS Indicator Surveys have shown that HIV is still more common among wealthier adults than the poor in sub-Saharan Africa — even in the countries with older generalised epidemics such as Uganda.

There could be a number of potential explanations for this. For example, HIV is more prevalent in urban areas in Africa where the wealthier people tend to live or at least have greater access to. Furthermore, wealthier people tend to be more mobile and have more leisure time — thus more opportunities for casual sex. Likewise, they could have a greater number of lifetime or concurrent sexual partners.

Also, wealthier people with HIV could simply survive longer — although conversely, the expense of dealing with HIV or loss of work would be likely to reduce wealth. Other cultural factors, such as male circumcision or polygamy could also play a role.

The study
Dr. Mishra and colleagues conduced a cross-sectional survey of socioeconomic status and a number of other factors linked with HIV-testing data from men, women and cohabiting couples in Burkina Faso, Ghana, Cameroon, Uganda, Kenya, Tanzania, Malawi, and Lesotho. The aim of the study was to explore the association between wealth status and several factors, such as urban/rural residence, age, education, occupation, etc., and to see whether wealth status was associated with key risk behaviours, such as polygamy, multiple sexual partners, non-regular partners, partner faithfulness, consistent condom use, male circumcision, and knowledge of how to avoid infection (ABC-based prevention). They also examined the association between these risk factors and HIV infection, and determined whether wealth status remained significantly associated with a higher HIV prevalence once all these other factors were incorporated into in a multivariate analysis.

In most countries:

• Wealth was more likely to be associated with having a better education, more mobility, and with living in an urban area where HIV is prevalent

• Wealth was associated with an earlier sexual debut in men though not in women

• Polygamy was not more prevalent among the wealthier, but married or cohabiting wealthier men and women were less likely to be faithful to their partners

• Wealthier men were more likely to have multiple partners in the last year — this pattern was not consistent among women

• However, both wealthier men and women were more likely to have had multiple lifetime sex partners

• HIV prevalence was associated with number of sex partners in the last year and sex with a non-regular partner in the last year

• HIV prevalence was strongly associated with number of lifetime sex partners and partner faithfulness

• Wealthier men and women have greater knowledge about HIV prevention methods, and were more likely to reporting using condoms, both with non-regular partners and consistently with all partners in the last year

• Wealthier men are more likely to be circumcised, except in Lesotho

• Wealthier men were more likely to have drank alcohol the last time they had sex

Individuals’ household wealth/socio-economic status was plotted out in quintiles, and the HIV prevalence tended to be higher among the some of the wealthier quintiles, though generally not the wealthiest. But the strong positive association was not statistically significant once adjusted for the other confounding variables and risk factors. In fact, the data for men and women tended to vary from country to country (making it impossible to see any clear pattern). It was clear though that HIV prevalence was not dramatically higher among the poorest individuals in these countries.

Dr Mishra noted that although poverty reduction is a worthy goal in its own right, it is unlikely to have much of an impact on HIV prevention “when the majority of HIV-infected people are wealthier, not poor.” He concluded that prevention programmes should be adjusted to take account of this reality on the ground.

And at the end of the conference, it appeared that his message had fallen on some fertile soil, when Dr. Mark Dybul, acting US Global AIDS Coordinator said that even though the idea that poverty isn’t related to higher HIV prevalence may have made people uncomfortable, “we must look deeply and dispassionately into data presented and discussed here and make sure they are right, but when we come upon data that we know are right, we must change our programmes to reflect the data.”

Delving a little deeper
However, other researchers in the field see the relationship between poverty and HIV as a much more complex one. In their recently published AIDS in the Twenty-First Century Professors Tony Barnett and Alan Whiteside of the London School of Economics and the University of Kwazulu-Natal note that income status has a limited ability to predict an individual’s risk of HIV infection independent of the social setting in which they exist.

In their opinion, the most important reason for focusing on the relationship between poverty and HIV is in order to understand they way in which impoverishment of a whole continent has led to the exceptionally severe epidemic experienced in sub-Saharan Africa.

Data from studies in South Africa also suggest that wealth is not a significant ‘contributor’ to HIV prevalence there — even among the black population (Kalichman 2006). Rather, in a study presented at the 2nd South African AIDS Conference, individual risk factors such as older age, early sexual debut and multiple lifetime partners were associated with higher HIV risk, but so were structural factors related to the community (Pronyk).

