Capital

Shared ownership of HIV/AIDS

By Dr Isayas Wehib

I have been with Elico Leather for more than five years during which time Elico's health unit has become increasingly modernized and mobilized in the fight against HIV/AIDS. The company established a health centre in 1997 and today it has 11 members of staff including one doctor, four staff nurses, one pharmacy technician and three junior nurses.
Elico Leather Private Limited Company was established in 1997 and is based in Akaki Kality subcity serving the local and export market with our finished leather products.
We have one head office and three operating units with 1450 permanent employees who are predominantly male (78%). 65% of the workforce is married and the majority of the workforce is young with 85% below the age of 49. This makes the workforce of Elico Leather a prime target area for the transmission of HIV/AIDS.
The health coverage provided by the company is very good, especially according to Ethiopian standards. Health insurance is provided annually to each employee worth 4000 ETB for personal illnesses. There is no limitation for work accidents and also no limit on HIV/AIDS patient care for opportunistic infections. This generous health policy ensures our employees get the treatment they need and can maintain productivity.

Identifying and combating the problem of HIV/AIDS
In 1999 the company identified that there was a problem with HIV/AIDS. The mortality rate of the staff was high, in some years more than 10 members of staff were dying and there were increasing costs of sick leave, decreasing productivity and a high turnover of skilled manpower due to illness and death.
In 2000 we established an HIV/AIDS and TB prevention and control policy. This policy covers sick leave toleration, full salary until death and transfer to light work (with the same salary) if heavy work proves to be stressful. It also provides for the fast facilitation of pension if an employee dies of AIDS and gives priority to a family member to replace an employee who has died of AIDS.
Elico Leather also established one of the first solidarity funds in the country. It was compulsory for all employees to pay 5 ETB towards this fund and this was matched by the company. This fund was originally used for ART for HIV positive employees and when ART became free through the federal government, it fell into disuse. We are however planning to revive the fund and hold the money in savings for when ART is no longer subsidized.
Practically, we operate a referral system for ART where we refer employees to hospitals and clinics who provide ART and we also provide awareness raising materials such as brochures on nutritional advice. Our HIV/AIDS committee is led by the Chairman of the company, which ensures it has the status and recognition it needs.
We have been working for about four years with our outreach communities on behavioural change. Our activities have included a drama on HIV/AIDS and awareness raising campaigns. The community also uses the company's VCT centre and we operate a similar referral process for HIV positive people from the surrounding communities.

Challenges
Our employees originally did not see the significance of an HIV/AIDS policy and resisted contributing to the solidarity fund. We had to educate workers on the importance of the policy and show employees that those with HIV did not have to die. We also had to be very transparent about the fund and importantly show that the money was going directly to the employees who needed it and not back into the company's pocket.
Working with the Ethiopian Business Coalition Against HIV/AIDS (EBCA)
Elico began working with EBCA in 2004. They provide very valuable guidance and training to employees and company managers, and in our case have been particularly helpful to our human resource function. Our policy is revised every year with EBCA's assistance and in line with EBCA training and guidance. EBCA has done much in the last year to help Ethiopian companies deal with HIV/AIDS and we would like to see them assist companies to combat other social and health issues, particularly Malaria and TB.

The difference
Since the company first initiated and implemented its HIV/AIDS policy and training, overall awareness has increased. Having a dedicated policy, referral process for ART and presence on HIV/AIDS has also resulted in some stark measurable changes.
The mortality rate and absenteeism has declined substantially, illness has decreased, particularly STIs, the associated costs for opportunistic infections has decreased and company production levels have consequently increased. Over the last few years we have also seen a tangible increase in staff morale and a decrease in stigma and discrimination, most notably with regard to employees sitting next to HIV positive colleagues on the company buses.
Our HIV/AIDS policy and activities have come a long way since 2000 and we are very proud of the fact that during this Ethiopian Millennium year to date, our mortality rate from HIV/AIDS is zero.

Next steps
Currently there are 80-90 HIV positive employees within the company and 35 employees on ART. More than half of our employees are aware of their status and our aim is to make 100% of our employees aware of their status. We are continuing to work with EBCA to regularly update our HIV/AIDS policy following any new developments and on the training and activities of the HIV/AIDS committee in particular looking at ways to support HIV positive employees. In our experience, in-kind rather than monetary support is more beneficial.
We also want to work to change the perception that HIV/AIDS is just a company problem. We need to encourage shared ownership. The problem is everyone's, not just the company's but his, his family's, the country, everyone's. Companies won't carry sick people, the profit and production rule operates. It is in the company and the employees' best interests to work together on HIV/AIDS.

(The writer is Head of Safety, Health and Service, Elico Leather Private Limited Company. )