Boston University Center for Global Health and Development
Abstract
This repository item contains a single issue of the Health and Development Discussion Papers, an informal working paper series that began publishing in 2002 by the Boston University Center for Global Health and Development. It is intended to help the Center and individual authors to disseminate work that is being prepared for journal publication or that is not appropriate for journal publication but might still have value to readers.BACKGROUND: Until recently, little was known about the costs of the HIV/AIDS epidemic to
businesses in Africa and business responses to the epidemic. This paper synthesizes the
results of a set of studies conducted between 1999 and 2006 and draws conclusions about the
role of the private sector in Africa’s response to AIDS.
METHODS: Detailed human resource, financial, and medical data were collected from 14 large
private and parastatal companies in South Africa, Uganda, Kenya, Zambia, and Ethiopia.
Surveys of small and medium-sized enterprises (SMEs) were conducted in South Africa,
Kenya, and Zambia. Large companies’ responses or potential responses to the epidemic were
investigated in South Africa, Uganda, Kenya, Zambia, and Rwanda.
RESULTS: Among the large companies, estimated workforce HIV prevalence ranged from 5%-
37%. The average cost per employee lost to AIDS varied from 0.5-5.6 times the average
annual compensation of the employee affected. Labor cost increases as a result of AIDS
were estimated at anywhere from 0.6%-10.8% but exceeded 3% at only 2 of 14 companies.
Treatment of eligible employees with ART at a cost of $360/patient/year was shown to have
positive financial returns for most but not all companies. Uptake of employer-provided
testing and treatment services varied widely. Among SMEs, HIV prevalence in the workforce was estimated at 10%-26%. SME managers consistently reported low AIDS related employee attrition, little concern about the impacts of AIDS on their companies, and relatively little interest in taking action, and fewer than half had ever discussed AIDS with their senior staff. AIDS was estimated to increase the average operating costs of small tourism companies in Zambia by less than 1%; labor cost increases in other sectors were probably smaller.
CONCLUSIONS: Although there was wide variation among the firms studied, clear patterns emerged that will permit some prediction of impacts and responses in the future
