AIDS Policy – COSATU

COSATU Model Policy on HIV/Aid in the Workplace – October 2002

HIV/AIDS already affects all our workplaces, and is likely to grow worse. Our concerns are: 1. Dealing with denial and discrimination against people with HIV and AIDS, from employers, other workers and communities

2. Ensuring that we are all empowered to prevent HIV, including in the workplace, and have access to free condoms

3. Getting medical treatment, adequate nutrition and wellness support, additional time off for opportunistic illnesses, and appropriate working conditions for workers with HIV

4. Making sure that workers who can no longer work because of AIDS get disability pay when they need it, and that if they die, their dependents – including their children – get adequate support from their retirement funds

5. Empowering women comrades, who often have to care for family members with HIV as well as facing sexual harassment and other kinds of discrimination, which make it harder for them to prevent and live with HIV.

To deal with these issues, we need to negotiate workplace policies and programmes on HIV and AIDS. Our demands must reflect what we know about HIV:

Between 10% and 20% of workers are already infected with HIV. In some occupations and workplaces, the figure is even higher.
You can only get HIV from bodily fluids. Workers cannot get HIV from normal contact in the workplace, including from touching each other, working together or sharing cups and toilets. But some workers can get HIV from their work, if they have to deal with blood or other body fluids – for instance, health workers, corrections officers, police and teachers. These workers must use universal precautions and be educated on how to avoid catching HIV.
Most workers with HIV will not get ill for seven to ten years. If they get enough to eat, have healthy working and living conditions, and get appropriate treatment they will live longer. This is especially true if they can get anti-retroviral treatment.
Workers with HIV can get very ill indeed, for instance with T.B., and then recover completely if they get the right treatment.
It is illegal for employers to discriminate unfairly against people with HIV, and it is illegal for healthworkers to tell other people about anyone’s HIV status without that person’s permission.

You can get more information on HIV/AIDS from the Workers Handbook on HIV/AIDS.

Legal framework

A number of laws aim to prevent discrimination against people with HIV, and to ensure that they get adequate benefits. Appendix I summarises the legal requirements.

2 .Model policy

We here present a model workplace policy on HIV and AIDS. It should be modified to meet the needs of your workplace and co-ordinated with existing collective agreements.

Aims

The policy aims:

a. To declare that HIV and AIDS are workplace issues and to improve interactions and education around them in the workplace.

b. To build consensus on how to deal with HIV and AIDS in the workplace.

c. To strengthen education on and prevention of HIV, as well as measures to support the health of people with HIV

d. To support voluntary testing and counselling and in that context to establish mechanisms to monitor the incidence of HIV while ensuring full confidentiality for individuals

e. To build solidarity amongst workers in dealing with HIV, preventing unfair discrimination, and creating a supportive environment f. To ensure that conditions of employment meet the needs of people with HIV without imposing undue burdens on the workforce

g. To take into account the special needs of women arising out of the HIV/AIDS pandemic

h. To establish appropriate grievance procedures for issues related to HIV.

2. Education

2.1. Education will be provided to all workers so as to:

a. Create awareness on HIV/AIDS

b. Promote safer sex

c. Strengthen respect for women’s rights

d. Promote solidarity with people with HIV and AIDS

e. Encourage people to get tested for HIV and to get counselling

f. Ensure people know about basic options for treatment for HIV and AIDS, including for opportunistic diseases and STDs

g. Promote understanding of workers’ rights, including around health care, testing and conditions of employment.

2.2. Education will be provided

a. to shop stewards in order to equip them with counselling skills,

b. to members of the health and safety committee to ensure they can i. assess working conditions for people with HIV and ii. where appropriate, require the use of universal precautions.

2.3. The parties agree to include education on HIV in the workplace training plan, and that the employer will fund it. The parties will jointly design the programme and designate the trainers.

2.4. The employer will provide time off as required for training, with a minimum of:

a. eight hours a year in paid time off for workers to participate in education on HIV, and at least

b. 30 hours for shop stewards to get training in counselling. [Specific demands on time off should be aligned with existing agreements.]

2.5. The parties will provide accurate and easily understandable educational material on HIV in the workplace for all employees.

3. Prevention

3.1. All employees and supervisors are responsible for preventing HIV both in the workplace and in their personal activities.

3.2. The employer shall provide free condoms for all employees.

3.3. The workplace must be equipped to prevent infection in case an accident leads to blood spills.

3.4. If employees come into contact with bodily fluids in the course of their work,

a. The employer shall ensure that the employees are educated about universal precautions and provide the necessary resources

b. The employer shall ensure that if an employee is exposed to HIV infection in the course of his or her work, the employee can get anti-retroviral treatment as post-exposure prophylaxis.

4. Counselling, testing and confidentiality

4.1. The parties will encourage all employees to get tested for HIV, and the employer will pay for counselling and testing for all employees.

4.2. No actual or prospective employee may be required to take an HIV test, and no employee may be tested without his or her knowledge and consent.

4.3. The parties will ensure that

a. All employees who get tested receive counselling by a trained counsellor, preferably a shopsteward, before and after the test

b. The results of an individual’s test remain fully confidential. Files related to HIV must be kept confidential and must not be marked or flagged in ways that indicate HIV status. Healthworkers must not communicate an employee’s HIV status to anyone without the employee’s written permission.

4.4. If the employer, a union official or shopsteward learns the HIV status of an employee, they will not communicate it unless the employee consents.

4.5. The parties will

a. Encourage workers openly living with HIV to conduct and participate in education, prevention and awareness programmes

b. Promote the development of support groups for workers living with HIV, including by giving space and paid time off for them to meet

c. Ensure that workers who are open about their HIV status are not unfairly discriminated against or stigmatised.

