Meeting the Challenge: Canada's Foreign Policy on HIV/AIDS - With a Particular Focus on Africa

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Section 7.0 - Canadian Businesses Operating Abroad

This section discusses the impact of HIV/AIDS on businesses in countries with a high prevalence of HIV. It describes the response of business organizations and individual companies, including some Canadian companies, and discusses how corporate responsibility extends beyond purely bottom-line considerations. The section then discusses the issue of providing HIV-related medications to employees living with HIV/AIDS.

No business is immune from AIDS... [T]he private sector is...in a unique position to respond to the epidemic because of its contacts with employees and the wider business community, and the wealth of experience and skills it has accumulated... [T]here is much that businesses can do, and the benefits of action go well beyond the workplace.

- Peter Piot and James Wolfensohn¹⁵⁹

Impact of HIV/AIDS on business

In countries with a high prevalence of HIV, the disease has affected the business climate, the workforce and productivity. Thus, HIV/AIDS is very much a bottom-line issue for businesses operating in these countries. The effects of HIV/AIDS are evident at the macroeconomic level and at the level of individual companies.

At the macroeconomic level, HIV/AIDS causes reduced earnings, higher health care costs and premature deaths. This results in reduced savings rates and reduced disposable income. This leads, in turn, to reductions in the market size for business, particularly in markets outside the basic necessities of food, housing and energy; to reductions in the resources available for production and investment; and, ultimately, to declining economic growth.¹⁶⁰

For individual companies, HIV/AIDS leads to declining productivity, as a result of increased absenteeism, increasing staff turnover, loss of skills, loss of knowledge and declining morale. It also leads to increased costs, due to increased demands for training and recruitment; and to increased payouts for insurance, retirement, health care and, in some cases, funeral costs. Studies in east Africa and Zimbabwe have shown that absenteeism accounts for up to 54 percent of AIDS-related company costs.¹⁶¹

In some sectors, such as the mining industry, where employees often work long distances from their home villages, there are even higher rates of HIV infection in the workforce than in the general population. In southern Africa, nearly three percent of the mining workforce becomes incapacitated each month due to HIV/AIDS.¹⁶²

The business response

Given the impact of HIV/AIDS in high prevalence countries, it is clearly in the companies' own self-interest to develop and implement comprehensive workplace HIV/AIDS programs. But even in countries with lower prevalence rates, companies should be implementing such programs. The struggle against AIDS has taught us that inaction and complacency can have very negative consequences. Low prevalence rates, if left unchecked, rapidly become high infection rates with consequent social and economic costs.¹⁶³

Fortunately, some businesses have responded and there are now a variety of organizations and resources that companies can turn to for advice in this area. For example:

• The Global Business Coalition on HIV/AIDS (GBC). The GBC is an alliance of international businesses dedicated to combating HIV/AIDS.
• The Global Health Initiative (GHI). The mission of the GHI, which was established by the World Economic Forum, is to increase the quantity and quality of business programs fighting HIV/AIDS, tuberculosis and malaria. The GHI website contains case studies of companies that have implemented significant HIV/AIDS workplace initiatives.
• The Canadian Alliance for Business in South Africa (CABSA). The CABSA has commissioned a study on HIV/AIDS and is interested in doing more work in this area.

More information on these organizations can be found in the Appendix.

The International Affairs Directorate of Health Canada has published Enhancing Canadian Business Involvement in the Global Response to HIV/AIDS, which describes how businesses have responded globally and at the individual company level. The GBC, the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the Prince of Wales Business Leaders Forum have issued The Business Response to HIV/AIDS: Impact and Lessons Learned, which is a comprehensive guide on how businesses should be responding, complete with case studies. The GHI, the International Labour Organization (ILO) and UNAIDS have collaborated to produce workplace reference menus (Action Against AIDS in the Workplace) for both Africa and Asia-Pacific. The menus include tools for assessing the impact of HIV/AIDS on a company. The ILO has also published The ILO Code of Practice on HIV/AIDS and the World of Work. More information on these and other relevant publications can be found in the Appendix.

