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The Nature Of The AIDS Pandemic In Africa's Workplace

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HIV/AIDS has dismembered the economic, educational, political, social and psychological fabric of African society. Speaking at the UN Security Council session in 2000, former World Bank President James Wolfensohn wailed: “Many of us used to think of AIDS as a health issue. We were wrong…nothing we have seen is a greater challenge to the peace and stability of African societies (and much of the world) than the epidemic of AIDS…we face a major development crisis, and more than that, a security crisis.”

Immediate South African President Thabo Mbeki saw AIDS as “a uniquely African catastrophe,” but wasted valuable time before deploying the resources of his government against this obvious truth. Mbeki distrusted anti-retroviral drugs which his Health Minister Mrs Manto Tshabalala-Msimang called “poisons.” Though his government commissioned a study in 2003 which said that 1.7 million deaths could be prevented by year 2010 if all AIDS victims got anti-retroviral drugs, it sat on the report for over three months until the press leaked it.

In 2000, Mrs Manto Tshabalala-Msimang wrote that HIV virus was created by the West to annihilate Africans. Malegatho Mandela, 54, lawyer/businessman son of Nelson Mandela died of HIV at Jo'burg's Linkfield Park Clinic on January 6, 2005. Mangosuthu Buthelezi, the Inkatha Freedom Party leader late 2004 lost two adult children to AIDS. Pledging to fight the pandemic “henceforth with my last breath,” he described HIV as “worse than apartheid.”

Col Muammar Qaddaffi graduated African tomfoolery about HIV to unprecedented heights. In an address to the Africa Union July 2003, the late dictator rejoiced that HIV was a “peaceful virus,” God's instrument of keeping white colonialists out of Africa! Incredibly; his fellow heads of state never disagreed with him.

As the ex-Libyan Maximum Leader spoke, millions of his fellow Africans were dying from the “peaceful virus,” not white colonialists! However, some statesmen were wiser. Former US Vice President Al Gore told a UN Security Council meeting January 2000 that AIDS is “a security threat of the greatest magnitude.” In agreement, former Botswanan leader Festus Magae confessed: “We are frightened.” At the 12th International Conference on AIDS in Africa in Burkina Faso December 2001, it was estimated that 28 million Africans will be felled by AIDS by 2003. Bill Clinton lamented before an international AIDS conference, Barcelona July 2002 that the AIDS pandemic is the greatest tragedy to afflict mankind since the bubonic plague. Nelson Mandela told the same conference that 25 million African children would be orphaned in a decade. Before the pandemic, Africa had one in fifty orphans. By 2000, it was one in ten!

Former UN Secretary General Kofi Anan told the BBC 2004 that AIDS is “a real weapon of mass destruction.” The failure of governments worldwide to tackle the pandemic in the opinion of this international civil servant, qualifies as “callousness that one would not have expected in the 21st century.” The judgment of history on us all in his opinion will be “harshly, very harshly.”

CONSEQUENCES OF HIV IN AFRICA'S WORK PLACE
Fearsome statistics don't come more complicated than the ravages of the HIV/AIDS pandemic. Globally, 24.6 million workers were infected from 2006 figures by the International Labour Organisation, ILO. 28 million workers had died as a result of HIV/AIDS by 2005. In the continuing tragedy, an estimated 74 million workers will die as a result of HIV/AIDS by 2015. Between 1992 and 2004, 43 countries heavily affected by HIV/AIDS lost a yearly average 0.5% rate of economic growth to the pandemic. Some estimates reveal losses in GDP of up to 2.3% in nations with HIV infection rates of over 10%.

Though statistics are sketchy, Africa's endangered economies burdened by corruption, inflation, high costs of doing business, multiple taxes and poor infrastructures are reeling under the weight of the HIV fire. AIDS kills and aborts valuable skills, decimating overburdened, underdeveloped and inefficient utilities. Observers mourn the waste of public and private sectors technocrats educated at great costs to power the continent's economic development.

