Credit: UNAIDS

In Guangdong, China’s most populous province, some bold HIV-related policy decisions are about to come into play. In the wake of concerted advocacy efforts—including by UNAIDS, UNESCO and ILO—the province has announced it will abolish restrictions which prevent people living with HIV from working as teachers.

The policy changes, which will come into force in September, represent a shift from previous regulations, which excluded people living with HIV, as well as people who had been diagnosed with a sexually transmitted infection (STI), from serving as teachers in the province.

There are an estimated 50 000 to 80 000 persons living with HIV in the Guangdong Province. At the beginning of 2013, UNAIDS, UNESCO and ILO advocated jointly with the Guangdong education authorities for the removal of teaching restrictions for people living with HIV, after this regulation was being considered in a policy revision process. Subsequently, the Guangdong authorities responded that, following consideration of the feedback received on the issue, the regulatory Article which excluded people living with HIV and other STIs would be deleted.

Acting UNAIDS China Country Coordinator, Nana Kuo, underlined the significance of the changes. “This move by the Guangdong education authorities sets a positive example for the rest of China, and for the region as a whole,” said Ms Kuo. “China has made tremendous progress in its AIDS response in recent years, and it is highly encouraging to see signs of concrete action to address stigma and discrimination, especially in the workplace.”

According to national data, more than half the estimated 780 000 people living with HIV in China remain undiagnosed. Fear of discrimination is considered to be a major obstacle to access HIV testing, treatment and care services, particularly amongst marginalized populations. Across China, people living with HIV are excluded from employment in many sectors, including the country’s civil service. An ILO study conducted in China in 2011 found that 65% of business owners felt that people living with HIV should not enjoy equal employment opportunities.

“We commend Guangdong's decision to remove employment restrictions that had excluded people with HIV from serving as teachers. We hope that this marks a step towards the removal of all remaining employment restrictions, whether in the public or the private sector, so that people with HIV are able to live full and productive lives, without fear of stigma and discrimination,” said Ann Herbert, ILO Country Director for China.

In recent years, China has seen several high profile court cases filed by people denied of employment as teachers on the grounds of HIV status, but to date none of the cases has resulted in a clear legal victory. In many cases, this is linked to the fact that provincial education authorities have generally based teacher recruitment guidelines on national civil service recruitment guidelines, which exclude people living with HIV. In this context, the policy shift in Guangdong has particular significance. As one of the country’s most prosperous and urbanized provinces, with a population of more than 100 million people, Guangdong is often considered to be at the vanguard of progressive policy making in China.

Meng Lin, the Coordinator of the China Alliance of People Living with HIV, underlined the significance of the developments in the Guangdong education recruitment policy. “When people know that a positive diagnosis may result in them being unable to find employment, or losing their job, they often prefer to just avoid getting tested. The move by the Guangdong Department of Education sends out the message that people living with HIV have the right to equal employment opportunities and that makes us hopeful for the future.”

Professor Sheila Tlou, Director of the UNAIDS Regional Support Team for Eastern and Southern Africa and Clive Tasker, Head of Corporate Banking International signed the memorandum of understanding between the Standard Bank Group (SBG) and UNAIDS.

The Standard Bank Group (SBG) and UNAIDS formalised, on 22 November, what had already been a long-term collaboration in the response to AIDS in sub-Saharan Africa. They signed an official memorandum of understanding (MoU) for an initial period of two years to further collaborate on AIDS education and advocacy initiatives in the workplace.

“Healthy staff and communities are high on the agenda for any corporate, especially those operating in developing countries.  Without a healthy workforce, economies can’t thrive,” said Clive Tasker, Head of Corporate Banking International. “As the biggest bank in Africa, we believe that we have a role to play in supporting government health objectives.  Our partnership with UNAIDS allows us to do so by working with a respected organisation to educate our staff and communities on HIV prevention and treatment, and remove the stigma associated with AIDS,” he added.

The SBG is the largest bank in Africa. It is represented in 33 countries (17 in Africa and 16 in five other continents), has over 600 branches in South Africa and over 400 outside of South Africa and employ more than 50 000 people worldwide (34 891 are in South Africa). Partnering with the SBG is providing UNAIDS with an opportunity to reach out to key communities in countries where the bank operates and where the epidemic is.

“Employers play a critical role in the AIDS response. UNAIDS is committed to bringing the knowledge, solid experience and the capacity of the private sector to the AIDS response,” said Professor Sheila Tlou, Director of the UNAIDS Regional Support Team for Eastern and Southern Africa.

