What can the ILO bring to the "3 by 5" initiative to combat HIV/AIDS?
The age group that is worst affected by HIV is from 15 to 49, the most productive segment of the labour force. So, services which look after the health of workers in the workplace are a very effective way of reaching a lot of people and treating them for HIV and related illnesses. The workplace is special. If you take action there you can see the effect immediately.
So, it's no longer enough to view HIV/AIDS as a health issue. It should be seen as a workplace issue too?
It's not only a public health issue, it is a developmental issue. It is a gender issue. It is an issue that cut across our all of our lives and affects economic growth because of its impact on human resources. When a company looks at the cost-benefit analysis of treating workers, it finds out that first of all it is cutting down the cost of recruitment, because when you lose your experienced workers you need to recruit new ones and train them. When experienced workers are dying it affects productivity and disrupts production. So, for all these reasons employers need to invest in treating their workers. A happy worker, a healthy worker, a contented worker is a more productive worker. That means the company can make more profits. So if by treating infected workers they can make more profits, it will do it.
Large companies may have the resources to operate such programmes, but many small companies may feel that they cannot afford to do so. What do you say to them?
What we're trying to do in the ILO is to ensure that big companies look after their small brothers, because these small enterprises are an essential part of the supply chain. This makes economic sense because if a large company doesn't get raw materials or semi-finished products that will affect its productivity. Some companies already do this. In South Africa the Ford motor company has its own HIV programme and has extended it to other smaller companies that supply them with the materials they need to assemble their products.
How big a barrier do you think that fear and stigma are when it comes to running effective HIV/AIDS workplace programmes?
Unfortunately, this is the key issue and we need to do more. The thing that prevents activities in the workplace – treatment, care and support – is stigma and discrimination. Once this fades we can do more, taking care of workers and treating them in their places of work. To have an effective workplace programme, there must be zero tolerance for stigma and discrimination. There have been cases when a worker gets to the cafeteria and goes to sit down, and because other workers think that he is HIV positive, they just move off or say "we just finished eating!" So discrimination is not just an issue between the employer and the workers, it's between workers and workers. But things are improving. I know of a farmer in Swaziland. He found out his tractor mechanic was HIV-positive. The first thing the farmer thought was that he should fire this person. But then he thought, "Hey, wait a minute. This guy has been with me for more than 25 years, he has what in medicine we call "clinical ears", so when you start the tractor's engine he knows exactly what is wrong with it". Also recruiting a new person will cost money. There will be training and he might also spend more on buying spare tractor parts unnecessarily. So the farmer decided to keep his mechanic and to give him treatment. He told us that he has never regretted his decision because the mechanic is still alive, productive and working well.