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ICEM HIV/AIDS e-bulletin - No. 77, February 2012

15 February, 2012

In this issue of the ICEM HIV/AIDS newsletter, we report on the HIV/AIDS evaluation workshop in India and on further trouble at the Global Fund. Also, a survey by South Africa’s Institute for Race Relations reveals the toll the HIV pandemic has had on the country’s population.

HIV and AIDS Evaluation Workshop in India

Since 2008, the German pharmaceutical company Boehringer Ingelheim has sponsored an HIV and AIDS project in India in collaboration with the ICEM affiliated Indian National Mineworkers’ Federation (INMF). The second phase of this project terminated at the end of 2011. An evaluation workshop was held in Kolkata on 30-31 January with some 25 participants of whom seven were women.

Master trainers and peer educators from four different subsidiaries of Coal India Ltd. (CIL) reported on their activities, pointed out problems and ways to overcome these problems. Three medical doctors from coal companies and the Deputy Chief Medical Officer of CIL also provided inputs.

Overall, more than 50,000 people – workers, their families and members of surrounding communities – were reached with awareness, prevention and behaviour change messages. With the invaluable technical support of the ILO Delhi Office, 61 master trainers acquired the necessary skills so that they in turn could train some 700 peer educators. The project also included courses for women counsellors and sensitization programmes medical and para-medical staff in company clinics as well as teachers and students in company schools.

Great progress has been made in the acceptance of an HIV positive status and the reduction in stigma, not least because of the involvement of people living with HIV and AIDS. This contributed to a higher take-up of testing in Integrated Counselling and Testing Centres (ICTC).

Vocational training centres have integrated talks on HIV and AIDS and the workplace in their curricula. Companies have increasingly contributed to the cost of activities. They have become more aware of the threat the epidemic poses to their businesses and they have become more concerned to meet the challenge. Several coal companies have asked the INMF to prepare programmes for them, which would be funded by the companies.

One drawback has been the high drop-out rate of peer educators. It shows that a large number of peer educators have to be trained so that a committed and motivated core remains to do the work. The follow-up work of affiliates in the cement, chemical and diamond sectors has been disappointing. Despite the fact that master trainers and peer educators were trained, few activities took place in these sectors.

Important to the project has also been the material which was produced, mostly adapted from material of the ILO Delhi Office, in the form of posters, booklets and information leaflets, not only in English but also in several local languages.

The project has demonstrated to management and government agencies how important the workplace is as a point of intervention and how crucial the role of trade unions is. This has been one of the outstanding achievements of the project. It has also shown how far relatively little financial support can go and that funding is not the most essential aspect, but motivation and commitment make the difference.

      

Global Fund Executive Director Michel Kazatchkine to Resign

On 24 January, Michel Kazatchkine announced that he will “step down” as Executive Director of the Global Fund by mid-March. He said that his planned resignation resulted from a decision by the Global Fund Board two months ago to appoint a General Manager who will supervise many Global Fund activities, and who will report directly to the Board. This decision by the Board to transfer many of Dr Kazatchkine’s responsibilities to someone else arose from the Board’s concern that the Fund’s managerial leadership was not sufficiently effective.

Dr Kazatchkine, 65, has been Executive Director of the Global Fund since April 2007. Prior to then, he served the Global Fund as the first Chair of the Technical Review Panel, then as Board member representing France, then as Vice-Chair of the Board.

The Global Fund also announced that the General Manager will be Gabriel Jaramillo, a prominent banker from Latin America, who was one of the members of the High Level Panel that extensively evaluated the work of the Global Fund during 2011. The Global Fund said that Mr Jaramillo will take up a 12-month appointment effective 1 February. In a subsequent statement, it was announced that he will exercise all of the powers and functions of the Executive Director, including the power to execute agreements on behalf of the Global Fund. According to media reports, Mr Jaramillo will work for a symbolic annual salary of $1.

(Source: Global Fund Observer, Issue 174 and 175 of 24 January and 6 February respectively. GFO is a free service of Aidspan www.aidspan.org; to receive GFO send an email to [email protected])

            

South Africa Loses 4.4 Million People to AIDS

A survey, published by the South African Institute for Race Relations, says there are 50.6 million people in the country and in the absence of AIDS, this would have been 55.0 million. By 2040, the population would have been 77.5 million without AIDS - 24.1 million more people than is projected.

The data shows that 31% of all deaths in 2011 were AIDS-related. By 2015, this proportion will have risen to 33% and by 2025 there will be 121% more AIDS deaths than there were in 2000. Also, the total number of people living with HIV/AIDS in 2015 (6 million) will be double the number recorded in 2000 (3 million).

The Institute's analysis is based on data sourced from the Actuarial Society of South Africa and the Institute for Futures Research (IFR). According to the IFR, the HIV prevalence rate is higher among young African adults, resulting in fewer people in this group reaching old age compared to other races. HIV/AIDS is also largely responsible for wider social ills such as orphan hood and child-headed households.

(Source: Business Live, Johannesburg, 24 January)

                  

Côte d’Ivoire: Government Scraps Free Health Care for all

Côte d’Ivoire is abandoning free health care for all after a brief experiment because of skyrocketing costs. In nine month the government had to pay 30 billion CFA francs (about US$ 60 million).

