I thank the National Academy of Public Administration and the Africa Working Group for this opportunity to share my insights on the impact of HIV/AIDS on Africa’s civil service. The Africa Working Group of the Academy under the leadership of Professor Sy Murray deserves credit for its focus on HIV/AIDS in Africa.

The civil service in Africa is unique for many reasons. First, an indigenous civil service is fairly young in Africa since most countries in the continent became politically independent in the last four decades. Second, the civil service in many African countries represents the best and the brightest of their generation since government is still the predominant employer of labor. Third, a typical civil servant in Africa, no matter his or her grade or monthly pay is responsible for the upkeep of more than 10 individuals. This responsibility ranges from the needs of immediate family members to the support of the extended family. Fourth, civil servants are leaders in their communities and hometowns, with influence exceeding what many in industrialized societies may comprehend. These civil servants are the natural opinion leaders of their communities, and, are often relied upon to attract government programs and services to their communities. Fifth, top civil servants in many poor African countries represent years of significant investments in education and in-service training that may not be immediately replaceable. Finally, in communities and environments where poverty is the rule rather the exception, civil servants such as teachers, nurses and agricultural extension workers are crucial to an impoverished community’s hopes to train their young, keep them alive and feed them properly to become effective leaders of tomorrow.

Consequently, extended illness or death of a civil servant in Africa has major repercussions. The immediate family will likely spend its meager resources trying to keep the breadwinner alive. Extended family members may no longer go to school as funds for school fees go toward keeping the breadwinner alive. The community may lose a valuable contact in government and policymaking circles. A national government may be left reeling from loss of highly experienced but difficult to replace worker.
Today in many African countries, HIV/AIDS is having extraordinary impact on the workforce. According to the United Nations International Labor Organization (ILO), a minimum of 26 million people worldwide living with HIV/AIDS are in the workforce, with at least two-thirds of them living in Africa. By the end of 2005, ILO estimates that worldwide more than two million workers, two-thirds of them living in Africa, will be too sick to go to work because of AIDS. In Uganda, ILO estimates that more than 50 percent of all teachers are living with HIV/AIDS. Tanzania loses 100 primary school teachers every month to AIDS. At least one million children in Africa have lost their teachers to AIDS. In Malawi, AIDS deaths among the civil service increased tenfold between 1990 and 2000. In many Africa Military, the biggest threat is no longer neighboring armies but HIV/AIDS in its rank and file. The police force and other paramilitary organizations in Africa are dealing with high rates of HIV/AIDS with devastating impact on performance and morale. By 2020, HIV/AIDS will cause between 10 and 30 percent reduction in the labor force of AIDS hard hit countries in Africa. For Nigeria and South Africa, with large concentration of individuals living with the HIV/AIDS, the effect is likely to be higher.

It is also important to note that the impact of HIV/AIDS is not restricted to government bureaucracies. In the private sector in Africa, the effect is equally devastating. According to the ILO, a survey of 26 firms in South Africa showed a 15.5 percent HIV prevalence rate in the mining industry and 13.0 percent in the manufacturing sector. In the same survey, 20.4 percent of all contract workers were living with HIV/AIDS, 14.8 percent of unskilled workers were infected with HIV and 4.1 percent of managerial cadres were living with HIV. The rates are higher in Botswana and Zambia. In many instances, businesses reportedly hire two or more individuals for the same position as a hedge against the inevitable absence from work or death from AIDS.
HIV/AIDS is a disease of the workforce in Africa. Unfortunately, workplace initiatives to address HIV/AIDS is yet to become a mainstream public sector issue in the continent. A workplace HIV/AIDS initiative on HIV/AIDS should include preventive programs, testing and counseling services, clinical care, support care, and timely transition benefits care for the families of workers who die of AIDS. The workplace initiative should also improve legal protections for workers living with HIV/AIDS. In addition, in Africa, a workplace HIV/AIDS initiative should include programs for extended family members and outreach services to the communities where workers live.

In my work with the UN International Labor Organization Program on HIV/AIDS, it became clear that workplace initiatives on HIV/AIDS should become a top priority of African governments to ensure timely access to preventive, clinical and support care for workers. It also became apparent that African countries needed to enact or enforce laws against employment discrimination due to HIV status. Laws protecting confidentiality of medical records need to be strengthened as an incentive for workers at risk of contracting HIV to come forward for testing and counseling.

HIV/AIDS in the work place also calls for end to the usual adversarial relationship between management and labor unions. Since HIV/AIDS is now an emergency problem in the workforce, senior civil servants in Africa, political leaders and labor union leaders need to work together to minimize the impact of HIV/AIDS in the workforce. The key is to prevent new HIV infection, keep infected workers as productive as possible and provide timely support care for their families if the workers are too sick to work or die of AIDS.

I thank you for the opportunity to address this plenary session.

About the author: Chinua Akukwe is a former Vice Chairman of the National Council for International Health now known as the Global Health Council, Washington, DC and has written extensively on health and development issues in Africa.