HIV/AIDS

The ILO considers that health care is a basic human right for all, and over 100 million health-service workers are providing health-care services to women, men and children worldwide. But the provision of health services remains problematic, and substantial inefficiencies exist in the allocation of human, material and financial resources. Increasing costs and structural adjustment policies have had a negative impact on the employment and career prospects of health personnel. In addition, difficult working conditions including stress, long hours, shift work, and violence have resulted in skyrocketing health staff vacancy rates. The HIV/AIDS pandemic is an additional factor. According to the WHO, the impact of HIV/AIDS often strikes hardest where health systems are weakest, and deals a double blow. Systems that in any case cannot cope are weakened further by HIV/AIDS deaths and disability among large numbers of health personnel. The health services sector has the unique feature of having a population of workers who, in addition to providing care to patients suffering from HIV/AIDS, are at risk of contracting HIV/AIDS because of their professional responsibilities. They also face discrimination should they become infected. At the same time, a larger, well-trained health services population is needed to address the different layers of HIV/AIDS and to provide help for those infected. A key impediment to the success of the antiretroviral programme in Africa is the shortage of health workers available to administer drugs to patients. A specific approach is needed to address the different layers of HIV/AIDS issues facing the health services sector. In particular, clear and coherent policies should be developed that address the prevention of HIV/AIDS specifically among health-care providers; the management and mitigation of the impact of the illness in the health services sector; and the reduction of discrimination and stigma faced by HIV/AIDS-positive health-service workers. Given that the health sector is a major employer of women, in some cases up to 80 per cent of all workers, the guidelines address the special concerns of women workers as well.

Based on the collection of information, best practices and a collaborative effort of both the ILO and WHO, the Joint ILO/WHO guidelines on health services and HIV/AIDS (pdf, 411k) were developed during a three-day tripartite meeting involving experts in the field of HIV/AIDS and health care and representing workers, employers and governments. They provide wide-ranging and practical approaches to protection, training, screening, treatment, confidentiality, prevention, the minimizing of occupational risk and the care and support of health care workers. The guidelines also address the essential role of social dialogue among governments, employers and workers in meeting the challenges posed by the HIV/AIDS epidemic in the sector.

The joint guidelines - also available in Arabic, Bahasa Indonesia, Chinese, French, Russian, Spanish, Swahili and Vietnamese - are being disseminated by the ILO and the WHO, with social dialogue activities and training to encourage their implementation.