The ILO Code should be considered the minimum standard for businesses. It requires, among other things:

• that employers ensure a safe and healthy working environment;
• that employers consult with workers and their representatives to develop and implement an appropriate policy for their workplace, designed to prevent the spread of the infection and protect all workers from discrimination related to HIV/AIDS;
• that employers initiate and support programs at their workplaces to inform, educate and train workers about HIV/AIDS prevention, care and support and the enterprise's policy on HIV/AIDS, including measures to reduce discrimination against people infected or affected by HIV/AIDS and specific staff benefits and entitlements;
• that employers not engage in nor permit any personnel policy or practice that discriminates against workers infected with or affected by HIV/AIDS;
• that employers not require HIV/AIDS screening or testing;
• that HIV/AIDS-related information of workers be kept strictly confidential and kept only on medical files; that access to such information be strictly limited to medical personnel; and that such information only be disclosed if legally required or with the consent of the person concerned;
• that employers, in consultation with the workers and their representatives, take measures to reasonably accommodate workers with AIDS-related illnesses. These measures could include rearrangement of working time, special equipment, opportunities for rest breaks, time off for medical appointments, flexible sick leave, part-time work and return-to-work arrangements; and
• that employers, workers and their representatives encourage support for, and access to, confidential voluntary counselling and testing provided by qualified health services.

DFAIT should promote the ILO Code among Canadian businesses operating abroad. DFAIT should also publish an annual report based on information from the companies on progress in implementing the principles and policies embodied in the ILO Code.

The response of Canadian companies

Some Canadian companies operating abroad are among the businesses that have taken steps to address HIV/AIDS. Molson, one of the companies profiled in the Business Response publication cited above, reports that it has supported HIV/AIDS awareness since the mid-1980s through corporate giving and the use of marketing campaigns. In Canada, according to the company's website, Molson is the National Founding Sponsor of AIDS Walk Canada, which is the major fundraiser for AIDS research and care; and it provides support to the AIDS Committee of Toronto, BC Persons with AIDS, and the Farha Foundation in Montreal for their annual AIDS Walks and other fundraising initiatives.¹⁶⁴

Barrick Gold Corporation, one of the case studies listed on the GHI website, reports that it has established a workplace and community HIV/AIDS program through a wholly-owned subsidiary, Kahoma Mining Corporation, which operates a mine in Tanzania. Barrick says that the program includes support for affordable housing for miners and their families, free condom distribution, syndromic management of sexually transmitted infections, voluntary HIV testing and counselling, and the use of community health educators to do prevention education.

Placer Dome Inc. reports that it has implemented a comprehensive HIV/AIDS workplace policy in the South Deep Mine in South Africa, which it operates in a joint venture with Western Areas Limited. As well, because many of its workers were becoming ill and returning to their villages where there is virtually no infrastructure to care for them, Placer Dome says that it has partnered with the Employment Bureau of South Africa to implement a Home-Based Care Program for terminally ill workers with AIDS. Partial funding for this program is coming from the Canadian International Development Agency. According to Placer Dome, the program provides locally manufactured medicines and dietary supplements to incapacitated workers; and training for families to enable them to care for the sick workers and to practice proper sanitary procedures in order to prevent the spread of the disease.¹⁶⁵

These are important first steps. These companies should now ensure that that they follow through on the initiatives they have undertaken or announced, and that they implement comprehensive measures to protect employees living with HIV/AIDS against discrimination, to extend treatment to these employees (see below) and to provide quality HIV prevention and education programs.

The Canadian companies that have responded to HIV/AIDS may be amenable to mentoring Canadian companies that are operating in Africa (or elsewhere) and that are looking for guidance in this area. DFAIT should consider establishing a formal mentoring program. DFAIT can also assist Canadian companies looking for guidance by encouraging them to join the Global Business Coalition on HIV/AIDS, and by referring them to other business organizations and to publications dealing with HIV/AIDS and workplace issues.

