Employer‐sponsored programmes for the prevention and treatment of HIV/AIDS: Recent experience from sub‐Saharan Africa

This article examines a sample of employer programmes in sub‐Saharan Africa that supplement government efforts to prevent and treat human immunodeficiency virus (HIV). Some of these programmes provide workers with in‐house education, voluntary HIV testing and antiretroviral treatment. Others rely on new forms of employment‐based group health insurance that include an HIV treatment package. In addition, some enterprises use the workplace as a platform for launching efforts into neighbouring communities to reach spouses, children, sex workers, secondary school students and others. Early evidence suggests that employer programmes maintain the health of large fractions of workers living with HIV who are served by them. They further enable enterprises to avoid productivity losses and turnover costs associated with HIV. At the same time, they take pressure off government agencies that face demands for treatment far exceeding their capacity. The article identifies features of successful employer programmes including “elite appeal”, which mobilizes community leaders and role models to deconstruct stigma, change perceptions and call for behavioural change; and “collateral linkage”, which extends the reach of HIV workplace programmes by linking them to related community concerns: e.g. alcohol abuse, malaria and domestic violence. Looking forward, the potential for expanding employer programmes as well as the restrictions associated with the limited scale of formal‐sector employment within sub‐Saharan African economies is assessed. Actions by which governments, employer associations, trade unions and international organizations can encourage further development of such programmes and extend their reach are suggested.