2 August, 2007August/September 2007
ICEM Affiliates: HIV/AIDS Activities Pick up
ICEM affiliates in Botswana organised a series of meetings on HIV/AIDS policy, peer education, and voluntary counselling and testing. The National AIDS Coordinating Agency (NACA) has shown an interest in the unions’ programme.
In Tanzania, ICEM affiliates TUICO and TAMICO organised training workshops for peer educators at the Mbeya Labour College and in Dar-es-Salaam. A separate seminar was held for members from the Kiwira Coal Mine.
Workplace union representatives were the target group of a training seminar in Côte d’Ivoire which dealt with behaviour change communication, the rights of HIV-positive workers, and the essential elements of workplace policies.
In the Democratic Republic of Congo, two training workshops for peer educators were held in Kinshasa and Moanda, which is a town on the border with Angola where prevalence is high.
All these activities were supported with funds for national activities from the LO/TCO-FNV Mondiaal HIV/AIDS project.
ICEM Regional Meetings in Africa
At the Regional Women’s Conference in Johannesburg, the National Union of Mineworkers (NUM) of South Africa presented a resolution on the gender dynamics of HIV/AIDS. Women need to be empowered to take control of sexual behaviour, especially condom use. HIV/AIDS and women workers has been made one of the priorities for the work of the women’s committee in the coming years.
Several speakers at the Sub-Saharan Africa Regional Conference in Gaborone, Botswana, referred to the importance of behaviour change, the need for testing, and the necessity for a wider availability of anti-retroviral drugs. HIV/AIDS must be considered a disease like any other. Only then can stigma, which prevents people from knowing their status, be eliminated.
The host unions in Botswana reported on a successful campaign when, on one day, 350 people were tested in Silebe Phikwe, a mining town with one of the highest prevalence rates in the country. Sadly, however, a delegate from Zimbabwe described a bleak situation where people prefer not to be tested because ARVs are not available.
Tanzania: Hope to AIDS Sufferers
As more and more people visit Care and Treatment Centres (CTC), the number of HIV patients on anti-retroviral treatment has doubled in just over a year.
The increase has been attributed to the introduction of “fellows” trained by the Benjamin Mkapa HIV/AIDS Foundation, an NGO jointly initiated by former presidents of Tanzania and of the US, Benjamin Mkapa and Bill Clinton, respectively.
These so-called fellows address the gaps in human resources for the public health sector, which is key in scaling up HIV/AIDS care and treatment.
Setting a good example, the current President of Tanzania, Jakaya Kikwete, publicly took an HIV/AIDS test.
(Source: East African, Nairobi, 24 July)
India: 2.5 Million People Living with HIV, According to New Estimates
The new 2006 estimates, released on 6 July by the National AIDS Control Organization (NACO), supported by UNAIDS and WHO, indicate that national adult HIV prevalence in India is approximately 0.36%, which corresponds to an estimated 2 million to 3.1 million people living with HIV in the country. These estimates are more accurate than those of previous years, as they are based on an expanded surveillance system and a revised and enhanced methodology.
The revised estimates will be used to improve planning for prevention, care and treatment efforts. “While it is good news that the total number of HIV infections is lower than previously thought, we cannot be complacent. The steady and slow spread of the HIV infection is a worrying factor. The better understanding of India’s epidemic has certainly enabled us to have more focused HIV prevention and treatment strategies and more effective deployment of resources,” said Mr. Naresh Dayal, Secretary of Health and Chair of the National AIDS Control Board.
Commenting on the new estimates and guarding against their misinterpretation, Sujatha Rao, Additional Secretary and Director General, National AIDS Control Organization said, “The calculation of figures for several years, using the new model helps us understand that the new lower estimates do not mean a sharp decline in the epidemic.” She cautioned against easing off the momentum of the HIV response.
Comments by the editor of this e-bulletin. Hans Schwass: The 2006 UNAIDS epidemic update put the 2005 figure for India at approximately 5.7 million with a variance of 3.4 to 9.4 million. This made India the country with the highest absolute number of people living with HIV/AIDS in the world.
Prof. James Chin, former unit chief at the WHO Global Programme on AIDS, says that UNAIDS has overestimated HIV prevalence in a large number of countries. He goes on to say that exaggerating the numbers will cause a backlash and damage support from the public and policymakers. He acknowledges, however, that the pandemic is severe in a large number of regions and countries and that it requires that AIDS programmes continue to receive the highest public health priority and funding.
