Memorandum submitted by Anglo American
plc
ANGLO AMERICAN'S
RESPONSE TO
THE AIDS CRISIS
IN SOUTHERN
AFRICA
1. The Company
1.1 Anglo American plc was formed from the
merger of Anglo American Corporation of South Africa and Minorco
SA and established its primary listing on the London Stock Exchange
in May 1999.
1.2 Anglo American is one of the world's
largest mining and natural resources groups. With its subsidiaries
and joint ventures it is a world leader in gold and platinum group
metals and has substantial coal, base metals, industrial minerals
and forest products operations. In Southern Africa the Company
has recently invested in acquiring the majority of the Zambian
copper mines and announced plans for a $2 billion expansion of
its platinum operations and significant new investment in zinc
production in South Africa. Thus, whilst we have considerable
experience of the tragic toll being taken by the HIV/AIDS epidemic
it does not lessen our confidence in, or commitment to, the region.
1.3 The Company has significant operations
in over 30 countries. As at 31 December 1999, including both wholly
owned companies and those in which Anglo American holds a majority
interest, including the independently managed AngloGold, the Company
employed some 229,000 people distributed as follows:
| South Africa | 200,000
|
| Rest of Africa | 12,000 |
| Australia and Asia | 2,000 |
| Latin America | 5,000 |
| North America | 4,000 |
| UK and Europe | 6,000 |
During the first six months of 2000 the numbers attributable
to the rest of Africa, Australia and the UK and Europe will have
increased due to acquisitions.
2. The HIV/AIDS Epidemic in Southern Africa
2.1 This paper concentrates upon the experience of our
operating companies in combating HIV infection amongst our workforce
in Southern Africa. As the Committee will be aware, Southern African
countries are experiencing the world's most severe HIV/AIDS epidemic.
Anonymous surveys of pregnant women at antenatal clinics provide
the most consistent information about HIV prevalence levels. The
following figures illustrate the severity of the problem:
— in Zimbabwe, antenatal HIV prevalence reached
39 per cent in Harare in 1996; the country is now experiencing
high numbers of AIDS cases and deaths;
— Botswana has a severe epidemic with levels of
39 per cent being recorded in Gabarone in 1998;
— Zambia has had an HIV epidemic for longer than
its neighbours to the south. Its antenatal sero-prevalence has
reached a plateau at around 28 per cent. In 1997 over 50 per cent
of clinical consultations and 70 per cent of hospital medical
admissions were reported to be HIV-related; and
— South Africa's national antenatal prevalence was
estimated at 22.4 per cent at the end of 1999, 0.4 per cent lower
than in 1998 (but compared with less than 1 per cent in 1990);
Kwa-Zulu Natal has a rate of 32.5 per cent and Mpumalanga and
the Free State 28 per cent.
2.2 Of the 34 million people believed to be living with
HIV/AIDS, 70 per cent are estimated to live in sub-Saharan Africa;
home to only 10 per cent of the world's population. In this region,
during 1999, some 4 million people became infected with HIV and
1.8 million died from AIDS. In South Africa some companies are
losing around 3 per cent of their workers each year to AIDS.
2.3 High levels of HIV infection are found in both rural
and urban contexts. Infection is not confined to particular social
groups or industry sectors. The rate of infection tends to be
higher amongst the less skilled sections of the workforce. In
all countries the highest level of infection is found amongst
young adults. This means that the workforce is disproportionately
affected relative to the population as a whole. The peak age for
infection amongst women in Southern Africa tends to be 8-10 years
younger than amongst men. Prevalence amongst women appears to
be higher than for men in the region.
3. Socio-economic Impact
3.1 HIV/AIDS represents an enormous human tragedy in
a region which is already struggling with more than its share
of social, political and economic problems. Sub-Saharan Africa
starts with the lowest proportion of skilled workers of any geographical
region and with a disproportionate share of the world's poorest
countries. The region is least able to absorb the increased medical
and social costs caused by HIV/AIDS or the loss of skilled and
educated people who are already in short supply. Furthermore,
the high incidence of HIV/AIDS in Africa reinforces the negative
perceptions which some international investors have of the Continent,
risking discouraging the private capital investment which Africa
so badly needs.
3.2 The progress of the epidemic and the reasons for
its continuing spread have to be seen within the context of a
series of linked social problems including: poor education; poverty
and associated phenomena such as high levels of prostitution;
low status of women; a weak healthcare infrastructure and a high
incidence of other sexually transmitted diseases which make HIV
transmission more likely.
