HAART for the HIV-infected employees of large companies in Africa

The International AIDS Conference held in Durban in 2000 was a watershed for highly active antiretroviral treatment (HAART) in Africa. Since then HAART in sub-Saharan Africa has been firmly on the international agenda and access to treatment in resource-poor settings has become a top priority. Multiple initiatives were developed to realise the goal of expanding treatment access (The Global Fund to Fight AIDS Tuberculosis and Malaria the US Presidents Emergency Plan for AIDS Relief the World Banks Multi-country AIDS Programme and many others). Although private sector employers in Africa were some of the first to embark on HAART for their workers (eg Anglo-American Compagnie Ivoirienne dElectricite Volkswagen South Africa) public sector approaches have now largely surpassed these efforts. Few large companies in Africa have launched comprehensive AIDS treatment schemes for their workers and dependants. Most employers in Africa hesitate to take responsibility and refer employees to government HIV programmes that are benefiting from international financial support but struggling with implementation. There is an encouraging trend among companies in countries with high prevalence to have HIV policies but even in countries with prevalences between 5% and 20% less than half of companies claim to have an HIV policy. In sub-Saharan Africa only 26% of the companies that have HIV policies provide antiretroviral treatment to their workers. (excerpt)