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For Discussion Purposes Only

HIV / AIDS and Decent Work

Zoren T. Amat

INSTITUTE FOR LABOR STUDIES


1

INTRODUCTION

―Nine of every ten people living with HIV will get up today and go to work.‖ Juan Somavia, Director-General of the ILO Since AIDS was first identified in the early 1980s, an unprecedented number of people have been affected by the global AIDS epidemic. Today, there are an estimated 33.4 million people living with HIV and AIDS and each year around two million people die from AIDS related illnesses. The epidemic has had a devastating impact on societies, economies and infrastructures. In countries most severely affected, life expectancy has been reduced by as much as 20 years. Young adults in their productive years are the most at-risk population, so many countries have faced a slow-down in economic growth and an increase in household poverty. In Asia, HIV and AIDS causes a greater loss of productivity than any other disease. An adult’s most productive years are also their most reproductive and so many of the age group who have died from AIDS have left children behind. In sub-Saharan Africa the AIDS epidemic has orphaned nearly 12 million children. The indifference and lack of appropriate information that many people think there is a 'cure' for AIDS, makes them feel safer, and perhaps take risks that they otherwise wouldn’t. However, there is still no cure for AIDS. The only way to stay safe is to be aware of how HIV is transmitted and how to prevent HIV infection. While we have made considerable successes in containing the disease for the past years, HIV has evolved affecting new segments of our population, which is distinct to what we have known before. And so, more than ever, it is important to think and rethink strategies on addressing the HIV/AIDS problem, because the social cost of complacency to the challenge of the disease is just beyond imaginable. There are different ways of addressing the challenge of HIV and AIDS. Many may see it within the framework of medical science, others as socio cultural issue, while some as a global security matter. However, with the changing demographics of people living with HIV, particularly affecting the young people during their most productive years, HIV and AIDS has also emerged to become a workplace issue. Such shift in perspective is very crucial in the achieving decent work for all, specifically in consideration of the following policy imperatives: AIDS has a marked impact on workers, their families and dependants, enterprises and national economies.


Discrimination and stigmatization against both women and men living with HIV threaten fundamental principles and rights at work, and undermine efforts to provide prevention, treatment, care and support. The workplace has a vital role to play in the wider struggle to limit the spread and effects of the pandemic. It can facilitate access for all workers in every country to HIV prevention, treatment, care and support. HIV infection is wholly preventable if timely action is taken. If workers living with HIV are placed on effective treatment, they can continue leading a normal productive life for many years. Hence, by using the Decent Work framework as the platform of HIV/AIDS discussions, different social actors- the government, workers, employers and civil society organizations will be able to have more objective exchanges to come up with new and effective responses on the issue of HIV/AIDS in the workplace. Decent work and the challenge of HIV/AIDS at the workplace Decent work encapsulates all the aspirations of workers, especially the vulnerable, and can be considered as one of the democratic demands of people everywhere. By realizing the four strategic objectives, namely: respect for fundamental rights; creating employment opportunities; social protection; and, social dialogue, we can truly improve the lives of workers living with HIV. Considering HIV/AIDS as a workplace issue encourages all stakeholders to always examine respective HIV/AIDS interventions under the lenses of the four pillars of Decent Work. In terms of the first strategic objective of decent work, the rights of workers are oftentimes violated, as workers and people living with and affected by HIV/AIDS are subjected to discrimination and stigmatization. Because of the stigma many workers after contracting the virus have become unemployed, putting additional burden to their families for support. The first pillar answer this challenge as it demands that the rights of people living with the virus should at all times be respected. It calls for the improvement of their working conditions, whether organized or not, and whether work occurs in the formal or informal economy- whether right in the home, in the community or in the voluntary sector. Effective implementation of labor standards that seek to protect and ensure the welfare of workers should always be ensured. This is especially important in addressing any forms of discrimination at work whether on the grounds of real or perceived HIV status.

On employment, HIV/AIDS has become a major threat in the world of work because it is

affecting the most productive segment of the labor force. It results to loss of productivity among young professionals who are considered to be susceptible to the disease, directly affecting human resource development in the country.


