HIVAids Workplace programmes

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A Case study of how De Beers is progressing in
managing the business risk of HIV and AIDS,
lessons learnt in dealing with a new operational
risk! Joy Beckett HIV/AIDS Manager
Operations De Beers Consolidated Mines Ltd.
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HIV/Aids Workplace Programmes
Why do we do it? HIV Aids is not only a
business risk but a threat to sustainable
development. In todays global economy, a disease
that has killed more than 30 million people is
everyones problem and every companys
responsibility. Global Business Coalition on
HIV/Aids
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Country HIV Prevalence according to UNAIDS
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General HIV Prevalence in RSA
ESTIMATED 4.8 MILLION TO 5.5 MILLION LIVING WITH
HIV IN SA
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HIV Prevalence in RSA Mines
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Company Profile

• Largest diamond mining company in the world,
  producing over 40 of global gem diamonds.
• The companys mining expertise extends to every
  form of diamond mining (underground, alluvial,
  opencast, marine and coastal).
• Exploration extends across 13 countries on five
  continents, with over 25 joint venture projects
  with a number of companies.
• 23 000 employees globally, of whom roughly 19 000
  are based in the southern African operations.
• Sero-prevalence surveys across the South African
  operations estimate an average infection rate of
  10.2 per cent.

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Policy creates framework

• Recognising and honouring the rights of all
  employees, including those who are HIV positive.
• Minimising the spread and impact of HIV
  infection.
• Providing access to treatment, care and support
  for infected and affected employees.
• Creating common standards across the family of
  companies.

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De Beers HIV and AIDS Strategy
De Beers Community HIV/AIDS Programme
COMMUNITY
Communications
Minimising the socio economic Impact COMMUNITY
Living with AIDS TREATMENT
Saving Lives PREVENTION
Stakeholder Engagement
WORKPLACE HIV/AIDS POLICY
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HIV/Aids Workplace programmes
PREVENTION EDUCATION AND TRAINING, PEER
EDUCATORS, VCT
PREVENTION AND SERVICES VOLUNTARY COUNSELLING
AND TESTING (VCT)
HIV Negative
HIV Positive Status Unknown
HIV Positive Status Known
DISEASE MANAGEMENT PROGRAMME INFORMATION,
WELLNESS ART
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Key interventions VCT

• Knowledge is power
• Targeted VCT campaigns at all our mines led to
  over 77 uptake in South Africa in 2006
• Service extended to contractors and, where
  possible, spouses and community

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Key interventions Treatment

• Clinical expertise and advice
• Counselling support
• Clinical data management

Treatment Model
THIRD PARTY DISEASE MANAGEMENT SERVICE PROVIDER
NETWORK OF TRAINED SERVICE PROVIDERS Including
mine doctors and private practitioners
State or donor funded
EMPLOYEES (incl retired and retrenched)
SPOUSES OR LIFE PARTNERS
COMMUNITY (incl contractors)
And children in Debswana
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Key interventions Treatment

• There is no cost to the employee
• Comprehensive programme which covers wellness
  advice, doctors consultations, pathology,
  counselling and support, prophylactic medication
  to prevent opportunistic infections such as TB,
  nutritional supplements, PEP and PMTCT, and
  anti-retrovirals when clinically required
• Debswana was the first company in the world to
  provide a comprehensive disease management
  programme outside of medical insurance
• De Beers was the first mining company in South
  Africa to provide free anti-retroviral treatment
  for spouses and retired and retrenched employees
  for life, July 2003

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Are we making a difference?

• Treatment Uptake
• While uptake has not been as high as hoped, it is
  not dissimilar from other corporate programmes on
  average 30-40 uptake based on HIV prevalence
  survey data
• Of the total HIV positive employees registered,
  50, in the SA programme of those who require
  HAART right now, are receiving it
• Gender Male 70 Female 30 on treatment.
• Research project to investigate uptake in
  workplace and social context is being undertaken
  by HEARD (funded by the MERCK Foundation)

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Are we making a difference?

