Memorandum submitted by Standard Chartered
Bank plc
INTRODUCTION
Standard Chartered is an international banking
group that is focused on the established and emerging markets
of Asia, Africa, the sub-continent, the Middle East and Latin
America. The Bank was founded in 1853 and has grown to become
an International Group that employs 26,000 staff and has operations
in over 500 offices, in more than 40 countries.
The following Memorandum provides some details
of our experience and observations on the impact of HIV/AIDS in
developing countries and also provides specific information on
the Bank's HIV/AIDS Programme. This initiative is currently being
implemented in 12 countries across Africa—Botswana; Cameroon;
Gambia; Ghana; Kenya; Nigeria; Sierra Leone; South Africa; Tanzania;
Uganda; Zambia and Zimbabwe. It is planned that the Programme
will also be introduced in 2000-2001 to the other developing markets
within which the Bank operates after the rollout in Africa has
been successfully completed.
STANDARD CHARTERED
BANK'S
RESPONSE TO
THE HIV/AIDS CHALLENGE
The Bank has recognised the need to take a proactive
response towards the HIV/AIDS epidemic and has initially focused
on Africa. Our initial research revealed that there was a lot
of stigma attached to this disease that any of our attempts to
manage AIDS would have to begin with a comprehensive education
programme. We also realised that the tackling of this problem
is a long-term initiative and would have to be approached in stages.
In response to this challenge we developed a
strategy which:
— would focus on educating staff and
reassuring them of our organisation's philosophy and views towards
this disease;
— once an awareness has been increased,
monitor the incidence of the disease within the organisation;
— based on the data gathered in the
above exercise, we aim to continually modify in the way we manage
this disease.
As of now we have focused on only the first
phase of our strategy of educating staff. We began by developing
an HIV/AIDS Policy and an educational Awareness Campaign.
The key aims of our Programme are to:
— provide information and educate all
employees in Africa, on HIV/AIDS, its magnitude, impact and preventative
and control measures;
— implement non-discriminatory Policies,
Procedures and Practices in managing individuals who have HIV/AIDS
through local Human Resources Departments;
— manage employees who have HIV/AIDS
in the same manner as those with other progressive and debilitating
illnesses;
— ensure that all of our global operations
have clearly defined HIV/AIDS policies and procedures taking into
account local practices, procedures, cultures and any legislation;
— join forces with other organisations
to counter HIV/AIDS and alleviate its impact by sharing the results
of our work and supporting their efforts.
The Programme has been introduced to all of our
businesses in Africa through the following methods:
— establishment of a centrally funded
London based Regional Project Office to manage, develop and roll
out the Programme in each country;
— training of over 200 HIV/AIDS "Champions"
to deliver the standard staff education Programme. The Champions
are also trained in basic presentation and counselling skills;
— the Champions will deliver staff,
family and customer-oriented presentations using the standard
Education Media Pack;
— distribution of an HIV/AIDS staff
handbook and flyers which provide information on HIV/AIDS and
how to prevent and control the spread of the virus;
— displays of posters and flyers in
the Bank's Offices and branches; and
— on-going monitoring of the scope
and impact of HIV/AIDS in each of our businesses.
KEY IMPETUS
FOR THE
STANDARD CHARTERED
BANK RESPONSE
The Bank's HIV/AIDS Programme has been developed
for the following reasons:
Social Responsibility
The Bank's businesses are based in the developing
markets of, for example, Africa and Asia. In these markets HIV/AIDS
is the single most important and daunting health problem facing
our stakeholders including our staff and their families, customers,
suppliers and Government. The current and future impact of the
HIV/AIDS disease on particularly those of productive and economically
active age—defined as ages 15-49 years poses an enormous
social and economic challenge. Of an estimated 36 million people
infected across the world as of the end of 1999, approximately
23 million, or 64 per cent, are in Africa. Standard Chartered
Bank considers that it has a corporate social responsibility to
support local and global HIV/AIDS preventative and control efforts
and protect the basic human rights of those in the workplace who
are HIV positive.
The Bank supports HIV/AIDS initiatives of both
local and international non-governmental organisations (NGOs)
including the Global Business Council on HIV/AIDS, Business Exchange
on AIDS & Development (BEAD) and similar country-based organisations.
We are sharing our HIV/AIDS education materials
and the Media Pack including posters, leaflets and staff handbooks
with these various organisations and other companies. The NGOs
also participate as attendees in our in-house HIV/AIDS prevention
and educational programmes including counselling and awareness
education.
Employee Health and Well Being
Employees are critical to the success of our
business. The loss of an employee is not only a personal and family
tragedy, but also results in direct and indirect loss to the Bank
in terms of medical costs, retraining, recruitment and productivity.