It has far-reaching social and economic consequences. The possible loss of workers because of the disease affects their families and communities through lost of wages and income. It boomerangs on enterprises, public and private, through the loss of skills and experience at the same time as it causes an increase in direct and indirect labor costs. Hence, the second pillar sustains the defense of rights at work which necessarily involves the obligation to promote the possibilities of work itself. It is therefore urged to promote the personal capabilities and to expand the opportunities for people living with HIV/AIDS to find productive work and earn decent livelihood. There is a need to promote reasonable accommodation so that they can continue to be productive member of society. An enabling environment for enterprise development lies at the heart of this objective.

Social protection for people living with the virus means protection against additional vulnerability and contingencies. It lays down the responsibilities of stakeholders to address different insecurities, especially when virus starts to take toll on the HIV positive workers. This also means that there should be provisions for programs that promote safe workplaces, even for families of workers to have access to adequate financial support mechanisms in the event of health and other contingencies happen.

Specifically, the third pillar calls for protection against of HIV positive workers particularly in terms of access to treatment and antiretroviral drugs, which is their top most concern. Measures should be laid down to address the vulnerabilties and contingencies, especially when opportunistic diseases start to manifest in their body forcing them to be unemployed. The third pillar also calls us to value prevention through safe and healthy workplaces. These efforts can be effectively realized through occupational safety and health trainings that focus on HIV/AIDS prevention. Social dialogue requires participation and freedom of association, and is therefore an end in itself in democratic societies. It is also a means of ensuring conflict resolution, social equity and effective policy implementation. Workers should be treated with respect at work; they should be free to voice their concerns and participate in decision-making about their terms and conditions of work. Social dialogue in the eyes of HIV positive community requires that the voice of people living with the virus is considered in policy debates. Affected and infected workers should be treated with respect at work; they should be free to participate in decision-making at the national down to enterprise levels. By empowering the organizations of people living with HIV and AIDS (PLWHA), it will ensure fast dispute settlement, protection of their rights and effective HIV/AIDS policy implementation. For this reason, HIV/AIDS has in effect reinforced the central role of the world of work in promoting development as well as combating the disease itself. It highlights the broader potential of the government, employers, workers and other social partners to contribute to national efforts, and the fundamental link between social dialogue and ownership, both of the problem and of its solution. Moreover, the workplace is a good setting for HIV/AIDS programs. Workplaces are communities where people meet and discuss, debate with and learn from one another. This


provides an opportunity for awareness raising, education and the protection of rights. The simple fact remains, that most people spend large amount of time at work, and this offers undeniable advantages for taking action in awareness raising and education on HIV/AIDS and even access to care, support and treatment.


2

FROM “LOW AND SLOW” TO “IMMINENT AND URGENT”: THE CASE OF THE PHILIPPINES

The threat of HIV/AIDS is real, and the Philippines is certainly not exempted from the spread of the virus. Since 2007, the country has already experiencing significant increase in number of HIV/AIDS cases. As of December 2009, the Department of Health National HIV and AIDS Registry has recorded a total of 4,424 HIV Ab seropositve cases in the country. The passive surveillance showed sudden increases in HIV positive cases which recorded a 54% increased from 2007 to 2008, and 58% increase in the following year. As compared to the monthly reported cases, averaging at 20-30 case per month in 2006 to 2007, the past 2 years have shown a sharp increase of 44 cases per month in 2008 and 70 cases per month in 2009. Doubling Time of HIV and AIDS Cases in the Philippines

Source: HIV/AIDS Registry


The median age was 26 years and the 25-29 age group registered the most number of cases. The statistics also show that 32% or 1,285 of those listed in the registry are said to be overseas Filipino workers, 264 of which became full-blown AIDS cases. Distribution of HIV Cases by Age and Sex, January 1984 – October 2009

Source: Philippine HIV AIDS Registry

With these figures, the threat of this disease particularly to Filipino workers cannot simply be ignored. As much as HIV/AIDS is a biomedical problem, it is both a social and labor issue. It affects the world of work in a variety of ways: it strikes the hardest at the most productive segment of the labor force and reduces earnings; it imposes huge costs on enterprises in all sectors through declining productivity, increasing labor costs, and loss of skills and experience. HIV/AIDS threatens fundamental rights at work and undermines efforts to provide women and men decent and productive work in conditions of freedom, equity, security and dignity. Of the 4,424 with HIV, 90% reported cases were infected through sexual contact. Of those who were infected through sexual mode of transmission, cumulative data shows that 55% of them were infected through heterosexual contact, 29% through homosexual contact and 15% through bisexual contact. However, in 2007, homosexual mode of transmission became the highest registering at 41%, followed by heterosexual, 32%, and 28% was bisexual.