These included easier access to a trading centre (p=0.02), higher proportions of short-term residents (p=<0.001)

References
Tony Barnettt & Alan Whiteside. AIDS in the Twenty-First century: disease and globalisation. Second Edition, 2006, Palgrave, London.

Fenton L. Preventing HIV/AIDS through poverty reduction: the only sustainable solution? Lancet; 364: 1186-1187, 2004.

Kalichman SC et al. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Soc Sci Med.; 62(7):1641-9. 2006.

Mishra V et al. Are poor more affected by HIV/AIDS in sub-Saharan Africa? The 2006 HIV/AIDS Implementers Meeting of the President’s Emergency Plan for AIDS Relief, Durban, South Africa, abstract 49.

Parker R, Camargo KR Jr. [Poverty and HIV/AIDS: anthropological and sociological aspects]. Cad Saude Publica.;16 ## Suppl 1):89-102, 2000.

Pechansky F et al. HIV seroprevalence among drug users: an analysis of selected variables based on 10 years of data collection in Porto Alegre, Brazil. Drug Alcohol Depend.;82 Suppl 1:S109-13, 2006.

Pronyk P.M, et al. Why do some communities have more HIV than others? The association between structural factors and HIV prevalence in rural South Africa. 2nd South African AIDS Conference, abstract, 2005.

Xia Q et al. HIV prevalence and sexual risk behaviors among men who have sex with men: results from a statewide population-based survey in California. J Acquir Immune Defic Syndr.; 41(2):238-45, 2006.

South Africa: Partnership to Help Eastern Cape Fight Aids

Public and private sector stakeholders in the Eastern Cape have signed an agreement to unite and strengthen efforts to fight HIV and AIDS in the province.

The Eastern Cape AIDS Council and the SA Business Coalition on HIV and AIDS (SABCOHA) co-hosted a meeting on Wednesday attended by among others Cosatu, the local Amathola Municipality and the provincial health department.

The agreement was signed by the provincial AIDS Council, SABCOHA, the Eastern Cape Development Corporation and inWEnt.

It is set to develop a capacity development initiative funded by the German government to create mechanisms and resources to deliver capacity development in three sectors across the province.

The sectors include construction, agriculture and the automotive industry.

The meeting was also supported by DaimlerChrysler SA, one of the biggest employers in the region.

The company has extensive experience in partnership initiatives to fight the disease, both because of its own workplace programme and the new supply chain initiative which targets small, micro and medium enterprises (SMMEs).

Enfin des programmes de sensibilisation destinés aux ouvriers agricoles

HOEDSPRUIT, 21 juillet 2006 (PLUSNEWS) «Travailleurs agricoles, prenez soin l’un de l’autre et utilisez toujours un préservatif», indique une affiche, collée sur un arrêt de bus de la petite ville de Hoedspruit, dans la province sud-africaine du Limpopo, où des centaines d’ouvriers viennent chaque jour travailler dans les champs.

Bien qu’ils représentent un groupe à haut risque, les travailleurs agricoles migrants d’Afrique australe sont une population oubliée, qui ne reçoit que rarement un soutien en matière de lutte contre le VIH, un manque que tente de combler l’Organisation internationale pour les migrations (OIM) via le ‘Projet Hlokomela’ à Hoedspruit.

Dans le nord de la province du Limpopo, située le long de la frontière mozambicaine, la plupart des ouvriers agricoles sont des hommes venus du Mozambique qui vivent sur les exploitations pendant de courtes périodes.

Lors du lancement du projet en 2005, Armindo Sitoi fut l’une des premières personnes à se faire dépister et à apprendre son statut, négatif.

Né dans le sud du Mozambique, Armindo Sitoi a fui la guerre civile dans les années 1980 pour s’installer en Afrique du Sud. «Mes parents sont morts pendant la guerre et je n’ai jamais revu mes frères … ils vivent peut-être ici en Afrique du Sud», a-t-il confié à PlusNews alors qu’ils chargeait des oranges dans une remorque.

