Memorandum submitted by the Trades Union
1.1 The following information is the TUC's
written submission to the House of Commons International Development
Committee inquiry into the impact of HIV/AIDS on developing countries'
social and economic development.
1.2 The TUC is an active member of the international
trade union Movement, affiliated to the International Confederation
of Free Trade Unions (ICFTU) which has 125 million members in
215 affiliated organisations in 145 countries and territories.
We and our colleagues recognise that HIV/AIDS is the probably
the most serious social challenge of our time and are alarmed
at the devastating effects of the disease on workers, their families
and the community at large. At the ICFTU's 17th World Congress
in Durban, South Africa on 1-7 April 2000, the international trade
union Movement made a commitment to raise general awareness of
the epidemic and to seek immediate, strong and effective action
to control and eradicate this terrible disease. Three priorities
for action were identified: to adopt preventive measures; to mobilise
against any form of discrimination against people with HIV/AIDS;
and to press pharmaceutical companies to lower their prices to
a level that developing countries can afford.
1.3 The spread of HIV/AIDS in developing
countries has been exacerbated by poverty, structural adjustment
programmes which starve key sectors such as health and education
of vital resources, and limited access to treatment. Ninety five
per cent of people living with HIV/AIDS are to be found in this
part of the world. However, it would be wrong to see HIV/AIDS
as a problem primarily for developing countries. It is a global
problem, undermining economic progress and development and requiring
an integrated, co-ordinated and sustained international response.
1.4 The workplace, in both formal and informal
sectors, is one of the most important points of focus for initiatives
to tackle the disastrous effects of the HIV/AIDS pandemic as it
provides access to a large, yet captive audience. Many workplaces
possess the infrastructure for training and education activities
which can be utilised for HIV/AIDS awareness and prevention campaigns.
For millions of people, the workplace may be the only place where
they can access the necessary information and education which
could help them, their families and communities meet the challenges
posed by the disease. Trade unions also form networks both nationally
and internationally which have been effective in promoting campaigns
for social rights such as the banning of child and bonded labour.
These network could be an effective tool in the struggle against
1.5 The values upheld by trade unionists
around the worldnon-discrimination; protection of children
and vulnerable groups; gender equality; promotion of efficient
social security systems and public services; and challenging the
power of multinationals where they behave in a manner which is
in conflict with the public interestare the values required
to combat HIV/AIDS.
2. THE IMPACT
OF HIV/AIDS ON
2.1 The impact of HIV/AIDS on workforces
2.1.1 The HIV/AIDS pandemic has a profound
and negative impact on the workforce, and by extension, the economy
of affected countries. The ILO has analysed the probable impact
of HIV/AIDS on the labour force in 15 countries, 13 in Africa,
one in Asia (Thailand) and one in the Americas (Haiti). Eight
of those countries have a high HIV prevalence (10 per cent or
more of the adult population were HIV+ in 1997) and the other
seven have lower prevalence (less than 10 per cent of the adult
population). It is expected that the age and sex distribution
of the labour force will change as a result of the rising number
of widows and orphans seeking a livelihood. A large proportion
of people suffering from AIDS in the age group 20-49 years will
lead to their early withdrawal from the workforce. This in turn
will result in the early entry of children into the active labour
force and the retention of older persons due to economic need.
2.1.2 The ILO estimates that the labour
force in high prevalence countries in the year 2020 will be about
10-22 per cent smaller than it would have been if there had been
no HIV/AIDS. In the case of the lower prevalence countries, the
impact is significant but smaller. The labour force is expected
to be between 3-9 per cent smaller (except for Thailand, where
the difference is just over 1 per cent) than it would have been
2.1.3 There is some evidence to suggest
that with high unemployment and underemployment in many countries,
the shortfall in the labour supply has been met by people seeking
employment. In some cases, importing labour from neighbouring
countries has also helped address the problem. However, even where
there is high unemployment, it is not always possible to match
the human resource requirements with the available labour supply
in terms of qualifications and training. Labour mobility for economic
reasons can increase the risk of HIV/AIDS transmission if adequate
education and prevention campaigns are not implemented.
2.1.4 Little is documented about the impact
of HIV/AIDS on the quality of the labour force in terms of education,
training and experience. However, it is probable that the disease
will also have a major impact in this area as it claims the lives
of skilled and experienced workers at the most productive period
of their lives. Replacing such skilled workers is difficult and
while it might be possible in some cases to substitute capital
or technology for a dwindling workforce, this is not always an
option. The situation is exacerbated by the toll that HIV/AIDS
is taking on the education sector. In some countries, it is reducing
the number of qualified teachers as they are dying from the disease.
