ACTU President Sharan Burrow outlines how the global union movement is contributing to the battle against AIDS.

Why have a trade union leader address a conference on AIDS?

Put simply, the impact of AIDS and importantly efforts to curb that impact are intricately connected to human rights. It is not possible to build a response to AIDS without strengthening the human rights of those affected by AIDS.

And, as this insidious virus impacts largely on people of working ages, an effective response must also involve the promotion and protection of the rights of workers affected by HIV/AIDS.

The International Labour Organisation (ILO) has recognised the importance of AIDS as a workplace issue by developing and adopting a Code of Practice on HIV/AIDS and the World of Work in Geneva in June this year.

In the introduction to this code, Juan Somavia the Director General of the ILO spells out the importance of unions, governments and employers recognising AIDS as an important workplace issue. He wrote of the economic consequences:

“beyond the suffering HIV/AIDS imposes on individuals and their families, the epidemic is profoundly affecting the social and economic fabric of societies. HIV/AIDS is a major threat to the world of work: it is affecting the most productive segment of the labour force and reducing earnings, and is imposing huge cost on enterprises in all sectors through declining productivity, increasing labour costs and the loss of skills and experience.

And more importantly the human consequences:

In addition, HIV/AIDS is affecting fundamental rights at work, particularly with respect to discrimination and stigmatization aimed at workers and people living with and affected by HIV/AIDS. The epidemic and its impact strike hardest at vulnerable groups including women and children, thereby increasing gender inequalities and exacerbating the problem of child labour.”

Pertinent Regional Statistics to be provided

Today, I commit the trade unions of the Asia Pacific region to working to ensure that this ILO Code is implemented in all countries in our region.

I congratulate the government of Thailand who has already started this important work and I call on the Australian government to do the same.

Social Context

AIDS is a complex disease and as such requires a difficult social dialogue. This means that developing an appropriate public policy response is also difficult. AIDS involves areas that are hard for societies to deal with. It involves issues of sex and intimacy. It means that we have to talk about and acknowledge the high incidence of injecting drug use, right throughout our region. We need to recognise that AIDS adversely impacts on gay men in some countries. We have to deal with the fact that for a range of reasons many workers earn their income as sex workers. We have to deal with fear of the virus and the consequential discrimination that those people affected by the virus might experience.

These are not easy conversations for government or organisations, including trade unions to have. But they are they conversations which must be had if we are to effectively deal with this epidemic. More importantly these are conversations to be held with people affected by HIV/AIDS and not conversations about people affected by the virus.

This is the only effective means of understanding the epidemic and developing programs to help prevent the spread of HIV and to provide access to care and treatment for people with the virus.

More and more we learn that the most important interventions are those which create the social environment that allows an effective public response. For example we can spend millions of dollars providing HIV tests and treatments but this will be of little use unless people likely to be infected feel protected from discrimination. Without this protection people will simply not have a HIV test.

Condom distribution programs by themselves are of little use without addressing the factors which disempower women in many sexual encounters. Programs and measures to empower women and increase their economic independence are probably just as important as a HIV intervention as a national AIDS awareness poster campaign.

World Of Work

Health policy workers and researchers have come to learn that understanding and influencing the social climate is an important step in designing appropriate responses to AIDS.

The same principles are true for the world of work

Those of us involve in industrial relations and workplace issues need to apply these same principles in responding to HIV/AIDS. This means that it we need to understand the working environment, the way work is organised, power relationships and particularly factors at work that increase worker’s vulnerability to HIV infection.

There are two groups of workers who are directly exposed to a risk of contracting HIV through their employment.

Clearly, workers involved in occupations where they come in contact with blood and blood products are at a risk of occupational exposure to the virus and have a right to expect appropriate procedures to minimise their risk of infection.
One of the major areas of work in this region which exposes large number of women and girls to HIV infection is sex work. It is vital that these women are seen as being engaged in work and therefor have the same rights as other workers to organise and to expect that their right to health and safety at work are respected. We must also address the factors that force many women and girls into sex work as their only form of income.

