WP-Policies & Programs Henri van den Hombergh, MD MPH Program Leader MOH/GTZ Health Sector Program Kenya

Transcription

1 HIV/AIDS and the Public & Private Sector WP-Policies & Programs Henri van den Hombergh, MD MPH Program Leader MOH/GTZ Health Sector Program Kenya

2 The HIV/AIDS Epidemic is increasingly recognized as a serious threat to economies, businesses and communities!

3 Is it

4 The global Competitiveness Report Executive Opinion Survey World Economic Forum 7,789 Firms in 103 Countries Assesses studies of the impact of HIV/AIDS on economies and businesses Executive Opinion Survey, focusing on questions covering HIV/AIDS and the disparities between prevalence estimates of UNAIDS and the private sector Conclusions and recommendations

5 World Economic Forum Klaus Schwab Each person infected represents a legacy of failed prevention The private sector need to contribute to the building of the next wave of response Business main Business is Business

6 3 + 1 key dimensions for action for companies Peter Piot (UNAIDS) : 1. Starting epidemic: manage risks actively through WP- Policy & Program with focus on prevention 2. Mature epidemic: protect your investment in human capitalby providing VCT, ART, Care&Support as a necessary counterpart to a full-scale WP- Policy&Program 3. Extend the efforts to Families, Communities and Business Partners Reduce stigma, it undermines all efforts!

7 Standard Chartered Bank s Motivation for WPP (Mervyn Davies) 1. Protect basic human rights 2. Preserve the integrity of the labour force 3. Reduce costs associated with HIV/AIDS 4. Respond to a real challenge

8 Dean London Business School Laura Tyson Most Companies have poor information on which to assess the actual risks to their business posed by the epidemic and to design appropriate responses Most companies have not developed company-wide policies and programs to contain the business risks of this epidemic Despite their relative inaction, most do express support for a broad societal response in which to play an integral part

9 Kenya (75 Firms) (Classified in the % prevalence league by UNAIDS) 37% estimate prevalence among the workforce 4-9% 36% say they have no idea 13% has done a form of prevalence survey/study 63% expects serious impact of the epidemic ( compare 43% says so about Malaria, 31% for Tuberculosis) But 13% expects it will seriously impact on: Productivity and absenteeism Death and Disability Medical and Funeral expenses 11% expects the epidemic to impact on revenues

10 75% no WP-Policy and/or Program 12% Yes!!! 13% missing value The average for Africa is 25%!

11 What is the Business doing? PWC (July-September 2003) 216 Organizations in Kenya, Tanzania, Uganda and Zambia The majority is ignoring the epidemic and its impact Only 39% has a policy 71% believed employees had died from HIV/AIDS 11% Estimates prevalence less than 5%, 75% does not know!

12 On the positive side 83% follows the ILO code of practice The majority: Do not discriminate on the basis of sero status when recruiting Do not ask staff to leave when identified HIV+ Only 6% felt that HIV/AIDS has no impact on their business and workplace 88 of 216 could put a monetary value on this impact

13 Kenya 59 Organizations 44% admits an increase of health care costs 27 % admits low, 12% a decline in productivity 46% has a formal HIV/AIDS policy! Protect staff and benefit the organization Learnt from others Makes good business sense Less expensive Understood the magnitude of the problem 23 offer a form of HIV testing (out of 35 of the 216!!!!!) 31% > <200 25% 12% 32%

14 80% Runs education & training courses 55 % distributes condoms 68% encourages VCT 28% excludes HIV/AIDS from the health care package but 49% explicitly state it is covered 33% provides ART 67% states HIV/AIDS raises financial issues, 51% says cost are increasing Kenya 59 Organizations

15 Private Sector Analysis (3-5/2004) for National AIDS Control Council by W. Kiarie et al. 19/52 has written Policy > % has a copy of ILO code of Practice <200 44% has some kind of WP-program (awareness, PMTCT, treatment of opportunistic infections and STI) 58% 19% 6% 33 % has some form of VCT (12% in house) 17% provides ART 17% < 35% uses substantial IEC Total sample = 52 Reasons for WP-Policy&Program Sources of funding and support: Substantial gaps identified (GF, MAP, DARE, NACC, PEPFAR, UN Global fund) 65% save lives 58% improve productivity 46% reduce costs 38% Corporate image

16 Private Sector Analysis (3-5/2004) for National AIDS Control Council by W. Kiarie et al. Total sample = 52 Current impact Future impact (in 5 years) Impact on community Percentage of firms selecting response Minimal impact Some impact Serious impact Leadership and live examples 58% did not identify a single business organization they look up to

17 Program Component Rating Programme component % of firms Level 1 Level 2 Level 3 Level 4 1. HIV/AIDS policy Management and coordination Awareness and education programmes Condoms VCT Treatment and Care Impact assessment, KAP surveys and HIV Nil prevalence surveys 8. Involvement of the community, customers, suppliers and other partners Overall Rating 52% 12% 29% 8% Legend: level 1: <9 out of 48 level 3: out of 48 level 2: 9-14 out of 48 level 4 >36 out of 48

18 Stigma! 80% acknowledges this as a key problem, the other 20% overcame stigma through their WP-Policy&Program

19 Current Situation: Declining Rates of Economic Growth in the 1980s & 1990s Trends in Real Growth of GDP and Per Capita GDP 7 Percent GDP Growth Rate (Real) GDP Per Capita Growth Rate (Real)

20 The Public Sector NACC in the Office of the president AIDS Control Units in Line-ministries Constituency AIDS Control Committees What plans KNUT National Health Insurance Civil Servants benefit schemes? Unions, Sacco s etc.

21 The way Forward (1/3) Close the info gap at all sides and levels

22 The way Forward (2/3) Balance Bottom-up with Top Down Balance Supply & Demand Apply: Scale up Scale down Engage the GOK Keep it simple Match your agenda with your agenda The epidemic strips time and human capacity out of the system Trust and Leadership at all levels

23 The way Forward (3/3) PPP: Public-Private or Private-Private Partnerships National Social Health Insurance Global Financing Initiatives (3X5, MCA, PEPFAR, MAP, GF) Sub-SWAP? Stop re-inventing the wheel!! The 3 Ms: Motivation, Mechanisms and Money Mutual respectful exchange will lead to: WIN-WIN situations