Fronts or front-lines? HIV/AIDS and big business in South Africa

Introduction

HIV/AIDS statistics in South Africa paint a bleak picture. Antenatal HIV sero-prevalence surveys at public sector clinics have shown a rise in prevalence from 0.7 per cent in 1990 to 26.5 per cent in 2002 (Department of Health 2003a). The country's first national household sero-prevalence survey, released in December 2002, showed that 11.4 per cent of the country's population (two years and older) is living with HIV/AIDS (HSRC 2002).² The primary means of HIV transmission in sub-Saharan Africa is unprotected heterosexual sex, with the highest rates of prevalence found among sexually active adults (UNAIDS 2003a). Poverty is regarded as an important co-factor in the likelihood of infection because of resulting behavioural and biological factors (Marks 2002). The virus' destruction of the immune system results in increased illness and eventual death within eight to ten years of infection unless treated with antiretroviral drugs (UNAIDS 2003b), yet such treatment has been beyond the means of most South Africans. Despite the government's belated decision in November 2003 to provide antiretroviral drugs in the public sector, the planned rollout will not be fully operational until 2008 (Department of Health 2003b).

It is widely acknowledged that the HIV/AIDS epidemic will impact significantly on South African business in terms of markets, investor confidence and workforces and the skills they embody (Barnett and Whiteside 2002; Clarke and Strachan 2000; ILO 2001; Rosen et al 2000; UNAIDS 2003; Whiteside and Sunter 2000). To date, a primary focus of the literature has been on companies' internal responses to HIV/AIDS; however, the social context within which HIV/AIDS is embedded raises questions as to how effective internal responses alone can be (Brink 2003; Dickinson 2004). A number of South African-based companies have begun mounting HIV/AIDS response programmes that extend beyond the immediate confines of the company. Daimler-Chrysler recognises the need to involve supplies (Panter 2003), Anglo Gold the provision of antiretroviral drug treatment to communities from which the workforce is drawn (Kruger 2003), and Unilever the provision of wellness services to sub-contractors (Harrower 2003). In December 2003 a consortium of seven multinational companies - including Anglo American, Eskom and Daimler Chrysler - announced that they would provide HIV/AIDS services in communities surrounding their African operations (Business Day, December 4, 2003). Despite these high profile actions, however, survey evidence indicates that the overall response of South African businesses to HIV/AIDS has been limited (Rusconi 2002; Save the Children 2002; Sabcoha 2002/2003; Stevens et al 2003).

This article examines the response of big business in South Africa to HIV/AIDS using data from a survey of the country's 50 largest companies conducted for UNAIDS. It adds to the existing body of knowledge on corporate responses to HIV/AIDS in South Africa by illuminating three key dimensions: perceptions of the threat of HIV/AIDS and companies' motivations for taking action, the extent to which internal company policies reflect accepted 'best practice', and whether company responses demonstrate a 'social' or 'isolationist' approach to the epidemic.

Although the survey sample is limited in size and the findings can therefore only be taken as broadly indicative of the overall corporate response, it is important to pay close attention to the response of South Africa's corporate giants. Not only do they make an enormous direct contribution to the South African economy, but they also play an important symbolic role within the private sector and the nation as a whole, thereby disproportionately impacting on perceptions of the South African corporate response and influencing how smaller companies are likely to respond.

While a questionnaire cannot identify the extent to which a company's formal policies are translated into practice, the survey and its findings do go some way towards penetrating the 'public front' that a formally adopted corporate HIV/AIDS policy can create, a front which can shield the fact that very little is actually happening on the ground. The results of the survey suggest that South African businesses are pursuing a range...