Examination of Witnesses (Questions 280
- 299)
THURSDAY 29 JUNE 2000
DR BRIAN
BRINK, MS
JENNY CRISP,
MR CHRISTOPHER
WHEELER, MS
NAOMI JUNGHAE,
MR JAMES
COCHRANE AND
MS GEORGIA
FRANKLIN
280. But you would have an annual health check?
I am not trying to single you out.
(Mr Wheeler) No, it is absolutely true.
281. Would senior management have their blood
tested?
(Mr Wheeler) Yes.
282. On a confidential basis?
(Mr Wheeler) Yes.
(Dr Brink) In our company particularly in the mining
industry, that annual periodic examination is a feature of employment
practice.
283. Every employee?
(Dr Brink) Every employee. Certainly for people who
work underground in a high-risk environment it is a very important
part of looking after occupational health. HIV testing is not
a feature of those examinations at all. If an employee were to
say, "I would like to know my HIV status," it would
be done on the basis of normal medical attendance on a completely
confidential basis. Management would have no interest in that
result.
(Ms Franklin) Compulsory testing is actually seen
by WHO and UNAIDS as a violation of human rights.
284. If I were an employee of a company and
had an annual health check by, for instance, Anglo American, and
they took my blood to test for whatever they take blood to test
for in those cases, I cannot remember, haemoglobin levels I think,
I would have thought it was something that could be done confidentially
as part of examining my health and would be quite good employment
practice, nothing to do with the company knowing about it.
(Ms Franklin) It should only ever be done on a voluntary
basis, confidentially, and if there is counselling provided with
it.
285. Would you not agree with me slightly here
that you have this pandemic which is perhaps infecting 20 per
cent of a population from which those people infected will die
within the next five to ten years and if you do a health check
is there not something slightly illogical about not checking for
the biggest killer that is around?
(Ms Franklin) I think it depends what you want to
do with that information.
286. I would like to know if it were me.
(Mr Wheeler) Not everybody does.
287. It knocks on to lots of other people as
well.
(Mr Cochrane) You would only like to know, I would
suspect, if you knew what you were going to do about it if you
were HIV-positive. If you did not know what you were going to
do about it because there was no access to treatment and no availability
of treatment, then you might not want to know. There are plenty
of instances in this country of people denying going to do things
if they do not want to know the result. Therefore I think it should
be voluntary.
Chairman
288. Is the practice that you describe of voluntary
testing of employees by Anglo American widespread amongst employers
in South Africa or are you way ahead of the pack?
(Dr Brink) I would not know whether we are way ahead
of the pack. I think that certainly in terms of our prevention
efforts which we have been making over the last 15 years we have
been in the lead there. To the extent that voluntary HIV testing
is made available to employees, it is part and parcel of a comprehensive
prevention response which is part of being ahead in that respect.
289. Do you operate a similar system in Zambia
and Malawi and elsewhere that you operate?
(Ms Crisp) No, we have only just recently moved back
into Zambia and we certainly have not got around to that at the
moment. We do not operate in Malawi. We do have operations in
Zimbabwe and Botswana but there has not as yet been any anonymous
sero-prevalence surveys. There has always been on-going voluntary
testing with counselling, particularly in a medical situation
because, as you will appreciate, most of our companies have clinics
and in some cases hospitals attached to them and right from the
start of the epidemic if a doctor has suspected that an underlying
cause of any problem is HIV or AIDS-related he would automatically
from a medical point of view suggest to the individual they have
an HIV test because it will assist in treatment. That is done
in strict accordance with Medical and Dental Council Guidelines,
as my colleague says, totally voluntarily and confidentially.
To answer your question about other companies there is an increasing
number of companies, the Electricity Supply Commission (ESCOM),
which is one of the leaders in AIDS prevention, have done these
anonymous surveys and there are a number of other companies also
that have done them so we are not alone in that.
Chairman: Thank you.
Mr Worthington
290. You are saying it is against human rights
but that does not mean it does not happen, and there are not companies
that do test?
(Ms Franklin) Several years there was a Mexican bank
which resolved to test its entire workforce. The cost of that
was four times greater than the cost of full treatment for the
six employees who were HIV-positive and they knew some of those
were HIV-positive anyway. There was no real purpose for the company
to do that.
Mr Robathan
291. That is not a human rights issue.
(Ms Franklin) No. But if a person does not want to
know the answer, then they should not be forced to have a test.
You are talking about countries in the developing world where
even if you know you are HIV-positive you do not know what you
can do with that information. It does not mean that you can take
drugs because they may not necessarily be available to you. You
need to have a company that is set up so that if they are testing
voluntarily its entire workforce they can then cope with the counselling
that needs to be employed and the medical treatment that needs
to be employed with anybody who is HIV-positive or has full-blown
AIDS. Without being able to do that you are absolutely violating
their human rights.
Mr Worthington
292. That is not the same question as I am asking.
It may well be violating their human rights. I think you said
in South Africa it is against the law to discriminate against
those who are HIV-positive. What I am asking is whether companies
do test on economic grounds. You can see the logic of what they
are saying. "We want to take on a workforce that is healthy
because that would be more efficient." Do you get any perception
of whether there are companies that do test their employees or
is everybody following this same line that it is wrong to discriminate?
(Ms Franklin) I could not answer.
Chairman
293. We are asking about discrimination against
AIDS.
(Dr Brink) As a company we have gone way beyond that.
We believe that that kind of approach is not going to help in
preventing the further spread of the disease.
Mr Worthington
294. What I am asking is whether that is universal.
(Ms Crisp) I think the short answer to your question
is, no, it is not and certainly in South Africa until the legislation
I am referring to was promulgated just in the last few months,
there certainly were companies that were testing. I think, as
Dr Brink says, it was an almost knee-jerk reaction. It seemed
to make a lot of sense early on in the epidemic but, as has been
suggested, to find out that somebody is HIV-positive is not helpful
to you from a business sense unless you know when that person
got infected and when they are going to get sick. As we all know,
somebody who is HIV-positive can remain healthy for a considerable
period of time and if they have access to the latest drugs almost
indefinitely. So you can test and you can find out how many and
who is HIV-positive but it is not necessarily helpful. Similarly,
there are people who are negative at the time of testing. Are
you then going to test every six months in order to update your
information? I think companies generally, certainly in South Africa,
the more enlightened ones, have come to the conclusion from a
business point of view that it is much more beneficial to do an
anonymous sero-prevalence survey and then to monitor that and
the progress of the epidemic within the company on an annual basis
than it is to try and identify which individuals are HIV-positive.
I hope that answers your question.
295. I am not sure it does. I can understand
that from the viewpoint of your existing companies but I was asking
whether there were other companies. We all know in this country
that you may well be appointed but it depends upon a medical check-up.
(Mr Wheeler) Companies do test.
296. At entrance?
(Mr Wheeler) Some do.
(Dr Brink) We do a medical check-up pre-employment,
pre-placement. The purpose of that is to see that the person is
medically capable and fit to do the job they are appointed to
do. Whether they are HIV-positive or negative will not make a
difference.
297. What then happens if you get back the response
at this pre-employment test that this person is HIV-positive?
(Mr Wheeler) It should not make a difference. One
would be much more interested in for someone who is HIV are they
well or not well? Are they well enough to work?
298. Here you have got a situation where the
company says you are appointed subject to a medical and the medical
comes back and says HIV-positive. What does the company do with
that information?
(Mr Wheeler) It is not a reason to not employ.
299. You are confident that is what happens
in all companies?
(Mr Wheeler) Within the bank that is the policy.
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