Leading the fight against HIV/AIDS
The company started the first HIV study in SA’S mining industry in 1986, when four of its 18,450 mineworkers tested positive
Companies, government and other stakeholders should ramp up communication efforts to increase prevention and combat new HIV infections.
“Targeting vulnerable groups such as young women is also important,” says Dr Charles Mbekeni, health lead for Anglo American SA.
During 2016, 88% of employees in high Hivburden countries participated in voluntary testing and screening, up from 68% in 2015.
The emphasis on testing has contributed to the detection of unknown cases, and the success of treatment programmes has diminished the number of deaths.
“To some extent the messaging around HIV nationally and globally has reduced,” Mbekeni says.
“Part of the reason is that being infected with HIV is no longer a death sentence, it is now as manageable as a chronic disease. An element of complacency has set in.”with a track record beginning in 1986 of supporting HIV/AIDS research, progressive workplace policies around the disease and offering education, testing and counselling services beyond the workplace in mining communities, Anglo American has long been at the forefront of the HIV/AIDS battle.
The company became the first in SA to adopt a human rightsbased policy around HIV/AIDS. In its initial policy, the company stated that HIV testing would not be a requirement of pre-employment medical examinations.
Anglo American’s policy ensured no pre-employment HIV/AIDS screening.
In 2002, the group started offering free treatment to employees, becoming the largest treatment programme in the world initiated by a private company at the time.
It was expanded in 2008 to also cover employees’ dependants. Today, most employees are on medical aid, and HIV treatment is now a prescribed medical benefit.
Initially, the uptake of voluntary counselling and testing was low, with fewer than 20% of employees participating. Prevalence of the disease was also still low. It was only by the late 2000s that uptake of the testing started to grow.
“We did a lot of things to try to do away with the stigma, to ensure that employees felt safe to get tested and that their results will remain confidential, and that they will not be discriminated against,” Mbekeni says.
The results speak for themselves. The HIV incidence rate across Anglo American in SA has halved since 2006, and the incidence of tuberculosis, a common infection in people with HIV, has declined by 70%. In 2016, the group formally committed to the United Nations’ 90/90/90 vision: by 2020, 90% of all people should know their HIV status; 90% of those who are positive should be on antiretroviral treatment; and 90% of those on treatment should have undetectable viral loads and as such be unable to infect others anymore.
“In SA, we continue to partner with government to tackle HIV/AIDS on an industry-wide scale.
One way to continue efforts to destigmatise the disease is by using “champions” — many of these are people living with the disease at different levels of the company — to successfully drive awareness campaigns and advocate the benefits of testing, Mbekeni says.
Anglo American offers HIV/AIDS testing as part of a wellness package Employees in high Hiv-burden countries Estimated HIV prevalence rate (%)
Number of employee voluntary testing and counselling (VCT) cases
HIV counselling and testing participation (%) Number of new HIV cases Estimated number of Hiv-positive employees Estimated HIV+ employees on anti-retroviral therapy (ART) (%) AIDS deaths (including tuberculosis cases) Number of contractor VCT cases where employees are also screened for various other diseases, such as TB, diabetes, hypertension and high cholesterol.
“These other conditions are becoming a serious public health issue,” he says.
While Anglo American is spending a “substantial” amount on its HIV/AIDS and other wellness programmes, the business rationale behind it is clear.
Various academic studies have found that workplace provisioning of anti-retroviral treatments can be cost-saving for companies in high Hiv-prevalence settings, as it reduces health-care costs, absenteeism and staff turnover.
“Company-sponsored HIV counselling and voluntary testing with ensuing treatment should be implemented universally at workplaces in countries with high HIV prevalence,” according to a study published in the academic journal PLOS Medicine in 2015.
“The cost-benefit analysis is a no-brainer.”
ANGLO AMERICAN KEY HIV/AIDS STATISTICS (2016) (GLOBALLY) 2016 2015
51 430 16,0 45 279 88 611 8 331 68 68 38 376 73 909 15,8 50 223 68 349 11 689 72 91 39 643
Destigmatised: Anglo American was the first private company in SA to adopt a human rights-based policy around HIV/AIDS, promoting voluntary testing and free treatment
UNAIDS executive director Michel Sidibé and Anglo American chief executive Mark Cutifani. The two organisations announced a public–private sector partnership to promote HIV testing worldwide