10 August, 2011
In this issue of the ICEM HIV/AIDS newsletter, we report on a survey on HIV/AIDS workplace policies and on the call for proposals for Round 11 by the Global Fund.
Workplace Policies: Survey Reveals Progress by ICEM Affiliates
Since 2005, the ICEM has implemented a comprehensive HIV and AIDS programme. National coordinators acquired knowledge and skills; hundreds of peer educators were trained; tens of thousands of workers and members of the communities attended awareness meetings and VCT campaigns and queued up for being tested and counselled. At a time when still more than two new infections occur for every additional person receiving antiretroviral treatment, prevention is a priority.
Although no baseline information exists, it can be assumed from anecdotal evidence that, with the exception of South Africa, in 2005 only some HIV/AIDS policies unilaterally drafted by companies existed. While more workplace policies and HIV and AIDS clauses in collective agreements have now been concluded, progress in this respect is still unsatisfactory. The ICEM has made a model workplace policy available for its affiliates. This aspect of the HIV and AIDS work of the ICEM and its affiliates has to be intensified.
No doubt, non-discrimination is the key to any strategy to fight HIV and AIDS at the workplace. Workplace policies negotiated and agreed by unions and employers are a first step. The effectiveness of such policies depends on employer commitment and the ability of a union to monitor implementation of the policy. While such policies commit the parties morally, their implementation can still be weak and workplace policies, as a rule, cannot be legally enforced. Therefore, the establishment of clauses in collective agreements provides one of the strongest measures to deal with HIV and AIDS at the workplace.
A preliminary survey conducted during the recent African regional workshop for nine sub-Saharan African countries revealed that affiliates have started to engage employers or sectoral employers’ bodies, such as Chambers of Mines, in discussions and negotiations to conclude bilaterally acceptable policies and draw up programmes.
To give but a few examples: in Ghana, major mining houses have HIV/AIDS workplace policies. Although some were initially drawn up unilaterally, the Ghana Mine Workers’ Union (GMWU) is now involved in the implementation. In Mauritius, collective bargaining agreements with ten companies, out of 36 which are bargaining partners of the ICEM affiliate Chemical, Manufacturing, and Connected Trades Employees’ Union (CMCTEU), contain non-discriminatory clauses. Affiliates Associated Mine Workers’ of Zimbabwe (AMWZ) and the Zimbabwe Energy Workers’ Union (ZEWU) have negotiated and concluded industry-wide HIV/AIDS workplace policies for the mining and energy sectors.
It has to be seen how further commitments to include specific HIV and AIDS clauses in collective bargaining agreements will bear results. Employers’ awareness of the threat of a spread of HIV infections to their operations helps. The existence of a national legislative framework is conducive. And union strength, leadership commitment, and membership support are absolute prerequisites.
Global Fund: Call for Proposals for Round 11, Change in Grant Architecture
The call for proposals for grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria will open on 15 August. Deadline for submitting proposals is 15 December. This is later than expected and poses some problems. As decisions concerning Round 11 funding will only be made by the meeting of the Global Fund Board in 2012, countries which have grants expiring would need special extension funding to avoid interruptions, especially of treatment.
Furthermore, new eligibility criteria apply for Round 11. Under the “history of funding” criterion, 78 countries, which have a history of recent funding for one or more of the diseases, are ineligible to apply in Round 11 for those components.
The Global Fund is also going to implement new grant architecture. It is designed to streamline and improve both the applications process and programme implementation. One of the ways it does so is by consolidating programmes and grants so that there is only one agreement per principal recipient (PR) per disease or health systems strengthening (HSS) programme.
Grant consolidation involves merging two or more existing grants for the same PR and disease into one. Anytime two or more existing grants have been consolidated into one, a single-stream-of-funding (SSF) agreement is signed with the PR. SSF agreements are very similar to the grant agreements that have been used up to now. The most significant differences are (a) the provisions for periodic reviews (replacing Phase 2 reviews); and (b) the fact that the SSF grant agreements will be revised after each periodic review and whenever additional funding for the PR is approved in a future round. Under the new grant architecture, the periodic reviews will be carried out at the same time for all SSF agreements for a given disease/HSS programme, regardless of how many different PRs are involved.