• Over 1300 people registered on the treatment
  programmes of De Beers Family of Companies in sub
  Saharan Africa (1019 employees and 294 spouses)
• Leading productive lives, earning a living and
  contributing to the well-being of their families
• Minimising the economic impact on the companies
  and society

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The Feminisation of HIV AIDS

• In South Africa
• In 2006, 33 000 pregnant women participated in
  government. antenatal clinics (16 500 in 2005)
• Decline in HIV rates in pregnant women below 20.
  15.9 (2005) to 13.7 (2006) BUT numbers of new
  infections among our youth contribute a 1/3 of
  the 500 000 new infections annually. (SA has - 5
  million HIV infections)
• HIV infection among the age group 25-34 is close
  to 40, illustrating women at their reproductive
  prime are at greatest risk the need for
  accelerated HIV prevention programmes targeting
  key issues multiple concurrent partners, gender
  inequality and violence against women

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Hard Lessons Learnt

• The importance of involving and equipping
  managers
• Defined deliverables and measurable goals
• Building and maintaining relationships
• Maintaining impetus
• Shared experiences
• Aligning the workplace programme with other
  initiatives

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Way Forward

• Making HIV testing part of health management and
  business processes, a part of your PREVENTION
• Moving from focus on treatment registration to
  treatment adherence
• Providing services for contractors, families and
  community members
• (Avoiding an Us and Them scenario)
  integration
• Measurement and evaluation

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Aids must not only be seen as a health issue.
It must also not be seen to be only about
economic development. Our response must address
human development.
former president Nelson Mandela
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Before 2006
LAC
Between 1998 and 2005, HIV and Aids related
projects were funded through the De Beers Fund
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What we do in the community

• The De Beers Fund invested over R3.5 million (14
  of its annual CSI budget in South Africa) in 22
  HIV/Aids related initiatives in 2005 alone

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HIV/Aids initiatives in the community
Palliative Care
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HIV/Aids initiatives in the community
Orphan Care
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HIV/Aids initiatives in the community
Food security and social welfare
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De Beers Community HIV/Aids Programme
Since 2006
HIV/Aids Coordinators
De Beers Community HIV/Aids Programme
De Beers Fund
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De Beers Community HIV/Aids Programme
De Beers Community HIV/Aids Programme R10 million
per annum over 3 years

• National level to address shared issues of
  national concern
• Regional level to address specific challenges in
  communities around our operations
• Partnerships with NGOs, CBOs, donors and local
  and national Government
• Sensitivity to the vulnerability of women and
  girls in the context of HIV/Aids

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Major initiatives in DBCHAP
Soul City Partnership Community Training
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Major initiatives in DBCHAP
Isibindi Project Galeshewe
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Isibindi Project Galeshewe
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EXTENDING TREATMENT THROUGH A PARTNERSHIP
BETWEEN DEBSWANA AND THE GOVERNMENT OF BOTSWANA
(MASA)
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MASA Programme

• Orapa and Jwaneng clinics registered as
  Government treatment sites
• Close on 3000 citizens receive treatment from
  these sites
• Mine provides facilities and staff, Government
  pays for medication

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In closing Are we making a difference?

• We estimate that between 12,000 and 16,000
  children have at least one parent who is still
  alive because of the comprehensive disease
  management programme - including ART - provided
  by De Beers, Debswana and Namdeb

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Reducing HIV in South Africa by 50

• The NSP targets are clear 2007 20011, there are
  19 Goals which offer a comprehensive plan to
  address HIV and AIDS, making that operationally
  applicable to your industry will determine the
  success
• Stop new infections, PREVENTION is the key and
  developing programmes that will change behaviour
  of men and women critical.

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A vision for the future!

• No babies born with HIV
• No people dying from HIV
• No new infections