Corporate responsibility

The impact of HIV/AIDS, particularly in high prevalence areas, is such that many companies are motivated to adopt workplace HIV/AIDS programs for purely bottom-line reasons. There are other pressures as well, pressures for companies to be more responsible and accountable to their wider stakeholders - workforces, suppliers, communities, governments and the general public.¹⁶⁶

The Organisation for Economic Cooperation and Development says in its Guidelines for Multinational Enterprises that enterprises should:

• contribute to economic, social and environmental progress with a view to achieving sustainable development; and
• respect the human rights of those affected by their activities consistent with the host government's international obligations and commitments.¹⁶⁷

The United Nations Sub-Commission for the Promotion and Protection of Human Rights adopted draft norms on the responsibilities of corporations with respect to human rights on 13 August 2003.¹⁶⁸ These norms, which would apply to the whole range of business enterprises and not just to multinational corporations, will be considered by the UN Commission for Human Rights at its 2004 session. The draft norms state that companies should be required to abide by basic human rights standards. They also say that:

States have the primary responsibility to promote, secure the fulfilment of, respect, ensure respect of and protect human rights recognized in international as well as national law, including ensuring that transnational corporations and other business enterprises respect human rights. Within their respective spheres of activity and influence, trans-national corporations and other business enterprises have the obligation to promote, secure the fulfilment of, respect, ensure respect of and protect human rights recognized in international as well as national law.¹⁶⁹

and that

Transnational corporations and other business enterprises shall respect civil, cultural, economic, political and social rights and contribute to their realization, in particular the rights to development, adequate food and drinking water, the highest attainable standard of physical and mental health, adequate housing, privacy, education, freedom of thought, conscience, and religion and freedom of opinion and expression, and shall refrain from actions which obstruct or impede the realization of those rights.¹⁷⁰

DFAIT should champion the adoption of these draft norms when they are discussed by the Commission, and its sub-committees and working groups, at upcoming meetings.

Provision of antiretroviral therapies and other HIV-related treatments

Providing full access to antiretroviral therapies and other HIV-related treatments to people who need them should be the responsibility of the state. Unfortunately, many developing country governments are unable or unwilling to provide such access, due mainly to the high costs of the medications.

Several multinational companies operating in Africa report that they are providing antiretroviral therapies free of charge to their employees. The list includes AngloGold Ltd., Coca-Cola Co., IBM, Anglo American PLC and De Beers Consolidated Mines Ltd. These companies have said that such a step is a key part of a comprehensive strategy to fight HIV/AIDS, and that it makes financial sense. AngloGold said in 2002 that an estimated one-third of its 44,000 South African workers were infected with HIV. It said that its drug program was expected to add US$3-7 an ounce to the company's cost of production, but that the cost of doing nothing was about US$9 an ounce. Recently the Coca-Cola Africa Foundation announced that all 40 of its independent bottling companies in Africa have enrolled in a program to provide antiretroviral therapies to their employees. Two Canadian companies, Placer Dome and Barrick Gold, are considering providing antiretroviral therapies to employees of their African mines.¹⁷¹

Some non-governmental organizations operating in Africa, including the International HIV/AIDS Alliance and CARE Zambia, are providing antiretroviral therapy and other HIV-related treatments free of charge to employees living with HIV/AIDS and their dependents.

In countries where people living with HIV/AIDS are unable to access antiretroviral therapies and other HIV-related treatments, DFAIT should encourage Canadian companies to provide these medications free of charge to their employees. DFAIT should also work with the governments of these countries to find ways to get these medications people in the communities where the companies are located. As well, DFAIT should work with these same governments to develop national policies and programs that will make these medications accessible to all citizens who need them.

