The State of Business and HIV/AIDS (2006) - Booz Allen Hamilton

3 Baseline: Current State of Business and AIDS
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A mining operator estimated that worker deaths from AIDSrelated
causes cost the firm $18,500 per employee, as well
as an increase in production costs.
3.4.4. Care, Support, and Treatment
Eighty-four percent of companies surveyed ensure
that their workers have access to HIV/AIDS
treatment—via health insurance, cost sharing, or
other mechanisms (figure 18).
The challenge comes for companies when access
to treatment is not locally available or there is
no insurance mechanism that companies can
leverage to fund treatment in a particular region.
Currently, the business case is clearest in Africa,
where 71 percent of companies versus 36 percent
of companies overall fully subsidize HIV treatment
for employees. Some companies have taken steps
to fund infrastructure (hospitals or clinics) or have
partnered with pharmaceutical companies to
provide access to treatment. Some of those that
have provided this initial investment are now looking
to co-invest with public organizations to ensure
access to treatment to the wider community.
Care and support is critical for the workplace when
responding to HIV/AIDS as mechanisms need
to be in place to foster an open, accepting, and
supportive environment for workers to disclose their
status and seek treatment. Where health services
are available in the workplace, appropriate support
and treatment should be provided. Where these
services are not available, workers should be linked
to those services available in the community.
Forty-five percent of companies surveyed are
extending their programs to provide access to
treatment for spouses and all registered/legal
dependants (figure 19). The majority of those
extending their programs are in Africa, where they
recognize that productivity can also be affected
when workers have to become caregivers for sick
relatives. Some companies are also working to
extend access to treatment in broader community
through partnerships.
Despite this positive response to providing access
to treatment, a number of companies interviewed
expressed concern with respect to the cost and
effectiveness of treatment. Some described
concerns about the number of dependents a worker
may have and the risk of that worker sharing his/her
medication among relatives or selling it. Others
reported that some of their workers continued to
go to traditional healers rather than seek treatment
in the mainstream health system, so would not
necessarily accept treatment. Another concern was
that once treatment started, it must continue, but
what if the worker is fired, leaves, or is transferred
to an area with no treatment? Finally, companies
with medical staff on their programs discussed the
need to ensure quality treatment and highlighted
the concern that the focus will need to extend from
reducing the cost of first-line treatments to other
treatments that are much more expensive.