Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

XIV International AIDS Conference

Abstracts ThOrG1505-ThOrG1i508 643

ployers' and workers' organizations are using it to increase the awareness of their
members.
Recommendations: Wide dissemination of the code, development of training
materials to guide its implementation, and advisory services and capacity building
for employers and workers, along with relevant government authorities. Projects
are underway with the social partners in eighteen countries in africa, Asia and
Eastern Europe.
Presenting author: Susan Leather, International Labour Office, 4, Route des
Motillons, 1211 Geneva, Switzerland, Tel.: [phone], Fax: [phone]
6349, E-mail: [email protected]
ThOrG1505 Investing in the epidemic: The impact of AIDS on
businesses in southern Africa
S.B. Rosen1, W.B. MacLeod1, J.R. Vincent2, M.P. Fox', D. Theab, J.L. Simon'.
1 Center for International Health, Boston University School of Public Health,
Boston, MA, United States; 2 University of California, San Diego, United States
Background: Better information on the potential costs of AIDS in the private
sector is needed to manage the epidemic and assess the net benefits of interventions, but few rigorous quantitative analyses are available. We estimated the
cost of AIDS to businesses and the benefits of prevention and treatment using
company-specific data on employees, costs, and HIV prevalence.
Methods: 5 large enterprises in South Africa and Botswana provided detailed human resource, financial, and medical data and carried out voluntary, anonymous,
unlinked HIV seroprevalence surveys of the workforce. We estimated the present
value of incident HIV infections with a 9-year median survival time and discount
rate of 4-10%. Costs included were sick leave; productivity loss; supervisory time;
death, disability, and medical benefits; and turnover.
Results: See table below. Using parameters from the literature, we estimated that
standard HIV prevention and care interventions (e.g. prevention and treatment of
Ols) would be "profitable" (positive net present value) for all companies and all
job levels. Antiretroviral therapy would be profitable for most companies and job
levels if it could be provided for $500-$750/patient/year.
Conclusions: The "AIDS tax" on African businesses was 1-10% of labor costs
per year for the companies studied. Investments in prevention and treatment can
have positive returns for most companies and most levels of the workforce at
increasingly feasible levels of cost.
Presenting author: Sydney B Rosen, Center for International Health, 715 Albany Street, 710, Boston, MA 02118, United States, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
ThOrG1506 Panama's AIDS business council, an HIV/AIDS
prevention initiative from the private sector
C.A. Nuhiez1, M. Burgos2, G. Marino3. 1PASCA/The Futures Group
International, Ciudad Guatemala, Guatemala; 2PASCA /Academy for
Educational Development, Panama City, Panama; 3Panama's AIDS Business
Council, Panama City, Panama
Issues: Panama currently reports the third largest incidence rate of AIDS cases
in Central America. Recently, through a special legislation on AIDS, National
Congress declared AIDS a national priority. A multisectoral plan has been proposed. Private sector decided to play an important role in promoting prevention.
Description: Highly aware of the AIDS epidemic in Panama after a joint implementation of an AIDS prevention project aimed at both workers and senior management personnel, the Panamanian private sector decided to sponsor the establishment of the Panamanian AIDS Business Council. This was an unprecedented
action in the Central American region. The Council has been actively involved
in national activities aimed at preventing HIV/AIDS in their labor force, as well
as in adolescents. Their actions are in close coordination with Panama's Ministry of Health. The Council is currently implementing a national level program of
information disseminations through posters and pamphlets with prevention messages. Council members have also been invited to regional meetings to share
their experience.
Lessons learned: The Panamanian AIDS Business Council has demonstrated
how important the involvement of the private sector can become in leveraging resources for HIV/AIDS prevention. Through the involvement of the private sector,
other community members may also become engaged in prevention efforts.
Presenting author: Cesar Nuhiez, 3a ave 20-96, Zona 10, Ciudad Guatemala,
Guatemala, Tel.: [phone], Fax: [phone], E-mail: [email protected]