Alice Sambane, une compatriote d’Armindo Sitoi qui vit à Hoedspruit depuis 1998, est favorable à la mise en place de programmes de sensibilisation au VIH parmi les ouvriers.

«On a peu d’information sur le sida ici. A mon avis, ils devraient faire la même chose partout ailleurs dans la région», a-t-elle expliqué.

Le nouveau projet s’adresse à plus de 3 000 personnes, qui travaillent dans 18 des 300 exploitations que compte Hoedspruit. Dans chacune de ces exploitations, un ouvrier surnommé ‘Nompilo’ (‘Mère de la vie’ en langue zulu) est chargé de sensibiliser les autres travailleurs aux questions de prévention, nutrition, stigmatisation et discrimination des personnes infectées au VIH.

Dans le cadre du projet, l’OIM espère bientôt pouvoir permettre la prescription de traitements antirétroviraux (ARV), car les services sanitaires habilités à proposer ces médicaments qui prolongent l’espérance de vie des patients, se situent à plus de 75 km des exploitations agricoles, a expliqué Christine Du Preez, coordinatrice du projet.

Se rendre dans un centre de traitement ARV peut coûter jusqu’à 90 rands (12 dollars), une somme souvent inabordable pour la majorité des ouvriers: leur revenu moyen avoisine les 800 rands par mois (111 dollars). En outre, par peur d’être reconduit à la frontière, rares sont les immigrants mozambicains qui se rendent dans les centres de conseil et de dépistage publics.

Selon l’OIM, entre 10 000 et 80 000 Mozambicains vivent dans la province du Limpopo, l’une des régions agricoles les plus riches d’Afrique du Sud. Les résultats d’une étude menée par l’agence en 2003 ont indiqué que malgré le taux de prévalence élevé enregistré parmi les ouvriers agricoles, ils n’avaient que des connaissances très limitées en matière de VIH/SIDA.

L’OIM a noté que la plupart des hommes et des femmes adoptaient des comportements sexuels à risque, et «que le nombre de personnes ayant des partenaires sexuels multiples était extrêmement élevé».

«Etant donné le manque évident de programmes de sensibilisation au VIH/SIDA destinés aux ouvriers agricoles et aux populations migrantes», ils connaissent peu de choses sur l’épidémie, les mythes entourant le virus abondent et un grand nombre d’ouvriers interrogés croit, à tort, que le sida peut être soigné, a rapporté l’agence des Nations unies.

«Lorsque la vie est une bataille quotidienne, le VIH/SIDA semble être une menace distante, une menace parmi tant d’autres que doivent affronter les ouvriers.»

Cote d'Ivoire : prochaine formation des inspecteurs du travail

Abidjan (Fraternité matin)

Le premier draft du document de politique nationale de lutte contre le VIH/SIDA dans le monde du travail est disponible.
Toutefois sa diffusion générale sera précédée de la validation finale par le Comité focal tripartite. Ultime étape du processus d'élaboration. C'est à cette conclusion qu'a débouché vendredi dernier à Grand-Bassam, l'atelier de réflexion et proposition organisé par le ministère de la Fonction publique, de l'Emploi et de la Réforme administrative. Avec l'appui technique et financier du PEPFAR et de Family Health International (FHI). Pendant trois jours, la trentaine de participant à cet atelier provenant du secteur public, privé et communautaire ont planché sur la problématique posée.
En vue de répondre à un besoin impérieux d'harmonisation et de mobilisation des ressources de toutes natures des interventions en milieu professionnel. Tout en se félicitant cette initiative, le représentant du ministère de la Lutte contre le SIDA a dans son allocution indiqué que des contacts sont pris pour le financement d'une formation des Inspecteurs du travail. Pour assurer la protection des PVVIH en milieu du travail. M. Pohé Jean, directeur de cabinet, représentait la tutelle à ces travaux.

Indian growth to slow

New Delhi (Financial Express)
With the ‘rapid spread’ of HIV/AIDS, India’s economic growth over the next 10-15 years would be noticeably less than its potential, warned the National Council of Applied Economic Research (Ncaer) in a study related on Thursday.

The economic growth and per capita GDP could decline 0.86% and 0.55% respectively over the period, the think tank added.

By 2015-16, the per capita GDP (at 2002-2003 prices) would decline by Rs 7,610.61, it predicted.