3.3 In Southern Africa life expectancy is falling and
is projected to be only 45 by the period 2005-2010. A recent study
conducted by ING Barings estimates that almost 19 per cent of
all skilled workers in South Africa will have HIV by 2015. They
conservatively estimate that the economic impact of the disease
will be to depress the country's annual growth rate by 0.4 per
cent (2006-2010) and by 0.3 per cent in 2011-2015. In Tanzania
it is estimated that by 2010 the labour force will have shrunk
by 30 per cent because of HIV/AIDS and that the mean age of workers
will fall from 32 to 28.
3.4 The World Bank estimates that once the disease reaches
8 per cent of the adult population per capital growth is reduced
by 0.4 per cent annually and once infection rates exceed 25 per
cent the cost to economic growth is at least 1 per cent per year.
3.5 The overall economic impact of HIV/AIDS in Southern
Africa is likely to include:
— reduced active working life expectancy (according
to the ILO an average of 15 years of working life will be lost
per employee due to HIV/AIDS);
— loss of trained employees and the need to train
additional manpower to compensate for impact of HIV/AIDS;
— lower labour productivity;
— reduced attraction for international investment
due to increased perceived country risk;
— lower unemployment but exacerbation of existing
skill shortages;
— an increase in the numbers of orphans and the
disruption of traditional family support systems;
— lower domestic demand/economic growth;
— an increase in numbers living in poverty;
— diversion of public and private sector resources
into healthcare.
3.6 At the level of individual companies in the region
the impacts are:
— cost pressures arising from increased training;
staff replacement costs; skill shortages and higher benefit payments;
— lower productivity inter alia through absenteeism
(eg nursing relatives; attending funerals, etc) and illness;
— disruption from the deaths of key workers;
— reduced competitive advantage relative to firms
located outside areas of high HIV/AIDS incidence; and
— increased pressures on pension funds and risk
benefit schemes.
3.7 Metropolitan, a diversified Southern African financial
services group, produced estimates in 1999 which predict that
for many retirement funds the cost of an average set of benefits
will double by 2005 and treble by 2010. Metropolitan also believes
that the indirect costs of HIV/AIDS (sickness and funeral attendance;
scarcity of skilled staff; training; low productivity of new staff
and low morale) will add costs equivalent to 10 per cent of the
current remuneration budget up to 2005 and the equivalent of 15
per cent by 2010.
4. Anglo American and HIV/AIDS
4.1 Anglo American's strategic approach to HIV/AIDS has
evolved over a period of 15 years. Initial efforts were focused
on awareness, education and the prevention of HIV infection. With
the advance of the epidemic over the ensuing 10 years, the emphasis
shifted to "Minimising the impact of AIDS". This strategy
relied on a twin pronged approach—"Prevent it"
and "Manage it".
4.2 In the year 2000, our strategy has further evolved
to one of "Total Management Commitment" encompassing:
— a comprehensive HIV prevention response; and
— specific and measurable management plans to control
and minimise the identified impacts of the HIV/AIDS epidemic on
operations.
In the course of defining "Total Management Commitment",
Anglo American has tried to identify all the elements of "best
practice" in the prevention and management of HIV/AIDS. The
problem is that on its own each element is a necessary but insufficient
component of an effective response. The challenge will be to integrate
all these elements into a comprehensive prevention and management
programme.
4.3 The testing and development of prevention and management
strategies has been informed by the experience of the Company's
operations in Zimbabwe, where the impact of the epidemic started
several years earlier than in South Africa. Using statistical
modelling techniques, the prevalence of HIV infection in the Zimbabwean
workforce is estimated to be 24 per cent. Information derived
from Group pension funds' data indicates that deaths due to AIDS
have accounted for over 60 per cent of all deaths over the last
six years. The death rate in 1999 was 8.4 per 1,000 employees,
which rate has remained relatively static for employees in service
over the years. The ill-health early retirement rate was 16.9
per 1,000 employees in 1999. This rate has increased by 73 per
cent over the last six years because of specific incentives designed
to encourage ill-health early retirement. The impact of HIV/AIDS
morbidity and mortality is felt hardest in the less skilled section
of the workforce where the exit rate due to death or ill-health
is 2.8 times that of highly skilled employees. We estimate that
up to 40 per cent of lost time at the Company's Zimbabwean operations
is due to the direct or indirect effects of the epidemic. To counter
these losses, the concepts of multi-skilling and self directed
work teams have been implemented at many of the operations. By
these means it is proving possible to maintain production targets.