5. Non-discrimination

5.1. The parties will work together to end unfair discrimination and stigmatisation against people with HIV.

5.2. The parties will ensure that an employee with HIV does not experience unfair discrimination in access to employment, training, promotion and/or benefits.

5.3. A manager, supervisor or other employee who discriminates, harasses or otherwise mistreats an employee with HIV shall face normal disciplinary procedures.

5.4. The parties will work together to create a supportive environment to ensure that employees with HIV are able to continue working for as long as they are able to do so.

6. Employment security

6.1. No employee may be dismissed or retrenched because of their HIV status.

6.2. If an employee with HIV cannot perform his or her normal duties because of opportunistic diseases, the employer must attempt to find reasonable alternative accommodation for him or her.

6.3. If HIV permanently disables an employee, the employer shall apply standard procedures for termination of employment due to disability, without unfair discrimination. [These demands should be modified depending on existing agreements on disability]

7. Grievance procedure

7.1. The grievance procedure shall be the same for an employee with HIV as for all other employees, without discrimination

7.2. If an employee’s HIV status is at issue in a grievance procedure, the parties to the grievance procedure shall not communicate it to anyone who does not need to know it as part of the grievance procedure.

7.3. If a party to a grievance procedure communicates an employee’s HIV status unnecessarily, she or he shall be subject to disciplinary action.

8. Health care

8.1. The employer will support adequate healthcare for all employees with HIV and their families, including:

a. General assistance to help people with HIV stay healthy, by providing nutritional support and immune boosters

b. Assistance with primary health care and referrals for treatment for opportunistic diseases

c. Provision of anti-retroviral treatment for people with HIV.

8.2. The employer will ensure that an employee with HIV is protected from unhealthy conditions at work.

9. Sick, disability and family leave

9.1. To recover from opportunistic diseases, an employee with HIV will receive each year, in addition to the normal leave allowance, a. ten days extra sick days, and b. six weeks extra disability leave.

9.2. An employee who must care for a person with HIV shall receive an extra ten days’ family leave a year.

10. Benefits

10.1. Benefit schemes shall be reformed to provide adequately for people with HIV in terms of: a. Healthcare, including anti-retroviral treatment b. disability and retirement support c. benefits for widows and orphans

10.2. A joint employer-union task team will where reforms are needed to meet the requirements given in paragraph

10.3. A benefit scheme shall not disclose an employee’s HIV status without the employee’s written permission.

11. Monitoring and evaluation The parties will evaluate progress in implementing this policy at least every three months.

12. Definitions

AIDS Acquired Immune Deficiency Disease – when a person with HIV gets severely ill because the HIV has weakened their immune system
Anti-retroviral treatment – Medication that can prolong the life of a person with HIV for many years, possibly decades Employee with HIV –
Employee infected with HIV
HIV – Human Immuno Deficiency Virus, which causes AIDS
HIV status – Whether a person is infected with HIV or not
Opportunistic disease – Diseases that people with HIV get when the HIV has weakened their immune system
Post-exposure prophylaxis – Short-term anti-retroviral treatment within two days of exposure to HIV (for instance from rape or an accident at work) in order to prevent infection
Safe sex – Sexual activities that prevent contact with bodily fluid, for instance by using a condom
Universal precautions – Measures such as rubber gloves to prevent infection of any kind from contact with body fluids.

Appendix 1. Legal framework

The Constitution of South Africa Act, No. 108 of 1996, prevents unfair discrimination. Other relevant legislation includes the following:

1. Code of Good Practice on Key Aspects of HIV/AIDS and Employment This Code is issued in terms of Section 54(1)(a) of the Employment Equity Act, No 55 of 1998. It is based on the principle that no person may be unfairly discriminated against on the basis of his or her HIV status. In order to assist employers and employees to apply this principle consistently in the workplace, the Code refers to the Constitution, the Labour Relations Act and other pieces of legislation.

2. Employment Equity Act, No. 55 of 1998 Section 6(1) of the Employment Equity Act provides that no person may unfairly discriminate against an employee, or an applicant for employment, in any employment policy or practice, on the basis of his or her HIV status. In any legal proceedings in which it is alleged that any employer has discriminated unfairly, the employer must prove that any discrimination or differentiation was fair. The Act also prohibits HIV testing without Labour Court authorisation.

3. Labour Relations Act, No. 66 of 1995; Section 187(1)(f) of the Labour Relations Act, No. 66 of 1995, provides that an employee with HIV/AIDS may not be dismissed simply because he or she is HIV positive or has AIDS. However where there are valid reasons related to their capacity to continue working and fair procedures have been followed, their services may be terminated in accordance with Section 188(1)(a)(i).

4. Occupational Health and Safety Act, No. 85 of 1993 Section 8(1) of the Occupational Health and Safety Act, No. 85 of 1993 requires an employer to provide, as far as is reasonably practicable, a safe workplace. This may include ensuring that the risk of occupational exposure to HIV is minimised.

5. Compensation for Occupational Injuries and Diseases Act, No. 130 of 1993 An employee who is infected with HIV as a result of an occupational exposure to infected blood or bodily fluids may apply for benefits in terms of Section 22(1) of the Compensation for Occupational Injuries and Diseases Act, No. 130 of 1993.

6. Basic Conditions of Employment Act, No. 75 of 1997; In accordance with the Basic Conditions of Employment Act, No. 75 of 1997, every employer is obliged to ensure that all employees receive certain basic standards of employment, including a minimum number of days sick and family leave.

