HIV/AIDS and Trade Unions
Trade unions around the world are at the forefront in the struggle against the effects of HIV/AIDS, especially in the workplace. They have created local and national programmes to help workers and their families cope with the illness, loss of income, prevention and much more. At the global level they have organized international responses via their Global Unions. And they have been central actors in the International Labour Organization as the ILO promotes its Code of Practice and works towards a new international standard which addresses HIV-AIDs in the world of work.
What is HIV/AIDS?
Although almost always referred to with the single descriptor – HIV/AIDS – there are two components to consider:
HIV is the Human Immunodeficiency Virus. It is a virus that attacks people’s immune system – the part of the body which protects people from infections and cancers. Once somebody gets the virus the result is a chronic, progressive illness which leaves people open to many different kinds of infections and cancers.
When a person’s body gets to the stage where it can no longer fight infection the disease is referred to as AIDS which stands for Acquired Immunodeficiency Syndrome. On average, it takes more than 10 years to progress from initial HIV infection to AIDS.
In order for a person to be infected, the virus must enter the person's bloodstream. (HIV cannot survive outside the body.) HIV is transmitted from one person to another through:
· unprotected sexual intercourse (vaginal, anal or oral)
· shared needles or equipment for injecting drugs
· unsterilized needles for tattooing, skin piercing or acupuncture
· pregnancy, delivery and breast feeding (i.e., from an HIV-infected mother to her infant)
· occupational exposure in health care settings
Over the past 25 years, nearly 25 million people have died from AIDS. This has had a devastating effect on workers, families and economies. The impact of the epidemic is very deeply felt in the world of work. Discrimination in the workplace threatens people’s rights and jobs. AIDS reduces skills and productivity. Household incomes are slashed as sickness and death affect people’s livelihoods. AIDS exacerbates poverty and inequality, increasing the burden on the most vulnerable people in society: women, children and the poor.
HIV/AIDS has also complicated efforts to fight poverty, improve health, and promote development by:
Through unprecedented global attention and intervention efforts, the rate of new HIV infections has slowed and prevalence rates have levelled off globally and in many regions. But despite the progress seen in some countries and regions, the total number of people living with HIV continues to rise. Here are some facts to consider:
• In 2007 there were 33 million living with HIV, 2.5 million people were newly infected with the virus, and about 2 million people died of the disease.
• HIV infections and AIDS deaths are unevenly distributed geographically and the nature of the epidemics vary by region. Epidemics are coming under control in some countries and growing strongly in others. More than 90 percent of people with HIV are living in the developing world.
• There is growing recognition that the virus does not discriminate by age, race, gender, ethnicity, sexual orientation, or socioeconomic status. HIV/AIDS can attack anybody. However, certain groups are at particular risk of HIV, including men who have sex with men, people who inject drugs with needles and commercial sex workers.
• The impact of HIV/AIDS on women and girls has been particularly devastating. Women and girls now make up 50 percent of those aged 15 and older living with HIV.
• The impact of HIV/AIDS on children and young people is a severe and growing problem. In 2007, 420,000 children under age 15 were infected with HIV and 290,000 died of AIDS. In addition to the estimated 2.1 million children living with HIV/AIDS, about 15 million children have lost one or both parents due to the disease.
• There are effective prevention and treatment interventions, as well as research efforts to develop new approaches, medications and vaccines.
• The sixth Millennium Development Goal of the United Nations focuses on stopping and reversing the spread of HIV/AIDS by 2015.
• Global funding is increasing, but global need is growing even faster – widening the funding gap. Services and funding are disproportionately available in developed countries.
What can trade unions do?
Because of their presence in the workplace and the respect by working people that they have earned trade unions have a special role to play in responding to the epidemic. They can help fight HIV/AIDS by:
· Protecting the rights of people at work against stigma, discrimination, compulsory testing and dismissal.
· Developing HIV agreements with employers to put in place policies and programmes at workplaces in public and private sectors.
· Supporting behaviour change. Because trade unions share the same background as the people they represent, their messages and educators are likely to be trusted and accepted.
