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"An instrument of accountability"
ILO/AIDS: A global plan
and a new Code of Practice
In a "moment of common purpose," the international community adopted a sweeping plan of action to fight the global epidemic of HIV/AIDS. At the UN Special Session on 25-27 June, the ILO launched a pioneering Code of Practice on HIV/AIDS and the World of Work *. The new code provides workers, employers and governments with global guidelines - based on international labour standards - for addressing HIV/AIDS and its impact in the workplace. This report examines the new Code, and the historic UN Assembly
NEW YORK- When world leaders gathered at the United Nations General Assembly Special Session on HIV/AIDS, the mood was grim. Twenty years into the worst epidemic in modern times, 36 million people around the world were infected with HIV, and some 20 million had already died.
Of those now infected with the disease, some 23 million, or three-quarters, were working people aged 15-49 - often our most productive people, people in the prime of their lives.
Clearly, after two decades, it was time for a dramatic, even historic gesture. The UN's response was to adopt unanimously a "Declaration of Commitment on HIV/AIDS" that Dr. Peter Piot, Executive Director of the United Nations Joint Programme on HIV/AIDS (UNAIDS) called an "instrument of accountability."
"What is important is that, after today, we shall have a document setting out a clear 'battle plan' for the war against HIV/AIDS, with clear goals and a clear time line," said UN Secretary-General Kofi Annan. "It is a blueprint from which the whole of humanity can work, in building a global response to a truly global challenge.
"Never, since the nightmare began, has there been such a moment of common purpose," Mr. Annan said. "Never have we felt such a need to combine leadership, partnership and solidarity. We must send the world a message of hope."
ILO participation
The ILO's role in this"battle plan" is embodied in a small, pocket-sized booklet that provides a large weapon in the war on HIV/AIDS in the world of work. The new ILO Code of Practice on HIV/AIDS in the World of Work is aimed at the enterprise and community where most people work and where most of the world's people with HIV/AIDS can be found.
"AIDS and HIV affect people at all levels of society, but have a profound impact on workers and their families, enterprises, employers, and national economies."
- Juan Somavia, ILO Director-General
New ILO data prepared for the AIDS session show that of the estimated 23 million working people suffering from HIV/AIDS, about 17.5 million, or the vast majority, are in 43 African states, where Mr. Somavia said, the HIV epidemic has created "a state of emergency". Data for other regions of the world show some 3.5 million people with HIV in Asia, 700,000 in North America, 226,000 in the Caribbean, 416,000 in Latin America and 543,000 in Europe.
The Code will help boost efforts to prevent the spread of HIV, manage its impact, provide care and support for those suffering from its effects and staunch stigma and discrimination which arise from it. It was adopted following intensive efforts by ILO staff and experts representing governments, employers and workers since being mandated by a Special High-level Meeting on HIV/AIDS and the World of Work during the 88th session of the International Labour Conference in June 2000.
ILO Director-General Juan Somavia, discussed the Code with Mr. Annan, representatives of member States and business leaders during the AIDS summit. "As it affects the most economically active members of society, it reduces earnings, productivity, skills and experience while imposing huge costs on enterprises, labour and governments. Thus, AIDS is not only a workplace issue, but a challenge to development worldwide."
The Code cites a number of key principles designed to promote prevention in countries where the epidemic already has a strong grip, and help prevent infection rates from increasing in relatively unaffected countries. What is more, it also provides guidance on such issues as testing, screening and confidentiality, non-discrimination in employment, and gender issues (see box, "Key Principles of the ILO Code on HIV/AIDS".
"The new Code is the most wide-ranging and comprehensive blueprint for workplace policy on HIV/AIDS ever developed and addresses this present situation as well as its future consequences for the world of work," Mr. Somavia said. "The Code is not just about policy and guidelines. It is about respecting the dignity of others and learning to live with the reality of HIV/AIDS."
The Code at the UN
The ILO Code was well-received during the course of the UN Special Session.
"What is significant about the ILO Code is that it will enable the ILO to provide technical assistance to its social partners and assist unions especially in their fight against HIV/AIDS," said Cunningham Ngcukana, General Secretary of the NACTU, a national trade union federation in South Africa. "Only through the ILO can we ensure that we will have the capacity to deal with this disease."
Among employers, Dr. Lettie La Grange of the Chamber of Mines in South Africa, who was a key member of the expert panel that adopted the Code, said: "This is a very strong document and I cannot see how any employer cannot adopt it."
The Director-General said the ILO's commitment to be a partner in the challenge of HIV/AIDS stems from its social mandate in the field of rights at work, as well as the threat posed to its primary goal of providing men and women with decent work in conditions of freedom, equity, security and human dignity.
"Our initial response to the challenge is a Code of Practice on HIV/AIDS and the world of work," Mr. Somavia said. "It represents a balanced approach to the problems of discrimination, confidentiality, employee benefits, care and treatment and other AIDS-related workplace issues.
"These negotiations are not about mere statistics. You are talking about the lives of millions of women who are battling this virus."
- Beatrice Were, Community of Women Living with HIV/AIDS
"Through our programme on HIV/AIDS, we will work with our tripartite constituents at national and regional levels to promote prevention in the workplace, and mitigate the social and economic impact of the disease," he added. "We have become a co-sponsor of UNAIDS in order to put ILO's unique tripartite structure and doctrine of social dialogue at the service of this global struggle."