7. Medical Schemes Act, No. 131 of 1998. In accordance with Section 24(2)(e) of the Medical Schemes Act, No 131 of 1998, a registered medical aid scheme may not unfairly discriminate directly or indirectly against its members on the basis of their “state of health.” In terms of s 67(1)(9) regulations may be drafted stipulating that all schemes must offer a minimum level of benefits to their members. Currently, regulations require that schemes provide treatment for HIV.

8. Promotion of Equality and Prevention of Unfair Discrimination Act, No. 4 of 2000. In accordance with both the common law and Section 14 of the Constitution of South Africa Act, No. 108 of 1996, all persons with HIV or AIDS have a right to privacy, including privacy concerning their HIV or AIDS status. Accordingly there is no general legal duty on an employee to disclose his or her HIV status to their employer or to other employees.[/su_spoiler]

[su_spoiler title=”COSATU Booklet on the Campaign Against HIV / AIDS” icon=”folder-1″]

By the end of 1998, there were 33 and a half million people living with HIV / AIDS in the world. Nearly every country is seeing new infections every day, and the epidemic is out of control in many places. It is estimated that in Africa 800 000 children, 12 million women and 10 million men have HIV or AIDS. More than 11 million Africans have already died, and another 22 million are now living with HIV / AIDS.

In South Africa, 3 and a half million people are infected with HIV. By the year 2000, if the epidemic continues to grow, as much as 20% (one fifth) of South Africa’s working population may be HIV positive. At some time, alsmost every workplace will have to deal with a worker who is living with HIV / AIDS.

The rapid spread of the disease is related to poverty and the lack of access to socio-economic rights such as housing, clean water, sanitation and health care.

Everyone and anyone can get HIV / AIDS, but those most at risk are youth, women, migrant workers, long-haul truck drivers and sex workers.

The following socio-economic factors help to spread the epidemic in South Africa:

Migrant labour increases the spread of the disease by breaking families apart.
Single sex hostels
Overcrowded housing
Poor access to health care
Lack of recreation facilities
Lack of information
Illiteracy and poor education
High unemployment
Exploitation and inequality of women (this makes it difficult for women to demand safer sex)
Other poverty related diseases such as TB
Sexually transmitted diseases

What is HIV / AIDS?

HIV stands for the Human Immune-deficiency Virus. HIV is the cause of AIDS, which stands for Acquired Immune Deficiency Syndrome.

There are cells in your body which protect you from invasion by bacteria, viruses, fungi and parasites. They also destroy cancer cells. The HI Virus attacks and destroys these cells in your body so that they can no longer fight diseases.

After you have been infected for a long period, usually 3 – 7 years, many of these cells will have been destroyed and your body will not be able to defend itself against infections and cancers. This is the phase of HIV – infection when you become sick, and is known as AIDS.

How can you become infected with HIV?

HIV must get into a person’s blood to infect them.For you to transmit it to another person it has to pass from your body in your blood or your sexual fluids, into their body through a break in their skin.

If you are infected, the HI Virus is in:

Blood;
Semen;
Vaginal fluids
Mother’s milk

You can get HIV from sex

HIV can be spread through sexual intercourse. Many infected people have no symptoms and have not been tested. If you have sex with one of them, you put yourself in danger.

If you have a sexually transmitted disease, the virus can pass much easier into your body during sexual intercourse because you will have open sores that allow the virus through. Women are infected more easily through sex, because the lining of the vagina breaks easily, and allows the virus into the body.

Safer sex

Most people in South Africa get infected with the AIDS virus by practicing unsafe sex. If you want to protect yourself from AIDS you must have safer sex. Sex is safer if:

You use a condom
The penis does not penetrate the vagina or anus
You have sex with only one partner in your lifetime, and your partner only has sex with you – this is a faithful relationship
You and your partner have an HIV test which shows negative and then you only have sex with each other – this is also a faithful relationship

You can get HIV from sharing needles

Sharing needles or syringes, even once, is a way of becoming infected with HIV and other germs. HIV from an infected person can remain in a needle or syringe and then be injected into the bloodstream of the next person who uses it.

HIV and babies

A woman infected with HIV can pass the virus on to her baby while she is pregnant, while she is giving birth or when she is breastfeeding. Any woman who wants to have a baby and who thinks she may have been exposed to the virus – even a long time ago – should go for counselling and testing for HIV.

Blood transfusions

In the past, some people became infected with HIV from receiving blood transfusions. Now all blood for transfusions is checked for antibodies to the HI Virus. There is very little chance that a person could get an AIDS infection from a blood transfusion. There is also no chance of getting AIDS by donating blood, because a brand new, sterile needle is used for each person who donates.

How you cannot get HIV

HIV infection does not “just happen”. You cannot catch it like a cold or ‘flu. HIV is not spread by coughing or sneezing. You only get HIV by receiving infected blood, semen or vaginal fluids from another person. HIV is not easy to get.

You will not get HIV through everyday contact with infected people at school, at work, at home, or anywhere else
You will not get HIV from clothes, telephones, computer keyboards or toilet seats. It cannot be passed on by things like cups, knives and forks
You cannot get HIV from eating food that has been prepared by an infected person
You will not get HIV from a mosquito bite. HIV does not live in a mosquito. You also will not get it from bedbugs, lice, flies or any other insects
You will not get HIV from sweat or tears

Four Important Facts about HIV / AIDS:

HIV infection can be prevented
HIV is only transmitted in a few specific ways
HIV does not discriminate – it can infect people of any race, age, gender or sexual orientation
There is no cure for HIV / AIDS

The stages of infection

Stage 1 HIV infection

This is when the virus enters the body. There are no signs or symptoms of infection.

