Differentials considerations for the caribbean



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PART IV. CONCLUSION
GENERAL CONCLUSIONS
HIV/AIDS was initially seen as a medical problem. However recognition that the disease required a more broadly based perspective going beyond biomedical and clinical models resulted in studies in other sectors of research. The concept of a multi-sectoral and expanded approach includes economic considerations and such overlapping and cross-cutting areas of microbiology and sociology (specifically gender) in this Report.
Apart and beyond the enormous suffering inflicted by an epidemic that takes a tremendous toll on so many fronts, the pandemic is destroying both new and time-worn development gains achieved over generations because it reinforces every problem that connects ill-health to poverty. The pandemic is cyclical in nature: without good health there can be little or no personal or national development and without development there can be few if any gains in the area of personal health or that of the nation, by and large.
Consequently, HIV/AIDS brings in its wake a development crisis:


  • it is a major threat to social and economic development on both the personal and national fronts,




  • it hits women, 50 percent of potential development human resources and a particularly vulnerable group, especially hard, and




  • it is the single biggest obstacle to the attainment of the Millennium Development Goals.


RECOMMENDATIONS TO OAS/CIM


  • It is vital that, in developing and applying a multi-sectoral response, the concept of gender is included at every stage. An understanding of the gender issues and dimensions of HIV/AIDS must be seen as central to all aspects of the analysis of causative and contributory factors and to the planning and execution of responses, whether aimed at prevention of transmission or mitigation of the impacts of the disease.




  • It is important to involve sectors and programs dealing with poverty alleviation, environmental degradation, urban growth and rural policy options. In all these areas, programs have to deal with issues of economic power imbalances, migrations, economic and social marginalization, development of workplace and community responses, participation and capacity-building for sustainability.




  • Responses need to be coordinated between relevant organizational divisions and in collaboration with PAHO, UNAIDS and other involved stakeholders in the private sector.




  • Resource mobilization efforts must be taken seriously to identify funding sources with private sector partners to work in Latin America and the Caribbean.

BIBLIOGRAPHY

ARTICLES/WEBSITES
“AIDS at 25: timeline of a pandemic”, http://www.gsk.com/infocus/aidsat25.htm
Bishop-Sambrook, Clare, “HIV/AIDS Susceptibility and Vulnerability Pathway: A Tool for Identifying Indicators, Role Models and Innovations”, www.fao.org/sd/2003/PE10063_en.htm.
Bollinger, Lori and Stover, John, “The Economic Impact of AIDS”, The Futures Group International, Glastonbury, CT, 1999.
Bonnel, Rene, ADF 2000 Background Paper, “Economic Analysis of HIV/AIDS”, The World Bank, ACT Africa, AIDS Campaign Team for Africa, September 2000, www.iaen.org/files.cgi/435 HIVcon AnalysisADF.pdf.
Centers for Disease Control and Prevention, at www.cdc.gov

Fauci, DR. Anthony S., “HIV Vaccine Research: Considerations of the New Millenium”, http://www3.niaid.nih.gov/about/directors/congress/1998/0916
“The Gender Aspects of the HIV/AIDS Pandemic”,

http://www.un.org/womenwatch/daw/csw/hivaids/matlinspence.html.
La Foucade, Dr. Althea, Scott, Dr. Ewan, Theodore, Professor Karl, and Beharry, Vyjanti, “HIV/AIDS: Economic Prospects for the Caribbean”, 2004/2005.
Nicholls, Shelton, et. al., (2000a) ‘Modelling the Macroeconomc Impact of HIV/AIDS in the English Speaking Caribbean: The Case of Trinidad and Tobago and Jamaica’. Paper presented at the AIDS and Economics Symposium, IAEN, Durban, 7-8 July.
http://www.jointcenter.org/international/hiv-aids/1 macroecon. htm
http://www.cpc.paho.org/\Files\Docfiles59 112. pdf
http ://ipsnews. net/aids/page 5 .shtmlhttp ://222.uneca.org/ADF2000/theme1 .htm, ‘HIV/AIDS and Economic Development in Sub-Saharan Africa’
BOOKS
Barnett, Tony and Whiteside, Alan, AIDS in the Twenty-FirstCentury Diszease and Globalization, Palgrave Macmillan, 2006.
Bourke, Dale Hansen, The Skeptic’s Guide to the Global AIDS Crisis, Authentic Media, Georgia, 2005.
Commonwealth Secretariat and Maritime Centre of Excellence for Women’s Health, Gender Mainstreaming in HIV/AIDS: Taking a Multisectoral Approach, United Kingdom, 2002.

D’Adesky, Anne-Christine, Moving Mountains The Race to Treat Global AIDS, Verso, London/New York, 2004, www.versobooks.com.


