Dodging An Epidemic
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Photo Courtesy of ABCAR
A coalition of Arab-world businesses have realized that HIV/AIDS in the region must be dealt with sooner or later — and it turns out that sooner means cheaper
By Ethar El-Katatney
Imagine this: One new HIV infection occurs every 9 minutes. The HIV infection rate is increasing by 300% per year, making it the second-fastest rate in the world. These are not the rates for South Africa. No, these statistics are drawn from the Arab world.
Today, nearly half a million Arabs are living with HIV, and the number of deaths resulting from AIDS in the region has increased almost six-fold since the early 1990s. At this rate, if nothing is done to combat the trend, countries in the region may face infection rates as high as 4% by 2015.
It’s time for Arab nations to stop burying their heads in the sand and face the facts: AIDS has the potential to become the second-leading cause of death among adults of working age, not just in the Arab region, but globally.
The business implications of that fact are staggering.
The HIV/AIDS Regional Program in the Arab States (HARPAS) of the United Nations Development Program (UNDP) has been working for the past four years with stakeholders in 20 Arab countries to tackle the issue of HIV/AIDS. These stakeholders include religious leaders, governmental institutions, legislators, policy makers, women’s leaders, and NGOs — all of whom have a vested interest in halting the spread of HIV/AIDS.
HARPAS commissioned research to assess the potential for the private sector — which was the only remaining stakeholder — to join the regional response to the challenge of HIV/AIDS. Based on this research, it was found that the private sector’s role in the combat of HIV/AIDS has become increasingly important, mainly due to the wave of privatization and economic reforms in the Arab region.
Private companies, which typically excel at long-term thinking and proactive actions, rarely see HIV/AIDS on their threat matrix. That’s surprising when you consider the corporate world has the most to lose.
AIDS is Bad for Business
In addition to the terrible human and social impact of HIV/AIDS, the disease is a wrecking ball on economies. HIV, after all, usually affects young adults in their most productive years — it kills families, but first it decimates workforces.
According to World Economic Forum reports, Middle Eastern and North American firms are among the least concerned in the world about how HIV/AIDS could affect their business. Less than 3% of companies in the Arab region have an HIV/AIDS policy. And what’s worse, the companies that don’t have a policy don’t believe that there is a problem — or that there will ever be a problem.
HIV/AIDS costs businesses money. Money spent on diagnosis. Money on anti-retroviral drugs. Money spent on hospitalization. It also wastes cash like nothing else: Sick days, lost and wasted training, higher healthcare premiums. Money spent to recruit, select and train new people. Money, money, money.
In light of the importance for businesses to face this growing threat, the UN pulled together leading businesses to form the AIDS Business Coalition in the Arab Region (ABCAR), which officially launched in May 2007 as a “regional, non-profit company that promotes and supports the implementation of life-saving and cost-effective HIV/AIDS programs in the workplace through business-to-business models.”
The brainchild of the UNDP and a number of multinationals, the organization has its roots in raw business logic — that an external threat (in this case, HIV/AIDS, but it could just as easily have been malaria, bird flu or global warming) is going to cost businesses dearly unless something is done about it.
According to Noeman Al-Sayyad, the UNDP’s top regional communications guru, “We use this term — ‘Good business sense’ — which was criticized as not being very sensitive when you’re talking about AIDS. But I think that is the main message, it does make business sense to start early in addressing the issue of HIV/AIDS.”
The size of the Arab labor force and its productivity will decrease as the number of people living with HIV/AIDS increases. The private sector must start planning for the future, and Arab countries should be leading the initiative, considering that foreign investment, for which Arab countries intensely compete with other developing nations, is largely contingent on human capital and productivity issues.
Beyond business interests, there is a wider interest in the well-being of the community at large. This equally has an economic dimension — if HIV/AIDS takes its toll on the most productive people in key age groups, then there will be a greatly reduced demand in each society for goods and services.
“[This is why] we try to convince business people that today, responding to HIV/AIDS with [protective] measures — in their workplace, for their employees — makes perfect sense in terms of social benefits,” explains HARPAS Program Advisor Pierre-Etienne Vannier. “We’re talking about saving the lives of their people — but also in [the] business sense. You take care of people and business.”
ABCAR’s primary role is to raise awareness. It is particularly important to get the message across to businesses that don’t believe (or refuse to believe) that AIDS will become an epidemic if they don’t do something soon. ABCAR advises companies to implement “life-saving and cost-effective measures,” which include educating their workforce on how to protect themselves against HIV/AIDS, giving them access to confidential anonymous testing and, if necessary, to treatment.