A COMPREHENSIVE HIV PREVENTION
RESPONSE
4.4 The prevention of new infections is a crucial component
of all workplace HIV/AIDS programmes and the most cost-effective
route to reducing the impact of the epidemic. The backbone of
our prevention programme historically has been made up of the
following activities:
— treatment of sexually transmitted diseases—in
employees and partners.
— distribution of free condoms.
However, we have now identified additional elements which
assist in the prevention process and these have been incorporated
into an expanded and more comprehensive programme.
4.5 The elements of this programme, with examples of
how they have been put into practice in the Anglo American Group,
are outlined below:
(i) HIV/AIDS Policy and Strategy Development
4.6 Anglo American has for many years disseminated an
overall group AIDS policy. A key feature of this policy is that
it does not discriminate on the basis of HIV status. The main
points of the current policy:
— whilst applicants for employment are required
to pass a standard pre-employment medical examination, this does
not include an HIV test.
— employees who become HIV-positive will continue
to be employed until they become medically unfit to work. Employees
who become HIV positive are not obliged to inform management.
If they choose to do so, every effort is made to protect the confidentiality
of the information.
— information and education programmes on HIV/AIDS
are made available to all employees.
— employees affected by the disease are given access
to counselling and support services.
— medical assistance is provided to HIV-positive
employees in accordance with their medical benefit arrangements.
When an employee is no longer able to continue in employment due
to ill-health the Company's general rules governing ill-health
and retirement apply.
Whilst the initial focus of the policy was towards important
human rights issues, such as non-discrimination, there is now
a need to include issues relevant to the sustainability of business
operations.
4.8 It is also important that the policy should reflect
a shared vision between management, unions and employees. The
importance of a joint responsibility for and ownership of measures
designed to tackle the HIV/AIDS epidemic should not be under-estimated.
4.9 The Group HIV/AIDS policy requires continual review
and updating in order to take account of the progress of the epidemic,
changing attitudes and the rapid advance of knowledge.
(ii) Developing culturally appropriate prevention messages
4.10 Talking about sexual matters is taboo in many areas
of operation, not only between managers and workers, but also
amongst peers. Thus, innovative ways to communicate HIV prevention
and education messages have been sought. It goes without saying
that understanding and impact are greatly enhanced by ensuring
that messages are delivered within the cultural context and in
the vernacular language of the target audience. In Southern Africa,
this can be a particular challenge with its rich diversity of
culture and language.
4.11 Song and drama are popular ways of dealing with
sensitive issues. Many Anglo American operations have engaged
industrial theatre companies to convey HIV/AIDS education and
prevention messages in this way. In other instances, employees
have formed their own drama groups and devised their own scripts
involving HIV/AIDS awareness themes as well as other topical issues
such as crime, interpersonal violence and other public health
concerns.
4.12 HIV prevention messages have to recognise the realities
in relation to polygamy and commercial sex work, whilst at the
same time seeking to reduce the danger of infection. Thus, at
many operations, mine-based medical services now provide primary
health care to the partners and dependants of employees, including
health education, counselling and the treatment of sexually transmitted
diseases.
4.13 Traditional healers still play an important and
influential role in Southern African society and it has been recognised
that working with them is an important component of an HIV prevention
response. Anglo American medical staff at the Mondi Paper Company
have engaged traditional healers to reinforce HIV prevention messages.
They have also advised them on safe consulting practices; on how
to avoid HIV infection themselves; and on avoiding transmission
between clients via contaminated instruments.
(iii) Tackling socio-economic factors
4.14 In Southern Africa, the mining industry is by no
means the only, or even the worst hit industry affected by the
HIV/AIDS epidemic. HIV infection rates amongst employees within
the Anglo American Group are comparable to those in wider society.
The HIV epidemic is exacerbated by widespread poverty, illiteracy,
mobility and unstable living conditions. To the extent that Anglo
American is a major employer in the region, this in itself counteracts
the root socio-economic causes of the epidemic.