The latest UNAIDS World AIDS Day 2012 report, shows that the acceleration in the AIDS response is producing unprecedented results. According to the report, the number of people accessing HIV treatment in sub-Saharan Africa reached 56%—compared to a global average of 54%. In 5 Southern African countries–Botswana, Namibia, Rwanda, Swaziland and Zambia more than 80% of people living with HIV who are eligible for treatment are receiving antiretroviral therapy. However, 7 million people still do not have access to life saving treatment which negatively impacts their wellbeing and the socio-economic development of their nations.

Project 90/90

Early in the year, the SBG piloted the ‘Project 90/90’, which aims to reach 90% of the Bank’s employees with comprehensive health assessments annually and place people in need on treatment within 90 days, by 2015. A typical 90/90 health assessment includes tests that check sugar levels, blood pressure, cholesterol, and HIV and TB status.

“If a staff member is at risk for any disease, it is our goal to get 90% of those staff onto a proper treatment programme,” said Dr Wendy Orr, Head of Inclusion at Standard Bank Group. During the six months that the pilot run in the Standard Bank Headquarters in South Africa, 6 500 out of the 16 000 of the Bank’s staff members underwent a 90/90 health assessment.  Of those, approximately 65% took an HIV test.  “We believe that by including an HIV test in a broad health assessment, we are starting to lessen discrimination—one of the key objectives of the UNAIDS ‘zero’ campaign,” said Dr Orr.  “Following the success of our pilot, it is our intention to scale up the number of tests we do so that by 2015 all staff across the group will be receiving 90/90 screenings annually,” she added.

Community outreach

In addition to the 90/90 project, SBG remains committed to its ‘wellness champion’ programme. This programme uses voluntary staff members of the Bank as ‘champions’ to conduct awareness and mobilisation activities in order to increase uptake of voluntary HIV counselling and testing as well as condom distribution at the workplace and in communities.

During the 2011 World AIDS Day commemoration period, the ‘champions’ in collaboration with UNAIDS reached communities in Ghana, Nigeria and South Africa where more than 4 000 people voluntarily tested for HIV. “Wellness champions are peer workers who do an amazing education and advocacy work within our organisation and in the communities we serve,” said Dr Orr.  “Our ‘wellness champions’ need access to quality healthcare information and our partnership with UNAIDS has been invaluable for the work that they do. They will continue to be crucial to our success as we extend our focus to the Standard Bank Group more broadly.”

L to R: Luiz Loures, UNAIDS Director of Political and Public Affairs; Margaret Chan, WHO Director-general; and Guy Ryder, ILO Director-General, holding a chart during the launch of the campaign showing that the likelihood of employment for people living with HIV increases with access to HIV treatment. Geneva, Switzerland

The International Labour Organization (ILO), together with UNAIDS and the World Health Organization, launched on 27 November the “Getting to Zero at Work” campaign to promote the rights of people living with HIV in the workplace. The initiative recognizes the vital role that the world of work plays in the response to AIDS.

“The United Nations is leading by example through its own workplace policies,” said ILO Director-General, Guy Ryder. “Today, we must all together, governments, employers’ and workers’ organizations and other stakeholders, recommit to protecting the human rights of people living with HIV so that they may enjoy the right to work free from discrimination.”

More than 30 million people living with HIV who are of working age still face a high level of discrimination, according to the ILO. This prevents or limits their access to jobs as well as HIV services. Recent evidence shows that providing access to HIV prevention and treatment increases productivity and bring back people to work.

“Zero AIDS-related deaths and zero new HIV infections are realistic goals. The most challenging objective is zero discrimination,” said Luiz Loures, UNAIDS Director of Political and Public Affairs. “The ILO’s efforts to get to zero discrimination at Work are critical for an effective response to AIDS. The workplace is the most effective place to protect the human rights of workers and ensure a safe and supportive environment for people living with and affected by HIV.”

Margaret Chan, WHO Director-general, highlighted the important role that health workers play standing on the frontline of the AIDS response: “If countries are to achieve universal access to HIV services, one of their first steps must be to ensure that all health workers have access to effective and affordable HIV prevention, treatment and care."

The “Getting to zero at work” campaign aims to promote the ILO Recommendation No.200, the first international labour standard on HIV and AIDS in the world of work adopted in 2010.  The ILO standard provides sound guidance on addressing HIV through the promotion of human rights, job security and enhancing access to HIV prevention, treatment, care and support services from a workplace perspective.

Speakers at the Heineken HIV/AIDS Symposium 2011

Thirty years into the epidemic, is business a full partner in the AIDS response in Africa? A recent symposium hosted by Heineken N.V. in Amsterdam highlighted that there are many ways the private sector can contribute.

