Journal of Social Development in Africa (1991), 6,2,53-70 
Company Policy on AIDS in Zimbabwe 
HELEN JACKSON AND MARIAN PITTS + 
ABSTRACT 
This paper examines current and potential AIDS policy, and its orientation, at the 
workplace in Zimbabwe, and looks at the degree of concern that commercial 
companies have about AIDS. All 94 companies studied expressed some concern 
about AIDS, but only one third had developed a specific AIDS policy, and two 
thirds had begun AIDS education programmes. Major concerns expressed by the 
companies included the recruitment of skilled labour; rising insurance, health and 
pension costs; loss of time and productivity; and lowered morale. Twenty two per 
cent of them had some form of HIV screening in place, and 41% thought preemploymentscreening 
was justified. Thepapernotes current educational initiatives 
and makes recommendations for supportive and coordinated policy development. 
Introduction 
As the AIDS pandemic worsens around the world, different sectors of society are 
becoming increasingly aware of its potential impact and the need to be actively 
involved in AIDS work and AIDS campaigns. It is not merely the health services 
thatare affected, butsocial welfare and security, education, and the legal profession, 
industry, and the economy as a whole. 
Of the many sectors that need to take up the AIDS issue, the formal employment 
sector is particularly crucial for a number of reasons. First, many of those at risk 
of HTV are employed in the formal sector, therefore employers risk losing large 
numbers of their active workforce. Absenteeism due to ill health, caring for sick 
relatives, and attendance at funerals, will increase steadily. Productivity may 
decrease and serious losses of skilled and experienced labour are predicted. 
Recruitment of skilled personnel may become very much more difficult than it 
already is in many developing countries. 
Second, some industries will be particularly affected by AIDS. The insurance 
industry is one example, as AIDS significantly alters actuarial projections. Other 
industries may also be affected if the impact of AIDS on the population is such that 
f Lecturer, School of Social Work, PB*g 66022, Kopje, H»rire, Zimbabwe. 
Principal Lecturer in Psychology, Staffordshire Polytechnic, Stoke on Trent, 514 2DP, UK.
54 Helen Jackson and Marian Pitts 
effective demand for different products and services is significantly reduced 
However.one or twoindustries,suchas rubber production, condom manufacturing, 
and the pharmaceutical industry, stand to benefit - and, indeed, some already are. 
However,thereisconsiderable risk that employers, as they become increasingly 
aware of AIDS, will try to minimise its impact by discriminating against infected 
employees. They may try to screen out those with HIV from employment 
altogether, from having access to occupational benefits, health insurance and 
pensions, or from travel or further training. Insofar as these measures are adopted, 
people with HIV or AIDS will be more and more isolated and impoverished, AIDS 
will be driven further underground, and the chances of developing effective 
awareness campaigns for prevention will be reduced. Thus discriminatory 
practices are not merely inhumane, but likely to incur serious long term costs by 
impeding prevention efforts. The World Health Organisation (WHO), which is 
coordinating the global response to AIDS, has consistently warned against 
discriminatory control measures in all spheres. The WHO, with the International 
Labour Organisation, drew up guidelines for supportive workplace policy in June 
1988 (WHO, 1988). 
An important area of study of HIV/AIDS is to find outto what extent employers 
are actively developing policies on HIV and AIDS, and whether discriminatory a 
supportive measures are being advocated. The study discussed in this paper 
targeted a wide crossection of the commercial sector in Zimbabwe to identify their 
main areas of concern in the areas of HIV/AIDS, the needs expressed by companies, 
and to chronicle some of the existing policies and practices regarding AIDS. This 
paper, within the context of the growing AIDS epidemic in Zimbabwe, presents the 
main findings of the study and makes recommendations for policy guidelines 
which could be applied nationally to ensure that appropriate and effective responses 
are made to the AIDS situation. Reference is made to studies in this field in other 
countries, but the authors are unaware of any other systematic data on company 
policy and AIDS in Zimbabwe itself nor in the Southern African region. 
The AIDS epidemic within Zimbabwe and the region 
The global pandemic of AIDS is proving particularly devastating within those 
countries ofSubSaharan Africa which are designated Pattern II by WHO. In some 
major Eastern, Central and Southern African cities HIV prevalence is estimated as 
being as high as 20-30% of young sexually active adults (WHO, 1990). In 
Zimbabwe, in a population of less than 10 million, 11 788 people, had beet 
diagnosed with HIV related ill-health, and 5 994 with full AIDS, by December 
1990 (ACP, 1991). Since 1988 AIDS has been reported as the leading cause of 
death in babies in the main hospitals in Harare, and by mid 1990 the Minister of
Company Policy on AIDS 55 
Health had estimated that 350 000-400 OOOpeople in Zimbabwe had HIV infection 
(Stamps, 1990). Neighbouring countries, such as Zambia and Malawi, also report 
high levels of HIV infection and AIDS, as does most of East and Central Africa. 
The reported incidence of AIDS is rising extremely sharply in many countries, 
because of improved reporting as well as reflecting real increases in HIV infection 
and AIDS. 