The potential costs to the economy arising from the continued and unchecked march of the HIV epidemic could be quite high, said a report on “The macroeconomic and sectoral impacts of HIV and AIDS in India.” Ncaer study was assisted by NACO and UNDP.

The epidemic could pull down incomes of HIV households by 9.24%, which in turn, could have an adverse impact on the economy in terms of reduced savings and investments, the report said.

“This may not read substantial, but to a respective group of affected people it can mean a lot. Like, in case of daily wage labour, even if wife gets the virus from the husband, it means two working family members being lost to the virus,” said Ramamani Sundar, a team member working on the report."

Treat, Train and Retain

LONDON (Reuters) - Crumbling health systems and chronic staff shortages are hampering efforts to provide AIDS sufferers with life-saving drugs, the head of the World Health Organisation's (WHO) HIV division said on Friday.

Dr Kevin De Cock said Africa, which has been hardest hit by the AIDS epidemic, is short of at least a million healthcare workers and, over the past quarter-century, infrastructures in many countries have eroded.

"If you work in these countries it is very obvious, very quickly, that the elephant in the room is not the current price of drugs," De Cock told Reuters in an interview.

"The real obstacle is the fragility of the health systems, particularly in Africa."

The Belgian-born infectious disease expert said bolstering health systems will be a priority for the global agency, along with expanding HIV testing and counselling, maximising prevention efforts, scaling up treatment and investing in surveillance, monitoring and research.

Although the WHO failed to meet its target of getting 3 million people on AIDS drugs by the end of 2005, De Cock said the 1.3 million that were on treatment by the deadline represented an eight-fold increase in Africa and three fold worldwide since end-2003.

Most of the estimated 40 million people living with HIV/AIDS live in sub-Saharan Africa.

"Treatment for AIDS is a legitimate aspiration for everybody in the world no matter where they live or how poor they are," De Cock said. "There is no going back on that."

The real challenge now, he added, is to sustain the momentum, to push for universal access to AIDS drugs and to get the political commitment to rebuild healthcare systems that have crumbled in the past 20-25 years.

"You have health infrastructure that is dilapidated, a health workforce that is demoralised, labs that don't work, supply chains that don't exist and diagnostics that are missing," he said.

"And in parallel with that, you have had the emergence of the AIDS epidemic."

To try to tackle the shortage of well-trained workers, De Cock said the WHO will launch a healthcare workers' initiative at the XVI International AIDS Conference in Toronto, Canada from August 13-18.

The initiative, called "Treat, Train and Retain," aims to address the problems, which are acute in Africa which has 24 percent of the global burden of disease but only 3 percent of health workers commanding less than 1 percent of world health expenditure.

"These are long-term issues but they are crucial," said De Cock.

"The whole issue of getting long-term treatment out to people puts into very brutal focus this issue of infrastructure, personnel and systems."

ZAMBIE: Après la crise économique, le sida

NDOLA, 20 juillet (PLUSNEWS) - Une hausse des cours mondiaux du cuivre a permis à la région de la Copperbelt de sortir de dix années de marasme économique, mais dans une région qui affiche le taux de prévalence du VIH le plus élevé de la Zambie, la population subira encore longtemps les conséquences de la récession.

La Zambie a connu une économie florissante pendant plus de 70 ans grâce à l’exploitation du cuivre et du cobalt. De grandes villes se sont développées autour des mines.

Puis, la privatisation de l’industrie minière dans les années 1990, la chute des cours mondiaux et les caisses vides du gouvernement ont entraîné un taux de chômage élevé et une chute du niveau de vie dans la province fortement urbanisée de la Copperbelt.

La pauvreté, la prostitution et le VIH/SIDA sont étroitement liés. Joyce Mutale, comme beaucoup d’autres femmes veuves, n’a toujours pas reçu les indemnités qu’elle aurait dû percevoir suite au décès de son mari, dans une mine en 1999.

Elle a dû finir par se faire à l’idée que la prostitution pouvait être une solution pour survivre. Ainsi, impuissante, elle regarde sa jeune sœur vendre son corps.