With Sharing responsibilities in the ‘World of Work’ in Africa as its theme, the symposium took stock of current business practices in Africa—in the workplace and beyond—and explored ways around how business good practices can be scaled up. Access to HIV treatment, resistance to treatment and gaps in funding were three of the main key issues discussed.

“There are many reasons why HIV is a smart investment for businesses,” said Dr Hedia Belhadj, UNAIDS Director Partnerships: “Addressing HIV in the workplace creates trust among staff and helps sustain productivity. Addressing HIV more broadly helps to boost consumer markets and bring about economic growth and reduce poverty.”

The symposium brought together representatives from the government of The Netherlands, including AIDS Ambassador Dr Marijke Wijnroks, international and non-governmental organizations, the public health community and the private sector.

Mr Ben Knapen, the Netherlands Minister for European Affairs and International Co-operation stressed the importance of partnering with the private sector to respond to HIV. “My government believes that public-private partnerships are an important tool in the response to HIV. Bringing together partners from both the public and private sectors creates the synergy and leverage we need in order to step up our efforts,” said Mr Knapen.

Private sector’s knowledge, resources, capacity and contacts are valuable resources that can contribute to an effective response to AIDS. By using their corporate communications and marketing skills, businesses can help raise AIDS awareness and promote behavioral change among employees, their families and communities. Companies can incorporate prevention messages that promote gender equality in existing communication platforms as well as instating zero tolerance policies to eliminate stigma and discrimination.

Private sector to become full partner in the global response

Two out of three people living with HIV go to work each day, according to UNAIDS. So the workplace has a vital role to play in mitigating the impact of the AIDS epidemic and facilitating access to HIV prevention, treatment, care and support. Workers that are living with HIV and taking effective treatment can lead healthy, productive lives for many years. Heineken—which employs more than 70 000 people worldwide—realized the value of this.

In the early 1980’s, the company began building clinics and training staff to provide health care to employees. In 2001 it adopted and implemented its HIV workplace policy which contributed to improve the response to HIV among employees and their families.

Today, the brewing group's workplace programmes include a “know your status” campaign with voluntary counselling and testing events and training by peer health educators, who also raise awareness about HIV to pupils in local schools.

AIDS committees have been established in nine breweries to also oversee education and condom distribution campaigns, information sessions for people living with HIV and awareness events around World AIDS Day.

Heineken provides treatment for all employees living with HIV and further, it guarantees treatment for employees and their families for life, regardless of whether they are still employed at the company.

Not all companies are willing to or capable of making such a commitment. The question of sustainability and the long term commitment that the company has to shoulder, given the little likelihood for national services to replicate the quality of HIV service delivery, was seen by participants as a major obstacle in implementing workplace policies related to HIV.

Dr Belhadj outlined the importance of the new ILO Standard on HIV/AIDS and the world of work. It provides a platform for business to promote healthy workplaces by defining roles and responsibilities at all levels of policy and decision-making processes, implementation, and evaluation of HIV programmes in the workplace.

Participants agreed that, to become full partners in the AIDS response, businesses need to engage in high level advocacy. The private sector can use their weight to promote accountability and transparency by reporting on money spent on social welfare programmes. They can break the upward trajectory of costs of drugs, supplies and delivery and participate in innovative public-private partnerships on research and development.

ILO human red ribbon which was illuminated as part of the Light for Rights global campaign. Credit: ILO

Preventing HIV and protecting human rights in the work place were the themes of the International Labour Organization’s (ILO) event on World AIDS Day. Staff members formed the traditional ILO human red ribbon which was illuminated as part of the Light for Rights global campaign.

Mr Guy Ryder, ILO Executive Director, Standards and Fundamental Principles and Rights at Work Sector, addressed the gathering of ILO staff as well as colleagues from other UN agencies, and civil society organizations. He asserted the determination of the ILO to keep the promise to stop the spread of HIV: “The new ILO Recommendation adopted in June 2010 is a significant step. HIV is central to the ILO’s Decent Work Programme.” 

Formulated with the aim of enhancing the contribution of the world of work to attaining universal access to HIV prevention, treatment, care and support services, the recently adopted labour standard also contains provisions for anti-discrimination measures at all levels and stresses the importance of confidentiality and employment and income generation for people living with HIV. It is also intended to protect workers against unfair dismissal due to actual or perceived HIV status and mandatory HIV testing.

Dr Sophia K. Kisting, Director of ILO Programme on HIV and the World of Work read the award winning poem  ‘Shining with HIV’ written by Bolivian José Willan Montaño Ferrel, which conveyed a strong message on the dignity of having a job and decent working conditions. It was one of the three winning entries in the contest ‘Positive workers write!’, held jointly in Latin America by the ILO and the International Trade Union Confederation (ITUC) .

