HIV/AIDS

The major community health issue facing Xstrata's operations is the HIV/AIDS epidemic in South Africa. Our approach recognises that HIV/AIDS is more than simply a health issue.

Photo: Breyten HIV Clinic, provides access to counselling, testing and treatment for employees and community members

Breyten HIV Clinic, provides access to counselling, testing and treatment for employees and community members

In addition to HIV/AIDS prevention, testing and treatment programmes for employees and contractors, we seek to address some of the far-reaching social, cultural and financial implications and causes of the pandemic through community initiatives. Our Health and Occupational Hygiene Standard requires us to promote the health and wellbeing of the workforce through access to health information and programmes. Our Community Standard states that Xstrata will provide support for community-related health programmes.

Xstrata employs over 11,500 people in coal and ferroalloys operations in South Africa. We estimate that around one in five Xstrata employees and contractors in South Africa is HIV positive, making HIV/AIDS the most significant health issue facing the Group. Xstrata Coal's HIV/AIDS strategy was developed in 2002 and Xstrata Alloys has developed a business-wide sustainable development strategy which makes specific provision for HIV/AIDS impact studies and programmes to address education, testing, treatment and training.

Strategy

Our HIV/AIDS strategy aims to address the underlying factors which contribute to the spread of HIV/AIDS, in addition to introducing voluntary counselling and testing programmes and ongoing education and anti-retroviral treatment for workers, contractors and their partners. More recently we have established a clinic to extend access to HIV/AIDS testing and treatment to wider communities with a further clinic anticipated for 2006.

Our South African coal business established an AIDS steering committee to oversee activities to manage the risk of HIV/AIDS to our business. A cost-benefit analysis was carried out to assess the cost of intervention compared with the cost of doing nothing. This analysis clearly supports our view that there is a clear business case for addressing the risks companies face from the spread of HIV/AIDS.

From this analysis, we estimate that doing nothing to address HIV/AIDS would add an additional cost to employment of between 3% and 6% to Xstrata's annual South African wage bill. The impact of the disease on costs includes increased absenteeism, loss of productivity, accelerated or premature payment of death benefits and increased recruitment and training costs. By contrast, the immediate business benefits of addressing contributing social factors, encouraging all employees to know their status through voluntary testing and enrolling those who are HIV positive in treatment programmes compare very favourably to this 'do nothing' scenario.

Initial prevalence, knowledge, attitude and practices campaigns were conducted across our operations and have been followed by an intensive voluntary counselling and testing programme across the coal operations. This programme aims to maximise the number of employees tested, so employees can know and properly manage their HIV status, whether positive or negative. Every employee who tests positive is offered appropriate treatment. The ultimate aim is to ensure every employee is tested and all HIV positive employees are enrolled into a treatment programme.

The accommodation of mineworkers in single sex hostels was identified as a causal factor in a number of social problems, including the spread of HIV/AIDS. To address this, Xstrata runs a programme to encourage employees to rent or buy their own homes in established towns, allowing families to live together. The programme has been underway for two years and more than 95% of employees have taken up the funding made available to them to own or rent their own family homes.

In order to assist employees' families to move to these new locations, Xstrata has also supported the establishment of a number of small enterprises, which supply businesses in the area with items such as overalls or cleaning services. In addition, we are supporting the development of a number of local schools, where mineworkers' children are educated.

Due to our work in this field, Xstrata was invited in 2005 to join the Global Business Coalition on HIV/AIDS. Our programmes in South Africa have recently been recognised as a 'programme of note' by the GBC's 2005 Awards for Business Excellence.

Workplace initiatives

The primary focus for Xstrata's HIV/AIDS initiatives is the workplace and our employees and contractors. Our objective is to maximise the number of employees who know their status and to ensure every HIV positive employee receives free treatment and counselling. We also aim to create a supportive work environment free from discrimination for employees living with HIV/AIDS and to break down the stigma surrounding HIV/AIDS.

Xstrata's workforce programmes incorporate three main elements – education, prevention and training initiatives; voluntary counselling and testing (VCT) programmes; and treatment programmes.