It is also leading to a rise in early school drop-out rates as
students leave school when their parents become infected and/or
die. This is a serious obstacle to the growth of human capital
which is crucial to developing countries. With the revolution
in information processing, communications and transport leading
the way to a "new" knowledge-based economy, HIV/AIDS
adds to the threat of the creation of a "digital divide"
that reinforces and deepens social inequality between developing
countries and industrialised ones.
2.2 The impact of HIV/AIDS on different economic
2.2.1 Certain sectors of the workforce are
more vulnerable to infection than others. In general, these are
characterised by the need for workers to work away from home for
long periods at a timecircumstances that are conducive
to multiple and casual sexual partnerships therefore increasing
the risk of HIV infection. These sectors include transport, mining
and fishing. Sectors relying on seasonal and short-term workers
such as agriculture, tourism and construction are also vulnerable
to the spread of HIV/AIDS.
2.2.2 In the rural agricultural sector,
losses of workers due to HIV/AIDS have led to reduced food production
and declining food security. Labour and time from agricultural
work is reallocated to non-agricultural care activities because
of the disease. For example, according to a study by the Zimbabwe
Farmers' Union, the HIV/AIDS-related reduction in the production
of maize has reached 61 per cent; cotton 47 per cent; vegetables
49 per cent; and groundnuts 37 per cent.
2.2.3 The impact of HIV/AIDS on some sectors
may also be significant due to the pressure it exerts on resources
and the negative implications it has for the sector. Most evident
is the effect that it has on the health sector. The number of
people seeking medical attention increases dramatically as a consequence
of the disease, stretching poorly resourced health systems to
breaking point. Most developing countries cannot afford the prohibitively
expensive drugs required to treat the disease. Workers in the
health sector are also at risk of HIV infection if proper health
and safety measures are not taken.
2.2.4 As stated previously, the education
sector is badly affected by the pandemic. HIV/AIDS reduces the
supply of teachers and forces children out of school for a number
of reasonsthey are needed to care for sick family members;
to work; or because their families cannot afford to keep them
in school due to inability to pay school fees as a result of reduced
household income, coupled with increased expenditure for medical
treatment. Apart from affecting the quality of the workforce,
HIV/AIDS also leads to the increased incidence of child labour.
2.2.5 Workers in the informal sector account
for a large section of the workforce in developing countries.
This sector covers small-scale income-generating activities which
take place outside the official regulatory framework and typically
utilise a low level of capital, technology and skills, while providing
low incomes and unstable employment. Due to the lack of regulation
and monitoring of the informal sector, workers have few rights,
little training and often work in unhealthy and unsafe conditions.
In the vast majority of cases, they do not have access to information
vital to prevent infection and are unable to exercise their right
to protection against discrimination if infected.
2.3 The effect of workforce illness on national
economies and development
2.3.1 HIV/AIDS has a far-reaching effect
on the labour force in affected countries which covers its size,
composition and quality. Once the disease spreads through the
workforce and affects enterprises, its impact will sooner or later
be felt at the national level.
2.3.2 HIV/AIDS and related illnesses reduce
the revenues of employers in a variety of ways. This includes
increased expenditure on healthcare (where this is provided),
and on recruitment and training of new employees. The loss of
experienced workers who have to be replaced by less experienced
ones combined with absenteeism arising from illness or attendance
at funerals leads to loss of productivity and by extension, to
higher production costs and loss of competitiveness both nationally
and internationally. For the small enterprises which are prevalent
in developing countries, loss of employees have even greater implications
as there is less capacity to replace them. In the case of family
businesses and micro-enterprises for example, the loss of the
key entrepreneur can be devastating.
2.3.3 The decrease in private savings due
to higher individual expenditure on medical care and loss of earnings,
combined with lower government revenues can lead to slower employment
creation in the formal sector which is capital intensive. Consequently,
more and more workers will be pushed into lower paid jobs with
poor working conditions in the informal sector.
2.3.4 Another significant impact may be
the loss, or reduction, of markets for a variety of enterprises
due to a decline in the purchasing power of the population.
2.3.5 The pandemic also puts a huge strain
on public services and the social security system (where this
exists) and drains away precious resources required to fuel development.
2.4 The effect of HIV/AIDS on workers and
2.4.1 HIV/AIDS has a huge impact on infected
workers and their families, as well as on their extended families.
