HIV programmes pay for themselves and save cash

Combating the spread of HIV among workers is not only right on moral grounds, but also makes good business sense, as Rod Newing reports

Business cannot leave the fight against HIV to governments. Beset by the high costs of absenteeism, medical costs, death benefits, and recruiting and training replacements, many businesses are taking responsibility for reducing its impact. They are educating, monitoring, treating and counselling their workforce, their families and the communities in which they operate.

“Business has a huge role to play in supporting people living with HIV, and promoting education and awareness among large workforces and networks,” says Deborah Jack, chief executive of NAT (National Aids Trust). Some companies undertake their own projects, others contribute through The Global Fund to Fight Aids, Tuberculosis and Malaria, combining their resources to attack the epidemic at a national level. Some, including Anglo American, are doing both.

“Companies can cross borders in a way that governments cannot,” says Ms Jack, “which means resources and reach are hugely broadened. In countries where HIV rates are particularly high, they support and protect both the current workforce and the next generation of potential employees.”

Business has a huge role to play in supporting people living with HIV, and promoting education and awareness

Anglo American

Two coal mines in South Africa are saving 9 per cent of the costs of HIV by making antiretroviral treatment available to their workforce since 2003. This is the finding of a research study led by the London School of Hygiene and Tropical Medicine and the Aurum Institute for Health Research.

The team reviewed ten years’ worth of data and developed a model to project forward a further ten years. Annual HIV costs of US$31.2 million for a workforce of approximately 8,000 are being reduced to $27.6 million, at an annual programme cost of $1.4 million.

Dr Brian Brink, chief medical officer at Anglo American, which owns the mines, explains that the savings come from reductions in death and pension benefits (50 per cent), absenteeism (35 per cent), training and recruitment of new staff (9 per cent), and inpatient and outpatient medical costs (7 per cent). “The investment is only 5 per cent of the cost of HIV, but you significantly reduce all these other costs,” he says.

Unlike a typical research study, which ensures complete adherence to the programme, this was based on real-life experience, where people drop off programmes and things go wrong daily. Although this represents a mining workforce in Southern Africa, Dr Brink believes that it demonstrates strongly that investment in treatment is worthwhile.

“Business needs to provide access to care, support and treatment for HIV, particularly in high prevalence settings,” he says. “It is not just something you should do, it is the smart thing to do.”

Shell Petroleum Development Company of Nigeria

Health-in-Motion is a programme that takes free healthcare services to remote rural communities in the Niger Delta. Doctors and nurses travel in challenging terrain, often by boat or helicopter, sometimes for more than five days, and often carry water, food and tents.

“This global epidemic affects our employees, contractors, suppliers and customers,” says Dr Babatunde Fakunle, Shell Petroleum Development Company of Nigeria’s regional community health manager. With decades of experience operating in these remote and volatile terrains, Shell has been able to plan and mitigate the security and logistical challenges of each journey.

The project started in 2007, funded by the company in partnership with local governmental and non-governmental organisations. In 2010 and 2011 the programme provided healthcare services to 328,000 people in 120 communities across seven states, the large majority living in poverty on less than $2 a day. HIV positive clients are referred to one of the 27 Shell-supported health facilities operated by the Niger Delta Aids Response Plus programme.

Originally focused on HIV and other communicable diseases, it has been expanded to include dental, optometric and ophthalmologic services. Partners provide advice and an army of diversely skilled volunteers. They include the State Action Committees on Aids, Rhema Care Partners International, the National Youth Service Corps, Hope Ke Abasi, God’s Intervention Support Group and Africare.

“Combating HIV in the Niger Delta is a major challenge for Nigeria,” says Dr Fakunle. “The project ensures that more Nigerians have access to healthcare and health advice where they live and work.”


In 2003, SABMiller introduced managed healthcare programmes for employees, their spouses and dependents throughout Africa. “At the time there was no visibility of the long-term benefits to the business,” says Yokesh Maharaj, human resources director of SAB Pty Ltd. “We did it because it was the right thing to do from a moral perspective.”

In order to quantify the effectiveness of its voluntary counselling, testing and treatment programmes, in 2010 the company carried out an in-depth study in South Africa using company data to gain a clearer picture of the cost benefits to the company. The study was an independent actuarial assessment by Aids Risk Consulting, which examined the direct and indirect costs resulting from HIV.

The assessment found that the company’s investment of around US$615,000 (R5 million) delivered savings of $2.8m (R22.3 million). These costs include employee benefits, human resources, medical expenses and managed healthcare.

The study also demonstrated the very important human impact of effective treatment programmes. Since the introduction of the programme in 2003, it is estimated that the company has saved 119 employees from dying of HIV-related illnesses, an average of 20 lives per year between 2003 and 2009.

“The savings demonstrated through the programme provide a clear business incentive for us to continue to encourage wider-scale participation in the HIV disease management programme,” says Mr Maharaj.

Mabati Rolling Mills

As the HIV epidemic became a national concern, Mabati Rolling Mills launched an HIV workplace and community programme to supplement the Kenyan government’s effort. “We needed to sustain company performance by teaching our employees, their spouses and the community about the epidemic,” says Bernard Munene, the company’s occupational health and safety officer. “They needed to know how to live free from infection or manage its impact, so as to improve and sustain productivity.”

The objective of the programme was to prevent new infections, and encourage and educate those already infected to manage their disease and live positively. The programme initially focused only on HIV/Aids, but was expanded to incorporate tuberculosis and malaria.

The company launched the Mabati Medical Centre in 2011, which can treat 40,000 people annually in the local community at a cost of only 200 Kenyan shillings (£1.46). The company holds annual medical camps to provide general and dental check-ups, eye tests and diabetes screening. The last reached 800 people in a single day.

Results include a 15 per cent reduction in absenteeism, a 10 per cent increase in annual productivity and a 50 per cent increase in employees seeking to know their HIV status.

“We play a major role in raising the living standards of the community,” says Kaushik Shah, the company’s chief executive. “Healthcare is an important and integral part of any organisation, and the health of every individual is important for the productivity of a nation. It is our policy to facilitate affordable healthcare in our areas of business.”