A Workplace HIV Project for SMEs in

Buffalo City Municipality, Eastern

Cape

Dr Simeon OdugwuProject Manager

June 6, 2007ICC Durban

BackgroundIn 2006• 25 of 40 million living with HIV/AIDS are in Sub-Saharan Africa• People living with AIDS - 5,5 million; 91% of them aged 20 – 64 years

• Prevalence in adults aged 15 to 49 – 18.8%

• Adults aged 15 yrs and over living with HIV - 5,3 million

• Orphans aged 0 – 17 due to HIV – 1.2 million

• Percentage of infected men and women on antiretrovirals – 21%

• Prevalence in ANC attendees in 2005 – 30.5%

• Incident HIV cases 527,000 (+/-1400/day; ~ 88% in adults)

• Deaths due to HIV - 320,000 (270,000– 380,000)

Background - contd

• STI, HIV/AIDS & TB epidemics closely linked

• Many socio-economic factors fuel the epidemic

• AIDS deaths will peak around 2012

• HIV/AIDS predominantly affects productive age groups impacting on the entire economy

• HIV/AIDS is a key development challenge

• HIV/AIDS is a critical risk management focus for business in South Africa

Which way is the HIV epidemic headed in SA I?

Trends in HIV prevalence: adults aged 20 - 64 years

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

SA Adult women (ages 20 - 64) SA Adult men (ages 20 - 64) SA Adults (ages 20 - 64)

EC Adult women (ages 20 - 64) EC Adult men (ages 20 - 64) EC Adults (ages 20 - 64)

Source of data: www.assa.org.za/aids

Trends in HIV Incidence

0.0%

0.2%

0.4%

0.6%

0.8%

1.0%

1.2%

1.4%

1.6%

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Incidence in total population SA Incidence in total population EC

Source of data: www.assa.org.za/aids

Which way is the HIV epidemic headed in SA II?

‘Everyone can help fight the disease …’

Objectives

1. Provide leadership for/stimulate local organized business response to HIV/AIDS.

2. Deliver comprehensive HIV and AIDS prevention, care, support, treatment and risk management services at SME level in the Buffalo City Municipality.

3. Build innovative partnerships for effective service delivery.

4. Strengthen comprehensive primary health care services in both public and private sectors.

Project Partners

1. DaimlerChrysler SA2. Border-Kei Chamber of Business3. DEG (Deutsche Investitions- und Entwicklungsgesellschaft

mbH)4. Participating companies5. BroadReach Health Care LLC6. Aid For AIDS Pty Ltd7. Buffalo City Municipality & Amathole District Municipality8. Department of Health Province of the Eastern Cape9. Eastern Cape AIDS Council10. Eastern Cape Development Corporation

DCSA / BKCOB / DEG HIV/AIDS Project 2006 - 2007

1. Burmeisters2. Defy Refrigeration3. Dimbaza Foundries4. Fabkomp5. Faurecia – EL Plant6. G4 Securicor – EL Operations7. Hemmingways Casino8. Johnson Controls Int – EL

Plant9. Lear Corporation – EL Plant

10. RedAlert11. Rehau Polymer12. Summerpride Foods13. Time Clothing14. Venture SA – East London15. Daily Dispatch16. Kempston Outsourcing17. Ronnies Motors

• 6700 employees• +/- 26000 dependants

Participating Companies – pilot phase 2006/2007

DCSA / BKCOB / DEG HIV/AIDS Project 2006 - 2007SME Level

1. Policy implementation & / or review2. Training for

• Management• Focal Persons & support – 27 trained, monthly meetings.• Employees – compulsory small groups training/counseling• Occupational health service staff• Patients• Peer Educators

3. On-site voluntary testing of employees4. Private care for HIV +ve employees/deps at no cost (GP

network)5. Risk assessment & risk management advisory services

DCSA / BKCOB / DEG HIV/AIDS Project 2006 - 2007PHC Component

• Quality of care audit & support of public PHC facilities

• Training of public sector PHC nurses & GPs in VCT & STI/TB/ HIV/AIDS Clinical Care

Community outreach component

• Community Wellness Days – 1/year

• Extension of HIV & AIDS care, support & treatment to an additional 1,000 patients in the public sector ART queue. These include BCM employees.

Achievements to date and lessons learned

1. HIV Training for Managers

1. Defy Refrigeration 302. Dimbaza Foundries 273. Faurecia 84. Johnson Controls Int 95. Lear Corporation 116. Daily Dispatch 297. Venture SA 88. Fabkomp 179. Summerpride Foods 14

10. Red Alert 3011. Rehau Polymer 812. Time Clothing 2813. G4 Securicor 3914. Burmeisters 1815. Kempston 416. Ronnies 1817. Hemingways37

Total 352

DCSA / BKCOB / DEG HIV/AIDS Project 2006 - 20071. Burmeisters2. Defy Refrigeration3. Dimbaza Foundries4. Fabkomp5. Faurecia – EL Plant6. Johnson Controls Int – EL

Plant7. Rehau Polymer8. Summerpride Foods9. Time Clothing

10.Venture SA – East London11.Daily Dispatch12.Lear Corporation – EL

Plant13.RedAlert14.Ronnies Motors - April15.Hemmingways Casino16.G4 Securicor – June17.Kempston Outsourcing -

yet

2. C & T completed in 15 companies over 12 months

Trained 3767

Tested 2333

Positive 196

CUR 88.0%

TUR 61.6%

ECR 54.2%

PR 7.7%

Performance Indicators

0.0

20.0

40.0

60.0

80.0

100.0

120.0

1 2 3 4 5 6 7 8 9 10 11 12 13

Counselling uptake rate Testing uptake rate Effective testing coverage Positivity rate

As of April 2007

4. Others

• 241 patients referred into our treatment programme

• 26 Nurses on STI/TB/HIV management

• 43 doctors on HIV management – refresher

• 32 nurses on voluntary counselling and testing

• 62 Peer Educators – new and refresher

Lessons

1. Pre-existing good employer-employee relationship is essential for success.

2. Owners/managers are keen to roll out workplace programmes but would rather leave implementation to the experts.

3. Employees are eager to participate but confidentiality remains a big issue.

4. Denial remains a hindrance to accessing treatment.

5. We need to find another way of reaching employee dependants.

Acknowledgements• Nita Laine• M. Mapenyane• Janet Bennett• H. Dwatyana• Neil Le Roux• Joyce Sauls• Tanya Starck• Zami Meke• Noxolo

Tetyana• Clee Waterson• Phumla Bazi• Judi Dargie

• Vuyokazi Bata• Reshma

Khandoo• Lyndy Loraine-

Grens• Margie

McKitterick• Ermel Robert• Dave Roger• Barbara van

Heerden• Anton Pretorius• Mike Kilroe• Ivy Makapela

•Gail Goliath•Brian Harmse•Jenny De Free•Bernie Richter•Nosipho Goduka•Tania Kilroe•Sheralee Walker•Monty Jagers•Michelle Taylor•Silvia van Rensburg•Siva Govender•Lindiwe eswina

•Joseph Sihlahla

•Ivy Ntlangeni

•Valerie Damane

•Bukelwa Moya

•Anele Dako

•Stella Heuer

•AfA

•BRHC LLC

•Clifford Panter

•Tanya Hosford

•Les Holbrook

•Lynn Paxton

•Zuki Jombile

•Jenny Inglis

•Janet Shuttleworth

•Lorna Schoffield

•Phyllis

•Andrea Knigge