In most of Africa, HIV and AIDS affect men and women in approximately 
equal numbers, although typically with a different age distribution. Peak HIV 
infection and AIDS occurs at a younger age in women than in men (Stamps, 1990; 
Chin, 1990), and about a quarter of diagnosed AIDS cases occur in babies and 
young children. The main mode of spread of HIV is heterosexual intercourse and 
from mother to baby, while contaminated blood transfusion and needle stick 
injuries contribute relatively little to spread. Homosexual spread seems to be a 
minor problem. The main cofactor in transmission is the presence of other sexually 
transmitted diseases (STDs). In a study of 412 STD patients at a Harare clinic in 
1990,51% were reported to have HIV compared with 18% of 500 STD patients 
studied in 1987 (The Herald, 17 August 1990). HIV infection is spreading very 
rapidly in the young-middle-aged adult population in Zimbabwe and this has clear 
implications for the workforce. 
Comparative research 
A number of studies have been carried out on HIV and the workplace in various 
countries. These studies have examined workplace policy, and problems of AIDS 
at work due to fear, stigma, economic cost and related factors. Companies seek to 
employ healthy, fit employees, and pre-employment medicals are routinepolicy in 
many countries. As the impact of AIDS on companies in Africa is likely to be 
similar in some respects to that in, for example, the USA, it is valuable to 
extrapolate findings from one to the other. 
A recent survey identified AIDS as one of the top three concerns of American 
employers (Backer, 1988). This concern is appropriate as one employer of every 
five who responded to the survey reported at least one worker with AIDS. By some 
estimates (Backer, 1988), AIDS is expected to cost employers in the USA more 
than US$55 billion in 1991. 
As the problem grows, employers are finding that they have to develop 
measures which enable them to cope with people affected in their prime working 
years. Workers with AIDS in America are covered by the Rehabilitation Act of 
1973, and hence employers have to accommodate sick workers who are still able 
to work. Many USA companies have responded to the crisis by developing 
strategic plans and education programmes (Halcrow, 1986; Cohen, 1985). Backer
56 Helen Jackson and Marian Pitts 
cites numerous other studies which indicate that, by 1988, approximately 21% erf 
companies had an AIDS policy or programme in place, while 40% had some form 
of AIDS education. He reviews individual programmes from famous companies, 
such as the Wells Fargo Bank, Levi Strauss and Warner Brothers. His conclusion 
sums up the issue (1988:983): 
"AIDS is a cost issue, a productivity issue, a human resources issue, a legal 
issue and it is a human issue, an issue of employer social responsibility." 
Between developed countries, however, there is wide variation in AIDS policy 
and the extent of education within the workplace. A Canadian survey (Canadian 
AIDS Society, 1989) reports that only 4% of 516companies hadany AIDS policy 
or educational programme at that time. In developing countries there are also 
widely differing responses, by governments, employers and labour organisations. 
At one extreme is the situation in Cuba where the entire population has been 
screened since 1986, and infected people not only lose their employment but are 
kept in lifetime quarantine in a sanatorium in Havana. Full pay, benefits and care 
are nonetheless guaranteed, and the prevailing ethos is reported to be one of social 
responsibility rather than victimisation or punishment (Panos, 1990). In many 
developing countries labour legislation and labour organisation are weak, and 
employers may get away with screening and discrimination even if this is not 
official policy. Numerous examples of victimisation are cited in The Third 
Epidemic (Panos, 1990). These may involve people who are already ill with 
AIDS, or, sometimes, fit workers with HIV detected in mass screening. In severely 
affected countries, such as Uganda, however, it is too difficult for companies to find 
substitute skilled labour for mass screening to serve any useful purpose, even if it 
were considered ethical. 
Within most of Africa and the Third World there is a critical shortage of skilled 
labour at all levels, and training is very expensive, frequently involving scarce 
foreign currency allocations for overseas training. Thus the loss of skilled labour 
to AIDS is particularly costly, both in terms of wasted training and replacement 
costs. This certainly applies to Zimbabwe. There is also sometimes a very close 
dependence of entire nuclear families on the place of employment, for instance in 
mines and agriculture. Often entire families live in compounds or housing schemes 
attached to the place of employment Loss of the breadwinner means the loss of 
housing as well as income, and often the loss of tied schooling for children. Thus 
the social costs of AIDS, as increasing numbers of young adults die, will be very 
far reaching. This is worsened by relatively poorer access to services of all kinds, 
to greater underlying poverty, and inferior social security provision in general 
Inadequate infrastructure and lower literacy levels make education and awareness 
campaigns, as well support services, less readily available in developing countries. 
The main legislative instrument in Zimbabwe has been the Labour Relations 
Act 1985, but new structural adjustment policies will weaken the workers' position
Company Policy OH AIDS 57 
generally. Health and safety committees have been established in a number of 
workplaces, within unions or under workers' committees. However, the majority 
of workers are not well organised, particularly on health and safety issues, and their 
rights are limited. Their capacity to safeguard their existing rights needs to be 
strengthened. The high level of unemployment, including among those with 'O' 
levels (ie 4 or 5 years of secondary education) contributes to worker insecurity, and 
makes them less likely to seek new safeguards. However, the Zimbabwe Congress 
bf Trade Unions (ZCTU), which established a Health and Safety Department in 
1990, held a policy workshop on AIDS in August 1989, and is subsequently 
developing policy guidelines on AIDS (Loewenson, 1991). 