Stage 2 Window period

The virus is present in the body but has not yet produced antibodies which can show up in an HIV test. There are no signs or symptoms of disease. This stage usually lasts from 2 to 12 weeks, but may last months.

Stage 3 Seroconversion

This is when antibodies develop in the blood and an HIV test will detect them. In other words, it is when you convert from being HIV-negative to HIV-positive. Some people have a flu-like illness for a few days – slight fever, tiredness, aching muscles and joints.

Stage 4 HIV infection with no symptoms

There are no signs or symptoms of illness, although infection is present. This period may last from a few months to many years.

Stage 5 HIV / AIDS related illnesses

The immune system (the cells which fight disease) has been damaged by the virus. Symptoms of diseases increase but as yet they are not severe enough to threaten life. Examples of symptoms are a low-grade fever that lasts several weeks, diarrhoea, extreme tiredness, weight loss, skin rashes, swollen glands and night sweats. Women may get vaginal infections (thrush) that never seem to clear up, even with treatment. Infections gradually become more frequent and more serious. This period may last for months or years.

Stage 6 AIDS

Serious infections and cancers invade the body because the immune system is now very weak. Typical infections are pneumonia, skin cancers, “slim’s” disease and TB. The patient could die at this stage from an untreatable condition.

Workplace conditions

There is very little chance that HIV can be transmitted in your workplace. Unless there is blood present, there is no danger of catching the virus from being around people who may be infected. Even if a person sneezes or coughs, there is no blood present so you cannot catch the virus. A worker with HIV / AIDS does not have to be isolated, and needs the support, sympathy and understanding of his or her co-workers.

In workplaces where there might be blood or other infectious fluids around, you are at risk of catching the HI Virus. You can get stuck with a needle with blood on it, get cut with a sharp instrument or get splashed in the eyes, nose or mouth with infected blood. Workers who may come into contact with blood include:

Health-care workers such as nurses, laboratory workers, laundry workers and dental assistants
Police officers
Emergency workers such as ambulance drivers and firefighters
Prison workers
Mental health workers
Teachers

In the workplace, use “universal precautions” whenever you come into contact with:

blood
body fluids
cuts, wounds, or other kinds of “open skin” or lesions

Universal precautions means treating all blood and other body fluids as if they were infected with HIV. Universal precautions include:

washing your hands between each patient or each task
after using the bathroom
after taking off your gloves
wearing gloves when you touch blood or other body fluids
wearing a gown, mask, or eye protection when you may be splashed with blood or other body fluids

Universal precautions should be used by all workers including housekeepers, laundry workers, diet workers and janitors.

If there are splashes of blood or body fluids on the floor or on your clothes, common cleaning materials such as bleach and water, and ammonia, destroy and dissolve the AIDS virus within 30 seconds.

What can the union do?

The union can help its members in at least three ways:

The union can protect workers from HIV infection by improving health and safety at work
The union can protect workers with HIV infection or AIDS
The union can provide support for workers and their families who have HIV infection or AIDS and may become too sick to work

Your role as a shopsteward

As workers, you will be concerned about avoiding infection with HIV and about fair treatment for workers living with HIV. You will be concerned about safe working conditions, protection from discrimination and protection of benefits. Shopstewards have a very important role to play in dealing with these concerns. As a shopsteward in a workplace, it is your duty to do the following:

establish an HIV / AIDS committee in your workplace or use the existing health and safety committee
help to ensure fairness and equal treatment for all your co-workers, including those infected with HIV / AIDS
help to establish a supportive atmosphere for workers living with HIV / AIDS
educate and inform co-workers about HIV / AIDS and how to prevent it
be able to demonstrate how to use a condom
help your union to develop a policy and programme on HIV / AIDS
ensure that there is a policy and programme on HIV / AIDS in your workplace
participate in the development of the policy and programme and ensure consultation takes place throughout the workplace
encourage workers to be involved in the programme
show commitment to the programme from the unions

The most important thing the union can do to support a member with HIV infection is to help the worker remain at work. Staying at work means that workers keep their pride, dignity and health-care benefits. Workers with HIV infection or AIDS should be assisted to do their job as long as they are able. The union must help them by protecting their benefits and protecting them from discrimination.

Discrimination

Discrimination is when:

An employer tries to fire a person with AIDS
An employer denies medical benefits or sick leave to a worker with AIDS
Co-workers refuse to work with a person who has AIDS
Unfair restrictions are placed on a worker, like having to eat lunch alone or take breaks away from other workers
A qualified worker is not promoted because he/she has AIDS
A worker’s personal health information is discussed without his or her permission

Developing an HIV / AIDS policy

An HIV / AIDS policy states how your organisation views its workers with HIV / AIDS and what it will do to support them, as well as the strategy it will use to prevent the spread of HIV / AIDS. The policy must be developed through consultation with all levels of workers. The policy demonstrates the commitment of your organisation to respond to the HIV / AIDS epidemic.

An HIV / AIDS policy should cover:

Access to jobs for applicants with HIV / AIDS
Job security for workers with HIV / AIDS
Whether workers and applicants should be tested for HIV / AIDS
Whether workers HIV status will remain confidential
The right of the worker to disclose his or her status
Protection against discrimination
Workers benefits
Access to training, promotion and benefits
Performance management
Grievance procedures
Reduction of risk in the workplace
First aid and precautions against infection
Education and awareness programmes
Other prevention programmes
Wellness management

A commitment in the form of policy must be taken further in the form of a programme.

There should be regular evaluation, monitoring and review of the policy and programme

(There is a draft workplace policy included at the end of this booklet that you can use to help you.)

AIDS and the law

The most important thing to know about AIDS and the law is that people with HIV / AIDS may not be discriminated against in the workplace.