Mode of Transmission Sexual Contact Heterosexual contact Homosexual contact Bisexual contact Blood/Blood Products Injecting Drug Use Needle prick injury Mother-to-child No data available

Dec 2009 n=126 119 16 (13%) 81 (68%) 22 (19%) 0 0 0 0 7

Jan-Dec 2009 n=835 804 216 (27%) 336(42%) 525 (31%) 0 0 0 2 29

Cumulative 4,424 3,994 2214 (55%) 1171 (29%) 606 (15%) 19 8 3 49 351

Source: Philippine HIV AIDS Registry

Since HIV infection has not spread to significant levels in the country’s total population, the HIV/AIDS prevalence in the Philippines can still be characterized as ‖low and slow.‖ The recorded infection is largely confined to individuals with higher risk behavior such as having multiple sexual partners, low condom use, high needle sharing among drug users, and practice of unprotected anal sex. Nonetheless, the Philippines cannot afford to be complacent in the current situation. There is a real possibility that a sudden and dramatic increase in the number of HIV infections will make the disease uncontrollable and might even develop into an epidemic. As most of the HIV/AIDS infected are breadwinners, and the impact of HIV/AIDS infections goes beyond the survival of families, socio-economic effects are felt over the enterprises, communities, and society as a whole. Hence, the ―low and slow‖ scenario does not alter the imminence of the virus’ threat to becoming a full blown virus outbreak and the urgency for coordinated national action is definitely warranted.


3

ISSUES AND RESPONSES: STAKEHOLDERS’ PERSPECTIVE

Rights at work ―Like all of us, my friends who are living with HIV should have the opportunity to live full and dignified lives.‖

Yao Ming, NBA player

International Labor Organization. HIV/AIDS at the workplace was included in the agenda of

98th International Labor Convention (ILC). Specifically, the discussion aims to: 1) determine the need for an international instrument on HIV/AIDS; 2) increase attention at the national and internal levels on HIV/AIDS and the world of work; 3) promote united action; 4) increase impact of the ILO code of practice on HIV/AIDS and the world of work; and, 5) review recent developments on HIV/AIDS. Although there is already an existing ILO code of practice on HIV/AIDS, the possible standard-setting on HIV/AIDS in the world of work will hopefully influence national contexts to sustain the principles that the Instrument will promote. Among the specific issues that should be surfaced during policy discussions include: Role of PLHIV in the workplace – empowering them to ensure that their rights are not violated and as advocates for strengthening HIV/AIDS initiatives at the workplace; How to further strengthen data collection (e.g. sector-specific, employment, spousal transmission for spouses of OFW, sexual orientation, occupational status) – in order to derived appropriate policy interventions; Grievance/disciplinary procedures at the enterprise level to address issues such as discrimination at the workplace, among others; Support for children whose parents are ill or have died as a result of HIV/AIDS; Active participation of labor judges and labor inspectors in the responding to the challenge of the virus; Strengthen coordination between health and labor departments such as the linkage between DOLE and DOH in the case of the Philippines. Implementation of policies for Workplace Actions on HIV/AIDS


Trade Union Congress of the Philippines. The Philippines have an enabling policy environment for workplace actions on HIV/AIDS. These specific policies are:

Labor Code of the Philippines – Book 3 , Article 134 which provides for family planning services and incentives for family planning RA 8504 otherwise known as The Philippines AIDS Prevention and Control Act of 1998; DOLE Administrative Order Nos. 236-1996/38-03 on the Creation of the InterCommittee on Workplace Based Strategies for HIV and AIDS DOLE Memorandum Circular No. 02-2000 on Guidelines in the Application of Workplace Component of the RA 8504 DOLE Department Order 56-03 on Rationalizing the Implementation of the Family Welfare Program (FWP) in DOLE where HIV/AIDS is a component DOLE Department Order 57-04 on the Labor Standards Enforcement Framework where HIV/AIDS is one of the items under OSH Standards for the Checklist for SelfAssessment DOLE Department Order No. 102-10 that sets the Guidelines for the Implementation of HIV and AIDS Prevention and Control in the Workplace Program. The DO provides direction on HIV and AIDS program implementation in the workplace. The most comprehensive among these policies is RA 8504 or the Philippines AIDS Prevention and Control Act of 1998. It contains provisions on – a) HIV/AIDS education in the workplace; b) prohibitions on compulsory HIV testing; c) discrimination in the workplace; and, d) guidelines on precautions against transmission during surgical and similar procedures. To reinforce these policies at the national level, the ILO came up with the Code of Practice on HIV and AIDS and the World of Work. Although non-binding in nature, the Code provides a framework for action and contains key principles for policy development and practical guidelines for program implementation. The Code covers areas such as: prevention of HIV; management and mitigation of the impact of AIDS; care and support of workers infected and affected by HIV and AIDS; and, elimination of stigma and discrimination on the basis of real and perceived HIV status. The Trade Union Congress of the Philippines (TUCP) has been at the forefront of implementing initiatives on HIV and AIDS at the workplace. As a policy, the TUCP centers on prevention and control of HIV/AIDS and STDs. This policy affirms the protection of workers’ rights and dignity of persons living with HIV/AIDS by establishing core groups on HIV/AIDS at the establishment level. The TUCP’s actions on HIV/AIDS operate under the framework of TUCP Cares. The framework centers on the following pillars: health and well-being; working conditions; addressing vulnerabilities; social protection; and, resolving work and family conflict. The fundamental strategies thru which these pillars will be realized include – workers education, collective bargaining negotiations, knowledge management, and capacity building. TUCP initiatives began in 1991 as part of the Family Welfare Program. Activities were mostly conduct of orientation seminars, group discussions, workshop and handling of telephone inquiries.


Employment opportunities ―If you take away our jobs, you will kill us faster than the HIV virus.‖ Naveen Kumar, living with HIV, New Delhi, India

Employers Confederation of the Philippines. Leadership is crucial to the fight against

HIV/AIDS and employers as leaders in the local community have a very important role to perform. According to the IRR of RA 8504, each employer shall develop and implement workplace HIV/AIDS education and information program for all their workers (Rule 2, Sec. 15 on IRR) and that education shall be integrated in the orientation, training and continuing education and other human resource development program of employers. In compliance with this, some employers in the Philippines have already embarked on implementing workplace programs on HIV/AIDS prevention. These companies include Levi Strauss Philippines, Central Azucarera Don Pedro, Yazaki-Torres and Mabuhay Vinyl Corporation. ECOP undertook several initiatives to assist its members in coming up with HIV/AIDS prevention programs. Series of business orientation-meetings/forums were organized in selected areas throughout the country. The said seminars were aimed at making the business sector aware and informed about the issue and its impact on the world of work. ECOP with the support of the International Labour Organization (ILO) started work on a manual on how to manage HIV/AIDS in the workplace. It has partnered with the Federation of Free Workers to conduct orientations and action planning workshops to help selected companies set up workplace policies on HIV/AIDS. Just recently it has develop Facilitator’s Guide on Managing HIV AIDS in the Workplace based on the earlier publication Program Management Training for HR Practitioners. Promoting HIV AIDS programs among the business sector continues to be a challenge. Workplace-based HIV/AIDS policies and programs remain to be few in the Philippines, as these were not seen as a priority due to insufficient fund that will sustain efforts on HIV AIDS prevention. In response to these challenges there are areas, which can be focused on to better encourage companies to institute HIV/AIDS programs at the workplace. This includes documentation of good practices to motivate other corporations to recognize HIV AIDS as an important economic and social issue. Approaches can also be done at the business community level and not at individual company, in developing concrete HIV AIDS programs. As they pursue activities and programs as a group, this will create economies of scale which is an important step to maximize resources and sustain the programs. Further, international development bodies like the ILO and UNAIDS may come up with compliance certification system on instituting HIV/AIDS prevention policies to encourage business organizations, especially multinational companies, to encourage more companies to implement their respective HIV/AIDS prevention programs.