Recommendations

59.	We recommend that DFAIT assist Canadian companies operating in Africa and in other countries to develop expertise on HIV/AIDS workplace policy and programming by:
	encouraging Canadian companies to join the Global Business Coalition on HIV/AIDS; encouraging Canadian companies that are seeking guidance in this area to consult business organizations with expertise on HIV/AIDS workplace issues,172 as well as existing publications on the development of workplace policies and programs;173 encouraging Canadian companies that are seeking guidance to approach other Canadian companies that have some experience in this area; and exploring with Canadian companies that have some experience in this area the possibility of setting up formal mentoring programs for companies seeking guidance.
60.	We recommend that DFAIT promote with Canadian companies operating in Africa and elsewhere the adoption as a minimum standard for their HIV/AIDS workplace policies the principles and policies contained in the International Labour Organization's ILO Code of Practice on HIV/AIDS and the World of Work; and that DFAIT publish an annual report based on information from the companies on progress in implementing these principles and policies.
61.	With respect to countries where people living with HIV/AIDS are unable to access antiretroviral therapies and other HIV-related treatments, we recommend that DFAIT encourage Canadian companies to (a) provide these medications free of charge to their employees; (b) work with the governments of these countries to find ways to make these medications accessible to people in the communities where the companies are located; and (c) work with the governments of these countries to develop national policies and programs designed to make these medications accessible to all people who need them in each country.
62.	We recommend that at upcoming meetings of the United Nations Commission on Human Rights, and its sub-committees and working groups, DFAIT champion the adoption of the Draft Norms on the Responsibilities of Transnational Corporations and Other Business Enterprises with Regard to Human Rights.

Notes

159. Global Business Coalition on HIV/AIDS, Joint United Nations Programme on HIV.AIDS, Prince of Wales Business Leaders Forum. The Business Response to HIV/AIDS: Impact and Lessons Learned. (Geneva and London 2002): p. 13. www.businessfightsaids.org/pdf/Impacts.pdf.
160. Global Business Coalition. The Business. 2002: p. 13.
161. Global Health Initiative, International Labour Organization, Joint United Nations Programme on HIV/AIDS. Action Against AIDS in the Workplace (Workplace Reference Menu). (June 2003): p. 2. www.weforum.org/site/homepublic.nsf/Content/Global+Health+
     Initiative%5CGHI+Business+Tools%5CGHI+Best+Practice+Guidelines. Accessed 20 August 2003.
162. When condoms aren't enough: The Home-Based Care program in Southern Africa. Share (World Bank staff magazine). Spring 2003.
163. Global Business Coalition. The Business. 2002: p. 17.
164. Molson website at www.molson.com/en/community/donation/
     index.php?sec=5&com=3&mdf=1. Accessed 21 August 2003.
165. Supra, note 3. For more information on Placer Dome's HIV/AIDS program, consult the website of the Global Business Coalition on HIV/AIDS at www.businessfightsaids.org/wpp_popup.asp?CompanyID=86. Accessed 19 August 2003. Or contact Phillip Von Wielligh, Manager, Sustainable Development, Placer Dome Western Areas Joint Venture, P.O. Box 57, Westonaria 1780, South Africa, Mobile Tel.: +27 (83) 655 2537, Email: pavwiell@southdeep.co.za.
166. Global Business Coalition. The Business. 2002: p. 19.
167. OECD. OECD Guidelines for Multinational Enterprises (Revision 2000). (France, 2000): p 19. www.oecd.org/dataoecd/56/36/1922428.pdf. Accessed 20 August 2003.
168. United Nations. ECOSOC. Commission on Human Rights . Draft Norms on the Responsibilities of Transnational Corporations and Other Business Enterprises with Regard to Human Rights. Prepared by the Working Group on the Working Methods and Activities of Transnational Corporations, Sub-Commission on the Promotion and Protection of Human Rights. 30 May 2003: Paragraph 1, p. 4. www.unhchr.ch/pdf/55sub/12AV.pdf.
     Accessed 23 August 2003. The draft norms were adopted by the Sub-Commission in August 2003. They will be presented to the Commission for approval in March 2004. The draft Norms apply principles developed in the Maastricht Guidelines on Violations of Economic, Social and Cultural Rights, discussed in Section 5.2 (Promoting Human Rights).
169. United Nations. ECOSOC. Commission on Human Rights . Draft Norms. 2003: Paragraph 1, p. 4.
170. Ibid: Paragraph 12, p. 6.
171. Stueck, W. Miners mull supplying HIV-AIDS drugs. Globe and Mail. 18 February 2003.
172. See the list of organizations in the Appendix.
173. See the list of publications in the Appendix.

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