Farmer, Paul, Infections and Inequalities The Modern Plagues, University of California Press, 1999.
Howe, Glenford and Cobley, Alan, The Caribbean AIDS Epidemic, University of the West Indies Press, Jamaica, 2000.
Theodore, Karl, CMH Working Paper Series, Paper No. WG1:1, ‘HIV/AIDS in the Caribbean: Economic Issues-Impact and Investment Response’, Commission on Macroeconomics and Health, March 2001.
UNAIDS, Report on the Global AIDS Epidemic, 2006.
United Nations, Population, Development and HIV?AIDS with Particular Emphasis on Poverty The Concise Report, Economic and Social Affairs, United Nations, New York, 2005.

APPENDIX I
Web Resources for HIV/AIDS Public-Private Partnerships
Case Studies:
BHP Billiton:

http://www.bhpbilliton.com/bb/sustainableDevelopment/community/programs/home.jsp

The corporate website for BHP Billiton has limited information on its efforts to help employees cope with HIV/AIDS in Africa. It also has community programs encouraging social and cultural dialogue in Peru and Chile. Neither of these programs, however, appears to have a specific HIV/AIDS, or even health component.
Chevron Texaco

  • ChevronTexaco Corporate Website

http://www.chevron.com/social responsibility/hiv aids/

Like BHP Billiton, ChevronTexaco only offers descriptions of HIV/AIDS programs in Africa. They do not appear to be targeted toward women. The company does have an HIV/AIDS policy applicable to all employees.

  • Global Business Coalition (GBC) on HIV/AIDS Chevron Case Study

http://www.businessfightsaids.org/site/apps/nl/content.asp?c=gwKXJfNVJtF&b=1008989& ct=1366183

Chevron is engaged in HIV/AIDS workplace programs in Sub-Saharan Africa. Notably, they have educational programs on the prevention of mother-to-child transmission.
Exxon

  • Exxon Corporate Website

http://www.exxonmobil.com/corporate/citizenship/gcr health stopaids.asp

The website provides a brief summary of the StopAids program. This program is aimed at prevention and education. Exxon has implemented it in sites in 20 African countries.

  • GBC Exxon Case Study

http://www.businessfightsaids.org/site/apps/nl/content.asp?c=gwKXJfNVJtF&b=1008989& ct=1366145

The summary further describes the StopAids program. It is focused on prevention, education, and the removal of any HIV/AIDS exclusions from medical plans.
Shell

  • Shell Corporate Website

http://www.shell.com/home/Framework?siteId=envandsoc-en&FC2=/envandsoc­en/html/iwgen/key issues and topics/our people/hiv aids/zzz l hn . html&FC3 =/envandso c‑

en/html/iwgen/key issues and topics/our people/hiv aids/our approach to hiv aids 27 042006.html

Shell’s corporate website outlines the company’s efforts in HIV/AIDS education and prevention, provision or arrangement of treatment for employees, and specifically mentions partnerships with other companies, national and international organizations. This policy was piloted in Africa, and, according to the website, will be launched in Asia, Latin America, and Europe in 2006.



  • GBC Shell Case Study

http://www.businessfightsaids.org/site/apps/nl/content.asp?c=gwKXJfNVJtF&b=1008989& ct=1366189

GBC provides a detailed description of Shell’s HIV/AIDS policy.


BP

  • BP Corporate Website

http://www.bp.com/multipleimagesection.do?categoryId=4522&contentId=7017928

BP’s corporate website offers a brief overview of AIDS programs it has undertaken in the Caspian region, and some information on Malaria prevention in Africa.


  • GBC BP Case Study

http://www.businessfightsaids.org/site/apps/nl/content.asp?c=gwKXJfNVJtF&b=1008989& ct= 1366163

The GBC case study takes a more in depth look at BP’s HIV/AIDS programs. In this case study, BP states a policy of treating employees infected with HIV/AIDS in the same manner as they would anyone else with a long-term serious illness, and of offering alternative employment/accommodations for illness-related disabilities, and of informing all employees of their health coverage. BP has set concrete goals for condom use and STD reduction, and has outlined efforts for prevention and education, testing and counseling, and access to treatment. This website even has sample information packets, and an outline of the guidelines for testing and treatment.


Va rig

Note: Varig is going through a major crisis. It is in deep debt, has grounded the majority of its flights, was refused a government bailout, and was recently auctioned off.