4.15 One of the most important contributions Anglo American
continues to make in reducing the spread of HIV in Southern Africa
is through its social upliftment activities. Although many of
these may not have initially been designed with the HIV epidemic
as a focus, their role in addressing the social factors which
contribute to the spread of the epidemic makes them a central
part of the Group's HIV prevention response. Community projects
supported by Anglo American include education initiatives, small
business development, improved healthcare and general welfare
initiatives. One of the main areas in which HIV/AIDS associated
requests for funding from the Anglo American Chairman's Fund (which
finances social investment projects) are expected in the future
is for help with orphan-care and home-based care projects for
the terminally ill.
4.16 Given the high incidence of poverty in the region,
Anglo American companies have sought innovative ways to create
sustainable economic opportunities for marginalized and needy
communities. By way of example, Mondi (Anglo Forest Products)
sponsors the Khulanathi Woodlots project which provides men and
women from rural communities along the coast of Kwa-Zulu Natal
with opportunities to grow commercial woodlots with advice and
assistance from Mondi. The Company secures an additional source
of wood fibre through an agreement to buy back timber at commercial
prices when the trees are harvested. To date this scheme has generated
some 2,854 growers, with 5,904 hectares of land under trees.
4.17 Other income generating projects undertaken by Group
companies assist women in impoverished communities, who might
otherwise be lured into prostitution to generate income. Examples
include the leasing or purchase of sewing machines and the subsequent
purchase of products from them such as curtains, uniforms and
protective clothing. One mine has assisted local women to set
up a bakery which then supplies its canteen.
(iv) Working with communities and establishing partnerships
4.18 A key lesson which has been learned from Anglo American's
HIV work is that effective HIV/AIDS prevention programmes need
to move beyond the workplace into surrounding communities. This
primarily involves seeking to build partnerships with other significant
organisations and individuals in the community.
4.19 International experience has shown that prevention
interventions, which specifically target individuals engaged in
high-risk behaviour, are the most cost-effective way to curb the
spread of the HIV epidemic. Sex worker peer education programmes
illustrate what can be achieved through a partnership approach
to HIV/AIDS prevention. These programmes explicitly aim to reach
both sexual partners and to build support networks for vulnerable
women. In a model developed by the University of Zimbabwe, peer
educators work through a range of one-to-one motivational sessions
and community meetings. They also work at "shebeens"
(informal bars), truck stops and other "hot spots".
Their aim is to change key sexual behaviour, including condom
use and attitudes to sexually transmitted diseases (STDs) amongst
women at high risk and their clients. By building mutual support
networks, sex workers become able to counteract their clients'
disproportionate power. The programmes are run through AIDS Committees,
which include diverse representation from government, the private
sector and local communities. Key indicators of performance (such
as number of meetings held, number of condoms distributed) are
monitored weekly.
4.20 Anglo Coal initiated such a project in the Kriel
district of Mpumalanga, which, because of its success, is now
being extended to other districts. Anglo Coal recently received
a Business Excellence award from the UNAIDS Global Business Council
on HIV/AIDS, recognising in particular its long-standing involvement
with local communities.
4.21 AngloGold is a joint venture partner in the Kopano
and Mothusimpilo projects serving the local communities around
the gold-mining towns of Welkom and Carletonville. These projects
aim to reduce the incidence of STDs, including HIV. They are managed
by an alliance of management trade unions, representatives of
the government health service and grassroots community organisations,
including commercial sex workers and residents of formal and informal
squatter settlements. The design of the projects importantly includes
baseline surveys of HIV prevalence and periodic monitoring of
key outcome indicators.
(v) Sustaining awareness, education and prevention
4.22 Most HIV prevention programmes traditionally begin
with raising awareness about HIV transmission and HIV disease.
Surveys conducted in a number of Anglo American companies have
shown a dramatic rise in employee knowledge about HIV/AIDS. Regrettably,
there has been a less dramatic change in attitudes to those already
infected as well as reported behaviour change and awareness of
personal risk.
4.23 Peer education programmes are important in sustaining
awareness since employees and their communities are more likely
to engage and trust their peers. There is still a reluctance amongst
persons already infected with HIV to become involved in these
programmes, although their participation is widely recognised
as a powerful way to communicate the risks and influence attitudes
and behaviour.
4.24 It is an ongoing struggle to sustain prevention
programmes. Anglo American has begun to address this by attempting
to integrate prevention efforts into management and supervisory
courses, induction courses, HR courses, safety training, fitness
and well-being programmes, and social events such as soccer matches.
