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Soapbox: What can the fight against HIV teach us about Ebola?
By Margherita Licata and Kofi Amekudzi, Technical Specialists at the International Labour Organization
The more we learn about the challenges of responding to the Ebola Virus Disease in West Africa, the easier it becomes to discern parallels to the HIV epidemic - another health crisis , which we've been battling for over 30 years now. The HIV response has some valuable lessons for the way we confront the disease in general, particularly in the workplace. Here's an example.
About four years ago, we were working in southern Malawi with the ILO Programme for HIV/AIDS on a project targeting workers at the Lujeri Tea Estate. Though the rate of new infections has slowed, Malawi still has some of the highest HIV infection rates in the world, affecting one in every four people who lives there.
If we at the ILO have learnt anything in 15 years of combatting HIV, it's that the workplace can provide a powerful bulwark against an advancing epidemic.
Our job was to work with the management and workers to decrease their own risks of exposure while making sure that those living with HIV had access to treatment and protection from discrimination.
It was a daunting task. The workers, who lived away from their families in compounds, typically had multiple sexual partners, consisting largely of women who would offer them sex for money. They generally lacked enough information to protect themselves and met with stigma and discrimination when they got infected.
All of this will sound familiar to anyone engaged in the fight against Ebola. Fear and misinformation fuel the spread of the disease while making survival and recovery harder for those infected.
It's true that the Ebola outbreak in West Africa is first and foremost a public health crisis. But if we at the ILO have learnt anything in 15 years of combatting HIV, it's that the workplace can provide a powerful bulwark against an advancing epidemic.
Another important lesson is to follow a human-rights-based approach. We developed the HIV workplace response based on a policy environment that promised non-discrimination and protection of rights. The same approach which helped to inform and protect workers at the Lujeri Tea Estate can empower workers in West Africa to help stop the spread of Ebola.
At the Lujeri Tea Estate, we worked with management and employees to set up an education programme that reached over 5,000 people with information about how to reduce the risk of transmission and how to access health services if they got infected.
A committee comprised of both workers and management was created to encourage all employees to know their status. Workers, who felt more comfortable receiving this information from their peers rather than from an official source, became more likely to get tested and more likely to seek treatment when they tested positive. In the meantime, the company made clear that it wouldn't tolerate discrimination against workers living with HIV.
As examples like this one illustrate, the workplace provides a strong entry point for reaching workers and whole communities with information that can save lives. The same approach which helped to inform and protect workers at the Lujeri Tea Estate can empower workers in West Africa to help stop the spread of Ebola.
It can help to establish common principles for how to avoid infection while dispelling the stigma which continues to haunt survivors. As health workers are on the frontline of the Ebola response, their working conditions are of utmost importance. They should have decent work conditions, get paid on time and have adequate training and equipment.
Fundamentally, we must continue to tackle underlying factors like poverty and inequality, which are driving the spread of the disease.
Traditional authorities, faith-based organisations, civil-society groups, employers' associations, workers' organisations and leadership at every level of government all have a role to play.
Experts agree that with climate change and growing urbanisation, public-health emergencies like the Ebola outbreak may only become more common. If that's true, then we must be ready to use the lessons and experiences we've learned from fighting HIV to deal with them, in the workplace and beyond.
8th January 2015