E Mohamed Rafique started seeing HIV cases among workers at Tata Tea Ltd’s Munnar estates and realized his employer had to address the disease before it was too late. And he knew just how to convince them.
“I talked money,” he says. Laptop in tow, he visited decision makers at Tata Tea and urged them to play a game called “Biz and AIDS,” (available on www.ishima.info) based on a research paper he wrote. Ignorance, he told them, could result in higher absenteeism, less productivity and even more cases.
So Tata Tea devised a workplace intervention programme covering more than 27,000 employees in all southern tea estates. The programme focused on prevention, voluntary counselling and testing and wellness management for those who tested positive. “Over a period of time we did see some behaviour changes among the workers,” says Dr Rafique, now a resource person at UNAIDS’s India office.
A World Bank report released this week underscores Dr Rafique‘s message—India’s private sector can benefit from supporting interventions aimed at preventing HIV both in the workplace and in local communities. Despite a revision in India’s caseload number to less than 3.1 million from 5.2 million, experts say that businesses cannot afford to drop their emphasis on tackling the disease.
“In a relatively low-risk, low-prevalence country as India is now, it’s crucial to intensify awareness and prevention efforts to reduce the long-term costs of treatment of an infected population if the disease spreads and companies are forced to put a greater emphasis on treatment,” says Dr Neeraj Mistry, technical director of the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria, an alliance of international companies.
In August last year, the Coalition partnered with New-Delhi business process outsourcing (BPO) firm iEnergizer Inc. to start an AIDS initiative among call centres. “Most call centre employees are young, single, have money to spend and a lifestyle to match. They are a vulnerable bunch,” says Ashish Mittal, iEnergizer’s vice-president of operations. The programme at iEnergizer emerged from a sexual attitudes study, which revealed that call-centre employees demonstrate higher risk-taking behaviour with 11% saying that they had more than five sexual partners.
IEnergizer has gone beyond awareness and prevention education to include access to comprehensive testing and support services. The impact of the initiative has not been gauged, but Mittal says it’s a start.
With its efforts, iEnergizer joins established programmes in the transport and construction industries, which employ large numbers of migrant employees considered a high-risk group for HIV infection.
Of the 2.5-3 million long-haul truckers that travel India’s highways, approximately one in 10 is infected with HIV, according to the World Bank.
The Transport Corp. of India Ltd runs an $8 million (Rs32.1 crore), five-year programme funded by the Bill and Melinda Gates Foundation’s Avahan India AIDS initiative, which targets truckers. Project Kavach (Hindi for shield) operates clinics to treat sexually transmitted infections, distribute condoms and educate truckers about HIV-prevention at 17 major truck stops in nine states with the aim of reaching 1.4 million truckers per year—even though TCI employs 4,000 truckers.
“In the long term we felt that if there is no intervention it could have a significant impact on the trucking business and business in general,” said Tarun Vij, project director at the TCI Foundation, the company’s non-profit arm which oversees the HIV initiative. “Most companies tend to see this issue at a distance from themselves and that can’t continue. If it doesn’t touch them directly, it might through their supply chain or someone they deal with.”
Other companies, including the $20 billion Reliance Industries have recognized this. At its Hazira manufacturing sites in Gujarat, the company runs a health centre that treats tuberculosis and HIV among the large number of contract and migrant workers.
It also runs HIV-awareness programmes for the 1,000 truckers per day that head there to off-load and pick up goods, according to the World Bank report and a Reliance spokesperson.
Initiatives such as those at Reliance and TCI are in line with the National AIDS Control Organization’s recently launched third round of national AIDS policy, which relies heavily on outreach and education for truckers, migrant labourers and other high-risk groups such as sex workers, injecting drug users and men who have sex with men, as the keystone of its prevention programme.
For all employees already on the rolls, TCI follows a policy promising confidentiality, barring discrimination based on HIV status and full treatment if an employee chooses to reveal his or her status. A major part of that is aimed at sensitizing senior and middle management at its 1,000 locations about the myths and realities of the disease, said Vij. “It’s amazing that educated people—sometimes very educated people—don’t know the basic facts about this disease and how it spreads and how it doesn’t, so we thought it was part of our responsibility to tell them,” he said.
The Indian division of Standard Chartered Plc. started its AIDS policy, which fights discrimination, provides information on voluntary testing and provides access to medicine, after witnessing how AIDS was affecting its Africa units.
“Our experiences there made us realize early on that there is a business angle to the pandemic,” says Arijit De, a spokesman at Standard Chartered.
Till recently, the Indian corporate sector’s involvement with HIV/AIDS has, by its own admission, been piecemeal. The World Bank report estimates that only a small share of the private sector—around 70 companies—are engaged in fighting HIV and AIDS. Most are large corporations.
But things seem to be improving. “Today, there is a lot of interest among corporates to have HIV/AIDS initiatives in the workplace,” says Kanika Singh, executive director of Mumbai-based not for profit HIV education organization, the Heroes Project.