Private initiative for AIDS prevention advisable

Private initiative for AIDS prevention advisable

By Meike Hensmann

JAKARTA (JP): Imagine one day the person you have been working
next to for years finds out that he or she is HIV-positive, and
decides to confide this to you.

What will you say? How do you react? Will you treat them
differently than before? Few of us are really prepared for such a
situation, but is it that unlikely to happen?

Equally unprepared are most employers in this country. What if
one of your employees confided to you that he or she is HIV-
positive or, worse, if you found out indirectly through co-
workers or an insurance company. What would you consider an
appropriate action? Do you really know enough about the HIV and
AIDS to make an informed decision?

Indonesia is beginning to experience the first signs of the
HIV epidemic. However, cases have been occurring since 1987, but
the response has been slow. Without effective prevention efforts,
the World Health Organization predicts that the country will soon
see an infection rate and a number of new cases that could
surpass Thailand and India.

But why should this interest employers and employees in
particular? For one simple reason: Most people affected by AIDS
are at a working age, and most are not members of such
marginalized populations as homosexuals or commercial sex
workers. They are those people standing next to you in the
office, on the production line, on the construction site.

AIDS-related diseases always have a direct, devastating
effect. Not only do those with AIDS face an untimely death,
preceded by a period of severe illness, many have to bear the
psychological burden of stigmatization and exclusion from
society.

But entire economies are also affected.

Modeling shows that once 20 percent of the adult population is
infected with HIV, the average mortality of a 30-year-old is
equal to that of a 70-year old. It is not hard to imagine what
this means in terms of employee turnover (due to death or
disability), health care and medical costs, absenteeism,
recruitment, disruption, training costs and productivity. In
industries that require highly skilled workers, the extent of
output loss can be significant.

If this still seems too theoretical, turn your eyes to some of
the countries in sub-Saharan Africa. There, preventive and
preparatory measures were -- if at all -- only implemented when
the epidemic reached noticeable proportions. In Zambia, for
example, firms have reported that the number of employees that
have died has increased eight-fold between 1987 and 1993 --
almost exclusively due to AIDS. Productivity was indeed
negatively affected -- and projections estimate that per capita
income growth will slow down by 0.6 percent every year. On a more
personal note, in Uganda, if an employee merely took time off to
attend funerals he or she would be absent for an entire month
every year!

Most studies in this field are of a macroeconomic nature, and
the World Bank, the United Nations Development Program, and the
World Health Organization alike warn of the potentially
devastating effect the AIDS epidemic could have on the economies
of Southeast Asia if there are no concerted national efforts to
halt it in time.

But why look at the macroeconomic level, individual businesses
and companies? Simply because private industries can implement
services for workers much more quickly than the government.

AIDS is not simply a health problem. HIV/AIDS awareness and
education programs is also in the interest of every company for
economic reasons. Their effects will be hard to notice, since the
absence of disease is typically harder to detect than its
occurrence, but that should not lead one to conclude that such
programs are not highly desirable.

Some companies in Indonesia have already had the foresight to
look for and implement AIDS prevention programs for their
employees. The Kusuma Buana Foundation, for example, in
collaboration with PATH (Provide Appropriate Technical Health),
an NGO, offers two strategic approaches for businesses, and both
have been successfully taken up.

In the first, in depth approach, the foundation assigns
outreach workers to companies for a period of around 6 months.

National Gobel (electronics), PT Busana Rama (garment) and PT
Sangra Ratu Indonesia (laundry) have chosen to prepare for AIDS
in the workplace by this method. The other less intensive but
very effective approach is through several days of small-group
seminars to all levels of the company. While this may disrupt the
usual work activities briefly (half-day per group), it requires
less of a time commitment from the company. Such seminars have
been held by the Kusuma Buana Foundation at PT Gillette Indonesia
and PT Unitex (textile).

One hopes that more businesses will follow the lead of these
exemplary few, as only a concerted effort from the private and
public sectors will prevent the human and economic catastrophes
that AIDS could inflict on this country.

Meike Hensmann, M.A. Ph.D., currently an M.P.H. student at
Yale University, U.S.A., is a summer volunteer at the Yayasan
Kusuma Buana.