As of February 2012, the free service would only be available to mothers and their children. Specifically, this will mean free care for deliveries and free treatment for diseases affecting children under six years old.

Theft, poor management and rising costs have made the service unaffordable. It was introduced by President Alassane Ouattara’s government at the end of civil conflict to ease the dire public health situation. (Note by the editor: It is not clear whether the provision of antiretroviral drugs falls under this).

(Source: IRIN, Abidjan, 26 January)

                        

Nigeria: Union Involvement Boosts VCT

Voluntary Counselling and Testing (VCT), organized under the workplace initiative by the Nigerian Labour Congress (NLC) and UK’s Trades Union Congress (TUC), has proven popular among workers in the Federal Capital Territory in Nigeria, where HIV prevalence is considered to be third highest in the country.

The outreach activities carried out under the Building Workplace Capacity to Combat HIV/AIDS Project funded by UK’s Department for International Development (DFID) have been instrumental in overcoming workers' reluctance and encouraging workers to go for testing. The NLC and its six affiliates participating in the Project – launched in July 2009 – have been remarkably successful in allaying fears among trade union members of the possible consequences of positive diagnosis.

The Jikwoyi Primary Health Care Centre, Abuja, and VCT Facility at Gwarinpa Hospital have seen a steady increase in the number of workers coming for testing since their opening in July 2010. By the end of December 2011, a total of 18,586 people had attended the clinics and 1,025 had been diagnosed with HIV (5.52%) and been referred to appropriate medical institutions for treatment, care and support.

This is more than twice the number of people, originally expected to attend the clinics during the entire two-year period from July 2010-June 2012.

The significant increase in attendance was primarily due to the wide publicity given by the NLC and its affiliates to VCT facilities through lunch-time information and education sessions organized at workplaces under the Project. The introduction of the Prevention from Mother to Child Transmission (PMCT) has added to the popularity. Counselling was also made available to those attending the facilities at the two sites. A two-day Peer Educators' workshop was held in February 2011 with a view to educating workers in the health sector on prevention, care and support and condom distribution.

(Source: TUC website)

                                

Comment

In the December 2011 issue of the ICEM e-bulletin, we reported on the 2011 Report by the WHO, UNICEF and UNAIDS on the Global HIV/AIDS Response. We also mentioned the release of a separate UNAIDS Report. Traditionally one report was released just prior to World AIDS Day, 1 December, published jointly by the WHO and UNAIDS.

On 21 November, UNAIDS published its assessment of the situation. On 30 November, however, the joined report came out. WHO and UNICEF are also co-sponsor of UNAIDS, so the duplication of efforts looks odd. Under the pointed headline “Get your act together, guys,” The Economist publication rightly criticized the release of two reports as wasteful. Strangely enough, the UNAIDS Executive Director, Michel Sidibé, described the production of separate reports as “costly and inefficient,” although it was UNAIDS which published a separate report.

(Source: The Economist 26 November 2011)

                                      

News from Global Unions

The International Transport Workers’ Federation (ITFwww.itfglobal.org), in its latest HIV/AIDS update 118 of 1 and 15 January reports on the launch of its report on HIV and AIDS among dock workers, and on an UNAIDS survey of 15 countries concerning possible catastrophic consequences of a potential funding roll-back by the Global Fund.

The International Trade Union Confederation (ITUC), together with the South African national centres COSATU and FEDUSA and South African human rights organisation Section 27, urged the authorities of Qatar to end discrimination on the grounds of an HIV positive status. A South African employee of the TV network Al Jazeera, who was tested for HIV without consent and who tested positive, was dismissed and subsequently detained and deported.

                                        

Five Years Ago: From the February 2007 Issue (No. 17)

The first issue of the ICEM HIV/AIDS e-bulletin was published in October 2005. In current issues, we refer to an article from the same month five years ago and reflect on developments.

In an opinion piece in the February 2007 issue of the ICEM e-bulletin, we reported on the controversial issue of voluntary versus routine testing under the headline “Ignorance is not Bliss,” with special reference to the United States. The Center for Disease Control of the US Department of Health and Human Services recommended that all Americans between the ages of 13 and 64 should be routinely tested for HIV.

The tests would not be compulsory but rather than testing only those who asked to be tested, the CDC wants clinics to test everyone who does not refuse to be tested, or the opt-out clause. With routine testing, doctors also hope to reduce stigma which is one of the largest barriers for people to avoid testing. The then head of the World Health Organisation’s (WHO) AIDS Department, Kevin de Kock, was quoted as saying that routine testing is a big step towards “normalising” HIV.

Will routine testing lead to mandatory testing? Doing away with written consent forms and pre-test counselling to simplify procedures as part of routine testing is certainly a dangerous development and poses threats to human rights.

From a workers’ rights point of view, certain principles must be observed for counselling and testing at the workplace. Together with the unions, companies must take steps to:

  • prevent any discriminatory practices against HIV status;
  • ensure confidentiality and informed employee consent;
  • ensure that there is no penalty if an employee chooses not to get tested;
  • ensure that testing is not in the form of pre-employment screening or mandatory testing; and
  • reduce stigma against people living with HIV in the workplace.

                                                

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