A third of the workforce in some sub-Saharan African nation's live with the virus. Fewer trained workers mean slimmer and emptier health schemes and lower productivity. “The way in which we deal with AIDS will to a large extent determine whether we remain a poor continent or whether we grow,” warned Kwame Owino, a researcher with Kenya's Institute of Economic Affairs as the pandemic took hold in 2000. HIV results in attrition rate of about 20 civil servants in Tanzania monthly.

The Kenyan Revenue Authority lost 40 of its 4,200 staff to AIDS related sicknesses in 1999, according to Kennedy Onyonyi, its public relations manager. He wailed that “when we lose someone it takes time to fill that gap” because some of the dead were its brightest graduates. Onyonyi sighed that “the fear is there that AIDS could eat quite a big proportion of our revenue, our workforce is aging because we're losing a generation of professionals.” Kenya's Sony Sugar company lost just 2 of its 1,700 staff to AIDS in 1988, but bled over 40 in 2000. Because older people are less promiscuous, some firms prefer them to younger staff. Though forced blood testing is frowned at by many unions; rights groups and HIV/AIDS activists, many firms condition hiring and promotion on regular testing.

Africa's productivity and growth has suffered because some bright graduates stick to uninspiring jobs and positions instead of going for blood testing for health cover that may expose their HIV status in high flying jobs. Many African workers have no life and mortgage policies because of prying questions by underwriting companies that conduct blood tests. James Osumo, a manager with Kenya's Kabage and Mwirigi Insurance Brokers affirmed that “sometimes people are reluctant to go through all that. Obviously, it has serious financial and moral implications for our industry.” More than half of Kenya's 25-29 year olds, its productivity segment are affected. Botswana will lose 1/3 of its workers to AIDS by 2015.

Tanzania government offices lost a fifth of its workers averagely by 2001. Though African governments are not open about the economic consequences of HIV on their economies and workers, it's no less devastating. Some are in more critical stages than Kenya, East Africa's largest economy. While dearth of reliable statistics is a problem in Nigeria, West Africa's largest economy and Africa's second largest economy and most populated country, the grim reaper has no less a harvest of workers and economic attrition there. Young people between the ages of 15-24, the nation's potential and active workforce were especially hit by the virus.

The public and private sectors has lost highly trained and experienced technocrats. Though the defence establishment denied it, ECOMOG {Sierra Leone and Liberian born} wives were expelled from army barracks and some of their husbands dismissed because of the threat AIDS posed to army combat readiness and national security. The various wars on the continent favour this grizzly enemy in its harvest of havoc. The various conflicts have necessitated interventionist and peacekeeping army brigades on assignments without their wives. These infected solidarity brigades return to infect wives, concubines and workers.

War and its attendant disequilibria – mass rapes, sexual slavery, internally displaced refugees, unhygienic lifestyles, breakdown of health facilities, disruption or lack of information access and NGOs absence tell on the morale and productivity of Africa's workers. In 2000, one quarter of South Africa's miners, one fifth of its construction workers and 19% of all its workers were projected to have AIDS in 2015. The ILO in 2000 decried how AIDS impacted on sub-Saharan Africa's workforce and enterprises that create the continent's wealth. It reckoned that twenty countries will experience smaller work forces in the decades to come.

The United Nations Fund for Population Activities UNFPA's State of the World Population 2004 address contended that “studies show that if 15% of a country's population is HIV positive, its GDP will decline by 1% a year.” Because the major route of HIV infection in Africa is heterosexual sex, women are infected more than men.

Unfortunately, women do three quarters of all agricultural tasks in Africa. Because of their high infection rate, there is resultant shortage in food production. This has brought about drop in investment, schooling and GDP. From the crystal ball of the National Intelligence Council, an advisory agency to the CIA, the disease is likely to negatively impact almost all sectors of Nigerian economy by 2010.