Aussi pénible que cela puisse être, «il serait hypocrite de ma part de ne pas reconnaître la misère dans laquelle nous vivons et de demander à ma soeur d’arrêter de se prostituer», a dit Joyce Mutale. «C’est l’argent qu’elle gagne qui nous permet de vivre. Je pourrai peut-être la décourager une fois que j’aurai obtenu les indemnités décès».

«Je sais que le VIH existe réellement puisque nous avons vu mourir beaucoup de personnes de notre entourage, dont des veuves, mais j’encourage toujours ma sœur à utiliser des préservatifs. Je ne peux rien faire d’autre en ce moment pour changer les choses», a-t-elle ajouté.

Les villes de Ndola, Kitwe et Chingola, toutes trois situées dans la région de la Copperbelt, affichent un taux de prévalence du VIH/SIDA de 26,6 pour cent, soit un taux supérieur à celui enregistré à Lusaka, la capitale, qui est de l’ordre des 22 pour cent, et à la moyenne nationale qui est estimée à 16 pour cent.

«Dans les villes minières, la pandémie de VIH/SIDA a donné naissance à un grand nombre d’enfants orphelins et vulnérables qui sont devenus des enfants des rues [vulnérables à l’exploitation]», a déclaré Aaron Nkhuwa, spécialiste VIH/SIDA auprès de l’agence de développement Care International.

Au cours des années 1990, l’industrie minière créait de moins en moins d’emplois, et employait, en 2001, 34 966 personnes. Cependant, la hausse des cours du cuivre a incité les investisseurs à revenir dans la région de la Copperbelt et en janvier dernier, 51 000 personnes travaillaient sur les exploitations, a indiqué le ministre des Mines Kalombo Mwansa.

Bien que la plupart des nouveaux emplois créés soient des emplois temporaires et qu’ils ne proposent pas les avantages offerts autrefois par l’industrie minière, qui s’est effondrée avant d’être finalement privatisée en 2000, ils permettent néanmoins de renflouer les poches des ouvriers et de revitaliser les entreprises.

En outre, le nouvel essor économique de la région s’accompagne d’une explosion de l’industrie du sexe.

«Je ne regrette pas d’être partie de Livingstone [la capitale touristique de Zambie] parce que je gagne mieux ma vie ici», a confié Josephine Chanda, une jeune femme de 32 ans, qui a quitté le sud du pays pour venir vivre, en mars dernier, à Ndola avec ses deux enfants. «A l’heure actuelle, toute prostituée digne de ce nom doit venir travailler à Copperbelt.»

Josephine Chanda a expliqué qu’en travaillant dans les bars de la ville minière, elle gagnait plus de 50 dollars par nuit, alors que le salaire d’un fonctionnaire s’élève à environ 210 dollars par mois. «Parfois, les clients me battent si j’insiste pour utiliser un préservatif, ils m’obligent à avoir des rapports non protégés et dans ce cas, je leur demande plus d’argent», a-t-elle ajouté.

Pour Henry Loongo, membre du groupe de travail sur le sida de la région, «l’augmentation de la prostitution dans la région de la Copperbelt est notre principale préoccupation».

«Elle risque d’aggraver les ravages du VIH/SIDA dans les villes minières, car l’épidémie se propage là où se concentrent les activités sexuelles», a-t-il conclu.

HIV and the South African automotive industry

WITH the South African automotive industry firmly positioned for another record year, pressure is continuously mounting on manufacturers to maintain a competitive edge to sustain these levels of growth.

Competitiveness has often been associated with the traditional measures of business performance including profitability, direct investment, cash flow, productivity, quality, cost and delivery.

Seldom does business consider the effects of HIV and Aids on the competitiveness of the enterprise as whole.

This can be attributed to the fact that even though the pandemic has become a topical issue in South Africa, there is still a lack of measurement and awareness around the impact on the business sector.

Many manufacturers still consider HIV a social responsibility and so an imperative on the government, not the enterprise.

While significant effort has been made by original equipment manufacturers and multi-national first-tier suppliers to incorporate HIV workplace programmes into their mainstream systems and practices, lower-tier suppliers remain well behind.

These suppliers, typically SME companies, would relate similar reasons when questioned as to the lack of effective workplace programmes to combat HIV and Aids.

These reasons include the need to focus on survival and primary business issues such as profitability and productivity, coupled with the lack of resources internally, and a lack of government support.

