Letter from the Editor

There is a new sense of hope in the air as expressed by both the public and private sectors in South Africa. And it is with this new energy that AAAO wants to tackle 2007. South Africans affected and infected with HIV are hearing proclamations (such as those made by the Deputy Health Minister Nozizwe Madlala-Routledge in a recent interview with Kerry Cullinan of Health-e News Service) of:

“We must get people off the antiretroviral waiting list.” and “We beat Apartheid - we must be able to beat AIDS.” The Deputy Minister also addressed support for HIV testing, acknowledged the ABC approach is not relevant where there is sexual violence in a society and spoke of her serious concern with regard to the flooding of South African market with untested HIV remedies.

The South African Business Coalition on HIV and AIDS (SABCOHA) is also proposing a private sector strategy of zero tolerance: zero new HIV infections, zero AIDS sicknesses and deaths, and zero new mother to child infections. The role that the private sector can and is playing in addressing HIV in the workplace should not be underestimated. In this edition we provide you with insight into two remarkable private sector HIV projects that are affecting thousands of South Africans in the workplace.

Daniela Rudner, Employee Wellness manager at New Clicks Holdings, gives us a glimpse into the successes and failures of implementing an HIV workplace programme for one of the largest retailers in South Africa. Daniela highlights significant learnings and shares some very valuable information regarding the mammoth task of gaining approval for such a programme, as well as rolling it out to thousands of employees.

The next challenge that the private sector faces is that of supporting small and medium enterprises (SMEs) in implementing HIV workplace programmes. With most of the bigger companies already having done so, the smaller companies are still struggling with the dilemma of HIV in the workplace. Thando Khaile form SABCOHA offers an interesting account of the Eskom/SABCOHA Supply-Chain initiative which aims to assist SMEs in the Eskom supply chain to roll-out HIV workplace programmes. Although smaller companies might not be too concerned with longer term sustainability, in the face of the immediate drive to remain profitable in a fiercely competitive environment, their clients (who represent big business) may want to ensure SME sustainability by assisting them to roll out HIV workplace programmes.

There is currently a need in South Africa for better delivery – in line with this, we aim to provide you with more case studies on HIV related issues in the workplace throughout the year ahead. We hope that these will inspire all of us to work towards a society free of HIV and AIDS.

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Our Business Case

Our comprehensive Employee Wellness Programme (EWP) has its origins in an HIV Project that was set up as a group initiative in August 2005. The intention was to define and implement a group-wide HIV Strategy

instead of having separate business brand initiatives.

Before we started the HIV Project, time was spent on evaluating our current and past approaches to determine what did and did not work in our past initiatives. We also looked externally at other companies’ practices and learnings; at what other retailers had in place; at what international research recommended and finally at what the various Service Providers were offering.

Some key points of learnings are:

• HIV and Aids is not the only issue our employees are struggling with. There are a whole range of broader sociological issues that impact on the day-to-day lives of our employees and their families, such as substance abuse, domestic violence, sexually transmitted infections, tuberculosis etc.
• Leadership buy-in is vital (for the funding and the sustainability of any programme).
• Communicating behaviour change is essential for the success of the programme.

We decided that it was necessary to commission an actuarial study. The intent of this was to allow us to estimate the demographic and financial impact of HIV and AIDS in the workplace, and weigh it against the benefits and estimated cost of an HIV Disease Management Programme. We also wanted to know how this could affect our bottom line. We commissioned Metropolitan to do the Risk Impact Assessment. We also extended our Business Case to include a general Counselling and Advisory Service that addresses all the other issues that impact on staff morale and productivity besides HIV and AIDS.

The intense work spent on our business case paid off: our Group Executive approved a R3.5-million budget for our Employee Wellness Programme (EWP).

Our Programme

On 22 September 2006, the New Clicks Group proudly launched its EWP including a comprehensive HIV Disease Management Programme. The latter is a programme managed by Qualsa that allows staff members who are not on any  Medical Aid to anonymously access free HIV testing, antiretroviral treatment as well as preventative treatment (post exposure prophylaxis and prevention of mother-to-child transmission), 5 free HIV related doctor visits and blood tests, multi-vitamins and last but not least - counselling and support (for Medical Aid members these benefits are covered by their scheme since they count as “Prescribed Minimum Benefits”).

This offering is complemented by an extensive Counselling and Advisory Service (managed by ICAS) available to all 9 000 permanent employees as well as their family members. This means that we are not only able to support all our staff members who are infected with the HI Virus, but also their families who are affected.

Besides HIV Counselling, the ICAS service offering spans all other health, personal and work-related problems including financial, legal and practical advice. All of these services can be accessed through a 24-hour toll-free number that is manned by professionals and available in all official South African languages.