By the time proposals for Round 11 are approved, the Global Fund will be well on its way to implementing the new grant architecture. Grants will be replaced by single-stream-of-funding. All proposals submitted for Round 11 have to be consolidated proposals. For all of the proposals approved in Round 11, single-stream-of-funding agreements will be signed with PRs. In most cases, a single-stream-of-funding agreement will cover not only new initiatives included in the proposal, but also all of the PR’s active “grants” for that disease. By the time the Round 12 single-stream-of-funding agreements have all been signed, the old grant agreements will be an endangered species.
(Source: Global Fund Observer, Issue 152 of 5 July. GFO is a free service of Aidspan www.aidspan.org; to receive GFO send an email to [email protected])
Nepal: Migration Main Factor for HIV Prevalence
HIV prevalence in Achham is estimated at 1.7%, but many residents, who have never left the remote western district, know HIV only as “Bombay [Mumbai] disease.” Naming HIV after India’s bustling commercial city is considered the most logical explanation for what happened to men who were healthy when they migrated for work and returned home years later sick. The district has supplied cheap migrant labour to cities such as Mumbai for years.
Although HIV prevalence in Nepal’s general population is a low, 0.5%, the country has been experiencing a concentrated epidemic among high-risk groups such as seasonal migrant workers. The government found that in 2008, 41% of all HIV cases in the country were among labour migrants.
Testing and public awareness for HIV are said to be increasing in Achham, where nearly 70% of households migrate at some stage, according to the ILO. An inclusive maternal care programme at district hospitals, which provide women with US$20 if they give birth on-site, has helped control mother-to-child transmission of HIV; the Achham District Hospital reports only 42 cases of transmission since 2005.
(Source: PlusNews, 27 July)
Swaziland Crisis Affects Treatment
Unease is mounting in Swaziland after reports that supplies of antiretrovirals are dangerously low. Resources have never been adequate to tackle the world’s highest HIV infection rate in the tiny kingdom, but in recent months, the cash-poor government and dwindling donor funding have led to increasing panic among people living with HIV. One in four Swazis between the ages of 15 and 49 is living with HIV – at 26.1%, the world's highest prevalence – in a population of about one million.
More than 64,000 Swazis were receiving ARVs by the end of June, a number expected to climb to about 69,000 by the end of July, according to the Monitoring and Evaluation Unit at the Ministry of Health. However, 200,000 Swazi adults are believed to be HIV-positive.
Swaziland is in the grips of an acute financial crisis. Social services have been cut and public servants are facing looming retrenchments. The government is the country's biggest employer. In addition, the Ministry of Agriculture last month reported a 29,000-million-tonne shortfall in the annual maize requirement – the country’s staple food – of a total of about 114,000 million tonnes.
The Southern African Customs Union (SACU), comprising Botswana, Lesotho, Namibia, South Africa, and Swaziland, applies a common set of tariffs and disproportionately distributes the revenue to member states. It has provided an economic lifeline to Lesotho and Swaziland, in particular, which have small impoverished populations, large numbers of HIV-infected people, and few or no natural resources. SACU revenue accounted for about 66% of the Swazi government’s income two years ago. Following a reorganization of customs union receipts, it will only make up 32% of this year’s budget.
Government has requested financial assistance from South Africa, which is obliged to consider the loan to avoid a humanitarian crisis on its doorstep and a flood of economic refugees. But Swazi NGOs, led by the Swaziland Coalition of Concerned Civic Organisations, and organizations in South Africa, such as the national trade union centre, the Congress of South African Trade Unions (COSATU), are calling for political reforms to be linked to any financial aid. Swaziland is also the last absolute monarchy in the world.
(Source: PlusNews, Mbabane 18 July)
Debt Swap Agreement Benefits Global Fund
The Global Fund has brokered debt swap agreements before, but not like the latest one between Germany and Egypt.
Under the Global Fund’s Debt2Health mechanism, creditors (i.e., countries that are owed money) may agree to write off a portion of the debt owed to them, on the condition that the debtor countries (i.e., the countries that owe money) invest an agreed-upon amount in local programmes approved by the Global Fund. Until recently, four Debt2Health agreements had been concluded – three involving Germany and, respectively, Pakistan, Indonesia, and Cote d’Ivoire; and one between Australia and Indonesia.