The constitution gives all workers the right to “fair labour practices” and states that everyone is entitled to equality and freedom from unfair discrimination.

The LRA also outlaws discrimination and protects workers from being dismissed simply because they are HIV-positive. It also protects them from being discriminated against with regard to benefits, staff training and other opportunities at work.

The Occupational Health and Safety Act requires employers to create a safe working environment. This means that proper equipment should be provided to protect workers against infection and that workers should be trained in the use of precautions.

The Employment Equity Act prevents employers from testing for HIV / AIDS before employment (pre-employment testing).

The Compensation for Occupational Injuries and Diseases Act provides compensation for workers who are injured in the “course and scope” of their employment. Therefore, if there is a possibility that a worker has been exposed to HIV during an occupational accident:

an accident report should be completed and forwarded to the Workmen’s Compensation Commissioner
the worker should be tested for HIV to determine their status before the accident
any other person who was involved in the accident should be tested with their informed consent
if he or she tests negative, the worker should be tested again at 3 and 6 months after the accident
if they sero-convert (test positive) during this period, an application for compensation may be made

The Medical Schemes Act prevents medical schemes from discriminating against people with HIV / AIDS

The right to confidentiality means that a worker does not have to inform his or her employer if he or she is HIV positive. Also, doctors and healthcare workers are not permitted to give any information to employers about any worker’s’ HIV status.

Testing for HIV / AIDS

It is important to get yourself tested for HIV if you think it is possible you have been exposed to the virus. It is important to know whether you have the virus because you can remain healthy by eating healthy food, sleeping properly and cutting down on alcohol. Also, you may be able to begin treatment immediately.

However, it is your choice as to whether you wish to be tested. Nobody may test your blood without your consent. If you agree to be tested in your workplace, your results must remain confidential and counselling must be provided before and after testing.

Employers are legally prevented from testing for HIV before hiring workers. The LRA also protects applicants from unfair or discriminatory hiring practices

Testing for HIV before you are admitted to a medical aid scheme is also illegal.

Medical benefits

The Medical Schemes Act prevents medical aid and medical insurance schemes from discriminating against people infected with HIV.

There are other benefits that workers may be entitled to , such as retirement and ill-health benefits, group life or disability cover and funeral benefits.

Workers should be made aware of how much cover their benefit schemes offer for HIV / AIDS. Any changes to benefit schemes should be made in consultation with employee organisations, workplace forums and bargaining councils. The negotiations on benefit packages must take place transparently so that all workers understand the changes.

Treatment

There is no cure for AIDS. There are medicines available which boost the immune system and reduce the amounts of the virus in the body. These are called anti-retroviral drugs and protease inhibitors. Most of them are produced by multinational pharmaceutical companies and are very expensive. It has been found that if you take three of these drugs together, it boosts your immune system effectively. However, South Africa would not be able to afford to provide this treatment to all of its 4 million HIV-positive citizens. It would cost about R200 billion to do so.

Two common examples of these drugs are AZT and nevirapine. AZT is particularly effective in reducing the possibility of a mother infecting her baby during childbirth. Because it costs the government a lot of money to treat babies who are born with HIV infection, it is more cost-effective for it to provide this drug to pregnant women who are HIV positive.

Apart from these anti-retroviral drugs, there are medications which treat the infections that invade your body when you have AIDS. These medications help people live longer and better. Again, most of the drugs are sold by American or multinational pharmaceutical companies, and are too expensive for workers. Some of the drugs are produced much more cheaply in other countries, such as India or Thailand, but South Africa is under pressure not to produce or import cheaper versions of the drugs.

The government has drafted a Bill – the Medicines and Related Substances Bill – which would allow South Africa to import the cheaper medicines into South Africa, and provide a wide range of treatments for AIDS infections. The Pharmaceutical Manufacturers Association, which represents many of the multinational drug companies, have taken the South African Government to court because they believe the Bill will affect their profits.

COSATU supports the government’s struggle to access cheaper drugs for the benefit of all of our people. An important part of COSATU’s HIV / AIDS campaign will be against the multinational companies involved in this action.

COSATU’S programme of action

Phase 1: September 1999 – December 1999

Develop a pledge on HIV / AIDS
Affiliates negotiate a day off for shopstewards training on 22/23 November 1999
Prepare training material on HIV / AIDS awareness, treatment and legislation
Workshop for health and safety coordinators, gender coordinators and COSATU regional gender coordinators and educators
23 – 30 November 1999 – discussions at all workplaces where shopstewards will educate workers on AIDS awareness and treatment
1 December – “World AIDS DAY” – distribute COSATU HIV / AIDS material, and each workplace to have an extended lunch-time meeting

Phase 2: February 2000 – June 2000

Begin training of core HIV / AIDS activists in COSATU who will attend structural meetings, continue educating workers and report on awareness and developments on treatment
Affiliates to negotiate HIV / AIDS policies for workplaces to be included in the collective agreements eg: paid time off for training shopstewards, no discrimination against affected workers, supportive working environment and funded training by SETA’s
2000 begin preparations for the HIV / AIDS conference taking place in South Africa

Shopstewards will lead this campaign. They need to be able to answer questions workers might have, and to create a supportive environment so that workers feel comfortable talking about and understanding AIDS. COSATU calls on all workers to be responsible, sympathetic and pro-active in the fight against this disease. We need to join forces and take on the battle against HIV / AIDS as a strong united working class! Every shopsteward should negotiate for extended lunch-time meetings at their workplaces for 1 December.