Photo: Breyten HIV/AIDS Clinic

Breyten HIV/AIDS Clinic

Our education, prevention and training initiatives include:

  • knowledge, attitude and practices surveys conducted at South African sites in 2003 as a baseline for Xstrata's response;
  • ongoing site-level education seminars and briefings about HIV/AIDS treatment and prevention;
  • the integration of HIV/AIDS awareness and education into induction and training programmes;
  • free condoms and targeted poster campaigns at each site;
  • training for employees to become 'peer educators', to provide support and advice for colleagues, to act as champions for VCT and to encourage colleagues to take a proactive approach to their health; and
  • training and technical support for senior and mine managers, supervisors and unions.

Xstrata Coal South Africa's HIV/AIDS programmes include 'Know your status' campaigns conducted by third party providers which were initiated in 2004 and completed at all sites by December 2005. Since the scheme began in September 2004, the VCT programme has achieved an uptake of around 78% of employees by the end of 2005. Anonymity for employees is assured with individual testing results remaining confidential between the 'Know your status' consulting company, Re-Action! and the employee. Contractors and partners of employees have also been provided with free HIV testing and treatment, through collaboration with local NGOs. Around 45% of those who tested positive have been directly enrolled into appropriate care, treatment and support services through Xstrata's primary care providers.

Our target in 2006 is to achieve 100% participation in VCT programmes. To do this, Xstrata Coal has introduced compulsory 'health interviews' which cover a range of issues, with a focus on HIV/AIDS voluntary counselling, testing and treatment. This programme aims to ensure every employee and contractor has the opportunity to know their status. Although attendance at health interviews is compulsory, no employee who does not wish to discuss HIV/AIDS or attend testing and counselling is compelled to do so.

These interviews comprise testing and retesting, counselling, education about healthy living and encouraging HIV positive employees to obtain treatment. We have also conducted training for 'peer educators' to encourage fellow employees to participate. This scheme has had a positive impact on participation rates and there is some evidence of a gradual improvement in attitudes towards HIV/AIDS and testing.

Xstrata Alloys adopted a full counselling, testing and treatment programme for every site (including the Xstrata-Merafe Chrome Venture) in 2005, through the healthcare provider OCSA. The objective is to have every employee and contractor participate in VCT by December 2006. The programme, which is similar to Xstrata Coal's programme, is run initially by OCSA, but training is provided simultaneously for site and divisional management, with the aim of enabling Xstrata Alloys to run the programme after the initial 12 month period. In 2005, a health awareness campaign was presented to the Xstrata Alloys workforce by the Department of Health.

Through 'Aid for Aids' (Medical Aid) and VCT programmes, we provide free anti-retroviral or other treatment as appropriate, depending on the stage of the disease for all Xstrata employees. Around 45% of Xstrata Coal employees who have tested positive are currently receiving treatment that is applicable to the various stages of the disease, including anti-retrovirals. This percentage has improved significantly since the VCT programme was initiated towards our target of 100%. The VCT programme currently underway at every Xstrata Alloys operation will improve participation rates in this business. Treatment is also provided to prevent transmission from mother to unborn child for employees or their partners.

Community initiatives

We recognise that our investment in our workforce is not sustainable unless benefits flow through to the members of local communities, many of whom may not have easy access to healthcare. Xstrata is working with NGOs, service providers and government agencies in innovative public-private partnerships to provide much needed services and facilities in areas where employees and local communities do not have access to primary healthcare and HIV/AIDS treatment. Initial funding is provided by Xstrata, with the long-term aim of ensuring, through our partners, that these clinics are not dependent on the company.

A health clinic was established by Xstrata Coal at Breyten in 2005 to provide a wellness clinic, treatment and HIV/AIDS testing for employees and the wider community. Details about this clinic and a further clinic at Kwa Guqa, currently under construction, are provided in the case study.

In addition to our initiatives to provide direct intervention and education, Xstrata's strategy also aims to tackle factors that contribute to the spread of HIV/AIDS and to provide support for communities dealing with problems associated with the disease.

One such issue is the plight of children who have lost their parents to AIDS. Xstrata provides direct support for these children through the provision of three specialist centres in South Africa in local communities – Middelburg Care Village (see case study), Ratanang Care Centre 1 and Ratanang Care Centre 2. These centres offer accommodation for more than 220 orphans and day facilities for 40 disabled children. Xstrata works closely with the Department of Social Welfare and other organisations such as the Rotary Club to fund and maintain these centres.

