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MSD unveils guidelines to combat HIV at work place

By Henry Neondo

Merck Sharp & Dohme (MSD) unveiled here a practical blueprint of strategies and guidelines to help companies implement workplace programs for HIV prevention, treatment and care for employees, their families and the surrounding communities, when feasible.

The blueprint, developed with the help of an international advisory panel with experience in workplace programs in Africa and elsewhere, was rolled out during a workshop on Dec. 7, 2005 at the 14th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA). A crowd of more than 300 conference participants filled a meeting room at the Abuja Sheraton Hotel to hear a presentation by panel members.

Elizabeth Ashbourne, senior coordinator for private sector AIDS partnerships at the World Bank, commended MSD for continuing to take the lead in corporate engagement in the global campaign to fight AIDS. She said the company had pioneered public-private partnerships with its comprehensive effort in Botswana and was now expanding it elsewhere in Africa.

Dr. Christophe Longuet, who serves as medical director of MSD’s HIV programs, said business efforts to combat the spread of the AIDS virus were not mere humanitarian gestures but also vital to the economic survival of companies in Africa. Unless the epidemic is addressed, one-quarter of the labor force in hard hit countries such as Namibia, Botswana, Zimbabwe and Mozambique will be wiped out by the year 2010, he said.

Longuet said HIV brings increased costs for employee health insurance and other items, while also reducing productivity because of absenteeism, staff turnover and declining employee morale.

The Blueprint for Business Action on HIV/AIDS is aimed at providing firms, both large and small, with practical advice and best-practice techniques on how to begin addressing HIV among employees.

Prince-Igor Any Grah, an occupational health specialist with Unilever in Ivory Coast and member of MSD’s advisory panel, outlined the building blocks of any workplace plan. He said the foundation was management recognition of HIV as a problem and the commitment to adopt a comprehensive approach to it as a part of business operations.

Once the commitment has been made, he said, companies need to form an HIV committee to develop an HIV policy and a plan to provide prevention, voluntary testing, anti-retroviral drugs to employees who need them. He said the programs must also be monitored and evaluated, and their value communicated inside and outside the firm.

Rose Kumwenda, who heads the Malawi Business Coalition to combat AIDS, said that companies needed to launch their workplace programs by establishing a clear policy statement about HIV/AIDS. She said such a policy was needed to ensure that company plans are consistent with national laws, to establish agreed upon standards and to guide employers, supervisors and managers in carrying out workplace programs.

George Wainaina, program manager for AIDS at the Kenya Business Council, said the HIV prevention programs mounted by companies needed to include HIV education and awareness, discussion forums, peer group educators, the involvement of people living with AIDS, the distribution of condoms and in-house counseling for those infected or affected by AIDS, voluntary testing and post-exposure prophylaxis for employees.

The most common pitfalls of workplace programs, he said, is that they fail to involve staff at all levels and firms do not put enough money into them. He underscored, as well, the importance of offering treatment to those who are infected, not just prevention. Prevention and treatment go hand in hand, he said, forming a “virtuous cycle.”

Dr. Henriette Meilo, a physician who led the successful effort to get anti-retroviral drugs to Cameroon, said the provision of the medicines at the workplace requires a multi-disciplinary, team approach that includes not just a company, but also the patient, the family, the hospital and NGOs. There should be a continuum of care, ranging from the provision of drugs to combat opportunistic infections, anti-retroviral therapy and home-based care, she said.

Dr. Meilo said companies have a number of options in how they deliver anti-retroviral therapy. Companies themselves can deliver the medicines to employees, or they can be provided through managed-care organizations, private doctors, public hospitals or at employees’ homes.

She said the key elements of success for the programs include a guarantee of confidentiality for employees and their families; a company commitment not to discriminate against employees based on their HIV status; employee involvement in drawing up the programs and voluntary employee participation; and the extension of treatment to infected family members and to employees after they leave the firm.

NACA’s Emmanuel Alhassan emphasized the importance of the role of public private partnerships to ensure the sustainability of the workplace program, while GBC’s Eric Maville’s presentation on Monitoring and Evaluation clarified the necessity of implementing reliable measuring tools in order to assess the impact of the workplace program.

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