Health is a leading measure of development failure or success and health improvements bring significant economic benefits. Significant progress has been made in recent decades to increase life expectancy and reduce child and maternal mortality, malaria, tuberculosis, polio and the spread of HIV/AIDS. Mine workers may be exposed to increased occupational health risks such as cardiovascular and respiratory diseases (such as silicosis), as well as communicable diseases like tuberculosis and HIV/AIDS. All ICMM members implement the 10 principles that underpin our Sustainable Development Framework. Principle 5 requires companies to continually improve health and safety performance with the ultimate goal of zero harm.
HIV/AIDS continues to dominate the modern healthcare agenda. Globally, the disease burden is stark, with an estimated 35 million people living with the disease around the world. It remains a major killer in sub-Saharan Africa. The SDGs make the ambitious call on the international community to end HIV/AIDS as a public health threat by 2030.
In 2002, Anglo American became one of the first major employers to offer free anti-retroviral treatment (ART) to its employees. The company now runs the world’s largest private sector voluntary counselling, testing and treatment programme for HIV/AIDS and TB for employees, their families and contractors.
Anglo American’s evolving response to HIV/AIDS
Anglo American’s response to HIV/AIDS can be traced back to 1986, when it launched two initiatives: an education and awareness programme on the disease aimed at the entire workforce; and the provision of more than $5 million in funding over the next few years to prominent researchers in Europe and the US to investigate treatment possibilities using decoy CD4 proteins inserted into red blood cells.
Anglo American was also one of the first companies to publish an AIDS policy, which explicitly stated that HIV testing would not be a requirement of pre-employment medical examinations
By August 2002, following a range of efforts to respond to the disease, Anglo American announced it would be making ART available to all its workers, a move described by senior executives at the time as a ‘leap of faith’.
A cornerstone of the programme is voluntary counselling and HIV testing (VCT). In 2003, VCT uptake among the entire southern Africa-based Anglo American staff was less than 10 per cent; by year-end 2014, 86 per cent of employees were checking their status every year.
Anglo American’s TB-control programme is based on similar principles to its HIV/AIDS programme and is designed to ensure the disease is actively managed and properly controlled. As the TB problem demonstrates, the health of mineworkers does not stop at the mine. It is closely tied to the health problems of the communities around the mines and, for migrants, the towns and villages in South Africa and the surrounding countries they come from, and where their dependents live.
Anglo American has been involved in community projects since the launch of the Anglo American Community HIV/AIDS Partnership Programme in 2003. It has supported youth programmes and HIV/AIDS initiatives and clinics, and has engaged in public/private partnerships. These include the building of a community health centre at Lillydale in the Bushbuckridge municipality, Mpumalanga province, and a clinic in Kathu township, Northern Cape province – both of which provide access to life-saving ART therapy.
The company supports UNAIDS’ targets for 2020, envisioning a world in which 90% of the seropositive people know their status, 90% of people infected with HIV receive anti-retroviral (ART) treatment, and 90% of those on treatment show undetectable levels of the virus.
By 2015 a total number of 620,000 tests for HIV were made by employees. Those who have been diagnosed positive have been referred into disease management programmes.
Anglo American demonstrated real leadership in committing to free anti-retroviral treatment for all employees in 2002. Its commitment to responding to the disease in a bold and proactive way has remained strong since that time.
The 2015 HIV/AIDS policy states that: 'The magnitude of the health challenge posed by HIV/AIDS is such that individual companies cannot adequately address it alone and we reiterate that a comprehensive and effective response to HIV/AIDS requires a partnership between all stakeholders'.
The business, as well as social, benefits were assessed in a 2015 research article on a cost-benefit analysis of the ART programme at Anglo American Coal. It found that ART saves costs even when only the direct costs of HIV are considered. The savings in this company have been estimated at one million dollars per annum.