Discrimination, stigmatisation and hostility against people living
with HIV/AIDS is commonplace both in the community and at the
workplace. They have difficulty obtaining decent jobs. If in employment,
they are often forced to leave their jobs once their HIV status
is revealed and are isolated in their communities. The economic
situation of workers with HIV/AIDS forces them to take on any
work that they can find in order to survive, making them particularly
vulnerable to exploitation.
2.4.2 HIV/AIDS is a debilitating disease,
leading to disability that can put workers' livelihoods, and therefore
their ability to continue supporting themselves and their families
at risk. Disability leaves workers suffering from HIV/AIDS open
to further discrimination.
2.4.3 Family members, including children,
are forced to work to supplement the family income when the main
breadwinner succumbs to the disease. The number of children engaged
in income-earning activities in countries with a high prevalence
of HIV/AIDS increases significantly.
2.4.4 Women are particularly badly affected
by HIV/AIDS. They are at a high risk of being infected themselves.
The burden of caring for HIV/AIDS orphans is also borne primarily
by women. Circumstances compel many women and children, who on
the whole possess limited education and training, to seek income,
putting them at risk of sexual, and other forms of exploitation.
2.4.5 Social security systems are practically
non-existent in most developing countries. The extended family
is, in effect, the only safety net available. Infected workers
and their families are therefore left to deal with the full impact
of the disease which drives them deeper into poverty.
HIV/AIDS ON DEVELOPING
3.1 The human and legal rights of those living
with HIV/AIDS in developing countries
3.1.1 HIV/AIDS generates fear and discrimination,
robbing people of the right to equal protection and equality before
the law, to privacy, liberty of movement, work, equal access to
education, healthcare and other social services on the sole basis
of their known or presumed HIV status. People living with HIV/AIDS
will not seek testing, counselling, treatment or support in an
environment where there is a lack of confidentiality and where
they face the loss of employment and other negative consequences.
This situation is further exacerbated by a culture of denial.
Public education and the protection of human and workers' rights
is therefore vital to the success of any campaign to tackle HIV/AIDS.
3.1.2 Workers regularly face many abuses
by employers, from tests at the time of hiring to dismissal of
those who are HIV positive. Workers' rights have to be protected
to enable them to carry on providing for their families for as
long as possible and to have a decent quality of life. These rights
include non-discrimination at work; no dismissal based on HIV
status; no recruitment and employment testing; medical confidentiality;
working time flexibility; early retirement options; and the right
for trade unions to negotiate on issues over and above the statutory
3.1.3 While there is no international labour
Convention that specifically addresses the issue of HIV/AIDS in
the workplace, there are many instruments that can cover both
protection against discrimination and prevention against infection.
The ILO's 1998 Declaration on Fundamental Principles and Rights
at Work declares four groups of principles as requiring respect,
promotion and realisation whether or not the Conventions on the
subjects have been ratified by member States. These principles
are: non-discrimination, freedom of association and the right
to collective bargaining, the elimination of forced labour and
abolition of child labour.
3.1.4 The Discrimination (Employment and
Occupation) Convention, 1958 (No 111) bans any distinction, exclusion
or preference which has the effect of nullifying or impairing
equality of opportunity or treatment in access to training; access
to jobs; promotion processes; security of tenure; remuneration;
conditions of work including leave, rest periods; occupational
safety and health measures; and social security benefits. The
Convention not only prohibits discrimination but also promotes
pro-active measures designed to meet the particular requirements
of persons needing social protection. Article 5(2) lists persons
with disability among the groups that might benefit from affirmative
action or measures of accommodation at the workplace. Moreover,
Recommendation no. 111, which accompanies the Convention, suggests
the creation of appropriate agencies and advisory committees,
composed of representatives of employers' and workers' organisations
and of other interested bodies to promote acceptance of the principle
on non-discrimination in employment, and to carry out specific
activities such as information and education campaigns.
3.1.5 The Termination of Employment Convention,
1982 (No 158) sets out the international position concerning possible
dismissals. Article 4 specifies that the termination can only
take place when there is a valid reason connected with the capacity
or conduct of the worker, or based on the operational requirements
of the undertaking, establishment or service. Article 6 makes
it clear that temporary absence from work because of sickness
or injurywhether occupationally related or notis
not a valid reason for dismissal. The Vocational Rehabilitation
and Employment (Disabled Persons) Convention 1983 (No 159) bans
discrimination based on disability. Article 4 promotes special
protective measures, such as workplace accommodation and transfers
in order to enable persons with disabilities to continue to gain
a living until such time as their disability affects their capacity
to do a particular job or until they are too ill to work.
