US embassy cable - 05GABORONE879

UNCLAS SECTION 01 OF 03 GABORONE 000879 
 
SIPDIS 
 
AF/S FOR MALONEY 
 
E.O. 12958: N/A 
TAGS: ELAB, KHIV, PGOV, PHUM, BC, KPRP, HIV and AIDS, Labor 
SUBJECT:  ADDRESSING LABOR EFFECTS OF HIV/AIDS 
 
1. (U)  Summary:  HIV/AIDS is slowing economic growth in 
Botswana by an estimated 1.5 percent per year, in part 
through its impact on labor - decreased productivity, 
increased leave taking, and lost workers.  In order 
better to quantify this drag on growth, the GOB has begun 
to collect data on the labor impacts of HIV/AIDS in the 
public sector.  To mitigate the economic costs of the 
disease, the GOB is developing a national policy on 
HIV/AIDS and employment.  USG assistance, through USDOL 
and PEPFAR, is helping Botswana manage the labor-related 
consequences of HIV/AIDS to minimize the economic losses 
occasioned by this epidemic.  More and better data on 
HIV/AIDS' workforce impact will enable donors and policy 
to develop strategies to ensure that economic growth 
continues despite a high HIV prevalence rate.  End 
Summary. 
 
HIV/AIDS IMPACTS ON CIVIL SERVANTS 
 
2. (U)  In May 2005, the National AIDS Coordinating 
Agency (NACA) released a report reflecting the impact 
HIV/AIDS had on the public sector workforce during the 
first quarter of 2005.  Dr. Boga Fidzani, who is 
overseeing this data collection and analysis at NACA, 
told PolOff that the report was the first in a planned 
series that will enable the GOB to monitor labor impacts 
of HIV/AIDS as well as the success of interventions 
designed to limit its spread and mitigate its impacts. 
The report measured, among other things, deaths per 
thousand employees, sick leave taken and other leave 
taken. 
 
3. (U)  Dr. Fidzani readily admitted that the data on 
which the report was based were yet not reliable. 
Ministries had been lax about entering information on 
leaving taking and deaths among their workers into a 
government-wide database on a consistent and timely 
basis.  Consequently, it would not be advisable to draw 
conclusions from the statistics contained in this initial 
report.  Thanks, however, to a public admonition by 
President Mogae to the Permanent Secretaries, the senior- 
most civil servants in the Government, to improve their 
reporting, Dr. Fidzani had received a number of calls 
seeking details about the report and how to access the 
database.  With the sustained commitment of the Permanent 
Secretaries, the quality of data used in the report is 
 
SIPDIS 
likely to improve considerably, making it a useful 
analytical tool. 
 
LABOR EFFECTS OF AIDS IN PRIVATE SECTOR 
 
4. (U)  In 1998, UNDP commissioned a study on the macro- 
economic impacts of HIV/AIDS.  Released in 2000, the 
study estimated that HIV/AIDS likely would slow economic 
growth by 1.5 percent, decrease by 8 percent house-hold 
level per capita income, and increase by 5 percent the 
number of people living poverty.  As skilled workers died 
from disease, the study estimated, a shortage of skilled 
labor would drive up the cost of skilled wages by 12 to 
17 percent.  In June 2005, the UNDP tendered a request 
for proposals to conduct two separate studies on the 
macro-economic and demographic impacts of HIV/AIDS to 
update the 2000 estimates.  According to Lydia Matebesi 
of UNDP, the organization hopes to have completed studies 
by the end of the year. 
 
5. (U)  In a conversation with PolOff on June 16, Jeffrey 
Makgolo at the Botswana Business Coalition on AIDS 
(BBCA), the HIV/AIDS branch of the Botswana Confederation 
of Commerce, Industry and Manpower (BOCCIM), lamented the 
absence of a similar mechanism within the private sector. 
Makgolo affirmed that employers generally recognize that 
AIDS has a negative effect on their ability to do 
business.  Few companies, however, have the resources to 
collect productivity-related data in order to quantify 
this effect.  Makgolo agreed that by keeping such data, 
the private sector could help to shape public policy and 
guide HIV/AIDS interventions in order to minimize 
setbacks to economic growth and development.  He noted, 
however, that the BBCA as an institution was quite young, 
established in 2004, and was struggling to meet its 
mandate as it was. 
 
6. (U)  Makgolo pointed out that, according to the most 
recent Botswana AIDS Impact Survey, awareness of the 
disease was much more common than participation in 
testing and treatment programs.  He reasoned that the 
absence of clearly-articulated policies regarding 
HIV/AIDS in local firms discourages employees from 
testing and, if positive, seeking treatment.  Uncertainty 
over whether an employer is likely to fire someone who 
becomes infected with the disease forces workers to 
choose between keeping a job and knowing one's status. 
Many choose not to risk losing their employment by 
testing or openly participating in a treatment program. 
In order to alter this dynamic, the BBCA is holding 
workshops, with the support of PEPFAR monies, to 
familiarize managers with the value of developing a firm- 
level HIV/AIDS policy and how to do so. 
 