The particularly severe implications of AIDS for the workplace in SubSaharan 
Africa, both because of the numbers affected and because of the factors noted 
already, make it highly likely that many companies will try to minimise the 
problem by seeking to exclude infected employees from employment, training and 
promotion. Whilst this response is readily understandable, and to be anticipated, 
t can be argued that it is both unjustified and counterproductive in the long term. 
i
Introduction to the study: background and methodology 
K wide crosscction of the commercial sector in Zimbabwe was targeted in this 
study. All delegates to a one day national seminar on AIDS held in Harare in March 
1990 were given a questionnaire to complete. One hundred and ten companies sent 
i total of 159 delegates to the Conference, who represented a workforce of 180 000 
fo 200 000 people. The sample was likely to be a good representation of private 
Commercial companies across the nation, but with a bias towards larger companies 
tie they could afford the seminar fees) and those with an existing concern about 
AIDS (ie they were willing to send a delegate). 
Confidentiality and anonymity were guaranteed, although delegates were 
requested to give full company identification and some details for statistical 
purposes and to avoid duplication. Almost all those who responded complied with 
ihis request The questionnaires were distributed at the start of the seminar to avoid 
bias in the responses from the seminar discussions. All were collected before the 
first presentation of the day. 
The questionnaire itself was detailed and contained 56 items requiring a 
response (apart from company/delegate information). An open ended format was 
generally used, although a few closed quantitative questions were included. The 
urn was to explore companies' existing concerns and priorities, rather then 
imposing the researchers' own preconceptions. Main areas of focus included the 
urns of any existing AIDS policy and its content; concerns companies might have 
ibout the impact of AIDS on issues such as insurance, pensions and recruitment;
58 Helen Jackson and Marian Pitts 
AIDS education at the woikplace; policy on screening of existing or prospective 
employees; counselling; confidentiality; and assistance the company might value 
from Government, Non Government Organisations or other sources. | 
Results 
General and demographic 
There was a high response rate from both the companies (84,5% or 94 of 110) and 
the delegates (80,5% or 124 of 159). Delegates to the seminar held senior posts in 
their companies, and included chief and senior executives, middle managers 
(personnel officers, training and accounts managers), and a smaller number of 
health staff (company doctors, health officers and clinic nurses). The majority 
were sufficiently senior to formulate or directly influence the formulation of 
company policy on AIDS. 
Average company size was just under 2 000 employees, with a range from 
under 100 to over 8 000. A few of the companies were multinationals or 
conglomerates. The following areas of business, commerce and industry were 
represented: mining; agriculture and timber; oil and chemical production; 
manufacturing and food processing; service industries and public service 
corporations; tourism; hotels and catering industries; retailers; banking, insurance 
and financial services. There wasawidecrossectionof companies from throughout! 
Zimbabwe. 
AIDS policy and concerns ! 
Of the 94 companies represented, 32 (33%) indicated that they already had an 
explicit policy on AIDS. Thirteen companies (14%) indicated that their policy was 
concerned with the prevention of infection and/or education (but other companies, 
as discussed below, have developed education strategies without recording this as 
company policy in their responses to this question). Four companies said that their 
policy was to treat AIDS in the same way as any other condition, but three indicated 
differential policy on AIDS and insurance. Four indicated a policy of providing 
counselling and support, one of no victimisation, one a policy to promote 'safe 
health conditions' at work, one a data gathering exercise, and another said that 
government must set paths forpolicy. More detailed subsequent questions elicited 
further material on these areas, indicating that more companies than those indicated 
here are concerned about AIDS policy. 
A separate question asked specifically about the insurance and pension rights 
of people with AIDS. Information was given from 42 companies (45%), and of 
these 28 (67% of those replying) indicated that there is no discrimination, and four 
that infected employees are discriminated against in pension and/or insurance
Company Policy m AIDS 59 
policies, with four indicating that policy in this area is under review. Two 
responses noted thatpolicy was up to the underwriters.andone said the multinational 
arent company was responsible. One respondent indicated that families would be 
aken care of, another that each case was assessed on merit, and another that 
existing employees' pension and insurance rights only would be ensured, not those 
rf new employees. 
Respondents were asked an open question on their most serious concern 
egarding the impact of AIDS on their company. One hundred and fifteen of 124 
ielegates (93%) gave detailed replies. Concern over the loss of skilled labour was 
he most frequently cited, by 41 (33%) respondents. Loss of manpower in general 
vas cited by 30 (24%), absenteeism by 8 (6%), and loss of senior staff by three 
2%). Four (3%) expressed concerned about personnel planning, and two (2%) 
loncernabout training. In response toaclosedquestionlateronregardingtime loss 
iue to AIDS 116 (94%) respondents expressed anxiety about this. 