4.25 The Company attaches importance to the involvement
of the workforce and its leaders. Unfortunately, employee representatives
have sometimes been slow to become involved, either as partners
with employers or in their own right. Anglo American is seeking
to continue to encourage employees and unions to share, or take
the lead, in prevention programmes and to initiate their own programmes.
(vi) Challenging denial and stigma
4.26 Overcoming denial is a prerequisite for achieving
behaviour change. The active support of senior management for
HIV prevention activities is very helpful in challenging denial
about the epidemic and encouraging prevention initiatives. The
prevention and management of HIV/AIDS must be a regular topic
at senior management meetings and we believe individual managers
should be evaluated in part on how well they have facilitated
HIV prevention efforts.
4.27 HIV prevalence studies are a powerful means of challenging
both management and employee denial of the extent of the epidemic.
Ethically acceptable methods of anonymously surveying the workforce
(by means of sputum testing) are now tried and tested. Such prevalence
studies are invariably conducted by independent consultants, with
the consent of both management and unions. An important part of
the process is to provide access to separate confidential testing
and counselling for those employees who wish to establish their
HIV status independently.
4.28 Anglo American companies which have carried out
these surveys confirm that they offer a unique opportunity for
engaging stakeholders and for promoting dialogue on HIV/AIDS prevention.
The information obtained is invaluable in helping management to
judge the effectiveness of prevention strategies and to formulate
appropriate targets and benchmarks for the future.
4.29 A further approach to combating denial is to restructure
employee benefits so as to encourage those with HIV infection
to seek early treatment and for those with debilitating disease
to apply for ill-health early retirement benefits. In Zimbabwe,
for example, Anglo American has managed to make changes to employee
benefits so that the discrepancy between death-in-service and
ill-health retirement has been narrowed. This enables more HIV
positive employees to access the early retirement option so that
they can spend time with their families prior to death.
(vii) Linking care to prevention
4.30 Primary health care clinics at many Company operations
are used to disseminate HIV prevention messages. For example,
clinic staff at Mondi's Richards Bay facility have produced a
booklet entitled "Living with the Consequences" which
explains how HIV is transmitted. It discusses the option of HIV
testing as well as offering counselling on HIV and financial issues;
it also places the HIV/AIDS epidemic within the context of other
diseases rather than focusing purely on sexual behaviour. This
publication has been widely distributed outside the Company by
the Professional Association of Occupational Health Nurses.
4.31 Care and support programmes have a positive impact
on prevention initiatives. If colleagues are treated sympathetically,
there is likely to be greater receptivity to prevention messages.
Such programmes send a positive message to employees about the
concern of the company for the human tragedy of AIDS.
4.32 AngloGold has developed a pilot rural health care
initiative, which aims to expand the linkages between prevention
and care where there is a geographical separation of employees
and their families. The programme has been observed positively
by organised labour and government. Should the pilot succeed,
the intention would be to extend the programme to other rural
areas with sufficient numbers of dependant families.
4.33 Aurum Health Research has developed a landmark programme
for AngloGold which aims to keep HIV positive miners healthy and
productive for as long as possible. The programme is designed
to prevent the opportunistic infections that account for a great
deal of morbidity and mortality amongst employees infected with
HIV. Trained peer counsellors, who themselves are living with
AIDS, recruit HIV-positive miners into the programme. An overwhelming
98 per cent of those recruited express a desire to go to the clinic
for treatment. Participants believe that the fact that the counsellors
and recruiters to the clinic are themselves living with HIV/AIDS
has contributed to this success.
(viii) Rigorous scientific analysis
4.34 A rational response to the HIV epidemic should be
grounded in scientific research, proper planning and rigorously
evaluated interventions.
4.35 Anglo American has actively contributed towards
HIV research programmes since 1987. Most of these have been carried
out in collaboration with well-established international research
partners. Early efforts were directed towards exploring treatment
options that were designed to block the virus from entering cells
in the immune system. In conjunction with the Center for Blood
Research at Harvard Medical School and the John Hopkins Medical
Institute in Baltimore, Anglo American has funded some US $6 million
towards research, which has developed recombinant transmembrane
CD4 molecules that block the entry of HIV into lymphocytes. Although
the clinical application of this technology remains elusive, researchers
at John Hopkins remain optimistic that a meaningful contribution
towards arresting HIV infection is possible.