ThOrG1 507 Heineken's response to AIDS; a research study to
support the introduction of HAART provision for
the workforce
J.M. Bausch, C. Laurence, J. Stover, K. Foreit, S. Forsythe. Futures Group,
Futures Group Europe, Edgar Buildings, 16-17 George Street, Bath BA 1 2EN,
United Kingdom
Issues: Heineken International sought long term assessment of the impact of
AIDS on their business in both direct cost and indirect cost terms. They required
analysis in three production locations in Africa and Asia to evaluate the impact
and implications of offering highly active antiretroviral therapy to HIV-postive employees. Futures Group analysed both risks of providing HAART, of withholding
provision, and the likely impact on Heineken's role as community leader and humanitarian employer.
Description: In the first research stage, a team spent six weeks at production
locations studing impact on staff, opeational costs and labour costs. In depth interviews were also conducted with local employees, managers, labour representatives and health providers to establish how the company was currently tackling
HIV/AIDS and the associated costs as a basis for future comparison.
Futures Group created a specially adapted computor -based model, AIDS IMPACT MODEL to project how HIV/AIDS will affect the company over the next
five and ten years. It developed estimates on numbers of Heineken staff and dependents were likely to become infected with HIV and projected the costs of the
disease. The final stage was to compare this against AIDS prevention and care
programme efficacy data to establish whether HAART inteventions would be cost
effective and affordable.
Lessons learned: The study showed that risk factors associated with HAART
are not limited to the cost of drug therapy itself. Although AIDS is a signifant cost
to the company, indirect costs of not providing antiretroviral therapy may outweigh
direct costs.
Recommendations: Corporate entities wishing to fully analyse their approach to
antiretroviral therapy and AIDS interventions must look at wider policy implications of their approach to health care.
Risk analyses must be undertaken to fully formulate a response to AIDS, from
both indirect and direct cost perspectives.
Presenting author: Jill Bausch, Futures Group Europe, Edgar Buildings, 16-17
George Street, Bath BA1 2EN, United Kingdom, Tel.: [phone], Fax: +44
1225 443656, E-mail: [email protected]
ThOrG15081 AIDS and the workplace: Maintaining employee
benefits versus the transfer of costs to the
household
M. Stevens. Ms, CHPR P 0. Box 1038, Johannesburg, 2000, South Africa
Issues: Employers are not bound to provide any benefits to their employees.
Costs for supporting a PWA are easily transferred from the employer to the state
to the household. Arguments have emerged suggesting that it may be cost effective for business to provide benefits to HIV positive skilled workers, the assumption being that it would be crippling to provide benefits to semi-skilled and
unskilled workers, even though the costing for this rationale has not been calculated.
Description: This paper is based on a stakeholder analysis involving public, private and trade union sectors, in which responses to HIV and employee benefits
were reviewed.
Lessons learnt: HIV/AIDS in the workplace is not a core management issue
for all sectors. It has been left to the human resources department. Planning for
the impact of HIV and responses are based on adhoc data largely controlled by
consultants hired by employees or insurance brokers. Partly as a response to
HIV, there has been a shift in the employee benefit environment essentially recusing employers and make employees individually liable to negotiate their own
benefits. Costing of impacts generally uses direct costs as opposed to including
indirect costs, which make up the bulk of the costs. Transferring costs of supporting PWAs to households may be counter productive in the long run as it will
reduce the pool of unaffected households from which to re-hire.
Recommendations: While benefits for skilled workers as a cost effective practice is important, the danger is to divide the workforce and to assume that for unskilled workers and semi-skilled workers it is not cost-effective. This is of concern
in terms of equity and discrimination. By supporting marginal workers with benefits, one supports households and contributes towards development. Enterprises
have to be profitable yet balanced with just and socially responsible practices.
In considering the role of employers more public and neutral data is needed for
planning.

Abstract ThOrG1505 - Table: Characteristics and results from the 5 companies
Sector Heavy manufacturing Agribusiness Mining Mining Retail
Workforce size (number of employees) >25,000 5,000-10,000 <1,000 <1,000 <1,000
Est. HIV prevalence 2002 (%) 9.9 24.4 33.6 24.1 11.2
Cost per infection by job level (present value, 2001 USD)
Unskilled/semi-skilled 32,393 4,439 10,732 9,474 4,518
Technician/artisan 50,075 6,772 17,972 14,097 11,422
Supervisor/manager 83,789 18,956 63,271 45,515 24,149
Average cost per infection (multiple of median salary) 4.3 1.1 5.1 2.9 0.9
Liability acquired in 2002 (future cost of incident infections) (% of payroll) 5.0 2.4 9.4 5.9 0.9
Undiscounted cost of prevalent infections in 2006 (% of payroll) 4.8 18.1 12.2 1.8