At the XV International AIDS Conference (Bangkok 11-16 June) the ILO will be launching its Report on the Global Estimates of the Impact of HIV/AIDS on the World of Work. Franklyn Lisk is the ILO’s Director ILO Global Programme on HIV/AIDS and the World of Work.
Q: What do you think will be the ILO’s main contribution to the Bangkok conference?
A: We estimate that at least two-thirds of the 40 million people living with the virus today are workers, in either the informal or formal economies. That makes HIV/AIDS a concern of the ILO. The epidemic affects all our tripartite constituents; workers through loss of earnings and livelihoods; employers and businesses through loss of skilled and experienced workers, reduced productivity and a decline in profits; governments because this affects revenue and their economy’s performance overall.
Socio-economic issues such as poverty and under-development are where the ILO can make the greatest contribution. In sum, we are moving on from the fairly narrow view of the epidemic as a public health issue.
Q: So, as progress is made on the public health aspect of the epidemic, and HIV positive people are healthier for longer, the question of how they are going to support themselves becomes more urgent?
A: For me, the important issue is that AIDS is about people. Human capital is needed by both the public and private sectors, in both developed and developing economies. We know that with care and support people who are HIV positive can remain productive for a fairly long time. So it’s important that we focus on people that we keep people alive and productive for as long as possible so they can continue to make a contribution and benefit from development efforts.
Q: What are the key components of the ILO’s approach to aids in the workplace?
A: There are three pillars.
The first is to ensure that rights at work are respected and that stigma and discrimination are addressed. This is why one of our first initiatives was the development of a Code of Practice on HIV and the world of work. The key principles include the protection of rights, non-discrimination in employment, gender equality, social dialogue, prevention, care and support.
The second pillar is to give our social partners the capacity to address the epidemic through their own activities.
The third pillar concerns partnerships. The ILO is one of the nine co-sponsors of UNAIDS. This gives us the opportunity to work with our UN co-sponsors to create a more coherent and cost-effective approach at national level. These kinds of partnerships typify the ILO’S approach to development, which is based on the social partners working together.
Q: Why does the ILO believe there should not be testing for AIDS in the workplace?
A: We believe there is a high risk of testing in the workplace being used to discriminate against workers. However, the ILO is not categorically against workplace testing. For example, we believe it is important that people know their HIV status. If the only facilities available happen to be the workplace then testing is okay as long as it is confidential, based on consent, information and counseling are available, and it is not used to screen people or encroach on the rights of workers.
Q: What do you say to those who might be scared to work with people who are HIV positive and who want compulsory workplace testing?
A: First and foremost I think this position comes from ignorance. I am sympathetic and I would emphasize the need for public education about HIV. Of course there is the issue of stigma, and the cult of denial. I have found employers in the Caribbean tourism sector who didn’t want to be identified with HIV issues because they feared people would see them an HIV infected establishment, rather than as an enlightened employer. I’ve also been told that in Botswana many people do not take free treatment because they don’t want to be stigmatized. This stigmatization is holding back efforts to prevent the spread of the epidemic.
Q: Many small businesses may feel they can’t afford to implement the Code of Practice. What do you say to them?
A: The implementation of the code in the informal economy and among small and medium sized enterprises is a big challenge for the ILO. This why we advocate the integration of the code into national strategies and national action plans. That way the burden doesn’t fall entirely on the employer and they can access to state or government facilities. Another way is for larger companies to help smaller companies, for example their suppliers. This help isn’t necessarily financial, it could simply be information.
Increasingly employers are realizing it is in their own economic interest to take action, it makes good business sense. If they loose key workers they have invested in and who have acquired skills and experience, they may be difficult to replace.
We will also encourage people, particularly leaders, to speak up in public about the epidemic and its impact on their activities. I think this would contribute significantly to de-stigmatizing the epidemic.
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