GOB FORMULATING POLICY ON HIV/AIDS AND EMPLOYMENT 
 
7. (U)  At the insistence of President Mogae, the 
Ministry of Labor and Home Affairs (MLHA) has expedited 
the process of developing a national policy on HIV/AIDS 
and employment.  With the assistance of the national 
coordinator of the HIV/AIDS Workplace Education Program, 
the MLHA and stakeholders from labor, government, the 
private sector and NGOs have prepared a draft policy. 
Milikani Ndaba of the Botswana Network on Ethics and Law 
and Patrick Chengeta of the Botswana Federation of Trade 
Unions confirmed to PolOff that NGOs and organized labor 
played an integral role in developing the draft policy. 
It lays out principles and standards of conduct relating 
to equal employment opportunities, reasonable 
accommodation of ill workers, testing, confidentiality, 
and access to care and treatment. 
 
8. (U)  According to Kushata Mosienyane, HIV/AIDS 
Coordinator at the Ministry of Labour and Home Affairs, 
two fundamental disputes arose among the stakeholders 
during the drafting of the text.  A number of 
participants, including some government officials, balked 
at the policy's proscription of pre-employment testing 
for citizens of Botswana.  Some Government 
representatives explained that the GOB had encountered 
major expenses when expatriates it had hired became ill 
and/or died due to an AIDS-related illness.  Objections 
that this could be addressed through other means, such as 
compulsory health insurance, notwithstanding the National 
AIDS Council, chaired by President Mogae, agreed to let 
stand this exception to the rule against pre-employment 
testing. 
 
9. (U)  The second major difference arose over reasonable 
accommodation and disclosure.  Employers argued that they 
could only accommodate an employee's health needs by 
altering his or her duties if they knew the nature of the 
illness that necessitated such an adjustment.  NGOs and 
workers countered that such disclosure is not necessary 
and would violate international ethical standards.  The 
National AIDS Council endorsed the draft text which 
protects confidentiality even in cases where reasonable 
accommodation is required. 
 
10. (U)  Marianyana Selelo, ILO National Coordinator for 
the HIV/AIDS Workplace Education Program, told PolOff on 
June 17 that the draft policy must be reviewed by the 
Minister of Labor and Home Affairs, after which it will 
be circulated among the various ministries before Cabinet 
finally approves it.  She expected that a final policy 
would emerge before the end of the year.  That document 
would then become the basis for developing legislation 
relating to HIV/AIDS and employment. 
 
TRANSLATING POLICY INTO REALITY 
 
11. (U)  As BBCA's Mr. Makgolo reminded PolOff, after all 
the consultation and consensus building to craft a 
national policy, it will remain a non-binding document. 
Until Parliament passes legislation based upon the 
provisions of that policy, the GOB, donors and NGOs will 
have to persuade employers of the need to adhere to its 
provisions. 
 
12. (U)  Translating policy into reality will be 
especially difficult in the agricultural sector.  Farms 
and farm workers are dispersed over large and remote 
areas.  Moreover, farmers historically have been 
reluctant to grant access to their property to allow NGOs 
to assist their employees.  The HIV/AIDS Coordinator in 
rural Ghanzi District told PolOff on June 23 that farmers 
are now beginning to voluntarily bring their workers in 
for HIV/AIDS testing, suggesting a growing recognition 
among farm owners that the epidemic will impact their 
lifestyles and livelihoods.  Given the murky status of 
the rights of farm workers, much remains to be done to 
protect their rights vis--vis HIV/AIDS. 
 
COMMENT 
 
 
13. (U)  Thanks to programs like PEPFAR, the most urgent 
needs in the war against HIV/AIDS, expanding access to 
prevention and treatment programs, are beginning to be 
met.  As the number of lives saved increases, the GOB and 
its partners must devote attention to ensuring the 
survival of Botswana's economy.  In order to develop the 
appropriate policies to facilitate sustained economic 
growth despite a high HIV prevalence rate, policy makers 
will need more reliable data about the impacts of 
HIV/AIDS and various prevention and treatment programs on 
the labor force.  USG assistance already is helping the 
GOB manage some of the labor-related challenges of 
HIV/AIDS.  Mission will encourage the private sector to 
recognize that its own interests would be served by the 
development of a mechanism for generating reliable data 
on the labor effects of HIV/AIDS. 
 
HUGGINS