HIV's toll heavily robs Africa economically of key government, professional and business elites and discourages foreign investment, although the oil sector is unhurt significantly. The World Bank in 2000 estimated that AIDS will dim some African economies to about 25% by the year 2015. A turning point in the fight against the pandemic came in 2007. After years of hostility, business began to respond positively with aggression and creativity. “The single most distinctive trend over the past twelve months is the private sector response to AIDS in Africa, the growth of public-private partnerships {PPPs} in AIDS and health care infrastructure,” said Victor Barnes of the Corporate Council of Africa's AIDS Initiative for Africa. Unemployment has been aggravated by reduced consumer spending and layoffs from AIDS.

Africa looses workers in their prime to the AIDS pandemic because of reduced life expectancy. Thanks to AIDS, life expectancy in Africa is a brutish 48 years, about 15 years below the world average. In southern Africa, it is below the world average by nearly 20 years! Profits of African businesses have gone south due to testing, health care, re-training, sick leaves, medical benefits costs {where applicable}, lost man hours and funeral expenses. Dysfunctional families have not allowed workers to perform optimally as a consequence of the ravaging AIDS bush fire.

Figures from the National AIDS Control Council of Kenya projected the annual per-employee cost of the epidemic to rise by 160% between 1997 and 2005. AIDS was calculated to have reduced Kenya's GDP by $10 billion by 2000. Health Minister Sam Ongeri had no doubt that “the economy is being decimated.” The Central African Republic closed about two hundred primary schools a decade after AIDS began to ravish the impoverished nation, thus foreclosing its developmental workforce and national growth. From studies conducted 2000 by the Economic Commission for Africa, 15-20 per cent of Nigerian soldiers live with the AIDS virus, triple the national average. The African average was put at about 13%.

As the experience of ECOMOG wives showed in Nigeria, Africa's female workers who have AIDS face another war: Sexism. Men receive more sympathy and confidentiality while she's called a “prostitute.” Even male patrons of sex workers who infect them are not vilified like hapless females. While sex workers in some EU countries have legal protection and health care, Africa's sex workers are at the mercy of police authorities who routinely raid and rape them.

The internationalization of the sex trade that makes African women sell their bodies in Europe has added a tragic dimension to a sordid tale. Because these women are trafficked illegally in Europe, they are not availed legal protection which leaves them at the mercy of heartless and exploitative mafias that benefit from the sex slavery. The CIA became afraid that the spread of AIDS could threaten US national security. Nigeria will boast of between 10 and 15 million PLWHA by 2014, overtaking South Africa, the continent's economic powerhouse as the world's leading HIV positive nation from the second position. The total number of Nigerians with the virus will outnumber the infected in Uganda, Mozambique, Botswana, Lesotho, Namibia, Zimbabwe, Swaziland and Zambia put together.

MEASURES TO COMBAT HIV/AIDS PANDEMIC IN AFRICA'S WORKPLACE

HIV/AIDS impacts on the economic status of workers, their families, businesses and Africa's communities. Households under siege by HIV/AIDS experience loss of productive labour, income, schooling, savings, training, growth, investment and food security. They are drained financially, spiritually, socially and emotionally. It's essential that at such periods, support structures be in place at all levels. Quality personal and family counselling help to mitigate the stress, wear and tear such victims and their families go through.

Many businesses have awareness campaigns that highlight the consequences of AIDS on their workers, business and community. Martin Lutalo of the International Finance Corporation, an arm of the World Bank noted 2007 that "corporate AIDS responses are becoming more integrated. As treatment and anti-retrovirals become increasingly available, companies are able to provide a fuller continuum of care for their employees and dependants." Phones for Health is a Nigerian and Rwandan partnership that links MTN, Voxiva, Motorola, Accenture and other businesses in joint collaboration in health care delivery.

From 2000, the IFC has partnered with corporate clients in analyzing the business risks presented by HIV/AIDS. It assisted with guidance on design and implementation of education, prevention and care programmes. The aim of the IFC, according to Lutalo is to protect workers and profitability as a risk management partner, a fountain of HIV expertise and a catalyst for AIDS action. Workers need a wellness agenda that will increase their morale and efficiency due to reduced absenteeism while businesses need overall improvements in their corporate image. Businesses without health care and wellness initiatives won't survive and grow.

Some businesses put AIDS-awareness messages in invoices and receipts. They leave free condoms in company toilets, reception areas and cafeterias and refer employees who need counseling and treatment for sexually transmitted infections to appropriate health facilities where services were free. They also partner with other organizations to provide antiretroviral therapy. Some corporate businesses checkmate HIV/AIDS by extending full worker's coverage to such diseases like malaria, tuberculosis, hypertension, heart disease and diabetes. From 2001, the IFC's US$1.4 billion Multi-Country Programme for Africa funnelled support via national AIDS coordinating bodies to help business coalitions grow private sector components in national AIDS strategies, expand workplace programmes in support of prevention, mitigation and treatment services.

NGOs such as Hope help develop effective HIV-in-the-workplace programmes and provide micro-credit to Small and Medium Enterprises SMEs, in support of widows and orphans of AIDS. In 2005 on-farm surveys, “cocoa farmers in West Africa identified AIDS and malaria as the two most important health issues facing their families," says Bill Guyton, President of the World Cocoa Foundation, an industry trade group of over 60 chocolate firms. The WCF and the National Confectioner's Association gave birth to Family Health International, an NGO for cocoa farmers. "Through the improved training material, an estimated 150,000 cocoa farmers will have improved information on AIDS and malaria prevention. This is a win-win for farmers, the chocolate industry and West African governments," enthused Guyton.

African governments should advocate that businesses follow the example of Anglo American which gave ARTs to its infected employees from August 2003. Anglo later extended the treatment to families of such employees. October 2003, it commenced a 3-year plan to spend $4.5 million for HIV testing and AIDS treatment in South Africa and rehabilitation of 900 of the country's public health facilities.

Anti-retroviral drugs have saved over two million lives from AIDS-related deaths. 6.65 million infected people receive anti-retroviral drugs in low and medium countries, but 7 million People Living with HIV/AIDS {PLWHA}, still don't. In Nigeria, only 500,000 out of the estimated 3 million infected persons that qualified for ARV received it in 2011.

African governments must evolve responsible strong political leadership that will not live in denial of the epidemic. Political leadership must take the lead in demystifying the pandemic. Religious, traditional, entertainment, sports and businesses icons should be recruited in the awareness campaign. Traditional and religious authorities should be co-opted into measures to promote high risk behavioral change. Dr. John Onaiyekan, the Catholic Archbishop of Abuja laid a good example. “We should all preach it loud and clear” declared the clergyman, “that HIV and AIDS are not punishment from God on sinners, and that care for the infected is a holy act pleasing to God.” At the federal, state and local government levels, improved health care systems and health personnel must be functional and affordable. It's important that local production of anti-retroviral medication begins. At the 12th International Conference on AIDS in Africa in Burkina Faso 2001, Burkinabe civil servant Mariam Konkobo Saba who lost her husband and three children to AIDS complained that she couldn't afford monthly bill of US $95 anti-retroviral drugs on her yearly income of US$235!

Africa needs reliable data base for its HIV/AIDS population by gender, age and occupation. It must be updated for educative programming, improved STI intervention and relevant treatment. It must put in place effective policy and advocacy programmes in conjunction with human, gender and HIV rights groups, Big Pharma, multilateral and international agencies. Academia and research institutes must be funded by state and non-state sponsors to undergo HIV/AIDS research. It's important that infected pregnant African females don't lack access to Nevirapine which stops mother-to-child transmission at birth. The media should execute HIV surveillance initiatives, sex worker health and education campaigns and condom use in the national population without projecting it as licence for sexual immorality that may offend religious groups.