The third component of our EWP (the Educational Programme and Health Awareness Initiative) has an important role to play in terms of HIV prevention. In the context of the programme, our "Lifecare" Education Programme distinguishes between manager and staff education. Manager education focuses on managing people in crisis whereas staff education uses audio-visual material (Tilly’s Tavern) that seeks to change behaviour by showing typically risky day-to-day activities as well as dangerous misconceptions around HIV and AIDS.

The Health Awareness Programme focuses on different health themes that are often directly or indirectly linked to HIV and AIDS (e.g. March is Lung Awareness Month and December is HIV Awareness Month).

Programme Uptake

The uptake of the HIV Disease Management Programme (including Voluntary Counselling and Testing) has been relatively slow - approximately one staff member joins per month. We are convinced that once the educational programme is initiated (we are currently in the Train-the-Trainer phase) it will be a very strong enabler for the uptake of our HIV Disease Management Programme. It is a well-known fact that the vast majority of people are resistant to finding out their HIV status, unless they understand the benefits of knowing. Our educational programme seeks to incentivise testing for HIV, which is freely and anonymously available and administered by Qualsa.

Another reason for the slow uptake could be that, to date, we have only had face-to-face sessions introducing our EWP to all management staff, but not yet with all our employees. We believe that once employees have had the opportunity to get first-hand information of the type of support the company offers and believe that it is safe and confidential to enrol; the uptake should escalate.

In general, the uptake of the Counselling and Advisory services has been outstanding (clearly above average compared to the ICAS client base) which proves our hypothesis that there is clearly a need for psychosocial support within our workforce.

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Supply Chain Initiative – Beyond Big Business
By Thando Khaile

A new form of private sector response to HIV and AIDS is emerging: workplace programmes targeted at companies in the supply chains

of multinational corporations. Most multinationals and nationals already have good programmes in place so the next step is to get large companies to help small and medium enterprises (SMEs) that supply and distribute products for them to do the same.

In 2003, the Bureau of Economic Studies found that small, medium and micro enterprises (SMMEs) in South Africa did not have the infrastructure or the capacity to develop HIV and AIDS workplace programmes. The findings led to a collaboration between SABCOHA and Eskom Holdings Limited that aimed at creating a pilot programme which could address the issue.

Eskom recognised that its suppliers’ sustainability could impact on its own and subsequently identified HIV and AIDS as a major risk factor in this regard.

Eskom also identified that some of its suppliers were particularly at risk because they did not have HIV and AIDS workplace programmes in place. Based on this information they decided that it made good business sense to invest in developing the capacity of these suppliers to manage HIV and AIDS in their businesses and communities.

The aim of the pilot was to develop best practice for implementing an HIV and AIDS workplace programme in a SME. The groundbreaking and pioneering work intends to explore the level of support needed by suppliers to develop an effective HIV and AIDS programme.

The pilot programme was fully funded by Eskom and rolled out by SABCOHA who offered free annual membership to the participating suppliers.

In the pilot phase, the SABCOHA HIV and AIDS Toolkit specifically developed for SMEs was utilized as basic methodology. SABCOHA engaged reputable service providers to provide capacity to the suppliers.

The pilot programme to roll out the HIV and AIDS toolkit (undertaken through the Eskom Procurement Division) involved 40 suppliers, who volunteered to participate.

Capacity building in the form of trainings was offered to management, steering committees and Champions.
46% of the participating companies employed fewer than 20 people, 30% had 20 - 100 employees and 24% had over 200 employees.

Of the 37 companies who participated, 87% had no form of HIV and AIDS workplace programme in place - a statistic that clearly supports the need and importance of the programme and its future expansion.

Successes in the pilot were evident in light of:

• A high level of commitment by management in most companies – 63% of the CEOs and Directors met with SABCOHA.
• A high percentage (74% of the 40) of companies participated in the pilot programme.
• 83% of participating companies received management training.
• 95% of participating companies’ champions were trained.
• By the end of the project: 92% of the participating companies had HIV and AIDS policy in place or in draft form.

Challenges and ideas for future intervention included:

• cost related issues
• sustainability
• addressing the lack of adequate Human Resource systems
• clear communication and
• commitment

Some key learnings from the pilot project included:

Working closely with Eskom’s Procurement Division is crucial for the success of the programme.
Involving supplier company management in the roll out of HIV and AIDS workplace programmes is vital.
Ensuring effective communication both before and during roll out is essential.
The SABCOHA toolkit proved a useful resource to companies setting up an HIV and AIDS workplace programme. The toolkit information is generic and thus allows for enhancement to suit the different needs of companies.

A report with outcomes of the four-month pilot program, aimed at providing a strategy (based on lessons learnt during the pilot project) is available on the AAAO website.

For more information, contact Thando Khaile at Thando@sabcoha.co.za

Acknowledgements: This project was a success as a result of the partnership between Eskom and SABCOHA in collaboration with Aganang and The Careways Group service providers.
Thando Khaile is currently the manager of Membership & Projects at SABCOHA with emphasis on small and medium enterprises. She has a background in social sciences and project management and has been in the HIV field for eight years.

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