Twenty seven respondents (22%) expressed concern about future productivity, 
ncluding six (5%) who were concerned about the market for their product, and four 
[3%) about their company's very survival. Two of these latter are in insurance, one 
n hotels, and one is a diverse multinational. Those concerned about the market for 
heir product included an alcohol supplier, a building materials supplier, a sugar 
tfinerand a packaging company. Fifteen (12%) were concerned about economic 
:osts to the company in general, and two about the national economy. 
Insurance and pensions most worried 16 (13%) respondents, and this was 
jartkularly expressed by delegates from insurance companies themselves. Two, 
is noted above, had anxiety about the survival of the insurance industry. A 
iubsequent question on the future impact of AIDS on insurance, pensions, health 
are and recruitment, revealed frequent anxiety in all areas. Seventy six (61 %) felt 
hat changes would be needed in insurance policy, with only three considering 
ihange unnecessary, and 35 (28%) non responses. Of those expressing the need 
or change, most gave general responses regarding increased costs, the need to 
Screen people for HIV/AIDS, and the need to reduce cover or to raise premiums, 
jroup policies were noted as particularly problematic by a few respondents. 
While 83 people responded to a question on pensions, 64 (52%) of the total 
esponses indicated concern, and 10 (8%) said there would be no problem in this 
uea, or that discrimination was uncalled for. Two felt the situation needed review. 
)fthoseexpressingconcern,commentsrangedform 'serious', 'drainonresources' 
tod 'cost/premiums up', to 'funds run out'. One respondent said that the number 
>f wives should be limited. 
Ninety (73%) responses were obtained regarding health provisions. Forty three 
35%) said that costs would increase, services needed expanding, including 
iducation on AIDS, and there would be additional strain on staff and material
60 HtUn Jackson and Marian Pitts 
resources because of AIDS. Only two respondents felt there was no problem. 
Seven (6%) respondents called for screening to exclude infected people from 
medical cover. 
Regarding recruitment, 93 (75%) responses were obtained, of which 40(32%) 
specifically expressed the need for screening of applicants, and a further 11 (9%) 
gave responses suggestive of this {such as 'careful scrutiny needed', 'medical 
certificates required'). Of the 42 other responses to this question, 40 (32%) of the 
total indicated anxiety about increased difficulty and cost in recruitment, one 
respondent was unsure whether problems would arise, and only one, a delegate 
from an insurance company, considered there to be no difficulty. This delegate 
nevertheless considered insurance, health care and pension prospects to be 'bleak' 
because of AIDS. 
Morale was a primary concern of only 10 (8%) respondents, and stigma of a 
further three. However, in response to a closed question on morale, 109 (88%) said 
this did cause concern. Ten also expressed serious concern about the impact of 
AIDS on families and family life. Two were primarily concerned about a lack of 
belief in AIDS and one about safe health conditions, with a total of 90 respondents 
(73%) concerned about safety in response to a closed question on this. A lack of 
trust was also expressed as the major concern of one respondent. 
Further concerns, expressed by one or more respondents, included attendance 
at funerals, family welfare, families living on company property, government 
legislation, loss of middle management, fear of other employees, breakdown of 
trust, victimisation, ignorance, and eating in canteens shared with infected 
people. 
HIV screening 
Respondents were asked detailed questions about screening policy for HIV. This 
included whether any screening is carried out on existing or potential employees, 
and oh what basis; whether consent is obtained and whether individuals are 
informed of their test results. Where results are given, is this accompanied by 
counselling and if so, by whom? Confidentiality and access to results was also 
explored. 
Only four respondents answered yes to the direct question "Does your firm do 
pre-employment screening for HIV or screen current employees?" Two said the 
purpose of pre-employment screening was to avoid employing people with HTV or 
AIDS, and two that it was a routine part of the medical. However, in answer to 
further questions, another five respondents indicated that pre-employment screening 
is in fact carried out for all job applicants. One gave the reason as being pension 
assessment A further respondent indicated that their firm would like to screen to 
avoid the high costs of training people with HIV, and another thatpre-employment
Company Policy on AIDS 61 
screening is to be introduced. One respondent commented that such screening is 
illegal. From theabove,atotalof9companies(10%)acknowledgepre-employment 
screening for HIV. Twelve (13%) acknowledge screening some existing staff, of 
whom two screen general workers, two on the basis of ill health, two white collar 
staff, two for pensions or major loans, and one senior management only. One 
indicated screening was offered on a voluntary basis, and one that it was linked to 
blooddonation. A total of 21 companies (22%)acknowledgeeitherpre-employment 
or some current employee HIV screening. 
It is noteworthy that 42 (33%) individual delegates gave no answer to the direct 
question on HIV screening, a much higher refusal rate than on most questions. 
Further there was a high degree of inconsistency between responses to the initial 
direct question and later more probing questions, and also between delegates from 
the same company. This suggests the possibility that screening may sometimes 
occur without the knowledge of many management staff, let alone other employees. 