But there are also certain types of work situations which make workers more susceptible to the risk of HIV infection. The ILO identified the following areas:

 

  • Work involving mobility, in particular the obligation to travel regularly and live away from spouses and partners;
  • Work in geographically isolated environments with limited social interaction and limited health facilities;
  • Single-sex working and living arrangements among men;
  • Situations where the worker cannot control protection against infection;
  • Work that is dominated by men, where women are in a small minority.

 

So this means that the issues for workers, unions and employers are much broader than simply the application of universal precautions in health care settings.

Truck drivers forced to be away from their homes for months on end are at greater risk of HIV infection. Government red tape that ties up drivers for up to four weeks at borders in Africa actually mean an increased risk of HIV.

A young teacher sent to teach in a village away from her family is more vulnerable to infection than if she were working in her own village.

Miners working in PNG often have to live in isolated single sex accommodation which puts them at greater risk of HIV.

Truck drivers and other workers forced to work long and unreasonable hours may be more likely to inject amphetamines again increasing their susceptibility to HIV.

This means that AIDS prevention measures for workers must take into account these work situation that increase vulnerability to infection. Programs need to be developed with workers and their unions which take into account these factors. For example South African transport unions are working with truck drivers and sex workers to develop such programs.

Union delegates and health and safety reps need to be trained in these issues so that occupational health and safety risk assessments include factors that increase vulnerability to HIV infection and measure to eliminate or mitigate these risks.

Let me talk for a moment of the most telling example of power, labour and HIV in our region – Burma.

The enforced labour policies of the Burmese regime are not only a breach of human rights. They are murderous. The International Labour Organisation has taken the unprecedented step of suspending Burma as a member nation because of these policies.

Up to one quarter of working people in Burma have been or are in forced labour. Workers are forcibly removed from their villages and live in labour camps.

Burmese workers are forced to escape and work over the Border in construction jobs and live in camps placing them at much greater risk of HIV infection. Often the only means of economic survival for some women and children escaping from Burma is sex work.

The actions of the Burmese regime are actually laying the groundwork for a huge AIDS epidemic in that country. They should be roundly condemned, as should countries that trade with Burma.

In conclusion, I would like to formally reiterate the world wide trade union movement’s commitment to the fight against AIDS. This fight needs to be fought on several fronts. We must continue our struggle to improve human rights everywhere, as this is so fundamental to reducing the impact of AIDS. This struggle is one that we in the union movement have a long history of involvement in.

Importantly the countries of the developed world must continue to keep AIDS on the agenda. Reduced death rates in Australia and the USA because of treatment advances does not translate into reduced death rates in Asia and Africa. The fight for access to treatments for all is one the union movement will work with you on.

It is disturbing to hear that some countries and some pharmaceutical companies are resisting the notion that access to treatments for everyone is not possible. Access to effective treatments for all people with HIV/AIDS is not too hard and the trade union movement will not accept the idea that some people get to live and other don’t. Global unions have established a workers capital committee. Through this committee we are committed to working with companies on socially responsible investment. We are equally committed however to working against companies who fail to balance the need for human rights with their desire for profit.

We have had recent experience of success in shareholder lobbying with Rio Tinto and such lobbying may well need to be employed with some pharmaceutical companies.

Importantly, the current unrest in the world will also mean that AIDS is again moved off the agenda. The probable military action and dislocation of hundreds of thousands of refugees will set the scene for a new AIDS disaster zone.

Hundreds of thousands of workers around the world have been lost to AIDS. Teachers, flight attendants, miners and truck drivers. Nurses, hotel staff, maritime workers, building workers, community sector workers, have been affected by AIDS.

In memory of these workers I will conclude with what is now an old saying but it is still just as timely – let us mourn for the dead and fight like hell for the living.

Sharan Burrow
PRESIDENT, AUSTRALIAN COUNCIL OF TRADE UNION (ACTU)
PRESIDENT, ASIA PACIFIC REGION, INTERNATIONAL CONGRESS OF FREE TRADE UNIONS (ICTFU)