3.1.6 The Occupational Health and Safety
Convention, 1981 (No 155) sets out basic requirements to protect
workers such as the provision of protective clothing and equipment
at no cost to the worker, and the right to be transferred to less
onerous jobs and the right to leave a situation of imminent danger
to the worker. The Occupational Health Services Convention 1985
(No 161) requires ratifying states to adopt comprehensive, co-ordinated
national policies. Its accompanying Recommendation No 171 lists
a number of measures including an assurance that health surveillance
is not used for discriminatory purposes, confidentiality of medical
examination data, collaboration in finding alternative employment
where transfer is required for health reasons, worker counselling
on the results of health examinations and the principle of no
cost to the worker for the health-related facilities provided
by such services.
3.1.7 International labour standards dealing
with negotiations and collective bargaining are also particularly
effective tools in combating HIV/AIDS. Measures for addressing
HIV/AIDS in the workplace can be included in the free negotiation
of terms and conditions of employment between employers and trade
unions which lead to binding collective agreements. A practical
example of this at the sectoral level is the 1991 AIDS Agreement
between the National Union of Mineworkers and the Chamber of Mines
in South Africa. The Agreement covers protection against discrimination
or harassment, non-consensual testing, counselling, benefits,
awareness and education programmes and a ban on adverse employment
consequences, including dismissal for the mere fact of HIV infection.
The collective bargaining mechanism has the important advantage
of providing an in-built monitoring system which enables workers
to ensure the implementation of agreements with employers, as
opposed to unilaterally adopted company guidelines for example,
which require independent monitoring systems to be meaningful.
3.1.8 The ratification and effective national
implementation of these, and other relevant ILO Conventions such
as those addressing specific groups of workers who by the nature
of their work are groups at risk of infection eg health workers
and migrant workers, will go a long way to address the devastating
effects of the disease on the lives of working people. Such legal
protection would enable them to live in dignity, maintain their
families and be productive for longer than they otherwise would
be. Crucially, it would also create a framework for prevention,
which must be a priority.
3.2 Responsibility and opportunities for HIV/AIDS
education and prevention
3.2.1 HIV/AIDS is a universal threat and
is the responsibility of all the social partners. Governments,
trade unions and employers, need to work together to eradicate
the disease, and to support the needs of those living with HIV/AIDS.
The ILO resolved at its 88th International Labour Conference in
Geneva this year to call upon member states, and where applicable,
employers and workers' organisations to: raise national awareness
with a view to eliminating the stigma and discrimination attached
to HIV/AIDS, as well as to fight the culture of denial, thereby
preventing the spread of HIV/AIDS; to strengthen the capacity
of the social partners to address the pandemic; strengthen occupational
safety and health systems to protect groups at risk; formulate
and implement social and labour policies and programmes to mitigate
the effects of HIV/AIDS; and to mobilise resources effectively.
3.2.2 Workplace HIV/AIDS programmes are
key to any strategy to address the pandemic and serve to strengthen
legislation at national level. These should be developed in partnership
with trade unions at enterprise level and include the following
prohibition on direct and indirect
discrimination on the basis of HIV status.
protection of occupational benefits.
working time and conditions of employment
should be adapted to facilitate necessary medical treatment.
education and information campaigns
to prevent the spread of HIV/AIDS, addressing issues such as stigmatisation
and encouraging a culture of openness.
strengthening occupational health
and safety programmes to protect groups of workers who are particularly
free distribution and availability
of condoms through the workplace.
protection of the right of privacy
and confidentiality about the health status of workers.
free testing and counselling services.
Programmes need to be adapted to the needs and
circumstances of specific enterprises and sectors. Where possible,
national trade union centres and international trade secretariats
(which cover sectors) should also be involved to provide a broad,
3.2.3 Trade unions have developed their
own HIV/AIDS action programmes. The Trades Union Congress of the
Philippines (TUCP), also affiliated to the ICFTU, joined the struggle
against HIV/AIDS in the early 1990s, eventually becoming instrumental
in creating the main NGO active in the struggle against HIV/AIDS.
The TUCP conducts preventive awareness and training campaigns,
producing a variety of materials and facilitates agreements with
employers and the Government. It has a network of 14 health centres
which provide its 600,000 members with counselling, diagnoses
and treatment in the areas of reproductive health, STD and HIV/AIDS.