Social protection ―AIDS-sensitive rather than AIDS-specific social protection instruments protect vulnerable households from the impoverishing effects of HIV and AIDS, while potentially encouraging pro-poor growth.‖ Ann Nolan, Technical Specialist in HIV and AIDS at UNICEF

Ocupational Safety and Health Center. HIV and AIDS, including other sexually transmitted

diseases are issues in the workplace because these threaten the occupational safety and health of workers. However, a more free and open discussion about STI, HIV and AIDS will hopefully eradicate if not diminish the stigma and discrimination. This should be done without comprising the individual’s right to privacy and non-disclosure. The initiatives on HIV/AIDS dates back during the crafting of DOLE National Workplace Policy and Strategy in 1996. This was followed by the enactment of RA 8504 in 1998. The International Labour Organization also published a Code of Practice on HIV and the World of Work in 2001. Further, the National AIDS Medium Term Plan (2005-2010) is in place to ensure coherence in the different HIV/AIDS initiatives of the different stakeholders. The prevention strategies on HIV and AIDS includes continuous advocacy, information, education and training, capability building for DOLE and partners, technical support on policy and program formulation and implementation, research and networking and referral. Capability building for focal persons, workplace safety and health practitioners, human resource personnel, managers and employers started in the 1990s and was pursued with the help and collaboration with different NGOs. Technical support in the form of Training of Trainers was provided by positive community such as Positive Action Foundation Philippines Incorporated (PAFPI) and Pinoy Plus. There is also a database on companies who have received HIV/AIDS courses and who among them have developed policies. Lastly, there is an interagency committee on HIV on the workplace that is comprised of PLWHIVs, unions, employers, and government offices. Partnerships are forged with the members of the academe, NGOs, and professional organizations. Through the technical assistance of OSHC, companies and establishments are integrating their HIV policy in their OSH policy and program and even in their corporate social responsibility activities. There are companies that have condom promotion/ screening and treatment of sexually transmitted infections. However, there are still some companies, which are experiencing difficulty in the implementation of HIV/AIDS policies and programs. The HIV/AIDS initiatives in the workplace often clashes with other concerns like wages, hours of works and benefits for the workers. Moreover, focal persons for HIV/AIDS have other safety and health concerns, which give them more reasons not to give ample attention to HIV/AIDS prevention initiatives. DOLE and its partners are working together to strengthen the implementation and enforcement of HIV workplace prevention by conducting technical advisory visits and enforcement of regional offices inspectorate. The Regional offices are tasked to check if


companies are implementing their respective HIV programs. In 2008, the Bureau of Labor and Employment Statistics surveyed non-agricultural establishments employing 20 or more workers to find out what occupational safety and health programs and services are offered by these companies. The survey showed that out of 24,457 companies, 6,368 have HIV/AIDS policies and programs. Although several programs were already put in place, the challenge is to further engage the business sector and encourage them to pour in more resources in the HIV/AIDS program and activities. There is also a need to propose legislation on harm reduction, specifically for injected drug use, which will extend beyond the workplace. Further, it is important that management and workers must work together and develop a policy to be translated into programs that will be made known to all workers. This will entail reviewing existing workplace education package, updating statistics, and studying new trends in the mode of transmission. Actions should focus on how to strengthen preventive measures despite existing limitations. Since the Philippines have low-prevalence of HIV cases, it would be better to focus on prevention rather than testing. The prevention can be strengthened by working with unions and involving the workers’ family and the community. At the policy level, DOLE released Department Order 102-10 in March 26, 2010. It aims to strengthen the workplace response in implementing RA 8504 specifically through the following components: 1) advocacy, information, education and training; 2) social policy; and 3) diagnosis, treatment and referral for other services. Private establishments are prohibited to terminate workers if the basis is actual, perceived or suspected HIV status. Job applicants and workers must not be asked to disclose HIV-related personal information. Workers, on the other hand, must comply to universal precaution and preventive measures and enjoined to share information on prevention and control of HIV and AIDS to their families and communities. The Bureau of Working Conditions through DOLE Regional offices will be enforcing this Guidelines, in relation to OSH standards and other labor standards policies and legislations. On the other hand, it is also a pressing issue that policies on harm reduction strategies should be harmonized with the provisions of RA 8504. This will make the approaches among government and other stakeholders more coherent. Similarly, the Civil Service Commission released Announcement No. 21-2010, Guidelines in the Implementation of Workplace Policy and Education Program on HIV and AIDS. With the release of this announcement, workers in both private and public sector should now have HIV/AIDS policies and programs in their organizations.

