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WELLBEING: HIV AND AIDS, PREVENTION
AND CARE:
The role of senior management
2 These responsibilities include:
(a) establishing a Center policy on prevention and caring for HIV and
AIDS across the Center’s headquarters, regional and country stations;
(b) communicating to all staff the full set of components of that policy;
(c) establishing a Center HIV and AIDS action plan;
(d) ensuring that all sites have appropriate workplace safety procedures;
(e) ensuring that all staff at each site have information about emergency
procedures, access to post-exposure prophylactic (PEP) kits in case of
rape and access to safe blood in case of accident or injury;
(f) ensuring that the Center’s HR group has sufficient resources
to provide appropriate training and support, both directly and through
external agencies;
(g) seeking periodic reports from HR about implementation of the action
plan, and other initiatives that should be considered to enhance the
action plan.
establishing a Center policy on prevention and caring
for HIV AND AIDS
3 A model policy is provided in these guidelines. It
recognizes the requirement for a Center policy (and related practices)
to be based on worldwide best practice for international organizations,
and based on the premise that people living with HIV can lead productive
lives for decades.
Diversity Alert
People living with HIV can lead productive
lives for decades
The preservation of life and prevention of further infection
are as important as compassionate care for those suffering and dying
from AIDS.
4 Thus the principal objectives of the policy and practices outlined in this Inclusive Workplace e-Resource Center are to:
- prevent further HIV infection among all CGIAR staff and their family members;
- preserve the lives of those staff and an appropriate number of their family members currently living with HIV and AIDS;
- provide compassionate health care for those staff and their family members who have progressed from HIV infection to full-blown AIDS;
- encourage a commitment to provide HIV and AIDS insurance coverage to all staff members, irrespective of their employment status or their geographic location;
- foster a workplace that does not discriminate on the basis of disease; and
- set an example for our communities and, particularly, our national research partners, for the prevention and compassionate management of HIV and AIDS.
The focus of workplace policy
5 The focus of workplace
policy has moved beyond issues of incidence to the impact of HIV and
AIDS in the work environment. Impact in the workplace is experienced
in various ways:
- in the most extreme case, there is the loss of productive staff and the cost of replacement and training;
- with advanced HIV infection, there is increased absenteeism and the concomitant loss of productivity;
- in a broader context, staff with family members infected with the disease will lose time at work to take care of them or to attend funerals, and they will carry a higher financial burden as family members die and they undertake the care of any orphaned children; and
- other areas of impact can include the breakup of research teams as a result of illness and death, or the isolation and withdrawal of the HIV-infected staff member.
Key issues for management
6 To achieve equitable standards
of HIV and AIDS management in the workplace, senior management must consider
the following questions.
- Are HIV and AIDS treated differently than other chronic, life-threatening diseases and serious medical conditions?
- Do current insurance policies reflect a difference in coverage between internationally recruited staff versus nationally recruited staff? If so, how can equitable insurance be obtained and at what financial cost?
- What is the local availability and cost of HAART at each Center’s location? How can access to this medication be improved?
The answers to these questions will affect the structure and content of the Center’s HIV and AIDS action plan, and the relative priorities within it.
7 Then, having ensured that the Center has an appropriate HIV and AIDS
management plan, senior management must ensure that:
(a) it is fully implemented across all sites, and
(b) appropriate staff members are held accountable for its implementation.
The scope of the policy: who should be covered?
8 The
principal focus of this policy is CGIAR staff. However, in these guidelines
the expression “staff and their family members” is
used from time to time. G&D is acutely conscious of the potential
cost implications of extending care beyond people who are the direct
responsibility of an employer, particularly in the extended families
in some communities. In some cases, the additional cost might be minimal,
e.g. inviting family members to educational activities. In other cases,
e.g. provision of medication and/or counseling, the costs could be significant.
9 However G&D believes that the benefits of this community approach would justify the cost. A staff member who is preoccupied by the failing health of a spouse or child is not going to be fully productive in the workplace. Her/his productivity should be partially restored by the knowledge that the loved one is receiving treatment that might not otherwise be possible.
10 Centers also have to recognize the impossibility of a situation in which an HIV-infected staff member also has an infected spouse/child, but the employer only provides medication for the staff member and the family cannot afford medication for the other members. In these circumstances, it would be a remarkable individual who could take medication while watching a spouse or child steadily deteriorate because of lack of that same medication.
11 In addition, Centers need to consider care for people providing services to the Center on a contract basis, such as cleaners, guards, drivers or gardeners. They should, for example, have full access to education and prevention programs.