  • WEF Case Study

http://www.weforum.org/en/initiatives/globalhealth/Case%20Studies/Varig

This site contains information about Varig’s program, which was made possible in part by the fact that a nonprofit had majority ownership of the airline. (The nonprofit is now saddled with a huge debt.)
Quality Tourism for the Caribbean (QTC)

  • GBC Case Study

http://www.businessfightsaids.org/site/apps/nl/content.asp?c=gwKXJfNVJtF&b=1009001& ct= 1366231

This is not a potential partner per se, but is interesting nonetheless. “Quality Tourism for the Caribbean (QTC) is a joint venture project which seeks to strengthen the overall quality and competitiveness of the tourism industry in the Caribbean through the establishment and dissemination of quality standards and systems designed to ensure healthy, safe and environmentally conscious products and services. The partners in the QTC project are the Caribbean Alliance for Sustainable Tourism (CAST), the environmental regional subsidiary of the Caribbean Hotel Association (CHA), and the Caribbean Epidemiology Centre (CAREC), the Caribbean's health monitoring and disease prevention agency, and a specialized institution of the Pan American Health Agency (PAHO).

QTC published HIV/AIDS Policy Guidelines for the Caribbean Tourism Industry to assist hoteliers and restaurateurs in protecting their workforces, and in so doing, protect the viability of their businesses. One of the two main components of the program is the development of health, safety and resource conservation standards and system supported by the establishment of a credible certification/registration process. It is expected that these standards will help:




  • Address the concerns related to the health, hygiene, and environmental conditions for guests and staff at hotels and other tourism businesses.

  • Provide more market share for Caribbean hotels through decreased liability and improved profitability.

  • Contribute to the sustainability of tourism industry and economic development in the region.

A core set of draft standards have been developed and the Project Execution Unit is seeking to finalize these standards before implementation at the industry level.

The Caribbean Tourism, Health, Safety and Resource Conservation project has taken up the call of the International Hotel and Restaurant Association for the global hospitality Industry to address the issue of HIV/AIDS in the workplace.”
Marriott


  • Marriott Corporate Website

http://marriott.com/corporateinfo/default.mi

No readily available information on any HIV/AIDS workplace programs.



  • WEF Marriott Case Study

http://www.weforum.org/en/initiatives/globalhealth/Case%20Studies/Marriott

The WEF outlines Marriot’s HIV/AIDS programs in Thailand which include prevention efforts and the application of its life threatening disease policy.
Nestlé

  • Nestlé Corporate Website

http://www.community.nestle.com/Sitemap.htm

Nestlé has an entirely separate website devoted to its community oriented efforts. There are no HIV/AIDS programs in Latin America, where most of the company’s efforts are focused on nutrition. In Africa there are generic HIV/AIDS programs, which can be found listed under the individual countries in that region. There is no mention of Nestlé’s 20 year old HIV/AIDS program in Brazil.


  • WEF Nestlé Case Study

http://www.weforum.org/en/initiatives/globalhealth/Case%20Studies/NestleThailand

Nestlé Brazil has an HIV/AIDS program that devotes 48% of its resources to prevention and 53% to treatment and care. The company offers voluntary and confidential testing as well as access to anti-retroviral therapy. The program has been in place since 1986.


  • GBC Nestlé Case Study

http://www.businessfightsaids.org/site/apps/nl/content.asp?c=gwKXJfNVJtF&b=1008997& ct=1366215

The GBC case study also covers Nestlé’s efforts at HIV/AIDS prevention in Brazil. Nestlé has engaged in preventive education efforts, the distribution of condoms, and has had a nondiscrimination policy in place since the mid-1980s. From 1999-2000 Nestle served as the President of the Executive Committee of the Conselho Empresarial Nacional para prevenção ao HIV/AIDS (CEN), and as the Vice President from 2001-2002.
Heineken N.V.

  • Heineken Corporate Website

http://www.heinekeninternational.com/pages/article/S2/VALUESANDPRINCIPLES.aspx

The only mention of HIV/AIDS is in Heineken’s values and principles statement.




  • GBC Heineken Case Study

http://www.businessfightsaids.org/site/apps/nl/content.asp?c=gwKXJfNVJtF&b=1008997& ct=1366199

In one of the most detailed case studies on the GBC website, Heineken summarizes its initial analysis of the HIV/AIDS situation, then prevention and education efforts which include education, condom distribution, and treatment of STIs at its workplace clinics, voluntary testing and counseling, and access to antiretrovirals for employees, employees’ partners and employees’ children as a part of its program through a contract with Pharmacess, a foundation that organizes antiretroviral treatment in Africa. Antiretroviral treatment and care is provided in clinics on location. In six of its African clinics, Heineken offers antiretroviral therapy to prevent mother-to-child transmission.
GlaxoSmithKline plc

  • GSK Corporate Website

http://www.gsk.com/responsibility/cr issues/ehs mf ems programmes. htm#hiv

This website has a very basic description of non-discrimination, education and treatment which varies depending on the circumstances of the location.