Standard Chartered Bank is committed to the
protection and maintenance of its employees' health and well being
within affordable limits. To implement our education Programme,
the Bank has developed and distributed an HIV/AIDS Staff Handbook,
posters, flyers and other media based information to all employees
and is currently presenting—to all 5,600 staff in Africa—the
"Staying Alive" HIV/AIDS Presentation.
The Bank is also collecting and disseminating
information on the magnitude of the disease and developments in
scientific research, especially those relating to preventive and
making this information accessible to all employees. For employees
travelling and for those on international postings, information
is provided on the destination country including the general level
of HIV/AIDS infection, any specific precautions to take, and advice
on the purchase of medical travel packs.
Human and Legal Rights of HIV/AIDS Infected Staff
Protection of the human rights and dignity of
HIV-infected persons, including people with AIDS, is essential
to the prevention and control of HIV/AIDS. Employees with HIV
infection need to be treated in the same way as other staff and
most people—subject to their health—want to continue
working.
Standard Chartered has therefore developed and
implemented a non-discriminatory policy on the Human Immunodeficiency
Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Key
elements of our policy are:
— implementation of non-discriminatory
policies, procedures and practices in managing individuals who
have HIV/AIDS; and
— to approach individuals who have
HIV/AIDS in the same manner as those with any other progressive
or debilitating illness.
HIV/AIDS AND SOCIAL
AND ECONOMIC
DEVELOPMENT
Projected Impact of HIV/AIDS on Standard Chartered
Bank in Africa including Mortality, Sickness and Morale
The HIV/AIDS disease is beginning to have an
impact on the Bank employees and is consequently a concern to
the Board of Directors. By way of background, only 44 per cent
of Sub-Saharan Africans are now expected to reach their sixtieth
birthday and life expectancy for a new born child is now only
49 years. In Botswana, for example, life expectancy is predicted
to reduce from 60 to 44 in the next 5-7 years.
Death and Death Benefits
As indicated above the loss of an employee is
a personal and family tragedy, and also results in direct and
indirect loss to the Bank. A dead or sick employee has also an
impact on the Bank's productivity as well as on the productivity
of colleagues.
In general, the more technologically advanced
an organisation is, the worse it may be affected by a large number
of AIDS-related deaths. All of the Bank's businesses, for example,
are fully computerised using First World technology. Our staff
are highly trained in the use of this technology but, with there
already being a shortage of skilled manpower, an organisation
such as ours needs to minimise the risk of losing such staff and
look after those that become unwell.
We have had difficulties in establishing accurate
statistics on the causes of death amongst our staff due to the
cultural barriers and the taboo associated with the disease. However,
it is estimated that currently 30 per cent of our staff in certain
African businesses are infected with the virus, while 80 per cent
of deaths due to sickness are due to AIDS-related illnesses.
At a local level, feedback reports from staff
during the introduction of our Africa Region HIV/AIDS Programme
indicate that 70 per cent of our staff have close relatives and/or
friends, who are infected with the HIV virus, have died or are
dying.
Due to the nature of our business and the dependency
on skilled labour the Bank has already invested heavily in the
recruitment, training and development, and health of all its employees.
The Bank has therefore recognised that it must monitor closely
the impact of HIV/AIDS on headcount. In addition, vigorous recruitment
and retraining drives are underway particularly in the businesses
in some of the countries where infection rates are estimated to
be between 25 per cent and 40 per cent—including Zambia,
Zimbabwe and Botswana. This is in order to ensure we are able
to maintain the level of service and staffing levels required
by the business/customers.
In the year ending 31/12/99, it is estimated
that approximately 92 members of staff died solely of HIV/AIDS
related disease with an extra Death Benefit cost to the Bank of
£750,000, almost 1 per cent of the annual Africa business
cost base. Projections indicate that Death Benefit cost will rise
by 30 per cent over the next three-year period.
HIV/AIDS: Impact on morale at the Staff Household
level
At the Staff household level, the impact of
HIV/AIDS-related sickness and death is sudden and catastrophic.
If an employee who is the main or only breadwinner develops AIDS,
his (or her) family is impoverished twice over: the income vanishes
as more and more is spent on drugs and relatives have to devote
time and money to nursing him/her. The wife or husband has to
take time off work or is forced to stop active employment in order
to help. Worse, HIV tends not to strike just one member of a family.
Husbands give it to wives, mothers to babies. One of our senior
staff lost her husband, all her brothers, and two sisters to AIDS.
She later died of AIDS. Her story is not rare.