Many suppliers feel that, within the existing business environment, it is difficult to focus on anything other than the fundamentals of survival in a demanding industry.

The SA Chamber of Business is quoted as saying that absenteeism in the workplace could be costing the South African economy as much as R12-billion a year. A reasonable percentage of this can probably be attributed to HIV and Aids.

In South Africa, between 15% and 20% of all adults are infected with HIV, giving South Africa the largest number of people (roughly five million) living with HIV or Aids in the world.

The Automotive Industry Development Centre has a mandate from both government and industry to provide solutions. HIV and Aids workplace programmes are a fundamental component of this.

Mozambique: UN Envoy Concerned At Levels of Aids

The special representative of United Nations Secretary General Kofi Annan on HIV/AIDS, Stephen Lewis, on Wednesday described as "worrying" the situation of the AIDS pandemic in Mozambique.

Lewis was speaking shortly after a meeting with Mozambican President Armando Guebuza, who told him of the country's difficulties in checking the spread of the disease, with the number of new infections increasing continually, as well as the number of orphans whose parents have died of AIDS.

Lewis described the situation in Mozambique as "serious" when compared with some other countries, where the epidemic is relatively stable.

The last national round of epidemiological surveillance, in 2004, showed that 16.2 per cent of the Mozambican population aged between 15 and 49 are HIV-positive.

Lewis, who also met with Health Minister Ivo Garrido, said that the best way to deal with this problem is a joint effort between the government and its national and international partners.

"On my return I will convey the concerns of the Mozambican government, and I will speak at the United Nations of the need to support the government's Strategic Plan to strengthen prevention to reduce the number of cases of the disease, but I will also broach the issue of treatment, which is urgent", said Lewis.

Meanwhile, the Mozambican private sector is preparing a study on the impact of HIV/AIDS in companies across the country.

The Executive director of the Business Against AIDS Association (EcoSida), Cornelio Balane, explained that the objective of the study is to identify the problems that private business faces because of the pandemic, and seek the best ways to fight against them.

"The private sector needs a study of the impact in order to determine the conditions in which it is working and identify the problems and the needs in order to move forward", he said.

Speaking in Maputo on Wednesday, at the opening of a seminar to train 35 trainers of peer educators at the workplace, Balane explained that peer educators are fundamental because they carry out education and counselling during working hours, with no need to interrupt activities as would be the case if somebody from outside the company was brought in.

"It is difficult to train workers, and thus we sought service providers who, in coordination with EcoSida, will train trainers within the companies. These are activists from civil society who offered to work in training workers in the companies", he said.

Balane also noted that the major challenge his association is facing is to design sustainable programmes. They cannot depend on outside implementers, because when one cannot find them, activities are interrupted.

He added that business campaigns against HIV/AIDS are underway in the central city of Beira, conducted by the Sofala Industrial and Commercial Association (ACIS), and in Nampula, in the north of the country, by the Nampula Industrial, Commercial and Agricultural Association (ACIANA).

Balane explained that EcoSida is now working with 60 companies across Mozambique.

owner-managed companies not concerned by AIDS

While the main concern is loss of productivity, many business owner do not link it with HIV/AIDS threat.

Some 5,4 million South Africans are living with HIV/Aids according to recent United Nations estimates, but the epidemic is having little or no effect on business owners.

This is the finding of a study by the South African Journal of Economics that was commissioned by the Joint Economic Aids and Poverty Programme (Jeapp).
The study results reveal that 62% of the 80 owner-managed businesses surveyed have never even considered HIV/Aids as a business issue, with business owners ranking Aids as ninth among a list of 10 concerns such as crime and the cost of labour.

The top concern among business owners, was the productivity of their workers.

Harlan Cloete, director of Siyakhana Training Consultants, says though securing more clients is their number one priority one can never really rule out Aids as a threat to one’s business.

He says since he has learnt that the spouse of one of his employees became HIV positive he has started to actively promote HIV/Aids awareness in the workplace.

But because we are a very small company we do not have the time or money to implement the HIV/Aids awareness programmes and policies that bigger companies have in place,” explains Cloete.


But Tim Quinlan, research director at the Health Economics and HIV/Aids Research Division (Heard) at the University of Natal, says their experiences have proven that it is very hard to conduct research of this nature on owner-managed companies, because their HIV statistics are non-existent.