Places to help you

National Organisations
AIDS HELPLINE	0800 012 322
National Progressive Primary Health Care Network (NPPHCN)	(011) 403 4647	pphcnjhb@wn.apc.org
Planned Parenthood Association of South Africa (PPASA)	(011) 482 4601	ppasa@ppasa.org.za
National HIV / AIDS and STD Programme, Department of Health	0800-012-322 Toll Free	smartr@hltrsa.pwv.gov.za
AIDS Law Project	(011) 403 6918	125fa2ra@solon.law.wits.ac.za
Provincial Organisations
*Eastern Cape*
East London AIDS Training, Information and Counselling Centre	(043) 705 2621
Port Elizabeth AIDS Training, Information and Couselling Centre	(041) 506 1249
Queenstown AIDS Training, Information and Counselling Centre	(0458) 38 2233 ext 2282
Umtata AIDS Training, Information and Counselling Centre	(047) 531 2763
*Free State*
Bloemfontein AIDS Training, Information and Counselling Centre	(051) 405
Leratong AIDS Centre	(057) 353 3029
Tshwaranang AIDS Centre	(051) 723 0197
*Gauteng*
The Community AIDS Information and Support Centre	(011) 725 6710 / 6721
AIDS Consortium, University of the Witwatersrand	(011) 403 0265	aidscons@global.co.za
Klerksdorp AIDS Training, Information and Counselling Centre	(018) 462 215
Mamelodi AIDS Training, Information and Counselling Centre	(012) 308 5570
Pretoria AIDS Training, Information and Counselling Centre	(012) 308 8743 / 8
Hope Worldwide, Soweto	(011) 984 4422	hwwsoweto@global.co.za
Vaal AIDS Training, Information and Counselling Centre, Vanderbijlpark	(016) 950 5337 / 8
*KwaZulu – Natal*
Durban AIDS Training, Information and Counselling Centre	(031) 300 3104	mdulit@durban.gov.za
Pietermaritzburg AIDS Training, Information and Counselling Centre	(0333) 95 1612 / 3
*Mpumalanga*
Nelspruit AIDS Training, Information and Counselling Centre	(013) 759 2167
Witbank AIDS Training, Information and Counselling Centre	(013) 690 6204
*Northern Province*
Pietersburg AIDS Training, Information and Counselling Centre	(015) 290 2363	herbie.smith@pietersburg.org.za
*Western Cape*
Western Province AIDS Training, Information and Counselling Centre	(021) 400 2184	cajacobs@cct.org.za

Draft Workplace Policy on HIV / AIDS

PREAMBLE

HIV and AIDS in South Africa are a major health problem, with employment, human rights and economic implications. This policy is intended to cover all employees and employers in the Republic of South Africa.

The policy is necessary for the workplace because:

HIV infection takes place mostly among the economically active age group;
Women are additionally at risk of HIV infection.

The policy recognizes that workplace based programmes that promote HIV / AIDS awareness, prevention and care are an important part of a national HIV / AIDS strategy.

The main objective of this policy is to reduce the number of new infections among employees and their families and to ensure that the rights of employees with HIV are fully respected. This policy conforms to the Southern African Development Community Code on HIV in Employment, which was endorsed at the SADC summit in September 1997. It is also in compliance with the protections against arbitrary discrimination that are embodied in existing labour legislation.

NON-DISCRIMINATION

Employees with HIV / AIDS should be treated the same as all other employees.
Employees with HIV-related illnesses, including AIDS, should be treated in the same way as any other employee with a life-threatening illness.
An employee with HIV / AIDS should not face unfair discrimination in access to employment, training, promotion, or employee benefits.
Employees infected with HIV should be protected from stigmatisation and discrimination by co-workers. Where there has been adequate information, education and provisions for safe work, then disciplinary procedures should apply to people who victimise other employees with HIV.

CONFIDENTIALITY AND TESTING

It is the law that HIV testing should only take place after appropriate counselling and with informed consent.
There should be no direct or indirect pm-employment testing for HIV. There should also be no HIV testing for training or promotion purposes.
The HIV status of an individual employee is of no relevance to an employer. People with HIV have equal rights to privacy and confidentiality. If an employee discloses his or her HIV status to colleagues and management this information should be treated as confidential.

MANAGING ILLNESS AND JOB SECURITY

No employee should be dismissed merely on the basis of HIV status; nor shall HIV status influence retrenchment procedures.
When due to medical reasons an employee can no longer continue with his or her normal employment duties, efforts should be made to offer alternative employment (reasonable accommodation). When the employee becomes too ill to perform his or her job, standard procedure for termination of employment due to incapacity should apply without discrimination.

EDUCATION, COUNSELLING AND TRAINING

A fund should be established at the industry level, jointly managed by the union and employers, for the purpose of HIV / AIDS education and training in the industry.

HIV / AIDS education and counselling should take place in every workplace during working hours.

The objectives of education, counselling and training should be:

To create awareness of the HIV / AIDS epidemic;
To remove the stigma against those infected;
To promote safe sex through condom distribution;
To equip union leadership with counselling skills;
To provide care and support for people with HIV / AIDS.

To ensure effective education, the industry should build partnerships with local, provincial and national government as well as with NGOs, CBOs and organisations of people living with HIV / AIDS.

Strategies should be devised to monitor the impact of training on an ongoing basis.

HEALTH AND SAFETY

All workplaces must ensure that they are equipped with proper universal precautions (infection control equipment and procedures) that can be used in cases where there are accidents that lead to blood spills.

Workplace health and safety committees should receive special training on HIV and AIDS and on how to take universal precautions.

HEALTH CARE FUNDS

Efforts should be made to standardise health care services throughout the industry, and primary health care protocols for the care and management of HIV should urgently be developed.

