Local employers start to care for their HIV-positive staff

The world fell apart for Ghanaian primary school teacher Haruna Ibn Hassan three years ago when his wife died of AIDS and he found that he too had contracted the disease.

But at least Hassan kept his job and his sympathetic headmaster reassigned him to administrative tasks that allowed him to take more time off to receive treatment.

At the time Hassan discovered that he was infected with the HI virus, his employer, the Ghana Education Service had yet to develop a clear policy for dealing with AIDS in the workplace.

But Hassan, who is now 38, was lucky. He confided in his bosses and they were sympathetic.

"When my health began to fail, I started taking regular unannounced leaves of absence from my school to seek herbal treatment. Later, when I realised that I risked being fired for dereliction of my duties, I opened up and told my head teacher and two other superior officers about my condition," he told IRIN.

As a result, Hassan was moved to the less demanding work of assisting the Educational Circuit Supervisor in monitoring schools in the capital, Accra. This allowed him ample time to seek regular treatment at the city's Korle Bu Teaching Hospital.

"If I had been still strong enough to go about my duties normally, I definitely would have kept my status a secret. I am just lucky that the people I told of my condition knew how to handle the situation well," Hassan said.

His experience highlights the dilemma confronting most HIV-positive Ghanaian workers.

They are reluctant to disclose their health condition to their employers, fearing stigmatisation and dismissal, because there are few properly planned workplace programmes to actively help them deal with the peculiar nature of the ailment.

But slowly things are beginning to change in this West African country of 20 million people.

Ghana's National HIV-AIDS and Sexually Transmitted Infections (STI) policy, launched last year, mandates the employment ministry, the AIDS Commission and other agencies to develop a comprehensive policy on employment-related HIV/AIDS issues.

It empowers them to institute measures to ensure compliance with the new policy as well.

The International Labour Organization, the Trades Union Congress, the Ghana Employers Association (GEA) and UNAIDS have together developed general framework guidelines, but little has so far been done to implement them.

"In Ghana, where the HIV/AIDS prevalence rate is low at 3.6 percent, the priority now is more on prevention. Treatment and care should be considered but it should not take the utmost priority," Kwasi Ampadu-Yeboah, GEA's industrial relations manager told IRIN.

Several multinational companies operating in Ghana, such as Coca-Cola and the French-based trading group CFAO, already implement policies to help their HIV-positive employees and their families access proper treatment and lead normal lives.

But elsewhere, where an AIDS policy in the workplace exists at all, it is mostly centred on awareness training by specially designated members of staff and peer counsellors.

"We realised quite early the menace that HIV/AIDS posed to our workforce, especially looking at the experiences of our sister companies in Southern Africa," said Jacob Amegashitsi, Coca-Cola's training and development manager in Ghana.

"Our workplace programme is functioning and is open to any member of our 750 workforce, who will want to take advantage of them," he told IRIN.

Coca-Cola Ghana has pumped nearly US $21,000 into the its comprehensive workplace programme for dealing with HIV/AIDS since it was launched in 2002.

It has arranged specialist treatment for its HIV-positive workers at three private clinics in Accra and Kumasi, Ghana's second largest city 250 km to the northwest. All of them enjoy strict confidentiality.

CFAO, which like Coca-Cola runs AIDS awareness and prevention programmes for its 250 Ghanaian staff, said it aimed to put in place a treatment and care programme for all its HIV-positive employees, their spouses and their children, by the end of this year. This would include free voluntary HIV testing.

Multinational companies are in a stronger position to implement comprehensive workplace programmes for their staff than most of their indigenous Ghanaian counterparts. They have the necessary resources to pay for treatment and care and experience of dealing with more serious AIDS problems in other countries.

The Ghanaian government currently only provides subsidised treatment and care for people living with AIDS at four state-run hospitals in the country.

And only 2,100 out of the 71,000 Ghanaians living with AIDS who would benefit from antiretroviral (ARV) drugs to improve their health and prolong their lives, actually receive subsidised ARV treatment.

That means that some companies keen to implement a comprehensive package of benefits to their HIV-positive staff are forced to pay the full commercial price for their ARV drugs.

Research conducted in Ghana by Family Health International in 2003 found that the annual cost of treating persons infected with HIV varied enormously depending on the stage of their illness and the level of clinical care and viral load monitoring required.

While it cost up to US $33 a year to treat opportunistic infections suffered by people in the early stages of AIDS, the cost increased significantly for those who required ARV therapy and viral load monitoring to US $1,120 per year.

"We have projected that about one to two percent of our annual staff expenses of US $1.2 million will be needed to fund the treatment and care phase, which we hope to start by the end of the year," Thomas Pelletier, CFAO's managing director in Ghana told IRIN.

"The most important thing for us is the human aspect," Pelletier said, "Although of course, at an economic level we also consider this to be an investment for the future."

But while profitable multinationals are prepared to make such an investment to retain and protect their highly trained and highly paid staff, few indigenous Ghanaian businesses are prepared to foot such a bill.

According to the GEA, some professional associations, such as the Garage Workers' Association, which groups Ghanaian mechanics, are developing general AIDS policies which in time will trickle down to their members through awareness and prevention programmes. But they are not yet making any provision for treatment.

"Unfortunately, most indigenous businesses do not take issues of HIV/AIDS seriously. Most of them are thinking of surviving financially in today's difficult business environment. We have just scratched the tip of the iceberg by trying to get our companies to effectively implement workplace programmes," Ampadu-Yeboah of the Ghana Employers' Association said.

AIDS activists warn that small businesses as well as big companies need to face up to the AIDS problem before it gets out of hand, as has occurred in Southern Africa, where in some countries more than 30 percent of the population is HIV positive and people falling ill and dying from AIDS are leaving behind critical shortages of skilled manpower in the economy.

"West Africa is lagging behind east and South Africa, where workplace policies on HIV/AIDS are actively being implemented," Nana Poku, HIV-AIDS research director with the United Nations Commission on HIV/AIDS and Governance in Africa, told IRIN.

"There is the mentality that this region is the least affected on the continent. This is dangerous. It would lead into complacency and manifest in phenomenal increases in infections rates. From 1992 to 1998 Cameroon for instance witnessed a six-fold increase in its HIV prevalence rates," Poku noted.

Already in Ghana, some donors are pushing the AIDS agenda in small business. The African Development Fund (ADF), for example, insists on Ghanaian companies putting in place an HIV/AIDS policy as a condition for providing loans to help them improve the working conditions of their employees.

"The health of the employees is a fundamental factor for the proper running of a business," said Baba Adongo, an investment consultant for the ADF, which is funded by the US government.

"For several years, we have found that HIV/AIDS can lead to the failure of all efforts to improve the lives and working conditions of employees. That is why the new ADF policy is to demand that borrowing businesses use part of the funds allocated to them to devise HIV/AIDS training and awareness programmes for their staff."