World AIDS Day is observed every year on December 1, in support of those living with HIV and to remember those lost to HIV/AIDS. This year’s theme is Global Solidarity and Shared Responsibility.

Workers here in Canada and around the world have long called for meaningful investments in public health care, protections for frontline workers and global access to medicines and vaccines. The global response to the COVID-19 and HIV/AIDS pandemics must aim to eliminate stigma and discrimination and ensure the protection and promotion of human rights.

“No one is safe until everyone is safe,” says CLC President Hassan Yussuff. “People living with or affected by HIV have been made especially vulnerable by the COVID pandemic, and not only in terms of increased health risk but in terms of access to the medications they need.”

The pandemic has drastically impacted the lives and livelihoods of workers around the world, highlighting strong connections between access to health care and social inequality. It has exposed existing racial, gender, social and economic inequalities, hitting the poorest and most vulnerable the hardest.

Between 2014 and 2018, the number of new HIV infections in Canada rose by 25.5%. Globally, in the last year, 38 million people were living with HIV and 25.4 million people were accessing antiretroviral therapy, 1.7 million people became newly infected with HIV and 690,000 people died from AIDS-related illnesses.

“Canadian unions are pushing back against austerity and privatization measures to ensure a robust response and recovery that ensures our collective well-being,” said Yussuff. “The current strain on our public health care system threatens access to HIV prevention, testing, treatment and care. Now more than ever, we need a Canadian plan that’s rooted in our way of doing things – and that means taking care of one another.”

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With effective treatment and care, many people living with HIV are leading long and healthy lives. In 1990, a 20-year-old diagnosed with HIV was not expected to live past the age of 40—today, that same person could live to age 70. Between 2000 and 2018, HIV-related deaths fell 45 percent worldwide.

Unfortunately, the cost and accessibility of treatment regimes in Canada varies from province to province. In some provinces, access to HIV medication is covered in all cases, while in others, access depends on how a person was exposed to the virus and whether or not they have private insurance. Coupled with drug prices as high as $1,000/month, the inequity of coverage intensifies.

“Provinces with little to no coverage are forcing Canadians to make tough decisions about medications. These inconsistencies stress the issue that no health care system is truly universal without coverage for medications,” said Hassan Yussuff, President of the Canadian Labour Congress. “Canadians with life-threatening illnesses deserve a universal pharmacare plan that would ensure they can get the medication they need, when they need it, regardless of where they live or their ability to pay. We all deserve that peace of mind.”

As part of World AIDS Day, the World Health Organization is calling for universal health coverage around the world. Canada’s unions want to ensure that coverage includes adding prescription medication to our valued public health care system.

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The Canadian Labour Congress is working with the International Labour Organization (ILO) and the Trade Union Congress-UK to support the National HIV Workplace Assessment in the sub-Saharan nation. Nigeria has the second largest HIV epidemic in the world.

Key stakeholders including the Nigeria Labour Congress, government, and health organizations coordinated the workplace assessment. Based on ILO Recommendation 200, the survey will emphasize the role of trade unions in Nigeria and throughout the continent, by linking Occupational Safety and Health (OSH) programs to HIV and AIDS awareness raising, prevention, testing, and treatment. This important work will help reduce gaps in HIV testing and treatment, and will support global efforts to end AIDS by 2030.

Researchers will use the information to identify any gaps in the current system, to inform national priorities and programs, to plan future workplace interventions and to help secure funding for trade unions to continue this important work.

Significant progress has been made in the AIDS response since the launch of the first UN World AIDS Day in 1988. This year’s theme “Know Your Status” aims to eliminate the stigma around HIV testing by focusing on awareness and encouraging individuals to get tested.

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Over the past 15 years, progress against AIDS has inspired a global commitment to end the epidemic by 2030. The CLC established an HIV/AIDS Fund in 2002.

Over the last three years, the fund has also supported the undertaking of a national assessment of HIV/AIDS in the workplace in Nigeria. Nigeria’s HIV epidemic affects all population groups and geographic areas of the country.

The International Labour Organization (ILO)’s Recommendation 200 highlights the role of workplaces in facilitating access to prevention, treatment, care and support of those diagnosed with HIV and AIDS.

“We are working in partnership with the Nigeria Labour Congress and ITUC-Africa, with support from the ILO, the UK Trades Union Congress and Canadian affiliates to carry out these workplace assessments,” said CLC President Hassan Yussuff.