No health care fund should be allowed to discriminate by refusing cost-effective treatment and / or reasonable benefits for the treatment of Sexually Transmitted Diseases (STDs) including HIV.

Additional funds should be made available in order for the health care funds to offer quality services for HIV / AIDS infection.

PROVIDENT FUND & OTHER BENEFITS

Whilst it is recognised that HIV / AIDS may make it necessary to restructure or revisit employee benefits, this should be done in a way that allows the funds to remain economic, but does not exclude or limit benefits to employees with HIV / AIDS.

The employers and unions should commission research into the impact of HIV / AIDS on the existing employee benefits.

IMPLEMENTATION

The union should establish necessary structures at all levels, including joint union and management teams, for the successful implementation of this policy.

REVIEW, MONITORING AND EVALUATION

A baseline study to establish the present impact of HIV in the workplace, including knowledge of HIV by workers and employers, should be conducted as soon as possible.

Pilot programmes to test AIDS prevention strategies should be devised and run jointly by the union and employers. In addition, there should be ongoing evaluation and monitoring of activities that are required by this policy.

The policy should be reviewed periodically in the light of changes in medicine and science concerning the HIV / AIDS epidemic.

Notes: If we are against discrimination against PLAs, then the word unfair discrimination should be avoided and discrimination should assume its rightful place. In other words, we should talk of discrimination instead of unfair discrimination.

Pledge by Representatives of Workers

We, the representatives of organized labour in South Africa, comprising the Congress of South African Trade Unions (COSATU), the Federation of Unions of South Africa (FEDUSA), the National Council of Trade Unions (NACTU), as well as independent trade unions, acknowledge:

The HIV / AIDS epidemic affects the economically active people in our country, South Africa

The proportions to which the disease is spreading and the serious challenges it poses to the country’s development and future.

Poor living conditions and low wages are factors that make it difficult for many people to change behaviour that puts them at risk of HIV infection

Our response, therefore, must to he to campaign for HIV prevention and care with the same determination and energy with which we fight many other working class struggles. We say AIDS must he made a priority issue for every trade union member. Campaigns to stop AIDS must be discussed at every trade union meeting.

It is now clear that awareness-raising and condom distribution, though important, are not enough. This requires a new approach and strategy. Therefore, labour will confront the HIV / AIDS epidemic with the same tools of the struggle: tenacity, vigour and militancy.

We therefore pledge to:

Campaign for adoption and implementation at every workplace the union-developed HIV / AIDS POLICY by October 2000;
Campaign for every workplace to have an HIV / AIDS prevention programme by October 2000;
Step up HIV / AIDS training within trade union structures;
Promote non-discriminatory employment practices, especially in access to employment;
Create a supportive work environment for workers with HIV / AIDS;
Campaign for access to facilities, materials, information, funding;
Continue to support efforts in search of a cure for HIV / AIDS;
Push for favourable policy and legislation, specifically:
1. Uphold and enforce Employment Equity Act;
2. Press for adoption of a legally enforceable Code of Good Practice on AIDS and Employment;
3. Join and support campaigns for accessible and affordable treatment for people With HIV / AIDS.

With a resolute determination to achieve the above, we recommit ourselves to a partnership with our government and other organs of civil society to ensure that the spread of HIV/AIDS is stopped: that the impact of AIDS on infected and affected people is minimised: and that the dignity of all South Africans living with HIV / AIDS is respected.

[/su_spoiler]

[su_spoiler title=”Declaration on HIV / AIDS” icon=”folder-1″]

Adopted by COSATU Special Congress, 20 August 1999

This Special Congress of COSATU notes the relentless advance of HIV and AIDS since the 1997 Congress. 3,5 million people in South are infected with the Human Immuno-deficiency Virus (HIV). Life expectancy in South Africa will reduce to 40-45 over the next ten years and health care costs will be beyond the capacity of survivors to pay for. It is now clear that publicity and condom distribution, though important, are not enough. This requires a new approach and strategy, based on a partnership between government and civil society in which the organised working class should play a leading role.

Against this background, Congress adopts the following:

HIV / AIDS to be declared a national emergency by the government.
COSATU will run a systematic education programme both on prevention and to raise awareness amongst COSATU members of the information about HIV / AIDS treatment and care.
COSATU will develop and distribute information and training packs for shop-stewards and union leaders which include guidance on giving positive assistance to workers living with HIV / AIDS affected by discrimination.
It will develop, with the assistance of specialist AIDS organisations, counseling and other services to union members and staff.
COSATU will engage Bargaining councils on the issue of funds and to ensure that Sector Education and Training Authorities are linking education and the issue of HIV / AIDS.
COSATU will continue to work with the Treatment Action Campaign to campaign:
- in support of the government`s progressive legislation on medicines;
- against multinational pharmaceutical companies which make huge profits on medicines;
- for COSATU`s existing policy on accessible primary health care and basic needs such as clean water, critical in prolonging the life of people living with HIV / AIDS.
COSATU will fight to ensure that the Minimum Benefits under the Medical Schemes Act provide affordable and effective treatment benefits for people with HIV / AIDS.
COSATU will continue to work in the most vulnerable sections of the working class such as transport workers, migrant workers, and workers in the single sex hostels should be intensified.
We re-affirm the Exco decision that, as part of fighting the silence of those who are living with HIV / AIDS, COSATU will encourage its leadership and members to voluntarily take HIV / AIDS test and break the silence. A new culture of openness will be encouraged, including encouraging parents to talk openly to their children, friends, and relatives about this epidemic and the need to use condoms.
COSATU will campaign for provision of a supportive environment for workers and people living with HIV / AIDS. It will support the rights of people living with HIV / AIDS to confidentiality.
COSATU will continue to fight against discrimination based on any unfair grounds, including HIV / AIDS status. In this regard, COSATU will make a submission to the Equality Legislation, and call for the improvement of the Employment Equity Act to protect the rights of people living with HIV / AIDS.
A more detailed COSATU policy must be developed, to be tabled at the next central committee meeting. Such a policy must also relate to the bigger question imposed by the epidemic given our poor social security net. COSATU must carry out a study on the socio-economic impact the epidemic will have on the country. This should be linked to issue of affordability and availability of drugs such as AZT that prolong the life of those carrying the disease.
For this programme to succeed, COSATU must invest both human and material resources. The Health and Safety unit of the federation, must co-ordinate the programme.