12 Having made this point, the references throughout this guide focus on staff members, to avoid distraction from the recommended practices.
communicating to all staff
the full set of components of the center’s
HIV and AIDS policy
13 A Center’s HIV and AIDS policy is so
vital that senior management must own and promote it. Managers must
be seen by staff as having a personal and ongoing commitment to making
the policy work effectively.
14 Senior management must ensure that all new staff members, irrespective of the location or duration of their appointments, have the Center’s HIV and AIDS policy and related support mechanisms explained to them early in the induction process.
15 Senior management will delegate responsibility for establishing a comprehensive education and prevention program. However, senior management must make sure that the program provides appropriate coverage of issues, encompasses all staff irrespective of geographic location and is structured to provide appropriate reinforcement from time-to-time.
16 In the Introduction, the warning was raised that staff with HIV and AIDS potentially face prejudice, fear and discrimination from fellow-workers. In fact, this Inclusive Workplace e-Resource Center contains a section specifically dealing with prevention of harassment and discrimination. Consequently senior management must ensure that line managers and supervisors both understand and exercise their responsibility to provide leadership if confronted by this risk. A Center’s ability to ensure a workplace of dignity is critically dependent on line managers and supervisors.
17 Consequently, senior management needs to ensure that line managers are periodically reminded of their responsibilities in preventing and stopping harassment and discrimination in their workgroups. This is one example of how senior management can demonstrate its commitment to making the HIV and AIDS policy work, using personal contact with line managers rather than e-mails, when possible. Line managers also must understand that they need to act decisively if they suspect inappropriate behavior in the workplace (i.e. taking preventative action without necessarily waiting for clear evidence of inappropriate behavior).
establishing a Center HIV AND AIDS action plan
18 A
good HIV and AIDS Action Plan will have the following components: policy
review and development; education and prevention; access to HAART; local
resources and staff training; and insurance coverage. Each of these components
should have clear commitments in terms of deadlines, staffing, expenditures,
etc.
19 Consequently senior management must not only supervise the development of its Center’s Action Plan, it must also sign off on the commitments contained in it. Where possible, a Center should undertake a risk assessment and cost projection as a preliminary step in the process of developing the Center’s Action Plan.
ensuring that all sites have appropriate HIV AND AIDS
COMPONENTS IN THEIR workplace safety procedures
20 Senior management needs
to be confident that all staff members, wherever they may be located,
particularly line managers and supervisors, understand the principles
of workplace interventions that focus on infection control. All staff
at each site must have information about emergency procedures and access
to post-exposure prophylactic (PEP) kits in case of accidents or violence
(e.g. assault, rape, etc.). A risk management approach would consider
provision of travel kits for staff undertaking duty travel.
ensuring that the Center’s
HR group has sufficient resources to provide appropriate training and
support
21 The
Center’s HR group has a major role to play in assisting
senior management with the development, implementation and review of
the Center’s HIV and AIDS policy and practices. This role is described
in the Sample Practice, “The role of HR”.
22 Obviously, providing this assistance is resource intensive, in terms of the need for both people and funds. A considerable range of support services (e.g. education programs and voluntary testing and counseling) probably will need to be delivered by external agencies. Consequently, senior management must ensure that its HR group has sufficient staff to undertake the activities for which it is personally responsible, and to coordinate and evaluate the services undertaken by contracted agencies.
periodic reports from HR about IMPLEMENTATION OF the
action plan
23 As with all major policy initiatives,
senior management should request periodic reports on implementation of
the Center’s
HIV and AIDS Action Plan, and should encourage HR to identify other initiatives
that should be considered to enhance the action plan.
OTHER ISSUES FOR SENIOR MANAGEMENT
24 All Centers need
to take an active interest in the continuing development of HIV and AIDS
policy and practice, as the environment for HIV and AIDS prevention and
care is changing rapidly, both locally and internationally. Senior management
needs to be confident that it is being kept aware of these developments.
25 All Centers, regardless of location, must pay closer attention to the HIV and AIDS education and care being extended by host institutions to their Africa- and Asia-based staff. The “home” Center cannot safely assume that HIV and AIDS care for their hosted staff is being fully managed on their behalf.
26 All Centers must engage in an accelerated and concentrated effort to implement HIV and AIDS policy, especially with regard to HIV and AIDS education and prevention and in areas such as voluntary confidential counseling and testing (VCCT). Only senior management can make this happen.
© CGIAR Gender & Diversity
Program 2006