4.36 The combination of Tuberculosis (TB) and HIV infection
has devastating consequences in developing countries. The medical
services of AngloGold have a long history of research into occupational
health, particularly occupational lung disease and TB. Recently
AngloGold has created and funded an independent, medical research
body, Aurum Health Research, which has achieved a leading position
in clinical research into TB and HIV/AIDS. Important research
areas include primary HIV prevention, HIV surveillance, TB control
programmes, multi-drug resistant TB, prevention of HIV and TB
morbidity, HIV vaccines and HIV drug therapy. International partners
include the London School of Hygiene and Tropical Medicine, the
World Health Organisation, John Hopkins University and the Centers
for Disease Control in Atlanta. Much of the research has been
published in peer-reviewed international medical journals. To
date, AngloGold has contributed over £1 million towards this
initiative. The results in terms of contributing towards the health
of mineworkers, establishing effective TB control programmes,
and managing HIV and TB in surrounding communities have been most
encouraging.
4.37 In the final analysis, it is now clear that an effective
and broadly applicable response to the HIV/AIDS epidemic in Africa
must include, as a high priority, the development of a vaccine
specific to the strains of HIV which are prevalent in the area.
Anglo American, through Aurum Health Research, is participating
in a vaccine initiative led by the Johannesburg HIV vaccine consortium.
MANAGING THE
IMPACT OF
THE HIV/AIDS EPIDEMIC
ON OPERATIONS
4.38 Whilst prevention efforts must continue, the rapid
advance of the epidemic dictates that increasing attention must
be devoted to managing its commercial impact. Anglo American has
developed guidelines for Group companies on how this should be
done. These are based on the premise that to manage a problem
it first has to be quantified and only then can appropriate responses
be developed.
(a) Impact assessment
4.39 In order to quantify the size and extent of the
problem it is essential to carry out an impact assessment. This
has three major components as follows:
Estimation of HIV prevalence
4.40 The first step is to estimate what percentage of
the workforce is HIV-positive. This varies from operation to operation
and will depend on factors such as staff ages, gender, whether
they reside with their families, their socio-economic status and
whether the company is situated in a high, medium, or low prevalence
area. The most accurate way of estimating HIV infection levels
is to carry out an unlinked, anonymous sero-prevalence survey
by collecting blood or saliva samples from a statistically representative
sample of the workforce and then testing the samples for HIV.
A number of companies within the Group have carried out such surveys,
but it is not a practical proposition for every company either
for logistical reasons or because it is not always acceptable
to employees and/or their unions. Other Group companies have estimated
HIV prevalence in their workforce by using a statistical model.
Information on the workforce is fed into the model, which then
provides a reasonably accurate estimate of HIV prevalence, together
with an estimate of the number of employees who are likely to
develop AIDS each year.
Impact on benefit schemes
4.41 The next phase of an impact study is to look at
benefit schemes—medical, retirement, disability, death and
funeral. HIV/AIDS will increase the cost of providing many of
these benefits. If a company has a reasonable idea of the proportion
of its employees who are HIV-positive, then it is possible to
estimate the additional costs which will be incurred.
Impact on productivity
4.42 Last, but not least, companies are asked to consider
to what extent HIV/AIDS will impact on their productivity. What
are key operations and which positions are critical to maintaining
these operations? How will these operations continue when employees
become sick and die? How will the company cope with increasing
levels of absenteeism, not only as a result of illness, but also
from employees attending funerals, which generally require them
to take between two and five days off work to travel to the rural
areas. What will be the cost of replacing employees and what effect
will frequent bereavements have on employee morale?
(b) Appropriate responses
4.43 The model adopted by Anglo American requires that
once the impact assessment has been completed appropriate responses
must then be developed. The steps in this process are outlined
below:
Policies and procedures
4.44 The first step is the development and implementation
of an AIDS policy. Anglo American has had a Group policy for many
years as described earlier in this document. Of necessity it is
a statement of basic principles, but each company has been asked
to develop these principles into a more definitive document appropriate
to its own circumstances. The AIDS policy provides an invaluable
framework for guiding the companies' response to the impact of
the epidemic and must be communicated to everyone in the company.
Its importance lies in preventing discriminatory practices occurring
and ensuring that both the company and employee are aware of the
way in which HIV+ employees will be managed.