He says many business owners can’t afford to run an efficient human resources department. As a result, their human resource records are appaling and don’t necessarily reflect the number of people who resign because they are too sick to work, he says.

Zimbabwe : un outil destiné aux femmes

Excellente initiative que ce toolkit spécifique destiné aux femmes traitées par ARV. Ecrit en trois langues, il comprend aussi du matériel multimédia. Certains sujets spécifiques aux femmes, notament sur les aspects hormonaux des traitements, sont abordés.

SAFAIDS, in conjunction with the American Jewish World Service (AJWS) and ActionAid International, on Monday launched the first ever women's treatment literacy toolkit, giving practical information on anti-retroviral treatment (ART) to women, girls and those supporting them.
The kit, a simple, user-friendly, and clear guideline in English, Shona and Ndebele, is designed to help its users make informed decisions about HIV/Aids prevention, care, support and treatment.
While making ART available seems to be the most important use of the kit, SAfAIDS said it was equally important to ensure that those on ART -- in this case the women -- were able to understand the basics of being on ART.
Illustrated with diagrams, pictures, fact sheets, posters, activity cards, a calendar, a brochure, an audiocassette and lists of additional resource materials, the toolkit would be equally useful for low literacy populations as well as those with visual impairment, it said.
"SAfAIDS has recognised that rolling out anti-retroviral therapy is not about availing anti-retroviral drugs but a complex exercise whose planning should adequately address special treatment concerns of girls and women.
"They include adherence, women-specific opportunistic infections, effects of treatment their biological (physical and emotional) lifecycle and reproductive and sexual health and choices, post-exposure prophylaxis in view of rampant gender-based violence and PMTCT Plus programmes."
As part of the comprehensive rollout process, the organisation had also organised a series of interactive workshops to train women's ART educators across the southern Africa region.
In a statement, SAfAIDS said the workshops would equip and empower participants to be better advocates in the area of women's treatment issues as a sound response to gender neutral and insensitive HIV/Aids treatment responses in communities of practice
They would also provide a platform for harmonising the uniqueness of the SAfAIDS Women's Treatment Literacy Toolkit with country specific treatment rollout efforts.
"Participants will be provided with relevant and adequate knowledge and materials that they can utilise to educate and empower others in their families, religious circles, workplace, social and peer groups.
"It is also our hope that the toolkit will act as a vehicle for mobilising communities to influence decision-makers towards protecting and promoting the HIV and Aids treatment related rights of women in their constituencies," SAfAIDS said.
These efforts would complement Government, civil society and multilateral agencies in their endeavours to scale up treatment literacy for women in Zimbabwean communities.
The Women's Treatment Literacy Toolkit was also launched and received with tremendous enthusiasm at the 10th AWID International Forum on Women's Rights and Development in Thailand, October 2005.
It was launched again at the 14th International Conference on HIV/Aids and Sexually Transmitted Infections in Africa (ICASA) in Nigeria, December 2005.
Rolling out the toolkit is meant to empower women in communities with accurate and relevant information to enable them to make informed decisions in terms of accessing and demanding their rights to full participation in anti-retroviral treatment programmes
It is also hoped that it would fortify the women's coping mechanisms in adhering to ART, and their ability to support their counterparts within the same continuum of care.
The toolkit will be rolled out countrywide during the course of this week.

Angola : labour inspectors to work on HIV/AIDS programs

Le gouvernement angolais veut que les inspecteurs du travail convainquent les employeurs de mettre en place des programmes sida sur les lieux de travail.

Angolan deputy minister of Public Administration, Employment and Social Security, Sebastião Lukinda, said Monday in Luanda that labour inspectors must guarantee measures of prevention against HIV/AIDS at workplace.
The deputy minister said so during the opening of the seminar on counselling of labour inspectors, job area and professional training on HIV/AIDS jointly sponsored by the Ministry of Public Administration, Employment and Social Security (MAPESS) and the National Institute of Fight Against AIDS (INLS).
According to him, it is a must labour inspectors manage to convince the managements to adopt sustained programmes on the disease and have the rights of HIV-positive workers respected, concerning confidentiality and non-discrimination.