Another ICFTU affiliate, the Congress of South African Trade Unions
(COSATU) has launched an HIV/AIDS awareness campaign and developed
a programme for its members on the issue. Activities have included
regional workshops, dissemination of information, training shop
stewards on HIV/AIDS issues and producing a manual for them. Many
of COSATU's affiliates (individual unions) have comprehensive
HIV/AIDS policies and programmes in place which include focus
weeks in provinces, information blitzing among their membership
and communities, training of peer educators, condom distribution
in the workplace and at union offices, and the negotiation of
workplace policies to protect the rights of workers. COSATU is
also actively engaged in lobbying to improve public healthcare
and for access to HIV/AIDS treatment, an issue of grave concern
to the international trade union Movement as a whole, which will
be discussed at a later stage in this memorandum. These are only
two examples of what trade unions are doing to combat the disease.
3.2.4 Clearly, trade unions can make an
enormous contribution to the fight against HIV/AIDS by mobilising
their members and by negotiating and monitoring agreements with
employers through collective bargaining to create an effective
HIV/AIDS prevention and management framework within the workplace.
By not recognising and guaranteeing trade union rights, governments
are effectively depriving themselves of essential partners in
the struggle against HIV/AIDS. A commitment by governments of
both industrialised and developing countries to core labour standards
and to strengthening the capacity of trade unions, particularly
those in developing countries, is a necessary component of any
effective strategy to combat the HIV/AIDS pandemic.
3.3 The response of the international community
3.3.1 The TUC supports the campaign by the
Jubilee 2000 coalition for the cancellation of the external debt
of developing countries. The crippling debt burden of developing
countries has hampered their ability to prevent and manage HIV/AIDS
effectively. In addition, there needs to be strong efforts to
incorporate a social dimension into structural adjustment policies
and programmes. Despite some effort by the World Bank and IMF
to integrate social development goals into structural adjustment
programmes (SAPs), the social costs of implementing SAPs remain
high. It is crucial to protect public expenditure for essential
social services such as health and education and to enable the
development of public policies to halt the onslaught of the disease.
Participatory approaches to the formulation and implementation
of SAPs should also be adopted. The ILO tripartite model would
serve as an effective consultative framework, and SAPs should
be underpinned by respect for core labour standards, including
freedom of association and the right to collective bargaining,
which are powerful tools for HIV/AIDS protection and prevention.
3.3.2 Prevention programmes can slow down
the spread of HIV/AIDS. However, for the many millions already
infected by the disease, treatment is the only hope. Few people
living with HIV/AIDS in developing countries can afford the medication
that can help them cope with the disease and extend their life
expectancy. This is true of both anti-retroviral drugs which target
the virus directly, and those which treat and prevent opportunistic
infections brought on by the weakening of the immune system. The
international trade union Movement is pressing the international
community to take a strong stand on this issue and to force the
major pharmaceutical companies to provide these drugs at a cost
that developing countries can afford. Governments in developing
countries must be allowed to make use of compulsory licences and
parallel imports to make HIV/AIDS treatment available at affordable
cost. There must also be greater commitment from governments to
intensify the search for a vaccine that can cure the disease and
is accessible to developing countries.
3.3.3 The low social and economic status
of women makes them less able to protect themselves and their
children from infection, which in turn contributes to the spread
of the disease. Development programmes need to aim at empowering
women economically, socially and politically to reduce their vulnerability
to HIV/AIDS. They should include measures to improve the enrolment
of girls in basic education, and to ensure that adult education
enhances the opportunities of women within their society. The
education of women is in itself insufficient. Measures to promote
and transform gender roles, traditional norms and social structures
are also needed.
3.3.4 The increase of child labour due to
HIV/AIDS threatens not only the future of individual children
but also that of countries in the developing world. The future
of a country relies heavily on its human capital and skills base,
particularly in the age of an emerging new economy. ILO Convention
182 requires the removal from work and into education of all children
in the worst forms of child labour. The UK Government has ratified
the Convention (and Convention 138 on minimum age for entry into
employment) and should therefore build its aims into its international
development policies. There is no evidence to support the view
that children can work themselves and their families out of poverty.
A more productive approach would be to educate them out of poverty
and to replace child workers with adults, where possible from
their extended families, who should be paid adult wages and ensured
basic rights at work. Greater commitment to these goals are required
from all governments. Governments of industrialised countries
have a particularly important role to play in building the capacity
of developing countries to address the problem of AIDS orphans
and children exposed to infection or forced into child labour.
4.1 The full potential of the world of work
as a key venue for addressing the HIV/AIDS pandemic needs to be
tapped. The trade union Movement, inter-governmental organisations,
national governments and employers need to work together to this
end, drawing in other civil society organisations wherever possible.
Trades Union Congress