Overseas Workers Welfare Administration. Protecting overseas Filipino workers from

contracting HIV/AIDS is also of the major concerns not only of the government but other stakeholders. In line with the ―HIV and AIDS Prevention For The Overseas Filipino Workers,‖ OWWA centered its efforts on: 1) preventing the spread of HIV/AIDS among OFWs; 2) providing cure and offer relief to OFWs from the opportunistic illnesses brought about by the virus; and 3) extending care and support for the OFWs and the affected families. The Pre-Departure Orientation Seminar (PDOS) is a mandatory information dissemination mechanism that aims to provide Filipinos with knowledge and familiarity about the


destination country. One module in PDOS is devoted to discuss diseases that OFWs could contract while they are on site. AIDS/HIV is one of the diseases covered by the module. Admittedly, the PDOS have some limitations in terms of educating the Filipino worker about HIV/AIDS. Those who undergo the seminar are often pre-occupied with other pressing predeparture concerns and may not fully absorb the topics discussed in the PDOS. This serves as a challenge as far as the prevention efforts of OWWA are concerned. To make the seminar more meaningful and interesting, OWWA asked (PLWHA) to give testimonies during the PDOS. Their testimonies are utilized to serve as proof of the reality and magnitude of HIV/AIDS. Presently, OWWA is in the process of coming up with a reading material to be given to ―ready-to-leave‖ Filipino workers which they could bring with them on site to reinforce their knowledge and appreciation of HIV/AIDS prevention programs. Likewise, to address the dearth of IEC materials on HIV/AIDS for OFWS, the UNDP/UNFPA together with the different agencies are planning to come up with a new idea of attaching IEC material to the passport holders which will be given to OFWs. The passport holder, which is being developed by Institute for Labor Studies will contain safety reminders including the contact information of agencies that OFWs can get in touched with should they have queries on HIV/AIDS. As for the curative component, there are existing health packages available to OFWs that could cover opportunistic diseases brought about by the virus. The health package although subject to financial cap, is higher than what PhilHealth provide to workers, as it includes hospitalization services on-site and at home. The training with OFW families that has been carried out in some selected regions in Luzon and Visayas is included in the list of activities under the care and support component of OWWA program. Training of families who were left behind was conducted in Regions 3 and 4A, 6, 7, and 8. A Visayas Network is already in the pipeline to be able to replicate these achievements and the establishment of support networks with the help of regional/local HIV/AIDS organizations. The biggest challenge is to be able to build a network of support for OFWs on-site. Trainings and consultations in the country of destination should be replicated for them to reach more OFWs and enhance its effectiveness It is very important to find allies in the country of destination so that there will be more partners who will extend help in protecting OFWs. Upcoming projects are now directed at ―strengthening capabilities of officials so they can extend assistance‖ and ―forging agreements with local health organizations‖ that could help OFWs while they are on-site.


Social dialogue ―To accomplish these goals, we must undertake a more coordinated national response to the epidemic. The Federal government can’t do this alone, nor should it. Success will require the commitment of governments at all levels, businesses, faith communities, philanthropy, the scientific and medical communities, educational institutions, people living with HIV, and others,‖ President Barack Obama, President, United States of America

Pinoy Plus. Non-profit organizations, such as Pinoy Plus, had to spent their own personal money to support their activities. Initially, the first activities of Pinoy Plus were home and hospital visits. As the Pinoy Plus forged more linkages with other organizations, a number of projects, particular on advocacy activities were realized through the assistance from foreign donors. Specifically, the activities include participating in the review and revision of RA 8504, helping out DILG in the establishment of local AIDS council and conducting sessions to address the issue of stigma and discrimination.

Social dialogue could also be a strategic venue to talk about the environment of a people living with HIV/AIDS. The hospital, clinic, community and home all contribute to the wellbeing and the development of happy and positive outlook in life by PLWHAS. The psychosocial support that faith-based organizations and the family provide is equally important as the medical attention given in clinics and private hospitals. Accordingly, Pinoy Plus also conducts capacity building activity through HIV Treatment and Literacy Education. Sensitization and home-based care training among family members, HIV/AIDS peer education workshop among infected and affected families are also part of the organization’s capacity building activities. One of the key accomplishments of Pinoy Plus is ensuring the accessibility and availability of Anti-Retro Viral drugs especially for its members. A month’s supply of ARV, if bought, will cost around P30,000 but through the Global Fund, the drugs are being providing for free. Another accomplishment is the forming of the Positive Speaker’s Bureau that seeks to disseminate information about HIV/AIDS to a wider audience. The organization was also able to establish referral mechanisms for continued care and support for its members. While these efforts are commendable, there are still many challenges and constraints that the organization has to deal with. First of which is the availability of funds, which put constraints in sustaining HIV/AIDS activities and programs. In this regard, Pinoy Plus recommended that the government allocate more resources to HIV/AIDS prevention and treatment programs. According to them, as the bulk of support comes from international organization, it is just prudent that this be complemented with government resource allocation.