In June 2011, Germany agreed to write off €6.6 million of Egyptian debt. What makes this agreement unique is that Egypt has agreed to contribute half of the €6.6 million to Global Fund programmes to fight malaria in Ethiopia. This is the first time that a debt swap arrangement under the Debt2Health mechanism has involved reinvestment in programmes in a country other than the original debtor.
(Source: Global Fund Observer, Issue 154 of 25 July. GFO is a free service of Aidspan www.aidspan.org; to receive GFO send an email to [email protected])
New Hope in Fight Against AIDS
Aids drugs designed to treat HIV can also be used to reduce dramatically the risk of infection among heterosexual couples; two studies conducted in Africa have shown for the first time. The findings add to growing evidence that the type of medicines prescribed since the mid-1990s to treat people who are already sick may also hold the key to slowing or even halting the spread of the disease.
The research involved 4,758 “discordant” couples, i.e. in which one partner was HIV positive and the other negative, in Kenya and Uganda and more than 1,200 sexually active men and women in Botswana. The studies found that daily Aids drugs reduced infection rates by an average of at least 62% when compared with a placebo.
The idea of such "pre-exposure prophylaxis," known as PrEP, has gained traction in the past year, following results of other research showing a fall in infection rates among gay men taking Aids drugs.
(Source: aljazeera.net, 14 July and Health Day News, 13 July)
News from Global Unions
The International Transport Workers’ Federation (ITF – www.itfglobal.org) in its latest HIV/AIDS Update 110 of 1 and 15 July, reports on a long-term HIV/AIDS workplace education project in cooperation with the National Union of Seafarers of Sri Lanka, which will cover all sectors represented by the union in Colombo Port, as well as four seafarers’ and maritime schools in Sri Lanka. The programme is funded by UNAIDS and the ILO and the UNFPA will provide technical guidance.
In anticipation of the next call for proposals for funding for Round 11 by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the International Trade Union Confederation (ITUC) issued a circular to all its affiliates and to the Global Union Federations. The circular gives details for a step-by-step approach to include workplace-related components in proposals submitted by Country Coordinating Mechanism (CCM). As cited above, Round 11 will open on 15 August; the deadline for submitting national proposals is 15 December.
Five Years Ago: From the August/September 2006 Issue (No. 11/12)
The first issue of the ICEM HIV/AIDS e-bulletin was published in October 2005. In current issues, we refer to an article from the same month five years ago and reflect on developments.
In the August/September 2006, we reported on the 16th International AIDS Conference which was held in Toronto from 14-18 August 2006. Over 20,000 scientists, politicians and activists participated in the event. The labour movement was well represented, highlighting the impact of HIV and AIDS on the workplace and outlining the role of workers in fighting the pandemic.
Prior to the Conference, the Canadian Labour Congress (CLC) organised a two-day labour forum with the support of the ILO. The forum convened union representatives from all over the world who expressed their support for intensifying the involvement of trade unionists and unions and to build strong coalitions with civil society organisations. On the occasion of the labour forum the CLC released a new report, “Labour Fights AIDS,” which demonstrates that unions are at the fore in the global fight against AIDS
The ICEM abstract written for the Conference was accepted for a poster exhibition. The ICEM was also invited to speak on “The importance of social dialogue and workers’ participation in public/private partnerships” at a Satellite Meeting Session with the theme “From the workplace to the community – Co-investment to access prevention, treatment and care in public/private partnerships.”
Several broader trends emerged from the Conference. Although still inadequate, treatment is becoming more available. However, those on antiretrovirals (ARVs) remain infected and require treatment indefinitely. This requires a re-emphasis on prevention. Despite many years of research at huge cost, a vaccine has not yet been found.
Also noted was that prevention techniques away from consent-requiring condom use focus on female protection to empower women to take control.
In that issue, we also reported on the 2nd Global Fund Partnership Forum in Durban in July 2006 and on the renewed commitment made by the G8 meeting in St. Petersburg, Russia, to tackle HIV/AIDS and to create a regular monitoring of its work.
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