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ILO/WHO to develop joint guidelines on health services and HIV/AIDS

Representatives of the International Labour Organization (ILO) and the World Health Organization (WHO) will join forces in Geneva on 19-21 April for a tripartite meeting of experts to develop new guidelines to protect the safety of health workers involved in the worldwide struggle against HIV/AIDS.

Press release | 19 April 2005

GENEVA (ILO News) - Representatives of the International Labour Organization (ILO) and the World Health Organization (WHO) will join forces in Geneva on 19-21 April for a tripartite meeting of experts ( Note 1) to develop new guidelines to protect the safety of health workers involved in the worldwide struggle against HIV/AIDS.

At a time when health-care services face unprecedented challenges due to the pandemic, members of the world's 100-million strong health-care workforce, who deal with persons with HIV/AIDS bear an inordinately large psychological and physical burden brought on by overwork, despair at seeing patients die, lack of adequate safety and health-care provisions and the risk of infection.

The new guidelines will be designed to promote safety for both health-care providers and patients, increase opportunities for HIV/AIDS-related services, reduce the impact of stigma and discrimination and thereby enhance public trust and confidence in the health sector.

"In the world of work, clear guidelines are amongst the most effective way to reduce the transmission of HIV and other blood-borne viruses, and to improve the delivery of care to patients", says Susan Maybud, ILO health services specialist. "Over 50 per cent of hospital beds in the countries of sub-Saharan Africa are occupied by people with HIV-related illnesses - a tremendous challenge for a workforce that is itself continually diminishing due to illness and death, departure from the health service due to low pay and poor incentives, and migration."

The new global guidelines for HIV/AIDS sector workers are seen as a major effort by the UN system to respond to the epidemic in terms of its challenges to development and social progress. The global HIV/AIDS epidemic represents one of the most serious challenges to the achievement of the UN Millennium Development Goals aimed at halving poverty by the year 2015.

Guaranteeing a functioning and healthy medical workforce will also be essential to achieving the worldwide target, established by WHO and UNAIDS, for three million people living with HIV/AIDS in developing and middle-income countries to receive antiretroviral treatment by the end of 2005.

"Achieving our goals to accelerate treatment is predicated on building a much more robust health sector and the provision of a safer environment for health workers", says Dr Jim Yong Kim, Director of HIV/AIDS at WHO. "At the same time, however, making antiretroviral therapy more widely available will ultimately help reduce the capacity crisis currently facing so many hospital wards and health centres."

The impact of AIDS on health workers themselves is significant. For example, the health service in South Africa reports that, between 1997 and 2001, 14 per cent of staff (principally nursing staff) died as a result of AIDS. It is estimated that Botswana will have lost 17 per cent of its health-care workers between 1999 and 2005, and if health-care workers are not treated, the proportion of those dying as a result of HIV/AIDS may reach 40 per cent by 2010. Similarly, AIDS affects the broader workforce in disproportionate ways. The vast majority of people living with HIV/AIDS are adults aged 15 to 49, prime working years. According to the ILO's recent report, HIV/AIDS and work: global estimates, impact and response, 2004 ( Note 2), an estimated 26 million workers (all sectors) worldwide are living with HIV/AIDS. In the absence of increased access to treatment, an estimated 28 million workers will be lost to the workforce due to HIV/AIDS by the year 2005, 48 million in 2010 and 74 million in 2015, the ILO analysis says.

The new health service guidelines will cover the role of social dialogue, which provides governments, employers and workers with a forum to discuss challenges such as HIV/AIDS in the health-care sector. They will also offer specific and practical ways to protect, train and inform health-care workers and address issues such as screening, treatment, confidentiality, the minimizing of occupational risk, and prevention, as well as care and support for health-care workers.

Significantly, the guidelines will also cover the issues of discrimination and stigma - by health workers towards other health workers and towards patients - a serious issue in many health settings, that is addressed in the ILO Code of Practice on HIV/AIDS and the world of work ( Note 3).

As the health services sector is a major employer of women, who in some countries represent up to 80 per cent of all workers in the sector, the guidelines being devised here will place special emphasis on their concerns and needs. According to the ILO report, Women, girls, HIV/AIDS and the world of work ( Note 4), the proportion of women of working-age living with HIV/AIDS is increasing in all regions of the world. In sub-Saharan Africa, women represent 57 per cent of all HIV-positive adults, and three-quarters of young people living with HIV are women and girls.

For further information, please contact Susan Maybud, ILO Health Services Specialist, Tel.: +4122/799-7883, email: maybud@ilo.org, or Tunga Namjilsuren, Communications Officer, WHO/HIV, Tel.: +4122/791-1073, email: namjilsurent@who.int


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