It could reflect the intention of companies to do screening clandestinely, knowing 
it is a controversial policy. People may be reluctant to apply for jobs in companies 
where they know HIV screening is done, thus making recruitment of skilled labour 
increasingly difficult 
Data on whether consent for screening was obtained indicated that in two cases 
pre-employment screening was anonymous, and in 6 companies consent was 
obtained for pre-employment screening. In another company two delegates 
disagreed on whether consent was obtained. Data on back up counselling was 
incomplete, but in twocasesofpre-employment screening with consent individuals 
would be advised to see their own doctor, and in one case would be counselled by 
clinic staff. Li one case of anonymous screening, individuals are also advised to 
see their doctor. In seven cases the company itself would not give the test results 
to the individual. 
Regarding screening of current staff, three companies are reported to carry out 
anonymous screening and 9 screening with consent Counselling is provided, 
either by the company doctor or through the medical services, in 11 instances. 
Where screening is anonymous it is carried out for statistical purposes 'to 
determine health trends', as reported by one delegate from a major company in 
which another delegate said that screening was with consent (and others said no 
screening occurred). 
Confidentiality of results is reported as being good, with only a private doctor, 
the company doctor and health staff being informed in all but a few cases. 
However, in four companies some of the management are informed of the results 
of pre-employment screening, and in four some of the management are informed 
of tests on current employees. It should be noted that responses to this question 
were incomplete.
62 Helen Jackson and Marian Pius 
HIV/AIDS education 
A total of 57 companies (61%) indicated that they already provided AIDS 
education at work. Two more indicated that they are about to begin this. 
Most companies providing AIDS education had begun this in 1988 or 1989, but one 
fanning estate and one insurance agency had begun AIDS education as early as 
1985, and three other organisations in 1986. Several began in 1990. Interestingly, 
even in some companies reporting AIDS education for two years or more, 
delegates differ regarding its occurrence. It would appear in some cases that AIDS 
education might take place at the head office, the provincial office, or the worksite, 
but not necessarily throughout the company as a whole, or as standard policy. 
AIDS education was reported to be organised variously by medical staff, senior 
management, personnel and training managers, and public relations officers. One 
farming estate which started AIDS education at the end of 1986 reports having an 
AIDS committee. 
Respondents were asked what form the AIDS education takes. Most common 
were talks (54, or 57%) and pamphlets (55, or 59%). Film/video was utilised by 
26 (28%), and 7 (7%) mentioned drama. Only three (3%) mentioned discussion 
groups or seminars, and three counselling. Twenty one delegates indicated that 
education was being evaluated (37% of 57 companies providing education, 22% 
of the total companies sampled). Others reported that no evaluation was being 
carried out, or that they did not know how to start evaluating. Methods of 
evaluation included measuring condom uptake; worker feedback, either informally, 
through discussion, or through questionnaires; and monitoring statistics for sexually 
transmitted diseases (STDs). Sixteen (28% of the 57 companies) indicated that 
they felt education was having a positive impact on awareness, on STD reduction, 
on condom uptake, or on reported reduced partner change. One respondent 
commented that there had been complaints by sex workers that they were losing 
business. However, one respondent noted that whilst awareness had increased, 
there remained a feeling 'it doesn't apply to me', and another that 'fear of victims' 
had increased. 
A question was included on why some companies do not have an AIDS 
education policy. The most commonly cited reason was that it was not an issue fa 
discussion (27, or 22%). Twenty (16%) gave the lack of a health and safely 
committee as a reason, 19 (15%) said they did not know how to implement an 
education campaign, and 7 (6%) that they had other priorities. 
Experience of AIDS 
Delegates were asked if they knew of anyone within their company who had died 
of AIDS or had left because of AIDS. Twenty six (20%) said they did, 89 (70%) 
that they did not, and 13 (10%) gave no response. They were asked, further, what
Company Policy o* AIDS 63 
reaction there had been within the company when someone died of AIDS. Five 
reported a reaction of fear, stigma and hostility; four reported disbelief; five a 
mixed reaction, surprise or a reaction that was difficult to assess; four reported little 
reaction at all; one reported increased awareness, and one compassion and 
understanding. In only four instances it was noted that few people were informed 
of the diagnosis. 
A further question on current employees with AIDS elicited a very similar 
response regarding numbers and reactions. Twenty four (19%) indicated that they 
currentlyknew someone with AIDS at work, while 88 (69%) do not Sixteen (13%) 
gave no response to this question. Twelve indicated that known infected employees 
were not much or not at all feared by colleagues, compared with 9 who were feared 
to a greater extent. 
Assistance 
Respondents were asked what assistance they would value from Government and 
from Non Government Organisations (NGOs). The most common request of 
government was for accurate statistics and information (41, 33%), followed by 
improved AIDS education (37,30%). Ten sought better counselling services, and 
10 improved testing facilities, including free testing services or explicitpcrmission 
to allow companies to test for HIV. Seven (6%) sought clear guidelines and 
legislation on AIDS. There were also calls for more money, improved training, 
advertising and treatment One respondent said that the government was already 
doing enough. One called for isolation facilities for infected people. Requests of 
NGOs overlapped closely with those of government, with the exception that few 
considered it an NGO role to provide accurate statistics on the epidemic. Rather 
more, 18 (15%), sought improved counselling and other support services from 
NGOs. 