Modernity in Africa occasioned loose sexual behavior, open homosexuality {legal only in South Africa and cash strapped Botswana}, rapes, incest and sodomy that fuels AIDS. Various degrees of belief spectrum are allies of this devastation of the African worker. An erroneous impression is strong in South Africa that sex with a virgin is a cure for AIDS, bringing about unprecedented rates of rape, incest and greater infection rates. A largely unconvinced Liberian population defines AIDS as American Intention to Discourage Sex! Western indifference to the plight of African workers under AIDS threat is also appalling.

In a continent where workers live on less than one United States dollar daily, it is horrendous to expect an infected worker to afford $8000 annually for retroviral drugs. HIV positive African workers buy Fluconazale in its patented form for US$18. Their higher paid Thai counterparts get the generic form for only thirty cents!

Dr Gordon Ambayo of Sony Sugar Kenya; observed the variables of the pandemic. “It's just a straight line up. There's a lot of extramarital sex here as well as wife inheritance. We try to educate the workers about the dangers, but they are not getting the message.” Africa has a few success stories against the raging HIV epidemic. Senegal saw its first HIV case in 1982 and began to screen for AIDS before transfusing blood in 1987. The government partnered with local community leadership, schools and the media in its awareness campaign for safe sex.

In 1995, Senegal's Islamic leadership strongly disagreed that AIDS was a divine scourge for immorality. The government reduced taxes on condom, increasing usage from 1% to two-third and 50% for men and women respectively. Senegal's worthy prevention programme brought about today's low adult prevalence rate of 0.8%. Uganda had its first case of HIV in 1982. Complacency gave the disease the power of life and death over one in four Ugandans in some districts by 1990. By 1992, it was on a roller coaster with one in twenty six people infected nationally partly due to the civil war. Shocked, President Yoweri Museveni went on the offensive. He embarked on public awareness campaigns about HIV, safe sex and established a national commission to checkmate the affliction. The media was enlisted in the war. Impressed with the openness and zeal of the Ugandan government; foreign donors poured in money and materiel.

These measures began to bear fruit. By 1996, infection rate in teenage women in a testing site in Kampala fell to 9 per cent from 26 per cent in 1992. Nationwide, Uganda achieved 8% infection rate by 2005. “We have had some humble successes,” rejoiced Dr. David Kihumuro-Apuli, the Director-General of Uganda's AIDS Commission. Botswana from a seemingly hopeless situation, fought back valiantly. In December 2002, it introduced a female condom, the first of its kind in Africa. It had good political sense, excellent health institutions, trained doctors and nurses, affordable anti-retroviral drugs, functional testing labs, rich foreign backers and credible awareness campaign to make a dent on HIV/AIDS over time.

Timely political leadership, honest acknowledgment and effective nationwide prevention helped it to contain this fire of affliction. Sadly, few African countries are equipped politically and economically like Botswana.

Many governments are careful before placing PLWHA on anti-retroviral drugs because the moment they commence treatment, they remain placed on it for life. Bureaucrats are careful not to enroll those who may not maintain the drug regime for life. Another handicap is that in Nigeria for example, 93 per cent of all HIV/AIDS activities are bankrolled by donor agencies whose long term commitment cannot be taken for granted.

Therapy come with risks, ARTs have short and long term side effects. The virus may master the therapy and bluff it. Such resistance then militates against future treatment.

ADDENDUM: Christian ministry necessitated this abiding interest in the HIV/AIDS pandemic that spares no class, tribe, tongue or race.

Pastor Emeka's first book, The Intercourse of Troubled Thoughts was published by Author House Inc., Indiana, USA.

Disclaimer: "The views/contents expressed in this article are the sole responsibility of Emeka Anumbor and do not necessarily reflect those of The Nigerian Voice. The Nigerian Voice will not be responsible or liable for any inaccurate or incorrect statements contained in this article."

Articles by Emeka Anumbor