HIV/AIDS remains a major area of concern in southern Africa and programmes to address this pandemic are in place at all our operations. Programmes developed and implemented at our operations in Rustenburg and Springs are progressively being extended to other areas within the group.
Agreements are in place with major unions in respect of the management of HIV/AIDS at the South African operations, and committees defined in terms of these agreements have been active for some years. There is some cause for concern that, during FY2007, the committee at our Rustenburg operations has not been functioning as well as it has in the past, as a number of former union representatives with extensive experience in this field have moved on to other areas. This is an area of focus for FY2008.
While Implats provides treatment programmes through its own medical facilities and in-house medical scheme, employees may choose to receive treatment through external medical schemes which do not report statistics to the company, or through government-provided systems. Consequently, HIV/AIDS prevalence levels and other statistics related to the impact of the virus are not known with absolute certainty. Nonetheless, the company has a great deal of information at its disposal to enable it to determine the risk presented by the infection, and has developed programmes to mitigate this risk. Implats has continued to engage leading external consultants to project the impact of the disease on its employees and its cost base.
Testing of employees undertaken on a voluntary basis in the past has indicated prevalence levels of around 16% at our Rustenburg and Springs operations, and of around 20% at the Zimplats operations. However, this is believed to have risen to around 19% in the Rustenburg area during the past year, based on limited pre-operative testing at Impala Medical Services.
Based on publicly available information (Department of Health), it is estimated that prevalence levels in the general adult population in areas of primary operations are as follows: Impala Rustenburg: North West Province – 29%; Impala Springs: Gauteng Province – 33%; Marula: Limpopo Province – 20%; Zimplats and Mimosa: Zimbabwe – 19%.
The rising trend at Impala Rustenburg appears to be a consequence of two primary factors:
These are both areas of significant concern to the company and are being addressed by a refocus on prevention and education campaigns going forward.
Of particular importance is the revitalisation of education campaigns and the running of separate streams of communication for HIV-positive and HIV-negative employees. The focus during the past two years on trying to get HIV-positive employees to prevent or delay the progression of their illness with treatment, particularly through the use of HIV-positive peer educators, has proved effective. It has become apparent, however, that education programmes for HIV-negative employees must be reinforced so as to emphasise the importance of maintaining their negative status, especially given the greater number of new entrants into the organisation.
Condoms and femidoms are freely available to employees and local communities and it is estimated that more than 844,000 were distributed by the group during the year. A high priority continues to be placed on the counselling and treatment of employees and their partners presenting with sexually transmitted infections (STIs).
A key element of the Implats group programmes is the availability and, indeed, the active encouragement of voluntary counselling and testing (VCT) at all of the companys operations. In total, some 6,800 rapid voluntary and diagnostic tests were undertaken in FY2007 (FY2006: 6,600) by the company during the year, with 883 new cases of HIV diagnosed. VCT was introduced at both Mimosa and Marula during the year.
Employees who are HIV-positive are encouraged to participate in the wellness programmes available through the company, or through the various medical aid schemes. As at the end of FY2007, 2,438 people were enrolled in the wellness programmes run at the companys health facilities. (FY2006: 2,350)
The wellness programmes include the provision of ART to employees and their dependants through the our Medical Plan or other medical schemes. In FY2007, 396 people received ART through the companys facilities (FY2006: 176). This is a significant increase in uptake, with 247 new patients starting ART in FY2007 following education programmes on the benefits of ART. The provision of ART started at Marula and Zimplats during the year.
Based on known HIV-positive cases, the company is aware of 468 employees who left the services of the group as a result of AIDS or AIDS-related illness during FY2007 (FY2006: 408 employees): of these 105 employees died in service while 363 employees left the group through a formal medical separation process. This process is one that is frequently initiated by the employee and ensures that the employee returns to the care of his or her family.
External consultants were contracted to project the impact of HIV/AIDS on employees and the company, and developed a model of cost forecasts that took into account the cost of the provision of health care, medical cost, sick leave, the cost of declines in productivity, training and replacement. In terms of this model, costs are expected to peak in FY2010, which is the projected peak of the epidemic.
The total cost to the group of the HIV/AIDS education and medical programme for employees is approximately R18.5 million.
|HIV tests||New HIV-positive cases||Number on wellness programmes||Number receiving ART||Known deaths||Medical separations|
Implats has applied the lessons learnt on internal programmes and within its facilities, to assist local and labour-sending communities with HIV/AIDS-related projects (in section on socio-economic development).
Key objectives for FY2008 are: