Roseline Mosibudi Nkgapele, a member of the National Union of Metal Workers of South Africa (NUMSA), has made it her mission to educate workers about HIV/AIDS. The virus is particularly cruel in that it strikes workers in their prime, affecting their ability to remain productive on the job and earn a living wage. Prevention and care is an urgent issue for workers and their unions.
When Nkgapele, a 10-year employee at AutoZone, an auto parts wholesaler and retailer in South Africa’s Gauteng Province, heard about the Solidarity Center’s project on workplace HIV/AIDS, “Be Faithful, Be Tested, Be Union,” she wanted her workplace to be included in the project.
Jean Lindsay, Autozone’s human resources manager, agreed, and they requested the Solidarity Center’s assistance in developing an HIV prevention and management strategy. As a result, Solidarity Center staff held multiple trainings which in turn empowered dozens of new workplace peer educators and sparked the creation of a new committee to shepherd HIV prevention at Autozone. Key to the trainings is educating men on the effectiveness of circumcision in preventing HIV/AIDS. To date, more than half of Autozone’s male workforce, have undergone circumcision.
“Be Faithful, Be Tested, Be Union” is funded by the U.S. Centers for Disease Control and Prevention through the President’s Emergency Plan for AIDS Relief (PEPFAR).
The partnership with the Solidarity Center and NUMSA, begun in August 2011, was the first time labor and management worked together on an issue, said Lindsay. Now, “we are feeling that there is a significant difference in our workplace: Workers are aware of their HIV status, men are undergoing medical circumcision that could potentially save their lives and their spouses, greater knowledge and awareness was gained and the team is empowered. Management and the union are united over the same cause and great relationships and partnerships have been formed.”
South African unions are at the forefront of the fight against HIV/AIDS. In South Africa, the Solidarity Center partners with the 302,000-member NUMSA, the largest affiliate of the Congress of South African Trade Unions (COSATU). From October 2008 to September 2011, the Solidarity Center in South Africa implemented HIV/AIDS workplace activities at more than 100 jobsites, ranging in size from 50 to 3,000 workers. To date, the Solidarity Center planned and faciliated small group sessions for more than 20,000 workers through HIV/AIDS workplace education.
Most recently, the Solidarity Center in September held a Voluntary Medical Male Circumcision drive attended by 2,000 men. (Click here to check out all World AIDS Day actions the Solidarity is sponsoring or taking part in.) Educating men through the workplace is extremely effective, says Solidarity Center South Africa Senior Specialist Gillian Cassell. By first getting male union shop stewards involved, their participation in circumcision overcomes the uncertainty other men may have, and enables them to follow their lead.
“The workplace at Autozone shows that men are comfortable sharing what they’re doing, something as intimate as medical male circumcision,” says Cassell. “We’re seeing the peer pressure approach work.”
As the global community gets set to mark December 1 as World AIDS Day, reaching workers on the job and educating them about HIV prevention is an essential element in slowing—and ultimately ending—HIV/AIDS. Worldwide, the number of those newly infected continues to fall: Adults and children acquiring HIV infection in 2011 was 2.5 million, 20 percent lower than in 2001. The sharpest declines were in the Caribbean (42 percent) and sub-Saharan Africa (25 percent).
Yet there is much work to do: Globally, 34 million people were living with HIV/AIDS at the end of 2011, and sub-Saharan Africa remains the most severely affected, with nearly one in every 20 adults accounting for 69 percent of the people living with HIV worldwide. In South Africa, the HIV infection rate is nearly 18 percent for people between ages 15 and 49.
• The World Health Organization—Between 2011-2015, the World Aids Day theme is “Getting to Zero: Zero New HIV Infections. Zero Discrimination. Zero AIDS-related Deaths.”
• World AIDS Campaign—The United World AIDS Campaign site includes resources, country-specific news on HIV/AIDS and more.
• World AIDS Day Timeline, 1988-2011
For the third time in as many months Hope’s 12-year-old daughter was sick. Hope (name changed), a domestic worker in Zimbabwe’s capital city, Harare, requested and received emergency leave in order to travel to her rural home, where her daughter lived with relatives. Once home, Hope found her daughter listless, malnourished and, at 60 pounds, severely underweight. Unable to access adequate medical care in the area, Hope brought her daughter to Harare.
I encouraged Hope, my domestic worker and my friend, to bring her daughter to my house so that she could receive round-the-clock care. When the mystery ailment persisted, I suggested to Hope that she and her daughter be tested for HIV/AIDS. Together we went to the clinic at Harare’s central hospital, where both underwent the rapid test for the virus. Within 15 minutes the results were in: Hope was positive and had passed the virus to her child.
Public health protocols in Harare are simple and clear: testing, followed by counseling, education, physical exams and free antiretroviral drugs (ARVs). ARV treatment is interspersed with periodic assessments of viral load and adjustments to medication, if necessary. Within six months, Hope’s CD4 count, the white blood cells that fight infection, had doubled, and her daughter was able to return to school and home.
This week scientists, medical professionals, donors and policymakers will meet in Washington, D.C., for the International AIDS Conference 2012. Its theme “Turning the Tide Together,” reflects growing international consensus regarding the tools required to end the HIV pandemic: scientific research, medical intervention and a focus on broader public health issues, including treatment for malaria and tuberculosis.
Access to competent medical treatment and ARVs is critical to survival and quality of life for people like Hope. Just as important, I believe, was our personal partnership.
Hope exemplifies the story of a single family. However, the importance of partnership writ large is evident in Zimbabwe’s neighbor, South Africa. There, national companies, working in partnership with trade unions, are combating the virus that has killed millions, deepened poverty and set back development across sub-Saharan Africa.
AIDS is a union issue. It kills workers in their prime. And South African trade unions are using their organizing muscle and credibility with workers to reach thousands of men with education, testing and counseling.
Companies, meanwhile, provide time off for education and testing, meeting space and a willingness to modify employee handbooks and policies to emphasize the importance of accessing HIV/AIDS services. Together, they are working to destigmatize testing and treatment and help workers better protect their health. In South Africa, with support from the Centers for Disease Control, the Solidarity Center has worked with the National Union of Metalworkers of South Africa (NUMSA) in more than 100 workplaces to deliver HIV and AIDS support. Those efforts have provided 20,000 workers with HIV/AIDS education. More than 10,000 men received voluntary HIV counseling and testing. Employers have seen a decrease in the number of recorded sick days and a decline in insurance costs following the introduction of testing and counseling programs. And, many companies are looking for ways to include HIV/AIDS programs in their worker health and safety protocols.
HIV/AIDS programs like the Solidarity Center’s target workers, the majority of whom are men, some in industries where risky behaviors may be prevalent, such as long-haul trucking. The male demographic—which include men having sex with men and men in multiple relationships—can be particularly difficult to reach with public health campaigns, making the very personal approach that comes through unions a unique and often successful tool for creating change. Beyond the individual impact of the program, workers often share information with their families and friends.
Globally, through formations like the International Labor Organization (ILO) and the International Trade Union Confederation, unions have collaborated on HIV/AIDS. Initially, the global threat and death of millions of workers demanded an urgent response. As important, partners throughout the global south, particularly in southern Africa, appealed for support from their union brothers and sisters. Today, unions continue to be engaged. Years of partnership have produced a body of successful, evidence-based, workplace partnerships that should be replicated. Additionally, as advances in medical treatments result in healthier workers with increased life spans, unions are working to ensure that workers are free of discrimination and stigmatization, which are included in the social protection platform recommended by the ILO.
When international health practitioners and donors meet next week in Washington, I would encourage them to look comprehensively at all successful approaches for stemming the tide of HIV/AIDS. Medical interventions are invaluable: Without access to medicine, Hope’s daughter would have continued in a downward spiral of ill health, most likely resulting in death. In addition, as was the case with Hope and thousands of workers in South Africa, workplace interventions and employer/employee partnerships also work.
Over the last decade, labor unions—traditionally focused on worker empowerment, collective bargaining and macroeconomics—have learned to use the strengths of the organizing model and ability to develop win/win relationships with employers to target this virus that cripples individuals, families, communities and companies. As the world comes together to hone its focus on medical interventions, let us not forget the partnerships that work.