HIV/AIDS
Engen accepts responsibility for managing the threat of HIV/Aids to our business
and we undertake to:
- Minimise the total impact of HIV/Aids on the company and our stakeholders
- Ensure the long-term sustainabiluitry of our business through programmes aimed at
reducing the infection rate among employees.
- Comprehensively manage and support those infected.
- Protect the rights of employees with HIV/Aids
A senior management committee convenes to ensure that issues around HIV/Aids have
a wider focus than just organisational health. One of the key functions of the committee
is to review the HIV/Aids management strategy to include multi-stakeholder involvement
in appropriate assessment, management, monitoring, measuring and reporting of the
impact on the business and operations of the company.
The 2008 UN-AIDS report on the global AIDS epidemic highlighted the following:
- Sub-Saharan Africa remains the most heavily affected by HIV, accounting for 67%
of all people living with HIV and 72% of AIDS deaths in 2007.
- The epidemic is stabilizing albeit at unacceptably high levels The rate of new infections
has fallen in several countries but this gain is offset by increases in new infections
in other countries
- In 14 of the 17 African countries with adequate survey data, the percentage of young
pregnant women (ages 15 – 24 years) who are HIV positive has declined since 2000
– 2001
- Globally, the percentage of adult women living with HIV has remained stable at 50%
for several years.
The Engen Medical Benefit Fund (EMBF) HIV/AIDS programme, introduced in 2000 continues
to play a vital role in maintaining an optimal health status of infected employees
and their dependents by providing access to appropriate levels of health care, including
the provision of anti-retroviral medication.
Successes
Since inception of the programme, 221 individuals have had access to benefits. To
date there have been 20 mother to child transmission cases, 8 post exposure prophylactic
cases, 53 resignations and 28 deaths. Of the 132 individuals currently registered,
97 are employees and 35 dependents. Of these, 68 employees and 27 dependants are
on ART medication.
Central to the success of the EMBF programme is the role the internal organizational
health (OH) specialists play in pressuring individuals to be tested, assisting with
referrals to HIV/AIDS clinicians, enrolment on the programme, and providing on-going
support and care to employees with HIV/AIDS.
Apart from the well established communication links between the case manager and
all the participants on the programme, an open communication line has also been
established and continues to be nurtured between the HIV unit's case manager and
the internal organisational health staff. This healthy collaboration has assisted
in proactively identifying and managing problem cases. The high level of confidentiality
maintained has enhanced the level of trust in the programme.
Ensuring adherence to treatment protocols remains the single most critical element
in determining an individual's return to an optimal health status and avoidance
of the development of complications associated with drug resistance. Reporting from
the EMBF data systems indicate more than 90% adherence, which aligns with good treatment
standards. Regular tracking of CD4 counts and Viral loads is a key indicator of
compliance levels. In general, the longer standing participants have had fewer hospital
admissions, another indication of good compliance, regular testing and effective
disease management.
Challenges
The number of dependents registered on the HIV programme is considerably less than
the number of members. This suggests they are at high risk of becoming infected
and/or are not being treated. A targeted intervention focusing on dependents is
required.
The expansion of our business into Africa is creating some unique challenges from
a health and safety perspective. Some countries have good infrastructure, access
to global funding, active government / community (NGO) participation, and dedicated
programmes for the relief of Malaria, TB and HIV/AIDS. Unfortunately, others have
very little that is functioning on the ground, particularly with regard to employment,
health and safety legislation, accessible and affordable health care and all this
amidst continuing political instability and poor psychosocial and economic circumstances.
Engen will therefore strive to find creative solutions to support our drive into
Africa. These will have to include the formation of critical local business / service
provider partnerships and access to funding.