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

Financial Mail - - CORPORATE REPORT ANGLO AMERICAN -

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

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