Select Committee on International Development Minutes of Evidence

Examination of Witnesses (Questions 280 - 299)



  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.


  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.


  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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