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7 June, 2006June 2006
Mission to Ghana – Breakthrough in ICEM Pilot Project
Key elements of the ICEM Global HIV/AIDS Project are the pilot projects. In identifying areas where we can make a real contribution, the ICEM has developed the concept of such projects in cooperation with major mining companies.
These projects target health clinics operated by the companies, which provide functioning medical services to their workers and immediate dependents. The clinics can be used to expand their services to the broader community in the area and provide voluntary counselling and testing (VCT) as well as antiretroviral treatment (ART).
The ICEM concept has now received recognition at the AngloGold Ashanti mine in Obuasi, Ghana. Building on discussions between the ICEM and management in Johannesburg, AngloGold Ashanti is now involved in a public-private partnership with the Ministry of Health. The project is intended to provide HIV clinic services, including voluntary counselling and testing (VCT) and antiretroviral treatment (ART) to employees, their dependents and the community of Obuasi.
In a good example of a co-investment project, the company makes the infrastructure of the hospital and the medical staff available. It provides VCT and ART to its employees and their dependents at its own cost and gets reimbursed for such services provided to the community.
During a joint mission with representatives of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), the ICEM Global HIV/AIDS Coordinator visited the Obuasi mine. Members of the delegation were briefed at the company’s Edwin Cade Memorial Hospital on the HIV/AIDS programme. Weekly health briefings at the Obuasi office of the Ghana Mine Workers’ Union will involve the union in the programme.
The delegation also visited the Malaria Control Centre which was opened by the President of Ghana on 28 April. The malaria control programme covers the spraying of all houses in Obuasi.
The joint ICEM/GFATM mission was a first for the global union movement. Representatives of the Ministry of Health/Ghana Health Service, as principal recipient of the grants, and members of the Country Coordinating Mechanism were briefed on the advantages of public/private sector co-investment projects for the implementation of Global Fund grants.
In all meetings the point was made that the private sector includes business and unions. The ICEM can take credit that this concept has been recognised by the Global Fund when exploring further co-investment projects in other countries.
United Nations High Level Meeting on AIDS
Heads of state and government, ministers and more than a thousand representatives of civil society and the private sector gathered in New York for the follow-up to the 2001 UN General Assembly Special Session (UNGASS) and a comprehensive review of the progress made in achieving the targets agreed by member states five years ago when the Declaration of Commitment on HIV/AIDS was adopted.
Trade unions attending the event have urged government representatives and HIV/AIDS activists to focus on workplace strategies to address stigma and discrimination attached to HIV/AIDS. 90% of the 40 million people who are HIV infected are found in the working age population. Many of them live in daily fear of losing their jobs.
The workplace is particularly well-positioned to combat discrimination in society and it holds tremendous potential for awareness-raising, prevention, treatment and counselling. More attention must be directed to the ILO Code of Practice on HIV/AIDS and the world of work, which speaks directly to the need for partnership and social dialogue in the workplace.
Trade union representatives have also approached government delegations to seek support for the creation of a high-level G8 Working Group on HIV/AIDS. This ongoing campaign had already targeted health ministers attending the World Health Assembly of the WHO in Geneva in May. It will continue at the International Labour Conference of the ILO in June.
As reported in the May issue of this e-bulletin, the UN produced two reports prior to the meeting, which can be accessed on the UNAIDS website www.unaids.org. On the eve of the High Level Meeting, UNAIDS launched the 2006 Report on the global AIDS epidemic. This special edition, marking the 10th anniversary of UNAIDS, contains the most in-depth date from countries to date, based on progress reports from 126 countries.
(The outcome of the Conference and the UNAIDS 2006 Report will be given more detailed attention in the July issue of this e-bulletin).
Global Fund Calls for Round 6 Proposals
The Global Fund to Fight AIDS, Tuberculosis and Malaria has issued its Sixth Call for Proposals. The application form and support documentation are available in six languages at www.theglobalfund.org/en/apply/call6. Proposals have to reach the Global Fund by 3 August.
The Global Fund does not have offices in any country. The application process is devolved to the national level. All proposals have to go through the Country Coordinating Mechanisms (CCM). The composition of the CCMs is supposed to be representative of all stakeholders in the fight against HIV/AIDS, including civil society, the private sector and organisations of people living with HIV/AIDS (PLWHA).
Very few CCMs include trade unionists. This should not prevent trade unions to work through members of the CCM who are sympathetic to their cause and to find cooperating partners who can develop workplace-related project ideas into proposals for the CCM.
The role of the workplace in the fight against HIV/AIDS is recognised. No workplace activities can be efficiently implemented without unions. The role of national unions and their international bodies, the Global Unions Federations, is acknowledged by international organisations such as the ILO, the WHO and UNAIDS.
The Global Fund is keen to build public/private partnerships and to implement co-investment projects. Without the involvement of the private sector, universal access to voluntary counselling and testing (VCT) and to anti-retroviral treatment (ART) is not possible or will be further delayed. The private sector is business and trade unions as the workers’ representatives.
The ICEM has worked with the Global Fund to establish this principle in public/private co-investment projects.
FNV Report Acknowledges Contribution of ICEM Projects
In a report entitled “Trade union support in the struggle against HIV/AIDS”, FNV Mondiaal, the international trade union development organisation of the Dutch national centre FNV, stresses the importance of HIV/AIDS as a trade union issue.
