How investment pays dividends

Such is the overwhelming scale of the Aids epidemic in southern Africa that only concerted action by a global business coalition can confront the HIV threat, writes Rod Newing


With up to 25 per cent of its workforce infected with HIV, mining giant Anglo American faced a crisis in southern Africa. Increasing numbers of workers were getting sick and dying, posing a serious threat to the business.

“Having made big investments in our employees, we suddenly lost key people in key jobs,” says Dr Brian Brink, the company’s chief medical officer. “We were even training two people for key positions, to ensure that we had a back-up.”

With breakthrough Aids treatment being relatively new, expensive and somewhat untested, governments had other priorities, so in 2002 the company made the decision to offer free HIV tests to all its employees and free treatment to all in need. In 2008 this policy was extended to dependents. As one of the world’s largest mining companies, Anglo American already owned and operated health services at most mines, so it was an extension of its existing work.

Such has been the success of the programme that the company now invests £6.3 million (US $10 million) a year in testing, treatment, care and support, voluntary counselling, prevention and community health initiatives. The treatment cost in 2007 worked out at £80 ($126) per employee per month, but saved the company £139 ($219) per month. More recent analysis shows similar savings.

HIV is a massive constraint on business and economic growth in developing economies

This comes from a massive reduction in days lost through sickness, reduced cost of treating associated illnesses, retention of skills, and recruiting and training fewer new people. There are also broader benefits in improvements in staff morale, employee relations and union relations. The company made an early decision on ethical grounds not to test people before recruiting them. “We work within a community and must take what comes with it,” says Dr Brink. “Anyway, trying to exclude people who are HIV-positive doesn’t work, because they could be infected the next day.”

He passionately believes that businesses must work together and with governments, non-governmental organisations and unions to confront the disease threat. “It is a massive constraint on business and economic growth in developing economies,” he says. “With huge populations, they are the emerging markets of the future, where business opportunities are going to be created.”

Although business understands sustainable development and gets involved in environmental issues, it doesn’t yet see that health is a big and vital component of sustainable business. Anglo American promotes GBCHealth, the New York-based global business coalition, as a forum to try to get more businesses involved. One business on its own will not make a difference to the epidemic and so far only a few companies have made similar investments.

Dr Brink says that the time is now right for businesses to get together to make a collective investment. “We now have the tools,” he says. “We fully understand the nature of the epidemic and how it is transmitted, and we can easily diagnose and treat it.” Key to dealing with the epidemic is preventing new infections, which is why the company doesn’t just work with employees, but also their dependents and the communities in which they live. The latest research shows that people being treated are 96 per cent less likely to transmit the infection, so early treatment is very effective in prevention.

In addition to its annual investment, the company is also giving the Global Fund to fight Aids, Tuberculosis and Malaria £633,000 ($1 million) a year for three years. It is also giving a similar amount to the Global Alliance for Vaccines and Immunisation. Dr Brink does not describe these as “donations” and instead sees the money as a long-term business investment in health over 30 years. He believes that vaccines are one of the best investments a business can make in health.

With nearly ten years hindsight, Anglo American can see that its investment in treating Aids has been an extraordinary success. “It is within our grasp to kill the epidemic,” says Dr Brink. “It is in all of our interests not to leave it to someone else, but to approach it collectively. We must find all the people infected with HIV and provide care, support and treatment for them to stop the infection being passed on.”

This will require a significant immediate investment, but Dr Brink says that Michel Sidibé, the executive director of UNAIDS, recently summarised it very succinctly when he said: “Pay now or pay forever.”

GLOBAL FUND’S BILLIONS

“There was a sense that things should be done in a new and different way,” says Jon Liden, director of ommunications at the Global Fund to fight Aids, Tuberculosis and Malaria. “Rather than only governments getting together to fight Aids, people wanted organisations representing sufferers and business to join them. It would combine best practices from business and public development, and avoid the worst mistakes.”

The Global Fund is an international financing institution established in 2002 with the support of the United Nations and G8 major economies. It has committed £14.2 billion (US $22.4 billion) in 150 countries to support large-scale prevention, treatment and care programmes, dispersed against achievement of agreed targets.

This includes just under a quarter of all international investment in Aids programmes worldwide, including support for more than half of all people on Aids treatment. About half of the grants are distributed outside government, to missionary hospitals, non-governmental organisations, private doctors, commercial organisations and others.

Companies investing through the Global Fund are able to demonstrate in the developing national markets that they are not just there to make money, but to contribute to the country’s long-term wellbeing. Companies are increasingly scrutinised for their social practices, which can help to insulate them from a crisis.

“The Global Fund has been a highly successful experiment in providing development assistance in the 21st century,” says Mr Liden. “In ten years we have learnt and shared valuable lessons in how the public and private sectors can work together in healthcare and beyond”.