Anglo American continues to drive a world-leading HIV/AIDS response. During 2009, the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria recognised Anglo Thermal Coal’s South African mines' performance with a business excellence award for the best workplace HIV/AIDS programme.
Anglo American plc Chairman Sir John Parker at the Johannesburg campus promoting HIV testingBy the end of 2011, we had 4,730 employees on anti-retroviral therapy (ART). Ultimately, all HIV-positive employees will need ART, so we anticipate, and are planning for employees starting treatment.
The CD4 count – the number of circulating immune system cells that are attacked by HIV – remains the best indicator of the state of the immune system in HIV infection. The aim is to start all HIV patients on treatment before their CD4 counts fall below 350 cells per millilitre of blood; that is, before their immune systems are sufficiently weak to contract TB and/or AIDS.
The ultimate success would be a situation where all HIV infections would be diagnosed early and all patients placed on ART before they get sick. With good adherence to the prescribed medication, there should be no deaths from AIDS. This is our long-term goal.
HIV disease-management programme
All employees who test HIV-positive are invited to enrol in our HIV disease-management programme (HIVDMP). Through ongoing counselling and regular immune system monitoring we can ensure optimal timing of treatment initiation. We have a policy of placing all HIV-positive enrollees on TB-preventive therapy, which has been shown in our programme to reduce AIDS mortality by 50%. The principle of ‘positive prevention’ is applied to minimise the further spread of HIV infection.
HIVDMP enrolment is currently 61% of the employees who are estimated to be HIV- positive. We need to improve uptake in order to prevent disease and ensure continued wellness and productivity for all HIV-infected employees.
We have ambitious plans to involve accredited traditional healers much more closely in our HIV care and support programmes, which we believe will significantly improve uptake and treatment adherence.
Tuberculosis (TB) and HIV/AIDS
In 2011, the TB incidence rate at Anglo American’s South African operations was 1,175 per 100,000 employees (2010: 994 per 100,000). There were 906 new TB cases recorded among our workforce and, sadly,,we recorded 65 deaths from TB, but this was significantly less than in 2010 (86). We are driving a concerted effort to further reduce deaths from TB through earlier HIV and TB diagnosis and treatment.