FNV Mondiaal is currently supporting 12 HIV/AIDS-related projects in cooperation with Global Union Federations and national unions. Fighting the pandemic is one of the priorities of its business plan 2005-2008.
The report cites the ICEM project, which also enjoys the support of the Swedish LO/TCO, as a good example of integrating HIV/AIDS issues in collective bargaining and global framework agreements.
The report gives credit to the ICEM’s efforts to build partnerships, especially in Ghana, to decrease the incidence of HIV/AIDS in mining companies and to upscale VCT and ART. It further acknowledges ICEM’s role in working with the Global Fund to Fight AIDS, Tuberculosis and Malaria and national Country Coordinating Mechanisms to involve unions and generate additional funds.
Australia and AIDS
Two initiatives have been launched in Australia to try to stop the spread of HIV infections in Asia, from where 40% of the disease’s growth is forecast to come over the next few years.
The first is a partnership between the Australian government and the Bill Clinton Foundation. Australia will provide USD 18 million to work with the Foundation in China, Vietnam and Papua New Guinea to provide test kits and antiretroviral drugs. The government-Clinton coalition will work with a second cooperative effort involving Australian companies that have operations in Asia.
(Source: The Economist, 1 April 2006)
South Africa: May Day Focus on HIV/AIDS
Along with a number of trade unions throughout Africa, the Congress of South African Trade Unions focussed its 1 May activities on HIV/AIDS under the theme “AIDS – The New Struggle”. It emphasised breaking the silence and building solidarity with the slogan “Each one teach one! Test, Treat and Fight for Life”.
Sectoral summits with employers and other stakeholders are planned during 2006 and mining companies will be asked to create a fund to assist with the scaling up of access to care and treatment in Lesotho and Mozambique, where the pandemic has been fuelled by migrant labour to the mines.
Fighting HIV/AIDS – Lessons from Brazil
In the history of the response to the HIV pandemic, Brazil is best known for its pioneering decision in 1996 to offer free combination antiretroviral treatment to all citizens.
The government-funded treatment programme has improved the health and extended the survival of countless Brazilians, has saved the country billions in hospital cost and has inspired similar efforts elsewhere – including the US President’s Emergency Plan for AIDS Relief and the WHO’s 3x5 Initiative.
Between 1996 and 2005, the government spent a total of USD 3.5 billion in response to HIV and AIDS, including USD 2 billion for antiretroviral drugs. All the money for drug treatment has come from internal funds; about 11% of total expenditure has come from World Bank loans, spent chiefly for prevention programmes and to establish a national laboratory network for the clinical monitoring of patients.
Brazil’s persistent and aggressive efforts to prevent new HIV infections have probably played an equal if not greater role than treatment in slowing down the spread of the virus and containing the country’s epidemic. At the beginning of the 1990s, the epidemics in Brazil and South Africa were at a similar stage, with a prevalence rate of about 1.5% among adults of reproductive age.
However, by 1995, the year before Brazil’s treatment programme was established, the epidemic in South Africa began to explode with a prevalence already greater than 10%, whereas the infection rate in Brazil had declined by half. The early success of prevention efforts allowed its national treatment programme to be feasible logistically and financially by limiting the number of people infected.
In turn, access to free treatment has made Brazilians more willing to be tested and has made it easier to address the types of behaviour associated with transmission.
In Brazil, during the week before Carnival, citizens who ventured to catch a bus, buy a beer or mail a letter were likely to be reminded by their government to use condoms. Postal costumers received condom brochures along with their stamps. Public health officials, contracted with Coca-Cola distributors, delivered condom posters to bars along with the soft drinks. Prevention efforts targeting high-risk parts of the population have achieved impressive success, particularly among injection-drug users and commercial sex workers.
An important factor in making the programme affordable was the expertise of the domestic pharmaceutical industry, which allowed the country to produce generic versions of antiretroviral drugs with patents that had been registered before 1996, predating Brazil’s signing of the TRIPS agreement.
For newly developed drugs, Brazil may still decide to issue compulsory licenses in the future on the basis of the WTO Doha declaration that the TRIPS agreement should be interpreted and implemented by member countries “in a manner supportive of WTO members’ rights to protect public health, and in particular, to promote access to medicines for all”.
(Source: The New England Journal of Medicine, No. 19, 11 May 2006)
News from ILOAIDS
A new brochure “The workplace: gateway to universal access”, published in April, gives a succinct overview of the role of the ILO in reducing discrimination and increasing access to HIV/AIDS prevention and treatment.
Published in May, “Saving lives, protecting jobs” is an interim report of the International HIV/AIDS Workplace Education Programme, also known as Strategic HIV/AIDS Responses by Enterprises (SHARE) and financed by the US Department of Labor. Under the programme, almost 2,800 government officials and key members of workers’ and employers’ organisations have received in-depth training on developing policies and implementing programmes on HIV/AIDS. Over 2,000 workers have been trained as peer educators.
Both publications can be accessed at www.ilo.org/aids.
REMINDER TO ICEM AFFILIATES
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ICEM affiliates are already engaged in a wide range of activities; some have formal agreements with companies; others run education and awareness programmes at the workplace.
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