Discussion 
AIDS is clearly beginning to be felt as a relevant and serious issue by the 
commercial sector in Zimbabwe, although only 33% of companies studied had 
developed workplace policies on AIDS by March 1990. This figure can be 
assumed to over-represent company policy development at this time in the country, 
because of the sample used. However, many more will have developed a policy 
since. Primary concerns expressed were to do with recruitment, particularly of 
skilled labour, rising costs of insurance, health care and pensions; time loss; 
reduced productivity; and lowered morale. The majority had not yet knowingly 
experienced deaths from AIDS at work, but where people were known to have died 
or to be ill with AIDS, only in a minority of cases was great fear, hostility or stigma
64 Helen Jackson and Marian Pitts 
expressed. However, in only one case was a supportive and compassionate 
response reported. 
Screening was singled out for special attention. Although data on this was 
incomplete, 22% of companies appear to be screening all or some of their existing 
employees or job applicants, either with or without consent Confidentiality of 
results varies, but generally appears good. Few companies give HIV results to the 
employee, but recommend that medical practitioners do this. It was noted, 
however, that, regarding the attitude of fellow employees to people with AIDS at 
work, in only four cases was it mentioned that the diagnosis was not widely known. 
It was not clear how fellow employees had learnt the diagnosis in the other cases. 
Forty one percent of respondents considered that job applicants should be screened 
for HIV, or have 'careful scrutiny' for related health problems. 
Education on HIV/AIDS is reported to occur in 61% of companies, the earliest 
campaign dating from 198S, the majority from 1988 and 1989. Talks and 
pamphlets were the most common educational approaches, followed by film/ 
video. A small minority include drama, discussion groups and counselling. 
Evaluation of education is reported in one third of those companies with education 
campaigns, and in two thirds of these (16 companies) it was felt that the campaigns 
had a positive impact However, evaluation methods were often informal and not 
comparable. Those companies'not providing education on AIDS cited lack of 
discussion, health and safety committees, and knowledge of how to do this as the 
main barriers. A smaller number indicated other priorities. 
Regarding assistance desired from government or NGOs, improved statistics 
and information, better education and awareness, and improved counselling 
services were most frequently mentioned. A minority wanted clear legislation and 
policy guidelines. 
Existing workplace policy on AIDS in Zimbabwe may be summarised as ad 
hoc and limited at present Whilst education is being increased, some companies 
are already adopting discriminatory measures against people with HIV or AIDS, 
and a majority express fears regarding the economic costs of training and 
employing infected people, insurance, health costs and pensions. Over 40% would 
like to see some screening of job applicants, which presumably could only serve 
to keep infected people out of employment altogether, or be used to deny them 
benefits such as pension, health, etc. Thus it may be anticipated that, unless clear 
guidelines or legislation on non discriminatory workplace policy is rapidly 
introduced, many more companies can be expected to adopt, in future, a screening 
policy to identify people with HIV. 
A question to be addressed is whether the potential costs to commercial 
companies of losing large numbers of the workforce to AIDS, and particularly 
skilled and experienced personnel, justifies discriminatory measures, and whether
Company Policy cm. AIDS 65 
this is the optimal long term strategy. The WHO argues strongly against this. 
Discrimination has the effect of driving HIV and AIDS underground, of increasing 
fears aboutitand increasing stigma. Italso punishes the sufferers and their families 
if infected breadwinners are out of work, and increases stress and hardships just 
when maximum resources are needed to cope with a life threatening condition. 
Thus at the individual level it is unethical and inhumane, and in many countries 
human rights and labour legislation would safeguard against such discrimination. 
In the absence of a vaccine or proven cure, prevention of infection with HIV is 
crucial. Primarily this means establishing voluntary sexual behaviour change to 
reduce risk by using condoms in any 'risky' sexual encounter, avoiding penetrative 
sex, or, ideally, increasing lifetime monogamous partnerships between uninfected 
people. To achieve and sustain safe sex behaviour involves educating people about 
the risks, helping them to apply those risks to themselves, and helping them to 
conclude that they have more to gain personally than to lose by adopting safe sex 
behaviour for life. Fundamental changes in knowledge, attitude and sustained 
behaviour are needed, yet these are extremely difficult to achieve. Maximum 
openness about the epidemic, the personal experiences of people with HIV and 
AIDS, and a supportive general climate are more conducive to encourage people 
to take personal responsibility for safe sex. A fearful climate in which people with 
AIDS are rejected and stigmatised is more likely to make people deny the problem, 
not to change risk behaviour, and not to seek help if infected. It should be 
remembered that it is the sexual behaviour of people who already have HIV that 
particularly needs to change in order to limit viral spread. 