[/su_spoiler]

[su_spoiler title=”Address by Joyce Pekane, COSATU 2nd Vice President, to the International Conference on HIV/AIDS” open=”yes” icon=”folder-1″]

9 July 2000

I would like to take this opportunity to welcome you all to this historic occasion on behalf of not only the 1.8 million members of COSATU, but also on behalf of all the working people of South Africa and the entire working class in our country. It is the working class in our own country and around the world that bear the harshest effect of global policies that has no regard for the lives of the ordinary people, this inhumane system that puts profits before all else. We come here today not only to strengthen the global solidarity emerging around the world to the call of people before profits but also to stake the just claim of affordable health care in South Africa.

Where people are engaging on the issues that confront us we must ensure that it the real issues in that area are considered and that is why we are here to tell the world that it is about saving the life of an unborn child and extending and improving the life of a mother that must be the deciding factor in defining our policies.

It is the poor of Africa and the world that are shouting out that we are tired of being expendable, marginalized and ignored, and that is the claim that we are making here today.

Thus far our own efforts have focused on the following:

Education and awareness: here we are trying to ensure that the message of aids and HIV awareness goes out to the length and breath of our country. And here our joint efforts have achieved amazing success.
Prevention has taken the form of promoting safe sex through the distribution of condoms and changed social practices.
Treatment: it is in this area that we are confronted by our greatest challenge, because while the technological progress of humanity has found many methods of treatment these medicines are denied to the majority of people because of excessively high costs. It is here that we see the real violence of poverty.
Ensuring an end to discrimination: We have made many strides at defending people against discrimination, both through legislation and agreements at the workplace.

The socio economic environment within South Africa, shaped by decades of apartheid and colonial exploitation has brought about a situation where because of the nature of work many workers have a greater risk of exposure to the disease. Amongst these are sex workers, workers in single sex hostels, migrant workers and truck drivers. The brutality of unemployment and poverty brings about conditions where the disease has moved along unchecked.

These conditions affect all people in our country but some are more vulnerable than others. Amongst these, woman are the most drastically affected by the epidemic as a result of the unequal power relations and the fact that many men are still stuck with their heads in the sand and refuse to acknowledge and accept responsibility for the management of the epidemic .For any campaign to be successful it must take special account of the situation that woman find themselves in.

The debt crisis experienced by many African countries contribute to the devastating impact that the disease has because these countries cannot allocate resources that are needed to combat the epidemic, rather theses countries resources are forced into serving debt repayments. The writing off of debt is a central part of the battle as we can no longer have a situation where those who have no responsibility, like unborn children have to pay the cost because of inadequate health care.

The tears of a mother, a lover, a child a caring compassionate health worker must shine like a beacon in directing our attention and our focus to what must be a priority need in our health care system and in our society.

There comes a time in the life in any nation when it must give up or stand and fight, we have no choice, we live with the epidemic everyday, we must stand and fight. We are standing and we are ready to fight for the value of life and the equality of all people in a world that shows no justice. This fight must be directed at the following areas:

We must confront our government to provide adequate health care and access to the medicines required to promote a reprieve from this disease. It must allocate the countries resources to this area, this after all is more of a priority than purchasing arms. It would seem there is more of an investment in the tools of death and destruction that the resources needed to promote health and good life.

The international rules of trade have destroyed our industries and wiped out hundreds of thousands of jobs causing unemployment and poverty in South Africa and the third world at large. Now these same rules seek to prescribe to us that we should not buy drugs to treat aids from those countries who would supply them the cheapest. These measures that have reduced the third world to servitude whilst making huge profits for multi-national corporations like Glaxo-Wellcome, Pfizer and other pharmaceutical companies. We will insist that our government rejects rules of trade that put profits before the lives of people. There can be no greater indication of the greed of humanity and the disregard for human life than that demonstrated by these companies and the governments where they originate from.

This campaign is about the power to change the international paradigm.

This campaign is about restoring the world’s sense of humanity and justice.

This campaign is about affordable drugs to treat our mothers our lovers and our children.

There is no doubt that Aids kills. There is no doubt that poverty kills. It is these twins of misery when they work together that is responsible for the absolute devastation that we see across Africa. Our Campaign must be designed to defeat both, through providing drugs and treatment and distributing more equitably the resources of our country to immediately reduce poverty. It is the inequality in our country that undermines our potential. It is the over- abundance of the one that is responsible for the abject poverty of the other.

This march raises the flag against the marginalisation and exploitation of those who are afflicted and affected by the disease through no fault of their own because like the plagues that have gone before our response should be one of humanity united in solidarity to overcome this for the sake of humanity. We will not allow a situation where some can profit from the misery of others. We have come here to tell this international Aids conference that there will not be business as usual, there will not be profits as usual, there must be a change. We have come here to demonstrate our commitment to that change and to fight for that change.

We will overcome.

[/su_spoiler]