The longer the corporate world waits before responding, the worse the problem will become.
Khadija Moalla, regional HIV/AIDS practice leader and program coordinator for HARPAS, clarifies that “if [companies] want to make a difference, it’s now — because now if they provide information — or even a condom — it will cost $1. If they want to provide later on, it will cost them $600 per person, per bed, per month, and you may lose them.”
Multinationals are the first on board for this initiative, after learning from the awful experience of sub-Saharan Africa. They waited too long to start their program, and when they did it was too late. The World Bank made projections that Africa would suffer an AIDS epidemic and it did, even earlier than planned. It remains to be seen whether or not the Arab region will learn from others’ mistakes. The window of opportunity is shrinking, and ABCAR is explaining that spending a bit on prevention through workshops and educating people is far better and cheaper than spending a lot later on treatment.
The Need for Leaders
The major obstacle to ABCAR’s success in the Arab region is the strong stigma associated with any company that implements an HIV/AIDS policy. “You will see people saying ‘if this company is doing something against HIV, it means that [they have] employees living with HIV, it means I don’t want to buy these products’,” elaborates Vannier.
This stigma remains, even though religious leaders, both Muslim and Christian, male and female, have issued declarations in response to the HIV/AIDS epidemic, most notably The Cairo Declaration of Religious Leaders in the Arab States in Response to the HIV/AIDS Epidemic and The Tripoli Declaration of Women Religious Leaders in the Arab States in Response to the HIV/AIDS Epidemic. Both declarations emphasize the importance of finding ways to deal with the HIV/AIDS crisis.
Another barrier to the private sector response to the imminent threat of HIV/AIDS is the Arab mentality of only dealing with problems that have become unavoidable. “There are business people telling us ‘unless I lose money, I won’t do anything’,” says Vannier. “And I tell him ‘what kind of management is that?’ If [they] think like this, then it is a very short-sighted vision for their company.”
Multinationals are the companies that are most willing to participate in such ventures, since they have already “lost so many people, and so many employees,” continues Vannier. “Let alone the impact on their activities, from a very cold and economic point of view. [AIDS] has beendevastating to their activities. They know that they cannot afford to do the same in the Arab region; they cannot afford to lose so many employees. In some countries in southern Africa, they are recruiting three people for one position, because they know that two of them cannot make it.”
It’s easier for multinationals to be pioneers, given that learnings (good and bad) from one country can be utilized in others. Local companies face resistance and criticism and can’t afford any losses their company might incur from negative public responses. It is therefore ABCAR’s aim that these multinationals will lead by example.
According to Michel Bayoud, CEO of Boecker Public Health Group, an ABCAR founder, says, “I think that when multinationals promote this trend and show that it’s OK [without negative repercussions], everyone will follow. Fifty years ago, it was [unimaginable] for women to work. But when pioneering companies started hiring women, others followed, and now it has become the norm.”
Even though multinationals may help in lessening the stigma attached to companies implementing an HIV/AIDS policy, there still remains the fact that the measures ABCAR is advocating cost money. The majority of companies in the Arab region are small and medium enterprises (SMEs) and do not have the funds or the willingness to join such an initiative. They do not think in the long term, with immediate survival and turning a profit being higher on their list of objectives than long-term sustainability. Although the costs of reacting now are cheap compared to the future costs of treatment, the costs are still more than they are willing to pay.
ABCAR aims to deal with this problem through its supply chain program, which consists of large companies and multinationals engaging their smaller partners. These large companies may even pay the costs of implementing an HIV policy for the companies that cannot pay, since, as Vannier comments, “$1,000 or $2,000 [per year] is nothing for big players.”
ABCAR, Moving Forward
It is clear that it is economically imperative for the private sector to get involved in the fight against HIV/AIDS. It’s not a matter of choice, and that’s the significance of ABCAR — it puts that message on the table.
Currently, ABCAR has three board members: Shell EP International, Lafarge Group, and Standard Chartered Bank. The UNDP and the International Labor Organization are its technical partners, along with the Arab League. Over 40 companies have either joined the initiative or expressed interest in collaborating. As a regional initiative, ABCAR also works to support national initiatives such as the Egyptian Business Coalition on HIV.
The vision is that ABCAR will become a private, sustainable, independent NGO, working together with its stakeholders to combat the threat of HIV/AIDS. The kind of threat that AIDS represents to the Arab world is matched in scale only by the opportunity that exists, right now, to avert a crisis. bt