Doing Business with the World - Mapeo de Promotores de RSE

HIV/AIDS action insub-Saharan AfricaLafargeGlobal construction materials companyLafarge employs some 7,000 people –10% of its global work force – in ninecountries in sub-Saharan Africa, a regionparticularly affected by HIV/AIDS. Since2000, Lafarge, in collaboration with localcommunity organizations, NGOs anddoctors, has been involved in a programto combat HIV/AIDS. Through the projectit offers anonymous screening to staff,counseling, medical advice and support,and access to retroviral therapies for staffand their families. It has also developedinformation tools about HIV/AIDS andnational and regional guidelines. In 2004,the group spent about US$ 1 million onthe program. Today, 90% of employeesin the region benefit from preventioninformation and activities, including thedistribution of free condoms, while 40%of employees – far higher than thenational average – have undertakenvoluntary testing. The program hasresulted in a healthier and more awarework force, a strengthened relationshipwith local community organizations andengagement by the government.Key challengeslimiting progressThe lack of access to healthcare facilitiesand medical practitioners is the biggestchallenge facing developing countries.Rural areas in particular lack appropriatehealthcare infrastructure – especiallyprimary health facilities such asdispensaries, medical centers, etc. – torespond to health needs. Poorlyequipped, under-resourced hospitalsand a lack of medicines and drugs alsohinder the delivery of healthcare.The problem is compounded by lowfinancial investment in the health sectorin many developing regions. There arehuge inequalities between thedeveloped and developing world interms of total health spending per capita(public and private), with Norway andSwitzerland spending US$ 3,809 andUS$ 3,776 per capita compared to Nigerand Sierra Leone at US$ 30 and US$ 34respectively. The effect is often a dearthof trained medical practitioners indeveloping countries (see Figure 31),with large sectors of the populationdeprived of access to trained physicians.For example, Niger has three physiciansper 100,000 people, while Burkina Fasohas six.This disproportion is often accentuatedwhen prospects of better conditions orhigher salaries encourage medicalpersonnel in developing countries toleave and settle in higher-wage settings,usually developed countries, creating amedical “brain drain”.Related to financial impediments is thequestion of poor or lacking regulatoryframeworks. Although health systems –which include supply, management,financing and regulation of healthissues – involve many different sectorsof society – including medicalpersonnel, patients, drug companies,medical equipment companies, medicalassociations, etc. – they remain a publicpolicy issue. However, in manydeveloping regions, comprehensivepublic health policies are either lackingor poorly enforced.Similarly, there are discrepancies infunding public health policies. Forinstance, with a few exceptions, mostdeveloped countries have achievednear universal health coverage throughthe implementation of a mixture ofsystems: national health (fundedthrough state taxes), social insurance800600400200USABrazilFranceSouth AfricaMalawi(funded by employer/employeecontributions), or market-based(private health insurance). In manydeveloping regions, although statefundedhealthcare exists, the reality isthat most people requiring healthcareare obliged to pay for it themselves,and rates of out-of-pocket spendingon health in developing nations areincreasing.Furthermore, public health campaignsaimed at encouraging behavior changeto stem the increase in preventablediseases such as HIV/AIDS are sometimesdifficult to manage and target. Andalthough advances in medical researchand the development of anti-retroviraldrugs mean that it is now possible forpeople infected with HIV to live relativelyhealthy, long and productive lives, thecost of such drugs is often prohibitive forthose in developing countries.Italy UkraineGreeceBangladeshThailandNumber of practisingphysicians per 100,000people, in 2004Number of practisingnurses per 100,000people, in 2004Figure 31: Numbers of practising nurses and physicians in selected countries in 2004Source: WBCSD. Health Systems: Facts & Trends. 2006.34