Dr. Sophia Kisting Director, ILO Programme on HIV and AIDS and the world of work Introduction to the concept of Occupational Safety, Health and Environment & HIV/AIDS and the World of Work in the context of the global economic crisis

“…The ILO and its constituents must be leaders in promoting occupational safety and health at work… …Decent Work must be Safe Work ”. Juan Somavia, ILO Director-General International Labour Conference 91st Session, 2003

Context of the HIV Problem 90% are working-age adults About 33.4 million people in the world are living with HIV (UNAIDS 2009). The world of work plays a key role in the provision of treatment, care and support, occupational health services and through negotiated workplace policies and programmes.

Occupational Safety and Health (OSH) and HIV and AIDS HIV is an occupational risk in some occupations where workers are more likely to come in contact with blood or body fluids e.g. health workers (nurses, cleaning staff, laboratory technicians and engineers). Provisions therefore need to be made to prevent occupational transmission of HIV. If such transmission and causal relationship is demonstrated there should be compensation. Source: J o i n t I L O / W H O g u i d e l i n e s o n h e a l t h s e r v i c e s a n d H I V / A I D S, 2005

UNAIDS impact analysis framework

Impact of economic crisis: May affect access to treatment for 5 million PLHIV on ART and 7 million who are in need of treatment. Allocation of national resources away from workplaces and focussing on affected and marginalized communities. 71% and 78% of respondents from Employers’ and Workers’ organizations respectively in the 10 countries stated that resources for HIV and AIDS workplace programmes would be affected by the financial crisis within the next 12 months. The current global job crisis has resulted in a high number of returning migrant workers. PLHIV among migrant populations are least covered through existing social protection schemes. Source: “Impact of the financial crisis on the world of work and HIV and AIDS services”, an ILO study undertaken in January 2010 in 10 countries in Sub Saharan Africa.

International Labour Standards and HIV and AIDS  Recommendation concerning HIV and AIDS and the World of Work, 2010 (No.200)  Fisheries Convention and Resolution, 2007  Maritime Labour Convention, 2006  Discrimination (Employment and Occupation) Convention,1958 (No. 111)  Occupational Safety and Health Convention, 1981 (No. 155)  Occupational Health Services Convention, 1985 (No. 161)  Termination of Employment Convention, 1982 (No. 158)  Vocational Rehabilitation and Employment Convention (Disabled Persons), 1983 (No. 159)  Social Security (Minimum Standards) Convention, 1952 (No.102)  Labour Inspection Convention, 1947 (No. 81)  Labour Inspection (Agriculture) Convention, 1969 (No. 129)

Dr. Sophia Kisting Director, ILO Programme on HIV and AIDS & the world of work (Tuesday 14 September, 9:00 – 10:30am)

New international labour standard: Recommendation 200 “….Recalling the importance of safeguarding workers through comprehensive occupational safety and health programmes, and ….Recalling the value of the ILO code of practice on HIV/AIDS and the world of work, 2001, and the need to strengthen its impact given that there are limits and gaps in its implementation...”

Applies to all workers (including families and dependants) and to all workplaces Job applicants and job seekers Persons in any employment or occupation Armed forces and uniformed services Laid off or suspended workers suspended workers Persons in training (interns, apprentices apprentices & volunteers) & volunteers) Informal economy workers workers

Rights referred in the Recommendation Protection against stigma & discrimination Access to HIV treatment prevention, care and support Confidentiality Social security and occupational insurance Rights at work

OSH in the new Recommendation: “…30. The working environment should be safe and healthy, in order to prevent transmission of HIV in the workplace, taking into account the Occupational Safety and Health Convention, 1981, and Recommendation, 1981, the Promotional Framework for Occupational Safety and Health Convention, 2006, and Recommendation, 2006, and other relevant international instruments, such as joint International Labour Office and WHO guidance documents. 31. Safety and health measures to prevent workers’ exposure to HIV at work should include universal precautions, accident and hazard prevention measures, such as organizational measures, engineering and work practice controls, personal protective equipment, as appropriate, environmental control measures and post –exposure prophylaxis and other safety measures to minimize the risk of contracting HIV and tuberculosis, especially in occupations most at risk, including in the healthcare sector.

OSH in the new Recommendation… 32. When there is a possibility of exposure to HIV at work, workers should receive education and training on modes of transmission and measures to prevent exposure and infection. Members should take measures to ensure that prevention, safety and health are provided for in accordance with relevant standards. 33. Awareness-raising measures should emphasize that HIV is not transmitted by casual physical contact and that the presence of a person living with HIV should not be considered a workplace hazard. 34. Occupational health services and workplace mechanisms related to occupational safety and health should address HIV and AIDS, taking into account the Occupational Health Services Convention, 1985, and Recommendation, 1985, the Joint ILO/WHO guidelines on health services and HIV/AIDS, 2005, and any subsequent revision, and other relevant international instruments…”

These should:  Be integrated into national HIV strategies, development plans, decent work and other strategies.  Be developed in consultation with employers’ and workers’ organizations and organizations of persons living with HIV.  Take account of the key principles of the Recommendation, the Code of practice and other relevant ILO instruments. HIV and AIDS Recommendation, 2010 (No. 200) Member States should adopt national Workplace Policies and programmes

Major themes for : Programme and Budget Background  Weak health systems constrain efforts to scale up HIV and AIDS programmes and services.  Health system strengthening is thus currently viewed as a key component of a comprehensive response to HIV and AIDS, TB & malaria (and other diseases)  For ILO this is an inclusive engagement with health workers. The ILO, as a cosponsor of UNAIDS, contributes to the health of workers and workplaces through:  Support to strengthen national health systems through a focus on health workers, their conditions of work (including remuneration) and the OSH standards under which they work (including their psychological health).

Strengthening legal-policy framework for action on HIV and AIDS in the world of work especially human rights protection. Improving gender equality, in terms of education and employment opportunities, to empower women in the face of an increasingly feminized epidemic. Integrating HIV and AIDS into existing world of work structures e.g. OSH, occupational health services, TB workplace programmes. Making workplaces gateways to Universal Access. Reaching out to the community and the informal economy to better address the needs of young people and women. Enhancing/sustaining capacity building for both ILO staff and ILO constituents and workplace peer educators. Mobilizing national resources to ensure sustainable programmes at country level. Follow Up