The event also premiered two videos, “Loggers Learn about HIV/AIDS Prevention in Guyana” and “Business Women on Board with HIV/AIDS Message in Malawi.” Both videos include strong messages on the need to eliminate stigma and discrimination at work.

UN Cares

On 29 July 2010 UN Secretary-General Ban Ki-moon awarded a "special commendation" to UN Cares during the UN 21 Awards at UN Headquarters in New York.

UN Cares is an inter-agency programme designed to reduce the negative impact of HIV on the UN workplace by educating UN staff and families on HIV and provide support for staff living with HIV.

The programme is designed to help staff and families to access their rights defined in the 1991 United Nations HIV/AIDS Personnel Policy and in the ILO Code of Practice on HIV/AIDS and the World of Work and recognize their individual responsibilities related to HIV. The global programme was launched in May 2008.

Developed through interagency consultation between UNAIDS Cosponsors and other UN bodies, UN Cares is available to UN system personnel and their families in all entities and all duty stations.

“This commendation by the Secretary-General acknowledges the outstanding global effort from UN colleagues worldwide and those who volunteer their time to disseminate UN Cares messages in the UN workplace,” said Ms Jan Beagle, UNAIDS Deputy Executive Director, Management and External Relations.

“UNAIDS plays a vital role in supporting UN Cares and the award highlights the great work of UNAIDS staff around the world in support of this groundbreaking programme that benefits thousands of UN employees and family members worldwide,” Ms Beagle added.

UN 21 Awards

The UN 21 Awards annual awards were established as part of the reform effort by the former Secretary-General Kofi Annan in 1996 to provide recognition to staff members for innovation, efficiency and excellence in the delivery of the Organization's programmes and services. Commendations are given for excellence and/or outstanding inter-agency coordination.

UNAIDS Deputy Executive Director, Management and External Relations Ms Jan Beagle. Credit: UNAIDS Anna Rauchenberger

The recent adoption of a ground-breaking human rights instrument on HIV and the world of work has brought the key role of the workplace in the global AIDS response into sharp focus.

On 17 July, the eve of the XVIII International AIDS Conference, the International Labour Organization (ILO) convened a workplace partners’ forum to explore how best to achieve greater coordination and harmonization in taking a rights-based approach to address HIV in the world of work.

Attracting high-level participation, the forum brought together delegates from UNAIDS and its ten cosponsors, HIV workplace implementers, workers, employers, donors and networks of people living with HIV. Speakers included the Honourable Rudolf Hundstorfer, Austrian Federal Minister of Labour, Social Affairs and Consumer Protection; Mr Patrick Obath, Chairperson of the Federation of Kenya Employers; and Ms Jan Eastman, Chairperson of the Global Union AIDS Programme.

UNAIDS Deputy Executive Director, Management and External Relations Brand, Ms Jan Beagle also gave a keynote address along with Dr Sophia Kisting, Director of the ILO Programme on HIV/AIDS and the world of work.

Ms Beagle highlighted the important role of the workplace in providing universal access to prevention, care and support saying “the workplace provides unique entry points to reaching people where they spend the most amount of time in their daily lives.”

“We are all aware that HIV affects the most economically active age range in every population and the majority of the 33.4 million people estimated to be living with HIV worldwide are workers. Many are still subject to stigma and discrimination and the threat, or reality, of losing their jobs due to their status,” Ms Beagle continued.

The forum catalysed action in the development and implementation of country-level interventions and promoted greater engagement of the private sector and business in HIV programming. It was an opportunity to share ideas and experiences with a view towards establishing a global partnership network that will be of special benefit during the implementation phase of the new standard, which is the first international labour standard to concentrate on HIV.

Labour standard on HIV in the world of work

Formulated with the aim of enhancing the contribution of the world of work to attaining universal access to HIV prevention, treatment, care and support services, the recently adopted labour standard also contains provisions for anti-discrimination measures at all levels and stresses the importance of confidentiality and employment and income generation for people living with HIV. It is also intended to protect workers against unfair dismissal due to actual or perceived HIV status and mandatory HIV testing.

Dr Sophia Kisting, Director of the ILO Programme on HIV/AIDS and the world of work. Credit: UNAIDS/Anna Rauchenberger 

Commenting on the event, Dr Kisting said, “This forum should allow us to generate creative ideas on how we can optimise the implementation of the Recommendation. Our success will be determined by our collective resolve to deliver."

Responding effectively to HIV in the workplace is seen as essential to the development of national HIV strategies and forms part of a wider spectrum including health, education and social protection. According to the ILO, workers should be central in the design, implementation and evaluation of workplace programmes which are to be developed through widespread consultations with governments, employers and people living with HIV.