The baseline data on HIV and AIDS in the workplace will help ensure that workers are included in national action strategies aimed at ending the epidemic by 2030.

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• 90 percent of all people living with HIV will know their status;
• 90 percent of those diagnosed with HIV will receive sustained treatment; and
• 90 percent of those receiving treatment will have suppressed viral loads.

Unions have long been part of the fight against HIV/AIDS, through awareness-raising; developing workplace policies; investing in local, national and global initiatives; advocating for government action; and challenging stigma.

Here’s a look at what Canadian unions are doing now to get us to 90-90-90 by 2020.

Internationally

For the past two years, the Canadian Labour Congress has been involved in an historic project in Nigeria: a partnership between Canadian and Nigerian unions, governments, and employers to help Nigeria meet the International Labour Organization (ILO) standard on HIV/AIDS.

After initial meetings, the CLC engaged an on-the-ground national coordinator to support African unions calling for national HIV/AIDS assessments. Since this February, she has been working with the ILO; the International Trade Union Confederation; and Nigerian government, unions, civil society and other stakeholders to hold the first-ever national assessment on HIV/AIDS in Africa. Those involved hope the assessment will not only make change in Nigeria, but also serve as a model for other countries.

The work in Nigeria would not be possible without the support of the Canadian HIV/AIDS Labour Fund. Since the fund was established in 2003, unions raised more than $500,000 to support unique, collaborative projects with unions in the following countries: Nigeria, Tanzania, Kenya, Zimbabwe, Uganda, Mozambique, Senegal, Ghana, Botswana and Rwanda.

Thousands of workers in Africa have received preventative education through this fund, which has also supported testing programs, union HIV/AIDS conferences, production of awareness materials, and incorporation of gender analysis into HIV/AIDS work.

In Canada

For over a decade, the Canadian Labour Congress has worked to support HIV/AIDS education, prevention, testing and treatment, through partnerships with Canadian organizations like the Council of AIDS Service Organizations, RESULTS Canada, the Canadian Network for Maternal, Newborn and Child Health, and coalitions like the Interagency Coalition on AIDS and Development, and the Global Treatment Access Group.

There is still work to do. Right now, HIV prevalence in Canada is still increasing — up 9.7 percent since 2011. Approximately 21 percent of Canadians with HIV are unaware of their status.

The Canadian government endorsed 90-90-90 last year, and unions are challenging the government to implement concrete plans to get us to those targets.

Plans must involve the communities most impacted. Men who have sex with men have HIV incidence rates 131 times higher than other men. Canadians from HIV-endemic countries, and Indigenous communities are also disproportionately impacted. Only by working with these communities to tackle stigma and support education, prevention and treatment, can we get to 90-90-90 in Canada.

December 1 is World AIDS Day. Statistics in this article are from CATIE.

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After the CLC brought the idea to the Canadian High Commission in Nigeria, the Nigerian Labour Congress, the Nigerian government, the Nigeria Employers’ Consultative Association (NECA) and other key partners signed on to the project. The goal would be to adapt lessons from Canada in order to assess Nigeria’s compliance with the International Labour Organization (ILO) standard on HIV/AIDS, and make recommendations for change.

“We came out with an historic agreement between unions, government and employers to take the first steps towards making Nigeria’s workplace sites of progress in the fight against HIV/AIDS,” said CLC President Hassan Yussuff.

Now, on World AIDS Day, December 1st 2015, the Canadian Labour Congress and its partner, the International Trade Union Confederation (ITUC-Africa) are planning the next steps for Nigeria, and looking to expand the model agreement to other African nations.

In Nigeria, there is still work to be done to complete the assessment and recommendations, and hurdles are likely to emerge, such as the criminalization of homosexuality in that country.

“The ILO standards acknowledge that we cannot fight HIV/AIDS without also fighting stigma, discrimination and inequality,” Yussuff stated, “The process cannot ignore that.”

Ultimately, Yussuff hopes having all the key players at the table – along with invited representatives from other governments with strong HIV/AIDS strategies: Norway, Sweden, the United Kingdom, and United States will lay the foundation for improving human rights at the same time as public health.

While participating governments supplied some funding for the work in Nigeria, The CLC’s HIV/AIDS Labour Fund was also instrumental. The fund was established in 2003 to assist the CLC and its affiliates to support unions in the global South to prevent HIV/AIDS and address the impact on workers and their families.