THE EFFECT
OF WORKFORCE
ILLNESS AND
MORTALITY ON
DEVELOPMENT
In Zambia, Zimbabwe and Ghana where the local
legislation obliges employers of our size to offer generous medical,
death and funeral benefits and paid sick leave, companies will
find many of their staff, as they sicken, becoming more expensive
and less productive. For example, three of our staff infected
with HIV in Zambia were on extended sick leave for almost 100
per cent of last year.
According to our Medical Scheme suppliers based
in Zambia and Kenya:
— Nearly 30 per cent of Standard Chartered
Bank Staff who visited the Medical Clinics in Zambia in 1999 are
HIV-positive; and
— One out of every five Staff visiting
the Medical Clinics in Kenya is HIV infected.
Absenteeism and Leave
Our country HR Functions report that the level
of Absenteeism in some of the African countries is rising by 10-15
per cent as staff take time off to deal with the sickness or death
of immediate family members, relatives and friends.
Other effects include early retirements on medical
grounds, mismatch between available human resources and business
requirements. In view of this, the policy on compassionate leave
is under review with a view to limiting the number of days employees
may take off to attend funerals and to tend the sick.
Welfare and Personal Staff Loans Budget
In addition, the Bank is under pressure to increase
the Subsidised Staff loan and welfare budgets. This pressure emanates
from an increased number of staff that are faced with financial
difficulties arising from the "extended family syndrome".
Under local African Culture the most well off member of the family
has an obligation to take care of all his immediate family and
relatives and particularly in times of sickness and death. Our
data indicates that 20 per cent of Emergency Staff Loan applications
are made to "support medical, hospital and school expenses"
mainly arising out of HIV/AIDS related sickness or death within
the family.
In better-off developing countries, people have
more savings to fall back on when they need to pay medical bills.
In most of the African countries where Standard Chartered Bank
operates, savings are a luxury for a majority of the population.
State medical and health insurance is also non-existent.
HIV/AIDS as a Business Operational Risk
The pressure from the Extended Family Syndrome,
absenteeism, sick leave and death all pose major operational risks
to the operations of a bank. Increased levels of control are needed
to discourage the potential for fraud and theft by employees.
THE IMPACT
OF HIV/AIDS ON
A COMPANY
BUDGET
Medical Health Budget
In a number of countries such as Ghana, Botswana,
Zambia and Zimbabwe, the health benefits are potentially very
generous-a consequence of the local labour legislation. However,
our experience indicates the need to establish a limit on the
amount of benefit as there is no doubt that the cost burden on
business will increase.
Our experience indicates that Medical Costs
are increasing at high rates. If we take into account the factors
such as inflation and headcount increases, the medical budget
has risen by 57 per cent, 81 per cent and 71 per cent in Zambia,
Botswana and Ghana respectively over the 1998-99 period.
Where the Bank operates both health and life
insurance, for example in Kenya, the Bank is incurring higher
premiums. In Zimbabwe, life insurance premiums quadrupled in two
years because of AIDS. Higher premiums force more people to seek
treatment in public hospitals: in South Africa, HIV and AIDS could
account for between 35 per cent and 84 per cent of public health
expenditure by 2005, depending on the HIV/AIDS incidence in the
country, according to UNAID projections.
In addition, both the World Bank and the South
African Government have indicated that the cost to treat all of
those known to have AIDS today in South Africa using the latest
cocktail of drugs would be greater than the annual health budget
(2 million Rand).
Cost of Treating AIDS Patients
According to Health Management Solutions (HMS),
a medical firm that support SCB and several other international
firms, the cost of treating a patient suffering from AIDS related
disease in East Africa has increased by 38 per cent during the
1998-00 period.
This is based on the fact that on average an
AIDS sufferer, during the advanced stages of this disease, would
normally visit a doctor 3-4 times per week and would be hospitalised
at least four times per year for a two week to one-month period.
CONCLUSION
In most sub-Saharan African countries there
continues to be a relative "wall of silence" on the
epidemic and this may be due to many not yet feeling the effect
in terms of cost to society. The level of awareness is increasing
but this will have to be reinforced by international political
and Non-Governmental bodies and businesses providing support to
those countries with the highest levels of infection.
For businesses there are four key areas for
intervention which have been recognised and put into action by
the Bank:
— customer/Family education and research;
— education to staff in the workplace—larger
businesses can indirectly send strong messages to the community
in which they operate by instituting policies to discourage stigmatisation;
and
— lobbying Governments for change—to
use our knowledge to educate and motivate policy makers to take
action on AIDS.
Only a few businesses, like SCB, are currently
prepared to show leadership in this area. However, businesses
are exceptionally well placed to join the fight against HIV/AIDS—both
on their own and in partnership with the Public Sector and NGOs.
They have the resources, are not necessarily tied to an establishment
agenda and are well placed to break through the silence.
Standard Chartered Bank plc
23 June 2000
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