· Reducing risk by promoting occupational safety and health and addressing social, economic and political factors that increase risk.
· Promoting access to care and treatment. Trade unions have a crucial role in working with employers to increase access to treatment and encourage people to be tested in an atmosphere of trust and non-discrimination.
· Developing national and international programmes, working with employers and governments to include strategies for the workplace in national AIDS plans, and making sure that AIDS is on the agenda of every trade union.
Over the past few years labour organizations have learned many lessons as they have organized the struggle against HIV/AIDS at the local, national and international levels. These lessons include:
· The need to develop international HIV policies.
Trade unions can be a significant force in helping shape policy. They can use long-established links with the ILO, UNAIDS, the World Health Organization, the World Bank and other international bodies to campaign for a commitment to greater resources for responding to the epidemic. They also contribute to the adoption of international standards and guidelines on HIV. The joint ILO-WHO Guidelines on Health Services and HIV promote the effective management of HIV/AIDS in the health sector. They seek to ensure care and treatment that respects the needs and rights of patients, and aim to provide health workers with decent, safe and healthy working conditions.
• International framework agreements can be very effective.
Framework agreements are contracts negotiated between global unions and transnational companies at the global level. They establish the rules of conduct for the companies. Since they are negotiated on a global level and require the participation of trade unions, International Framework Agreements are ideal instruments for dealing with the issues such as HIV/AIDS. For example the global union for metalworkers – the ICEM – tries to ensure that the ILO Code of Practice on HIV is incorporated into every international framework agreement it negotiates.
• Joint union-employer global projects can be very effective.
The example of the ICEM also demonstrates how links with multinationals can be the lever for workplace projects on HIV prevention and care and treatment in companies’ operations worldwide. For example, the ICEM is working to negotiate with pharmaceutical companies for targeted donations of antiretrovirals for the mining sector, and is developing partnerships with global mining companies on a proposal for workplace clinics in southern Africa.
• Worldwide programmes are essential.
The global union for education workers - Education International (EI) – has shown how to build on its longstanding relationships with international organizations to fight HIV/AIDS. EI has worked with the World Health Organization, the WorldBank, UNICEF and UNESCO to develop a worldwide HIV education programme for teachers. The programme is based on partnership and brings together the unique resources and skills of the health, education and labour sectors. EI has developed a training programme and cascade approach to delivery that can be rolled out and adapted for countries worldwide.
• Supporting national affiliates is necessary
A global union such as Education International can also exert a positive influence on the national delivery of HIV programmes. For example, the impetus for a teacher training module in Rwadan schools came initially from the global union body. Teacher unions in Rwanda made the program happen at the country-level by high-level committment, leadership, and the contribution of resources. As another example: the Public Services International is guiding its membership to negotiate with governments to make sure that public sector workplaces have policies and programmes on HIV.
• Political mobilization is needed.
Moblizing people to contribute to the fight against HIV/AIDs is crucial. The experience of COSATU in South Africa in mobilizing thousands of people in support of the campaign for affordable treatment shows the power of international solidarity. The campaign was boosted by global support from trade unionists and development activists who came out in force in their own countries to demand justice for people in South Africa. UNISON, a British trade union, is another example of how the labour movement in many industrialized countries uses political networks to demand greater international action on the epidemic.
The Global Unions HIV/AIDS Program
A major response by the international labour movement to the AIDS epidemic is the Global Unions Programme on HIV/AIDS. Global Unions are international labour organizations which represent particular sectors of workers. They work closely with the International Trade Union Confederation. They are:
EI - Education International
IMF - International Metal Workers’ Federation
ICEM - International Federation of Chemical, Energy and Mine workers
PSI - Public Services International
UNI - Union Network International
ITGLWF - International Textile, Garment and Leather Workers’ Federation
IFBWW - International Federation of Building, Wood Workers
IUF - International Union of Food, Agricultural, Hotel, Restaurant, Catering, Tobacco and Allied Workers' Associations
ITF - International Transport Federation
IFJ - The International Federation of Journalists
The Global Unions have agreed to join forces in order to bring the combined strength of their mass organisations into the global struggle against HIV/AIDS. The goals of the Programme they have established are to:
The Programme is focussing on the following activities:
The International Labour Organization
The ITUC and the Global Unions are strong supporters of the International Labour Organization and the ILO’s work on HIV/AIDS. Over the past few years they have promoted the adoption of the ILO’s Code of Practice on HIV/AIDS and the World of Work by companies all around the world. The key principles of the Code are:
· Recognition of HIV/AIDS as a workplace issue
HIV/AIDS is a workplace issue not only because it affects the workforce, but also because the workplace can play a vital role in limiting the spread and effects of the epidemic.