  • GBC GSK Case Study

http://www.businessfightsaids.org/site/apps/nl/content.asp?c=gwKXJfNVJtF&b=1008975& ct= 1366165

The GCB case study is also very short, with little information beyond stating that GSK has a non-discrimination policy, and is focused on education and prevention within its workforce.
Timberland


  • Timberland Corporate Website

http://www.timberland.com/include/csr reports/CSR Global Human Rights.pdf

Timberland’s CSR and Human Rights report contains a brief summary of its HIV/AIDS and workplace health programs.




  • WEF Timberland Case Study

http://www.weforum.org/en/initiatives/globalhealth/Case%20Studies/Timberland

A brief summary of the case study shows that Timberland places a priority on educating factory employees in China about prevention and HIV/AIDS. The study notes that many of the employees are young women. In order to raise awareness Timberland has partnered with Verité, an organization that works with women’s reproductive health education.


  • Timberland in The Economist

http://www.economist.com/surveys/displaystory.cfm?story id=5517678


  • Timberland in Time

http://www.time.com/time/insidebiz/printout/0,8816,1139825,00.html
Miscellaneous:


  • Business for Social Responsibility

http://www.bsr.org/CSRResources/HumanRights/index.cfm

This is a website with reports on enforcing responsibility in global supply chains, working with indigenous communities, and efforts to improve women’s health in the workplace. These reports contain some information on best practices and case studies.

  • BSR Women’s Health Report - Addressing the General and Reproductive Health of Women in Global Supply Chains

http://www.bsr.org/CSRResources/HumanRights/WomensHealth Report. pdf

This report contains case studies on partnerships for women’s health all over the world. Most partnerships involve corporations and NGOs, or NGOs and governments.


  • Mexico’s National Business Council on HIV/AIDS

http://conaes.com/

A very sparse website, but it does list members of the Business Council.




  • Women, HIV/AIDS and the world of work”

http://www.ilo.org/public/english/protection/trav/aids/wd04en.pdf

ILO fact sheet on women, the workplace, and HIV/AIDS




http://www.ksg.harvard.edu/cbg/hiv-aids/background.htm

This site has articles, presentations, and papers from several workshops on business partnerships to combat HIV/AIDS.


  • Boston University School of Public Health

Publications from the Program on the Social and Economic Consequences of the AIDS Epidemic

http://www.bu.edu/dbin/sph/research centers/Publications.htm


1. Prepared by Dr. Alison Moses, Social Economist.



2. A National Public Radio show reported, in the fall of 2006, that a person is infected with HIV/AIDS every eight seconds.


3. http://www3.niaid.nih.gov/about/directors/congress/1998/09/16

4. http://www.gsk.com/infocus/aidsat25.htm

5. UNAIDS, Report on the Global AIDS Epidemic, A UNAIDS 10th anniversary special edition, Joint United Nations Programme on HIV/AIDS (UNAIDS), May 2006, p. 8.

6. http://www.kaisernetwork.org/Daily_reports/rep_index.cfm?DR_ID=41192

7. http://hivinsite.ucsf.edu/global?page=cr02-00-00

8. http://www.amfar.org/cgi-bin/iowa/programs/globali/record.html?record=128

9. Ibid, UNAIDS, 2006

10. http://data.unaids.org/pub/EpiReport/2006/07-Caribbean_2006_EpiUpdate_eng.pdf

11. Op cit, UNAIDS, 2006.

12. UNAIDS, Report on the Global AIDS Epidemic, May 2006, p. 38-40.

13. http://www.aidsonline.com/pt/re/aids/fulltext.00002030-199814000- 00020.htm;jsessionid=GVnCnJJ62qR2VhWQTkvcHmQkQzLcb0sgw1 bNhQJ7NBjsvKFJQyHg!1 877702476!- 949856145!8091 !-1 AIDS: Volume 12(14)October 1998p 1879-1887

14. http://data.unaids.org/pub/EpiReport/2006/07-Caribbean_2006_EpiUpdate_eng.pdf

15. According to UNAIDS report 2006, 330,000 people were living with the HIV virus in the Caribbean, 22,000 of whom were children younger than 14-15 years. It said that nearly 37,000 persons became infected with HIV in 2005, and that women comprise 51 per cent of adults living with the virus.

16. http://www.jamaica-gleaner.com/gleaner/20060601/news/news6.html

17. http://www.aids.harvard.edu/news publications/har/fall win99-1 .html.

18. Marisa Casale and Alan Whiteside, IDRC Working Papers on Globalization, Growth and Poverty Working Paper Number 3, The Impact of HIV/AIDS on Poverty, Inequality and Economic Growth, Health Economics and HIV/AIDS Research Division (HEARD) University of KwaZulu Natal, South Africa, October 2005, p. 3-4.

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