A programme to engage with traditional healers is being implemented in partnership with Xstrata's community development programmes in South Africa. The programme will seek to establish two-way communication and education between traditional healers and Western medicine health workers to tackle conflicting advice over how to manage HIV/AIDS and to mobilise community support for testing and anti-retroviral treatment, to encourage workers to manage their HIV status proactively.

Xstrata also funds a number of community education and prevention programmes including educational materials for schools and an awareness programme for teenagers via radio programmes and specific magazines.

Leadership and advocacy

Xstrata Coal has joined with BHP Billiton Ingwe, Eskom and Highveld Steel to form the Highveld HIV/AIDS Coalition. The coalition was established at the end of 2005 and the intention is to pool these companies' resources to tackle large-scale HIV/AIDS initiatives. The coalition intends to involve national and local government and NGOs in addition to businesses active in the region.

Xstrata Coal is an active member of the HIV/AIDS Powerbelt Project and is a voting member of the Steering Committee. The project is a collaborative initiative established by Xstrata, Anglo Coal, Ingwe, Sasol and various governmental departments including the Department of Mines and Energy, Department of Health, Council for Scientific and Industrial Research to advocate action by businesses in the workplace and in the community.

Xstrata also joined the Global Business Coalition in early 2005, the lead organisation for the business response to HIV/AIDS.

Xstrata's two South African businesses have shared knowledge and best practices in tackling HIV/AIDS. For example, Xstrata Alloys incorporated experience in running a voluntary counselling and testing programme by Xstrata Coal in designing and adopting its own VCT programme. Xstrata Coal is introducing Medical Aid for all employees from April 2006 in addition to its HIV/AIDS programmes; this decision was taken through consultation with employees and unions and incorporated feedback from Xstrata Alloys, where all employees are enrolled in a Medical Aid scheme.

Each commodity business has a steering committee dedicated to managing HIV/AIDS issues including senior Xstrata management, union representatives, government representatives, Xstrata's chief medical officer and external healthcare providers. Site level steering committees have also been established and include union representatives, HR managers, General Managers of the various operations and peer educators.

Evaluation and monitoring

The HIV/AIDS steering committees for each business assess ongoing programmes against objectives at least annually, together with service providers, community members, NGOs and government. Xstrata's HSEC Assurance Programme independently assesses each site's systems and performance against the Group's 17 Management Standards. For South African sites and divisions, this includes an assessment of each site and divisions' response to HIV/AIDS. Every Xstrata site was audited in 2005.

HIV/AIDS is being introduced as a critical performance indicator for mine managers and senior management. Performance indicators include participation rates in VCT, effective HIV/AIDS committees at site and divisional levels and effective training of peer educators.

Xstrata's South African businesses are also using the Global Business Coalition's self-assessment tool, the Best Practice AIDS Standards Assessment Tool (BPAS), to benchmark programmes against the Global Business Coalition's 10 areas of best practice. Self-assessment was completed at end of January 2006. In future, Xstrata's corporate HSE function may independently assess programmes against the GBC's best practice assessment tool. The tool sets out 10 areas of best practice:

  1. Non-discrimination
  2. Prevention, education and behaviour change
  3. Testing and counselling
  4. Treatment care and support
  5. Product and service donation
  6. Corporate philanthropy
  7. Community and government partnerships
  8. Business associates and supply chain engagement
  9. CEO advocacy and leadership
  10. Monitoring, evaluation and reporting

Xstrata Coal and Xstrata Alloys assessed existing programmes using the GBC tool at the end of 2005. Xstrata Coal scored very highly in non-discrimination, prevention education and behaviour change and testing and counselling, with lower scores in product and service donation, partly due to the nature of the mining industry's products, and business associates and supply chain management. This is a focus area for 2006, as Xstrata Coal is engaging with suppliers, particularly companies providing short-term contract workers who may not be fully engaged in Xstrata's programmes, to ensure all contractors enrol in Xstrata's programmes, or that companies provide their own programmes. Community and government partnerships are being strengthened and the Breyten and Kwa Guqa community clinics are examples of such partnerships in action.

Xstrata Alloys' score was lower overall, reflecting the later adoption of voluntary counselling, testing and treatment programmes at the end of 2005. These programmes are expected to materially improve this business unit's self-assessment score. In 2005, Xstrata Alloys' highest scores were in non-discrimination, prevention, education and behaviour change, reflecting the focus on the programmes underway before 2005.