There should be no discrimination or stigmatization of workers on the basis of real or perceived HIV status.
· Gender equality
More equal gender relations and the empowerment of women are vital to successfully preventing the spread of HIV infection and enabling women to cope with HIV/AIDS.
· Healthy work environment
The work environment should be healthy and safe, and adapted to the state of health and capabilities of workers.
· Social dialogue
A successful HIV/AIDS policy and programme requires cooperation and trust between employers, workers, and governments.
· No screening for purposes of employment
HIV/AIDS screening should not be required of job applicants or persons in employment. Testing for HIV should not be carried out at the workplace except as specified in the code.
Access to personal data relating to a worker's HIV status should be bound by the rules of confidentiality consistent with existing ILO codes of practice.
· Continuation of the employment relationship
HIV infection is not a cause for termination of employment. Persons with HIV-related illnesses should be able to work for as long as medically fit in appropriate conditions.
The social partners are in a unique position to promote prevention efforts through information and education, and support changes in attitudes and behaviour.
· Care and support
Solidarity, care and support should guide the response to AIDS at the workplace. All workers are entitled to affordable health services and to benefits from statutory and occupational schemes.
A new ILO international instrument on HIV/AIDS
In June 2009 the ILO undertook took a major initiative to reinforce its widely used-used Code of Practice. A first discussion took place at the ILO’s International Labour Conference and draft conclusions were agreed upon. The result was a draft text of a new international instrument – an ILO Recommendation. The text is being circulated to ILO member states for comments. Each state has an obligation to consult trade unions as they develop their response to the draft text. The comments presented by the member states will be used to create a revised text which will be presented for adoption at the International Labour Convention in June 2010.
This is a very significant event in the international response to HIV/AIDS. Up to now HIV/AIDS has been covered implicitly by international ILO labour standards, such as Convention No. 111 on Discrimination (Employment and Occupation). However, if adopted in 2010, this standard will be the first international standard to focus explicitly on HIV/AIDS, human rights and the workplace. The adoption of the new instrument would give new impetus to anti-discrimination policies at national and workplace levels. Through its emphasis on rights, and specific guidance on the components of a workplace package on HIV/AIDS, it would strengthen the contribution of the world of work to achieving universal access to HIV prevention, treatment, care and support. It would also provide a framework for coordinating workplace responses at country level and promote information-gathering and reporting.
At the Conference in June 2010 the ILO will finalize the provisions of the Recommendation and address its adoption. Once the Recommendation is adopted at the Conference, governments will have 12 months to submit the new instrument to their “competent national authorities”, which are usually Parliaments. Governments give effect to the new instrument by adopting or modifying legislation and policy, as necessary. The International Labour Conference may also decide to establish a follow-up mechanism. Governments might be asked to report on the law and practice in their States and explain how effect has been given to the Recommendation.
It is crucial that as governments are considering their response to the new Recommendation that trade unions be involved. They can bring into the discussion their expertise concerning workplace issues and the lessons they have learned about how to organize globally struggles against HIV/AIDS. The time for trade unions to influence the ILOs new instrument on HIV/AIDs is now.
How is HIV/AIDS being fought in your countries or countries?
How can your labour organization work with the ITUC and the Global Unions to implement programmes to fight HIV/AIDS?
How can your labour organization be involved in the development of the new ILO Recommendation on HIV/AIDS and the world of Work?
More information on how HIV/AIDS is being fought by labour organizations and the ILO can be found at the following web sites:
International Labour Organization