A further consideration is that HIV infection may not lead to illness or death for 
many years. The average time for full AIDS to develop is believed to be eight to 
ten years in the USA. Whilst this may not hold for Africa, nevertheless the 
likelihood is that an employee with HIV may be fit for work for many years to 
come. If screening is used to block infected people from employment, thousands 
of fit men and women will be unemployed and unemployable, all their skills, 
training and experience wasted. Existing labour shortages would be exacerbated 
and inevitably a double standard would develop whereby those with particularly 
valued skills would be employed regardless of HIV status. Rather than screening 
out people with HIV employers need to consider expanding training programmes 
to provide a larger pool of skilled labour. 
Mass screening for HIV also has practical problems of implementation, 
occasional false positive and negative results, and expense. There are also ethical 
considerations for anonymous, or with consent, testing, and, if the latter, whether 
individuals are given adequate pre and post test counselling. 
In the long term, maximum integration and support of infected people is the 
most likely strategy to reduce infection and to help infected people and their
66 Helen Jackson and Marian Pitts 
families to cope. Discrimination should be kept to the minimum possible level to 
safeguard work colleagues, clients, employers, productivity, pension funds and 
medical and other insurance benefits. It is inevitable that changes will be needed 
in some pension and insurance cover based on actuarial tables that did not take 
AIDS morbidity and mortality into account A format needs to be developed in 
these and other areas of concern that balances the needs of those with and without 
HIV infection, employees' rights and those of the company, and individual 
enterprise needs and those of the community and the nation as a whole. All sectors 
and organisations must share the costs of AIDS, and not try to shift costs on to 
vulnerable individuals or on to the state. 
To achieve a balanced national and enterprise policy, it is essential that 
workers' organisations and committees, management and government come 
together to identify the issues and develop guidelines. The common interests of all 
should be recognised, ie maximising prevention efforts in a climate of optimal 
support for those already infected and their families. The WHO guidelines could 
form a useful basis and orientation for this. Pending clear government guidelines 
giving a national framework for policy, individual companies in Zimbabwe could 
examine these and other guidelines and policy documents by individual companies 
to develop their own strategies through union and management discussion. Certain 
companies in Zimbabwe, like David Whitehead Textiles, provide useful models. 
The Ministerof Health has also indicated governmentorientation on workplace 
policy, which is against screening and discrimination in all spheres of work. The 
AIDS Control Programme (ACP) is identifying Health Programme Facilitators in 
different companies and ministries. These personnel, after training, should act as 
coordinators of AIDS prevention initiatives. As at January 1991 (ZAN, 1991) 
about sixty had been identified. 
Employer confederations, such as the Confederation of Zimbabwe Industry 
(CZI), the Employers' Confederation of Zimbabwe (EMCOZ), the Zimbabwe 
National Chamber of Commerce (ZNCC), the Chamber of Mines, the Zimbabwe 
National Farmers' Union (ZNFU), and others, need to collaborate to promote a 
national response to AIDS, and to standardise policies. The National AIDS 
Council is one obvious forum for this and the Zimbabwe AIDS Network (ZAN), 
primarily for NGOs, includes some representatives of employer and worker 
organisations. 
Some organisations, such as the Institute of Personnel Management, have 
organised national workshops on AIDS to educate senior and middle management 
and to discuss policy issues. These are very valuable. Awareness then needs to be 
consolidated in policy formulation andprogrammedevelopment. TheCommercial 
Fanners' Union (CFU) has a national AIDS representative who keeps the 
organisation appraised of HIV/AIDS statistics and has developed projections for
Company Policy OH AIDS 67 
the impact of AIDS (Frazer-Mackenzie, 1990). He has also set an example by 
developing an extensive AIDS and STD awareness campaign on his own farm at 
Mutoroshanga, and distributing condoms widely. 
A critical element of any workplace policy on AIDS must be effective 
education or awareness campaigns to promote knowledge, attitude and behaviour 
change. This needs to be evolved with the active participation of the target 
population, so that the approach is meaningful, involving, appropriate andaccessible. 
Imaginative and varied educational approaches should be adopted, including 
opportunities for small group focused discussion and counselling, so that people's 
personal concernsmaybeeffectivelyaddressed.Myths,superstitions and unfounded 
fears should be allayed, with education aiming to empower people to take 
preventive action themselves, rather than provoking further fear. Education needs 
to be ongoing, and to be backed by appropriate support structures for infected 
employees and their families. Condoms should be freely supplied at work and their 
use explained as necessary. Some companies give out condoms in pay packets. 
Cadres at different levels within the workplace need to be trained as educators and 
counsellors, rather than relying permanently on external support. Senior 
management need to be convinced of the cost effectiveness of investment in well 
planned and coordinated educational campaigns and support services, as, in the 
short term at least, these will require substantial inputs of staff time and money. In 
the longterm this will be vastly outweighed by reducing the social and economic 
costs of widespread ill health and early death. 