Positive Action Foundation Philippines Incorporated (PAFPI). For PAFPI, many policies are

already in place, what is needed is to translate these into actions. There are many challenges that both civil society organizations and the positive community confront. These problems include genuine policy implementation, greater need for meaningful involvement of people with HIV/AIDS, unclear sanctions for violation of policies, and the limited of monitoring mechanisms for HIV/AIDS programs at the workplace. Companies tend to pay attention on how to increase profit and devote little attention to formulating a HIV/AIDS program. PAFPI also raised the issue of monitoring the compliance of companies and establishments with these policies. PAFPI pointed out that partners are helpful in supporting HIV/AIDS preventive programs. Specifically, PAFPI mentioned the following areas for collaboration and partnerships: 1. In mainstreaming HIV/AIDS in CSR activities of the private sector; 2. In providing referral structures for access to psychosocial support services and treatment; and 3. DOLE Inter-agency Committee to serve as watchdog to monitor implementation of HIV/AIDS program in the workplace. Finally, PAFPI stressed that the number of HIV cases among young workers is increasing. The young workers should therefore be considered ―at risk‖ so that they will be at the receiving end of activities and programs concerning HIV/AIDS education and awareness.


3

POLICY RECOMMENDATION

―It is important for us to think and rethink our strategies on how we do things because the social cost of complacency to the challenge of HIV/AIDS at the workplace is just beyond imaginable. I believe that by using the Decent Work framework as the platform of our discussion, we will be able to have more objective exchanges, and in turn come up with new effective responses to HIV/AIDS in the workplace.‖ Assistant Secretary Ma. Teresa Soriano, DOLE

The HIV/AIDS is major health problem that needs to be addressed with urgency. The crucial foundation on which effective HIV/AIDS prevention strategies can emanate has been successfully laid down. While other countries struggle to establish concrete policies as they are confronted with a full blown epidemic, the Philippines was able to keep the prevalence of HIV/AIDS at manageable level. The Philippines have been implementing various initiatives involving the multi-sectoral approach, to address issue related to HIV/AIDS at the workplace. These strategies include crafting of policies, information and education campaign, carrying out various programs designed to protect Filipino workers from HIV/AIDS. While these are commendable in itself, there are still many things that need to be done to make the HIV/AIDS policies and programs contribute more to the attainment of decent work objectives. The following are recommendations to fine tune policies and programs: 1. At the policy level, provisions on strengthening the role of PLHIV in HIV/AIDS prevention should be realized. By giving them strategic roles in implementing government policies they will be empowered to ensure that their rights are not violated and as advocates to strengthen HIV/AIDS initiatives at the workplace; 2. Policies should be directed at integrating treatment, care and support mechanism for HIV positive employees, improving the monitoring and evaluation mechanisms, replicating effective policies and activities and strengthening collaboration with civil society organizations; 3. Policy should also be strengthened in the areas of data collection, specifically regarding on sector-specific data like employment, spousal transmission for spouses of OFW, sexual orientation, occupational status. Through these data and information, more appropriate policy interventions can be derived; 4. Coherence with of RA 8504 with other government policies should be ensured. This is specifically true with RA 9165 or Comprehensive Dangerous Drugs Act of 2002 wherein there are provisions that are in conflict with the AIDS law in implementing harm reduction strategies.


5. The following are more specific actions to address the challenge of HIV/AIDS at the workplace: a. Institutionalization of grievance/disciplinary procedures at the enterprise level to address issues such as discrimination at the workplace; b. Ensure participation of labor arbiters and OSH officers in HIV/AIDS programs and services to make them more aware and sensitize on HIV/AIDS issues; c. Positive sexual attitudes and behaviour among young people should be developed through school-based HIV/AIDS education; d. Stronger information and education campaigns—especially those that use mass media and peer groups— that have been proven to be effective in reaching young people, vulnerable groups and mobile populations; and e. A change in attitude and behavior towards safer sexual practices, including condom use, to reduce vulnerability to sexually transmitted infections and HIV/AIDS.


HIV / AIDS and Decent Work