All Journal Articles

Hard choices: rationing antiretroviral therapy for HIV/AIDS in Africa

Abstract In the past three years, expanding access to antiretroviral therapy (ART) for HIV/AIDS has become a global objective and a national priority for many countries in sub-Saharan Africa. Large-scale treatment programs have been launched in countries spanning the continent from Lesotho to Ghana, paid for by domestic funds mobilized by African governments and by international donor contributions. While these funds, which reach into the billions of dollars, will pay for ART for many 

Provision of antiretroviral therapy by the private sector

Abstract The assessment by Lester Venter (Apr 2, p 1215) of the extent to which the private sector is filling the need for antiretroviral treatment (ART) for HIV/AIDS is misleading. Public announcements by a few large private companies about the scale of their HIV/AIDS programmes should be interpreted cautiously. Few companies have made public what proportion of employees are eligible for the programmes, what proportion are in need of treatment, or how many are actually receiving it. We 

The impact of HIV/AIDS on labour productivity in Kenya

Abstract Objectives: To estimate the impact of HIV/AIDS on individual labour productivity during disease progression. Methods: We used a retrospective cohort design to study the productivity and attendance of tea estate workers who died or were medically retired because of AIDS-related causes between 1997 and 2002 in western Kenya. We compared daily output in kilograms of tea leaves plucked, use of paid and unpaid leave and assignment to less strenuous tasks by 54 workers who died or were 

The prevalence of HIV in workforces in southern Africa, 2000-2001

Abstract Objectives: Most data on HIV prevalence in low-risk populations in sub-Saharan Africa are drawn from sentinel surveys of pregnant women attending antenatal clinics and are not representative of formal sector workforces. We surveyed workforces in southern Africa to determine HIV prevalence among formally employed, largely male populations. Methods: Voluntary, anonymous, unlinked seroprevalence surveys of 34 workforces with 44,000 employees were carried out in South Africa, Botswana, 

The cost of HIV/AIDS to businesses in southern Africa

Abstract Objectives: To estimate the cost of HIV/AIDS to businesses in southern Africa using company-specific data on employees, costs, and HIV prevalence. Methods: Six formal sector enterprises in South Africa and Botswana provided detailed human resource, financial, and medical data and carried out voluntary, anonymous HIV seroprevalence surveys. The present value of incident HIV infections with a 9-year median survival and 7% real discount rate was estimated. Costs included were sick leave; 

Care and treatment to extend the working lives of HIV-positive employees: calculating the benefits to business

Abstract Although HIV infection rates in South Africa have been high and rising for nearly a decade, the epidemic of HIV/AIDS-related morbidity and mortality is just beginning. As South African adults start to sicken and die, concern is mounting about the potential costs to companies of HIV/AIDS among employees. When a business recognizes the threat posed by HIV among employees, it can pursue three basic response strategies for mitigating short- and long-term financial consequences: (1) try to 

Shifting the burden: the private sector’s response to the AIDS epidemic in Africa

Abstract As the economic burden of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organizations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and 

AIDS is your business

Abstract If your company operates in a developing country, AIDS is your business. While Africa has received the most attention, AIDS is also spreading swiftly in other parts of the world. Russia and Ukraine had the fastest-growing epidemics last year, and many experts believe China and India will suffer the next tidal wave of infection. Why should executives be concerned about AIDS? Because it is destroying the twin rationales of globalization strategy-cheap labor and fast-growing markets--in