(Source: UNAIDS Press Release, 6 July and The Monitor, Kampala, 28 July)
HIV: A Time Bomb for the Mining Industry?
Mining companies all over the world have belatedly realised that at a time of booming demand for minerals, HIV/AIDS is hampering their operations.
Mining areas regularly have a higher prevalence rate than the national average. In South Africa, the infection rate is nearly double that of the general working population; in the Russian mining town of Irkutsk, it is three times higher than the national average. To a large extent, this is due to the working and living conditions of mine workers and the high rate of migrant workers who are employed in the industry and who have to leave their families behind. Remote mining sites also attract commercial sex workers.
Brian Brink, Senior Vice President Health of AngloAmerican mining house in South Africa, admits that despite all their efforts, they did not stop the epidemic. A lot of cases still go undiagnosed and do not get reported. In India, where the prevalence rate is still low (see previous article), there are areas where the rate is around 1%. “In the early 1990s, that is where we were and then it is very difficult to stop,” declared Brink. “Other countries must not fall into the same trap as South Africa, said Lennox Mekuto, Health and Safety Officer of the ICEM-affiliated National Union of Mineworkers (NUM).
(Source: The Namibian, Windhoek, 13 July)
News from ILOAIDS
Edwin Cameron, Judge at the Supreme Court of Appeal of South Africa, gave a talk at the ILO on 19 June on “Legislating an Epidemic: The Challenge of HIV/AIDS in the Workplace.” The talk was given on the background of the ILO having started work on developing a Recommendation on HIV/AIDS in the World of Work, following a decision of the Governing Body in March 2007.
On a workplace perspective, Judge Cameroon made three propositions: that the effects of the epidemic on the workplace are distinctive, and must be distinctively addressed; that in countries where the epidemic has taken hold or threatens, the response by unions, employers, and governments to workplace issues has not been sufficient; and that the workplace offers a particularly appropriate location for addressing HIV-related issues.
He went on to say that since the adoption of the ILO Code of Practice on HIV/AIDS and the World of Work in 2001, the epidemic has moved fast and that some aspects of the Code seem outdated now. He gave two reasons: the Code elides treatment and its approach to testing is antiquated.
On treatment Judge Cameron argued that since 2001, large-scale provision of anti-retroviral treatment, even in resource-poor settings, has proven to be effective and feasible.
The Code is fully five years behind. Encouraging access to anti-retroviral treatment should now be a cornerstone of every employer’s policy in every country where the epidemic has taken hold. Although it probably remains too ambitious to want to oblige employers to provide ARVs, they should certainly be obliged to assist and to provide information on ARVs, and to provide assistance in accessing them. The fact is, the workplace is an ideal environment for treatment literacy campaigns, for partnering treatment roll-out programmes, and even for directly observed treatment supervision.
On HIV testing, he maintained that the Code’s approach is out-dated. In the present climate of continuing stigma, amid the availability of treatment, the Code’s approach to treatment is even retrogressive. It was valid before large-scale treatment became available and at a time when testing was all too frequently merely an excuse to discriminate and exclude.
Thus the Code cautions that testing should not automatically be carried out in the workplace and that it should be strictly confidential and with informed consent. The debate about testing has moved far beyond these constricting parameters. Where non-discrimination protections do exist, and where confidentiality is assured, testing should be actively encouraged – not hedged around with impediments. The ability to establish your HIV status should be celebrated as a means of self-knowledge, self-empowerment, and as a portal to treatment. According to Cameron, the Code’s approach badly needs an over-haul.
Judge Cameron declared his HIV positive status publicly some time ago and is, as he stated, “proudly and openly gay.” At the ILO, he went on to say, “I owe my own presence with you here in Geneva today to anti-retroviral medication. I started taking ARVs nearly ten years ago, in November 1997, when I was very sick with AIDS and facing death. I have been on the same drug combination for nearly seven years – since early 2001.”
News from the Global Union Programme and Global Union Federations
In its most recent HIV/AIDS updates (Nos. 24 and 25 of 1 and 15 July) the International Transport Workers’ Federation (ITF), www.itfglobal.org, reports, among other items, on plans by India’s National AIDS Control Organisation (NACO) to increase the number of condom vending machines from 600,000 to 3 million. Condom promotion is one of the priority areas for NACO in HIV prevention. It also reports on a new public/private partnership to use cell phones to bolster care and treatment in ten African countries.