London’s Guardian Examines Stigma, Other Obstacles to South African Companies’ Antiretroviral Drug Programs
London's Guardian on Thursday examined persistent social stigma and other obstacles to South African companies' efforts to provide free antiretroviral drugs to HIV-positive employees. Mining conglomerate Anglo American was one of the first companies in South Africa to provide antiretroviral drugs to its employees, but after one year of offering the program, only 700 employees had enrolled in the program and were receiving treatment. The company estimates that approximately 25%, or 30,000, of its South African employees are HIV-positive; however, no accurate statistics exist because the "biggest problem" is getting employees to agree to be tested for the virus, according to the Guardian. A "huge" social stigma still surrounds the disease in South Africa, causing many employees to avoid learning their status because they fear discrimination, according to the Guardian. "There is still a huge amount of ignorance in the country and lack of leadership from government has caused confusion," Brian Brink, Anglo's chief medical officer and architect of the antiretroviral program, said, adding, "We are moving ahead now but we all need to do a whole lot more." John Standish-White, head of Anglo's Goedehoop coal mine community, said that he tries to convince workers to learn their status so that they can enter the program, but "breaking the silence is a huge issue." Standish-White added, "Just talking about sex is not easy here."
Another difficulty for Anglo is that the "powerful" National Union of Mineworkers is not "entirely supportive" of the antiretroviral program, according to the Guardian. Welcome Mboniso, NUM health and safety officer, said, "We are pleased that companies are beginning to tackle the problem, but we need to have proper HIV agreements at the national level signed by the union general secretary and the company chief executive. There have been no such deals, only companies going off on their own implementing local programs." Union members are especially frustrated that Anglo is providing HIV treatment for its staff but not their dependents, according to the Guardian. Anglo is concerned with the "spiraling costs" -- estimated to be $4,227 per year per patient including administrative costs -- that could come with a plan to treat employees and their family members, the Guardian reports. The company currently does not offer antiretrovirals to employees' family members, but Brink said that position is "untenable," according to the Guardian. Brink noted that diamond miner and distributor De Beers, which is partly owned by Anglo, currently is offering antiretroviral drugs to both its staff and their families. Brink said that he hopes to have a total of 1,000 HIV-positive Anglo employees on treatment by the end of 2003. He also said that he hopes the South African government will follow the recommendations of its own task team to implement a national antiretroviral treatment program (Macalister, Guardian, 10/9).
Anglo on Monday announced $4.35 million in funding for a community partnership project to accelerate the provision of comprehensive HIV/AIDS care and prevention services in government clinics in the six South African provinces where the company has business units. The three-year initiative, which is believed to be the first large effort by a South African company to extend employee HIV/AIDS programs to surrounding communities, will help fund the National Adolescent Friendly Clinic Initiative, a partnership between loveLife and the South African government. LoveLife -- South Africa's national HIV prevention program for youth -- combines a sustained, high-intensity, multimedia education and awareness campaign with countrywide efforts to establish adolescent-friendly services in government clinics and a national network of community level outreach and support for youth (Kaiser Daily HIV/AIDS Report, 10/8).