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African Unions Go To War Against AIDS

By Luc Demaret

The war on AIDS is now the number one priority of the ICFTU's African Regional Organization (AFRO), which has launched an ambitious five-year action plan in nine of the most severely afflicted African nations.

"I am 26 and have one child. In 1996, a blood sample taken when I was pregnant revealed that I was HIV positive. I didn't even know that I was going to be tested for it. I thought that AIDS was a disease that only affected homosexuals and prostitutes. I went to see several doctors because I just couldn't believe it. I warned my husband immediately, but it took me more than a year before I dared tell my mother. My baby died at 21 months".

Stories such as this, by South African Nthabiseng Sandra Moagi - now committed to the fight against AIDS launched in South Africa by NACTU (National Council of Trade Unions) - lie behind the terrible statistics of the AIDS pandemic that has ravaged the African continent. But in her speech to an assembly of African trade unions convened recently in Gaborone (Bostwana) by the ICFTU's African Regional Association (AFRO), Nthabiseng placed the emphasis on remedial action.

AFRO listened to what she had to say and then took the necessary action. The figures are there, implacable. The HIV virus is spreading fastest in South Africa, where another 1,500 people become infected each day. Globally, more than 11 million people have died from AIDS and more than 34 million are HIV positive. Of these, over two thirds live in sub-Saharan Africa.

Botswana, Namibia, Swaziland and Zimbabwe are some of the most affected countries, with between 20 and 26% of the 15-49 age group HIV positive. In Botswana, where AFRO held its conference, one person in three has the virus.

"The fact that AIDS kills off people in Africa is, in itself, a direct threat to development", says ORAF General Secretary Andrew Kailembo. The economic and social consequences of this plague ravaging the active population of the countries concerned are truly catastrophic." He continues: "The nature of their work is such that workers in the transport sector, especially road and maritime transport, are extremely vulnerable to the disease. Similar risks have been observed in the mining communities of South Africa, Namibia, Botswana and in the agricultural sector and the plantations of East Africa. The commerce and hotel sector in Kenya, Uganda and Tanzania are also highly exposed."

This fact naturally led the ICFTU and AFRO to consider that the workplace plays a key role in AIDS prevention campaigns.

AFRO therefore drafted a five-year action plan in Gaborone in late September which it then officially launched in Nairobi.

The action plan, which has benefited from a number of large financial contributions, will include on-the-job training, health and hygiene programmes, the forging of alliances with other bodies fighting AIDS and information campaigns. These campaigns will also be directed at governments and employers. "We want to encourage the African governments to voice their concern about this plague and to demonstrate their political determination to see it eradicated", Andrew Kailembo said recently.

Beyond mere prevention, two major problems will also be tackled by the unions: discrimination against people who are HIV positive and the relative inaccessibility of treatment. The unions feel that thousands of people are being discriminated against at the work place simply because they are HIV positive. There is no doubt that this is a very real problem but it is often shrouded in silence.

"Discrimination is widespread," explains Franklyn Lisk, an expert at the International Labor Organization (ILO). "But what comes to our attention is only the tip of the iceberg. Many workers prefer to remain silent, afraid of revealing the fact that they are HIV positive to the people they live and work with". Nevertheless, there have been many cases of unfair dismissal, HIV tests performed on job applicants, violations of confidentiality and refusals to promote or train those afflicted by the disease.

Recently, the national carrier South African Airways was forced to hire a steward whom it had refused to recruit because of his positive HIV test result: this court ruling has set a precedent. Franklyn Lisk notes: "It is not uncommon for training requests to be turned down. Employers are not keen to invest in a worker who risks falling ill at any time".

Fortunately, not all employers react in the same way. In South Africa, the carmaker Ford is leading the way. Johan Strijbom explains: "In our company, confidentiality is the rule. The worker can have the test done by the plant clinic safe in the knowledge that the result will remain confidential. We will not tolerate any discrimination against HIV positive workers." Each month the company hands out thousands of contraceptives and has gone into partnership with the unions on the AIDS issue.

Breaking the wall of silence surrounding discrimination is one of the central aims of the AFRO plan. The organization is also inviting the unions to negotiate protection clauses in their collective agreements on the basis of ILO Convention 111, which outlaws any discrimination at work, and Convention 159 on vocational training.

Finally, the lack of access to treatment for AIDS sufferers remains a major problem. Andrew Kailembo is critical: "In most African nations, a patient has to pay out around $42,000 a year to have access to the treatment he needs to keep him alive. It's just not realistic."

His criticisms are aimed essentially at the pharmaceutical multinationals, protected by the World Trade Organization's intellectual property rules, which despite reaping massive profits refuse to lower the cost of life-saving medicines.

Stopping off in the Kenyan capital, Nairobi, ICFTU Secretary General Bill Jordan fumed: "The greatest scandal of our time is the way the pharmaceuticals companies are holding people on death's door to ransom. They are equalled only by the governments that defend them through an immutable view of intellectual property rights". He added: "No right is more important than the right to life".

Unequal access to medicine is probably one of the main lessons sadly highlighted by the AIDS epidemic. Alain Lejeune, professor of pharmacology at a Belgian university and an acknowledged world expert reports: "When it comes to the consumption of medicines, Africa doesn't even enter the frame". While the pharmaceuticals industry generates global turnover of USD 214.4 billion, Africa accounts for less than 1% of this. The inequality goes beyond this, however, with 17% of the world's population consuming 83% of global medicine production. In other words, only 17% of production goes to the remaining 83% of people. What is more, now that the pharmaceuticals industry has managed to shrug off the Californian lobby, which appears relatively satisfied with tritherapy solutions, it is less motivated to undertake research into an AIDS vaccine.

Doctor Lejeune stresses: "The industry is still researching this problem, but it only makes a concerted effort when there is funding from governments or international organizations. And, of course, it would rather sell its expensive medicines in countries with the requisite purchasing power and health insurance funds".

And yet only 40 years ago, the experts recall, the pharmaceuticals industry managed to produce a low-price low-margin polio vaccine. Perhaps this was because the disease threatened the wealthier nations. The fight against AIDS must challenge the role played by the medicine multinationals. AFRO, in any event, is targeting them for a campaign that has since become "the mother of all trade union campaigns in Africa".

For more information, please contact the ICFTU Press Department on +32 2 224 0212

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