Employers should conceptualise the risks posed by HIV/Aids to employee health and to business sustainability and profitability more broadly as a component of total risk assessment and management says Mercedes-Benz of South Africa’s Group Health and Safety Advisor Dr Clifford Panter.
This broader perspective of total risk management has useful implications for organisations like the Siyakhana Health Trust which offers small and medium sized companies comprehensive HIV and AIDS prevention, testing and treatment at minimal direct cost to companies.
Siyakhana is a non-profit organisation funded by MBSA, German development agency, DEG (Deutsche Investitions- und Entwicklungsgesellschaft mbH) and the Border-Kei Chamber of Business, and like any non-profit organisation sustainability remains a risk it must manage. Since Siyakhana’s  establishment in 2005 it has assisted 33 of companies and has offered 10 596 employees voluntary counselling and testing and 431 have tested positive and have access to the Siyakhana treatment programme.
“Employers are beginning to incorporate managing HIV/Aids risks to business into broader risk management. This includes traditional Health and Safety Management which companies are compelled through law to comply with. ‘Total Risk Management’ includes managing classical safety, health environment and quality risk factors as well as financial, political, economic and social risks - all of which impact directly on the bottom line. Companies, even small and medium-sized ones, must start to realise that ‘cherry picking’ HIV and AIDS as the only health risk worth focussing on cannot be the best strategic choice.”
With the emphasis shifting to a more holistic view of employee health management and based on trends emerging from the 29th International Congress of Occupational Health in Cape Town in March 2009, Panter says employers are looking for services where health, safety and employee wellbeing can be managed as part of total risk management.
“In response to this growing trend a number of global and national health, safety and employee wellbeing organisations and initiatives are crafting unique and innovative services for small and medium companies;  this poses an opportunity for Siyakhana,” Panter said. “I see Siyakhana moving from merely providing HIV/Aids management services in the workplace to offering participating small and medium sized companies a comprehensive health and safety management solution - as part of total risk management”.
 The HIV positive rate in companies Siyakhana works with is around 10% - which is lower than the 18 - 19% of the general economically active population that includes people who are not employed. “We are mindful that sick people are not at work, so the people the Siyakhana project reaches are well and at work. “And those who are well and at work face a number of health and safety risks in the workplace and bring chronic illnesses, other than HIV/Aids, with them to work”, notes Panter.
The spread of chronic illnesses amongst employees seems consistent across all demographic and geographical locations in the country with the five most common chronic illnesses being obesity, high blood pressure, diabetes, HIV/Aids and stress, anxiety and depression. A number of other chronic conditions occur quite frequently amongst workers including heart disease, orthopaedic conditions (especially lower backache) and substance abuse (especially weekend binge drinking).
Sickness absence is another significant health risk that must be properly managed. Panter says that actuarial research by large risk insurers indicates that usually about 65% of sickness absenteeism in companies is ascribed to minor ailments and 35% is a result of chronic illness. The research suggests that between 40 – 70% of absenteeism as a result of minor ailments is unnecessary absenteeism - often sick leave over-utilisation or abuse. Legislation provides for sick leave benefits which some employees utilise, irrespective of whether they are ill or not.
Adding to the strategic impetus for all companies to move towards a more comprehensive approach to health risk management in the workplace is the implementation of a National Health Insurance (NHI) system which is likely within next five years.
“There is some indication that the NHI could be legislated by as early as next year. Business would be well advised to get involved in how the NHI is managed to ensure they are not left with a sense of ‘throwing good money after bad’. This presents yet another opportunity for an organisation like Siyakhana to broaden its service offerings in line with how business should approach health and safety and to a large extent will be compelled to.”