The Code of Practice is part of new ILO efforts to mitigate the impact of HIV/AIDS in the workplace. A technical cooperation programme on HIV/AIDS has been launched and projects developed for a number of countries. ILO fact-finding missions have visited in 16 countries in Africa, Asia, Eastern Europe and the Caribbean with a view to setting up projects on HIV/AIDS prevention and mitigation to support national efforts in Cambodia, India, Malawi, Namibia, Nigeria, Russian Federation, Tanzania, Ukraine, Vietnam and a sub-regional project for the Caribbean.
These projects will be implemented by the ILO in collaboration with UNAIDS and bilateral donors. Joint projects are being developed in Ethiopia, Madagascar and Thailand. Plans call for a regional impact study to be carried out in the main ports of Anglophone African countries plus Mauritius, and joint activities with other organizations in Botswana, Brazil, Burkina Faso, Cambodia, Ghana, Nigeria, Republic of South Africa, Swaziland, Thailand and Uganda.
The new UN Declaration
The Declaration of Commitment adopted by the General Assembly contains sweeping language designed to focus the global campaign against HIV/AIDS and provides specific guidelines for addressing the disease in the workplace. Among its provisions are: establishment, on an urgent basis, of a Global HIV/AIDS and Health Fund of US$7 billion to US$10 billion to finance an urgent and expanded response to the epidemic based on an integrated approach to prevention, care, support and treatment.
In the world of work, the Declaration calls on nations to:
• strengthen the response to HIV/AIDS by establishing and implementing prevention and care programmes in public, private and informal work sectors and take measures to provide a supportive workplace environment for people living with HIV/AIDS;
• develop and begin to implement national, regional and international strategies that facilitate access to HIV/AIDS prevention programmes for migrants and mobile workers, including the provision of information on health and social services;
• implement universal precautions in health-care settings to prevent transmission of HIV infection;
"If we are to have any effect on this pandemic at all, we cannot shy away from being very specific about the groups who are the most vulnerable to infection, who need to be educated about prevention, and who need care and treatment."
- Richard Burzynski, International Council of AIDS Service Organizations
• evaluate the economic and social impact of the HIV/AIDS epidemic and develop multi-sectoral strategies to address the impact at the individual, family, community and national levels;
• address the impact of HIV/AIDS on household income, livelihoods, and access to basic social services, with special focus on individuals, families and communities severely affected by the epidemic;
• review the social and economic impact of HIV/AIDS at all levels of society especially on women and the elderly;
• adjust and adapt economic and social development policies, including social protection policies, to address the impact of HIV/AIDS on economic growth, provision of essential economic services, labour productivity, government revenues, and deficit-creating pressures on public resources; and
• develop a national legal and policy framework that protects in the workplace the rights and dignity of persons living with and affected by HIV/AIDS, and those at the greatest risk of HIV/AIDS in consultation with representatives of employers and workers, taking account of established international guidelines on HIV/AIDS in the workplace.
"I think we should all recognize this as a truly historic event," said Mr. Annan. "The world is at long last waking up to the gravity of the HIV/AIDS crisis. And second, the Declaration ... provides us with a clear strategy for tackling it."
* An ILO Code of Practice on HIV/AIDS and the World of Work, International Labour Organization, Global Programme on HIV/AIDS and the World of Work. International Labour Office, Geneva, 2001. ISBN:92-2-112561-0.
Key Principles of the ILO Code of Practice
on HIV/AIDS and the World of Work
• HIV/AIDS should be treated like any other serious illness/condition. This is necessary because the workplace, as part of the local community, can play a vital role in the wider struggle to limit the spread and effects of the epidemic.
• Workers, employers and governments should collaborate to promote prevention, particularly in changing attitudes and behaviours through the information and education, and in addressing socio-economic factors.
• In the spirit of decent work and respect for the human rights and dignity of persons infected or affected by HIV/AIDS, there should be no discrimination and stigmatization against workers on the basis of real or perceived HIV status.
• The gender dimensions of HIV/AIDS should be recognized. More equal gender relations and the empowerment of women are vital to successfully preventing the spread of HIV infection and enabling women to cope with HIV/AIDS.
• HIV/AIDS screening should not be required of job applicants or persons in employment and testing for HIV should not be carried out at the workplace except as specified in this code. Even outside the workplace, testing for HIV should involve voluntary informed consent and be performed by qualified personnel only, in conditions of strictest confidentiality.
• Asking job applicants, workers or co-workers to disclose HIV-related personal information is unjustified. Access to personal data relating to a worker's HIV status should be bound by the rules of confidentially consistent with existing ILO codes of practice.
• HIV infection is not cause for termination for employment and persons with HIV-related illnesses should be able to work for as long as medically fit in available, appropriate work.
• There should be no discrimination against workers and their dependants living with HIV/AIDS in access to and receipt of benefits from statutory social security programmes and occupational schemes.
• Successful implementation of an HIV/AIDS policy and programme requires social dialogue between employers, workers and their representatives and government, where appropriate, with the active involvement of workers infected or affected by HIV/AIDS.
An information kit and pocket-sized copies of the code are available. For more information, see www.ilo.org/AIDS, or contact ILOAIDS@ilo.org