The Family AIDS Caring Trust (FACT) in Mutare isdeveloping a two hundred 
and fifty page manual for workplace education on AIDS. This should prove a very 
useful resource. David Whitehead Textiles has produced a short cartoon booklet 
of apersonal AIDS story related to workplace issues. A drama on AIDS called "Me 
and My AIDS" has been developed by Meridian Theatre Company specifically for 
the workplace. Another drama, "Manyanya", by Batsirai Theatre Group was 
developed collaboratively through the Zimbabwe Association of Community 
Theatre (ZACT) and the AIDS Counselling Trust (ACT). Performances of the play 
are followed by discussion with the audience. The process of developing the play 
was videotaped so that this would be a resource to help others in developing an 
AIDS drama (ACT, 1990). The Old Mutual has run a poster competition as part 
of its AIDS awareness campaign. Anglo American Cooperation has modified and 
reprinted twenty thousand copies of a school cartoon magazineon AIDS, ACTION 
Magazine, by the Action Team, Harare. A copy has been given to each employee. 
Many organisations invite ACT, FACT and others to give talks, and the Family 
Counselling Unitruns AIDS training workshops for company personnel. Zimbabwe 
Red Cross promotes AIDS awareness when visiting workplaces to collect blood. 
These are some examples of the many initiatives already being developed in 
Zimbabwe.
68 Helen Jackson and Marian Pitts 
In Brazil small clay figures of workers are being used in the construction 
industry for education on AIDS (AIDS Action, 1988). This follows a local 
tradition of using 'bonecos', as such figures are called, for story telling. In South 
Africa, Puppets Against AIDS tours different venues with massive puppets to 
convey AIDS messages in a humorous way. Prostitute collectives in Australia and 
Latin America have developed various AIDS education strategies including songs, 
dance, drama and circulating leaflets to promote condom use amongst potential 
clients in the workplace, beerhalls and nightclubs (Vth International Conference 
on AIDS, 1989). There are many different approaches to AIDS or to health 
education in general, depending on the knowledge, interests, education, culture 
and needs of employees and their families, and on the resources made available. 
It is up to employers to support educational initiatives from the shop floor, 
personnel, health and other departments, by providing time, facilities and money. 
They should also collaborate to develop clear policies for the enterprise internally 
and at a national level. 
Conclusion and recommendations 
AIDS throws into stark relief issues of narrow economic cost effectiveness versus 
employer social responsibility, and shortterm gain versus longterm investment To 
curb the AIDS epidemic it is vital that integrated and supportive policies are 
implemented at individual enterprise and at national level, so that widespread 
understanding and appropriate behaviour change are fostered throughout the 
population, rather than increased fear, stigmatisation and isolation. A beginning 
has already been made. Developments that are urgently required, or need to be 
strengthened, include at least the following: 
1. Policy development 
* collaboration by the government, employers' confederations and labour 
organisations to develop a national policy on AIDS and employment 
* legislation against discriminatory practices, such as anonymous testing and 
the routine blocking of people with HIV from employment, training or 
promotion 
* increased information and programme sharing between enterprises 
themselves, and between enterprises and ACP, AIDS organisations and 
other support services (such as through the National AIDS Council and 
Zimbabwe AIDS Network) 
* rational policies on health insurance, life assurance, pensions and other 
benefits to safeguard funds whilst minimising AIDS discrimination.
Company Policy on AIDS 69 
2. Education 
* the development of ongoing and imaginative AIDS education programmes 
at all levels throughoutemployment to promote sound knowledge, supportive 
attitudes, and appropriate behaviour change; where possible, such 
programmes should also reach families 
* tramingofkeyrjersonneltoactasAIDSeducatorsandsupporters/counsellors 
within the workplace, training of peer counsellors/educators, and support 
for the ACP's Health Programme.Facilitators initiative 
* evaluation of education programmes. 
3. Improved health, safety and support 
* improving health and safety measures to minimise risk of blood contact, 
particularly in personal services, but also in all first aid and company clinic 
facilities 
* free provision of condoms at the workplace, with support and advice on 
their use 
* exploration of funding mechanisms to provide maximum support for 
employees with AIDS and their families. 
4. Expanded training 
* expanding of personnel development, technical, managerial and other 
training programmes to take into account increased managerial and skilled 
labour shortages that are projected because of AIDS. 
The AIDS crisis could force companies, structural adjustment notwithstanding, 
to develop more comprehensive health and safety policies, become generally more 
socially aware and provide better welfare services within a strengthened national 
policy framework. The alternative is increased workplace discrimination, 
stigmatisation, rejection and isolation of infected persons and their families. The 
latter would, in the shortterm, be a personal disaster for thousands of people, and 
in the long term could be catastrophic at a national level. Nevertheless, as noted by 
Tony Devlin of the Anglo American Corporation (Devlin, 1990). 
"If... the experience of employers over the coming years is one of increasing 
work absences, death in service and loss of the very skills engendered by 
training, then one can imagine the situation where the voice of the preemployment 
testing and repeat screening lobby gain momentum". 
At the same time, precisely because of the increased difficulty recruiting skilled 
staff, companies may find they need to have supportive HIV policies to attract 
skilled personnel, rather than policies that create fear. People may avoid applying 
for a job in a company that undertakes screening. 
The time for concerted, positive action is now. In the overall national AIDS 
campaign the workplace has a particularly pivotal role to play.
70 Helen Jackson and Marian Pitts 
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