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Cross-sector partnerships: The fight against HIV/Aids is everyone’s business


Mpumi Zikalala is the Managing Director of De Beers Group Managed Operations and Chairperson of the South African National Aids Council Private Sector Forum.

As the world navigates the Covid-19 pandemic, it is important not to take our eyes off one of the world's most serious public health challenges – HIV/Aids. The mining sector, and business more broadly, has played an instrumental role in reducing the scourge of HIV/Aids. But our work is by no means done.

With Covid-19 having engulfed the entire globe, HIV prevention, testing, treatment and care services are being disrupted, particularly in countries with fragile health systems. This is a major threat to the gains we’ve made fighting the HIV/Aids epidemic, because we know that any slowing down of these initiatives will leave many vulnerable populations at greater risk of infection. This is why reinvigorating cross-sector partnerships is crucial: now more than ever, we need to rally private sector peers, governments, civil society, and individuals to sharpen their response to fighting HIV/Aids.

By the late 1990s, we knew that we had an HIV/Aids problem. Mining represented part of the worst-affected demographic in an industry that had been hit hardest by the epidemic. With an average of 121,000 employees throughout the 1990s in South Africa, the epidemic was a reality for us as a company, but more importantly, for our people and their families. 

We have come a long way since then, with 94% of HIV-positive employees in the Anglo American group on antiretroviral therapy, and zero HIV/Aids-related deaths over the past two years. None of this would have been possible without our extensive and ambitious HIV/Aids prevention, care and treatment workplace, and community programme. Similarly, South Africa’s mining sector as a whole has also made great strides through the pioneering work of individual companies and the Minerals Council South Africa, who have rallied the industry to adopt an integrated approach to managing the twin pandemics of TB and HIV/Aids through initiatives such as the Masoyise Health Programme.

South African business, through Business Unity South Africa and the South African Business Coalition on HIV and Aids has made the attainment of the United Nations’ Sustainable Development Goal of “good health and well-being” a core part of their contribution to South Africa’s development. All of this is because business believes that the greatest economic and developmental asset for any community, business and economy, on a macro scale, is its people. 

Several studies have been published on the economic benefits of a well coordinated workplace ARV treatment intervention. A study from 2015, where nine leading researchers spent time examining ARV workplace treatment programmes at our operations, found that workplace ARV provision can be cost-saving for companies in high HIV prevalence settings. The study found that as ARV coverage increases from 10% to 97% of eligible employees, it increases the rate of survival and retention of HIV-positive employees and reduces potential cases of absenteeism and benefit payments. 

Another study published a week ago in the Journal of Health Economics found that an effectively executed HIV/Aids prevention, care and treatment programme brings substantial value for companies through the reduction of health-related absenteeism. The findings of the study’s cost-benefit analysis reveal that these initiatives lead to savings of about R5,500 per worker and per year for Anglo American in the long run. Beyond making “good business sense” a company-level HIV prevention, care and treatment programme including ARV, could go a long way towards improving the strained labour relations in the South African business sector, especially when improved access to HIV/Aids treatment and care extends to the entire community.

Case for reinvigorating cross-sector partnerships to end HIV/Aids 

The argument for greater private sector involvement in the fight against HIV/Aids is by no means an exclusion of government and civil society. Many of us remember the early 2000s. 

Those years were arguably the most challenging; the scourge of HIV/Aids had reared its head globally, placing enormous challenges on the global health system, and challenging big business to shape a rapid and sustainable response. 

Things have changed since then. Infection rates have lowered – though far too many new infections persist – and governments, the private sector and civil society have pulled together to ensure global access to ARVs and other care and prevention programmes. From initiating what was once the world’s largest ARV treatment programme to building healthcare facilities for the treatment and care from the epidemic, 30 years down the line, our pioneering efforts at Anglo American have held us in good stead. 

Just two years ago, we as De Beers Group Managed Operations, hosted an extensive health fair which reached more than 10,000 community members in Musina – providing much-needed comprehensive health screening. Business can play a role in developing initiatives such as this, at scale, to increase HIV/Aids testing, treatment and care for communities. 

When looking at some of the milestones reached in the fight against HIV/Aids, whether it’s the fall of ARVs globally in 2003, which allowed vulnerable countries access, or efforts to curb mother-to-child transmission, all of these were reached through collaboration across sectors. 

We have an opportunity to reinvigorate this spirit once again as we work towards ending the HIV/Aids epidemic. In 2020, Anglo American, along with UNAIDS and GBCHealth, launched the Business Alliance to End Aids by 2030 at the World Economic Forum. This partnership recognises the important contributions that business can make over the next decade in making HIV/Aids history. Whether it’s jointly building healthcare facilities, investing in health research and actively supporting progressive HIV/Aids treatment, care and prevention campaigns – the field is ready for us to work. Ultimately, the failure to cocreate an efficient and sustainable business response to HIV/Aids on a global scale will steer us backwards. 

While we are making strides to achieve the global UNAIDS 95/95/95 targets, which aims to ensure that 95% of people globally will know their status, 95% of all HIV-positive people will receive sustained ARVs, and 95% of them will have an undetectable viral load – more needs to be done. These global targets will require us to redouble our efforts to prevent deaths and the slowing public health response to HIV/Aids. 

Our two most important global health challenges are to ensure that we achieve global vaccine equity for Covid-19, while keeping our eyes firmly on achieving an Aids-free world. 

This is where the private sector, working with government and civil society, can play an important role. It’s a bold aspiration for an immense challenge. But it is precisely these immense challenges that push us as a people to do more, together. DM/MC


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