Treatment and care
4.45 Finding ways of providing appropriate treatment
and care for employees who are HIV+ is becoming increasingly important
as more employees become sick. This is particularly so in the
mining companies where full (and free) medical care through mine
clinics and hospitals is provided for the less skilled members
of the workforce. AngloGold have instituted a well-being programme
for HIV positive employees based on antibiotic therapy to prevent
opportunistic infection. Anglo American is currently investigating
a pilot project, in conjunction with Aurum Health Research and
Glaxo Wellcome and other major pharmaceutical manufacturers, to
evaluate the practicalities, costs and benefits of providing antiretroviral
treatment for employees. More senior personnel who belong to contributory
medical insurance schemes already have access to such treatment.
4.46 Another consideration and concern for the mining
companies within the Group is that healthcare facilities are often
inadequate in the areas to which many mineworkers will return
when they are no longer able to work. AngloGold is currently looking
at how this problem can be overcome and whether training of family
members and community personnel in home-based care will help to
alleviate the problem.
Restructure benefit schemes
4.47 The next step is to look at the results of the impact
assessment on benefit schemes and to decide which benefits it
will still be possible to provide, whether some schemes must be
restructured or whether limits must be placed on certain benefits.
Changing benefits must be negotiated with employees and their
representatives. Most companies within the Group have completed
this phase and have restructured their benefit schemes or have
capped certain benefits.
Performance management
4.48 Managers need to be alert to signs that an employee's
productivity is slipping. As well as reduction in output, factors
such as absenteeism, time keeping, or a change in demeanour and
general well-being, can indicate that an employee is struggling
to cope with a positive HIV diagnosis or related illness.
4.49 A good performance management system ensures that
once an employee becomes too sick to carry out their duties, alternative
arrangements can be discussed. These include the possibility of
alternative employment, some changes to the employee's job description
or, failing either of these, ill-health early retirement. Companies
are encouraged to ensure that such discussions are held timeously
and that both the employer and employee are party to any decisions
taken.
Develop plans for replacements
4.50 With regard to losses in the labour force, Anglo
American companies have identified a number of ways by which they
will replace employees who become too sick to work. There are
various options including pool gangs, mechanisation, multi-skilling,
multi-tasking and additional training. Clearly, long-term planning
is of crucial importance in preparing for contingencies.
Involve the unions
4.51 Because many of the issues associated with HIV/AIDS
are union matters as much as they are management ones, companies
have been encouraged to develop open and honest discussions with
union representatives to ensure that both sides understand the
ramifications of the epidemic and are able to plan effectively
for the impacts.
Comply with legislation
4.52 Most of the countries in Southern Africa have legislation,
which guides employer-employee relationships including those relating
to HIV/AIDS. All companies within the Group are aware of the need
to ensure that their policies and procedures comply with relevant
civil and labour legislation.
Monitor the epidemic
4.53 Although many companies within the Anglo American
group have already taken pre-emptive steps to manage the impact
of the epidemic on their operations, progress in this regard will
now be monitored on an annual basis by means of a centralised
reporting system which requires each company to report on statistics
such as number of deaths and ill health retirements and changes
to costs associated with benefit schemes.
4.54 The challenge for companies within the Group is
to do whatever is necessary to minimize the impact of the epidemic
on their operations whilst at the same time providing the empathy
and compassion that is necessary to assist those employees who
are HIV+.
5. CONCLUSION
5.1 The scale of the unfolding HIV/AIDS tragedy in Southern
Africa is distressing and sobering. The human cost is substantial.
The private sector must play its part in preventing infections
and in the support of those who have been infected. We must also
seek to ensure that livelihoods remain for those who will survive
and come through this tragic chapter. Anglo American believes
that its companies have evolved much valuable best practice and
are striving to do more.
5.2 Whilst our prevention efforts may not have succeeded
in arresting the progress of the epidemic, we remain determined
to make an impact in preventing new infections. The great majority
of employees are not infected with HIV, so there is still plenty
of scope for prevention work. The possibility of developing an
AIDS vaccine needs to be pursued with vigour and Anglo American,
through its medical research initiatives will be actively involved
in early clinical trials.
5.3 We need to renew our efforts in caring for those
who are living with HIV or who have become AIDS sick. There are
promising developments in the field of drug treatment for HIV
infection and AIDS. Anglo American will actively explore ways
and means to make this treatment accessible, affordable and effective.
5.4 In 15 years of experience of dealing with HIV/AIDS,
we know that the epidemic is manageable in the workplace and that
our businesses will remain viable and profitable. Anglo American
will continue to invest in Southern Africa and contribute to the
emerging economies of the region.
Anglo American plc
16 June 2000
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