Since its inception, more than $500,000 has been raised and put towards union and workplace programs and policy advocacy in the following countries: Nigeria, Tanzania, Kenya, Zimbabwe, Uganda, Mozambique, Senegal, Ghana, Botswana and Rwanda. For example, the fund has supported peer education, testing and counseling programs, union HIV/AIDS conferences, surveys, production of awareness and training materials and specific projects on supporting women and gender analysis in HIV/AIDS work.

“Thousands of workers in Africa have received preventative education and counselling treatment because our Labour Fund has supported the HIV/AIDS work of their unions,” Yussuff said.

Yussuff sees this work as a key part of the labour movement’s role in advancing the UN’s new Sustainable Development Goals (SDGs). Goal 3 is “to ensure healthy lives and promote well-being for all at all ages,” includes a target of ending AIDS by 2030.

“Unions, governments and employers in all countries need to work together for us to meet the UN target of ending the AIDS epidemic by 2030,” said Yussuff.

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Globally, 35 million people live with HIV, and 19 million of these do not know they are HIV-positive. Although HIV infections have dropped by 38% since 2001, there were 2.1 million people newly infected in 2013. Young women and adolescent girls are disproportionately at high risk, as more than 4 out of 10 new infections among women occur in 15-24 year olds. There are also 22 million people with the disease who are not accessing life-saving treatment.

The figures underscore the critical role of workplace training, education, and concrete actions to address the pandemic both here in Canada, and the rest of the world.

In cooperation with the African Regional Organisation of the International Trade Union Confederation (ITUC-Africa), the CLC calls on member states of the International Labour Organization (ILO) to step up efforts for implementing the ILO R-200 – HIV and AIDS Recommendation, 2010 [No. 200], concerning HIV and AIDS and the World of Work (R-200).

The CLC also urges the Canadian government to follow up on its own R-200 assessment that it undertook in 2011, and to support educational programs for workers within Canada and in other countries.

The current Ebola crisis is a grim reminder of the consequences of sidelining health systems for preventing, detecting and treating any pandemic, including AIDS. Throughout the world, health systems need to be strengthened, along with better social and financial support of workers who have become victims of AIDS.

The CLC calls on the Canadian government to intervene in the UN negotiations on the Post-2015 Development Agenda, in order to incorporate the above issues within existing targets for the ILO Decent Work Agenda and to support the Get to Zero Discrimination strategy by UNAIDS.

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Abuja, Nigeria — A series of meetings in Abuja between union, government and business representatives of Nigeria last week concluded an agreement to assess the country’s compliance with the only international standard on HIV and AIDS in  the workplace, known as Recommendation No. 200 (R200) of the International Labour Organization (ILO).

The agreement has set up a tripartite process for a national assessment on HIV and AIDS, which will identify gaps in addressing the pandemic through the world of work via joint union and employer actions. An initial meeting will identify the terms of reference and scope of the assessment. Discussions are now underway with funding agencies to support the initiative.

The Nigeria Labour Congress (NLC) welcomed the agreement as one that could have lasting impact on the lives of Nigerian workers and their families. The national Ministry of Labour and Productivity has agreed to lead the process, with the involvement of the Federal Ministry of Health.

The Nigeria Labour Congress (NLC), Nigeria Employers’ Consultative Association (NECA) and the Nigerian Business Coalition against AIDS (NIBUCA) will be key players, with the ILOAIDS and UNAIDS assisting in and contributing to the process.

The process was also welcomed by the National Agency for the Control of AIDS (NACA). This agreement is seen by observers as a needed boost to the country’s Comprehensive Response Plan (PCRP) by reinvigorating private sector engagement to the ambitious targets set by President Goodluck Jonathan. R200 promotes dialogue between workplace actors and aims to address the underpinnings of HIV and AIDS, including human rights, stigma and discrimination, as well as equality and gender issues.

Last week’s discussions were initiated by the Canadian High Commission in Abuja and the Canadian Labour Congress (CLC) to draw on Canada’s experience in conducting a similar assessment. The Embassy Representatives from Norway, Sweden and the United States joined in the discussions, as each have international HIV and AIDS programs of their own.

The driving force behind last week’s meetings is a five year old partnership agreement between the CLC and ITUC-Africa and over a decade-long partnership between NLC and CLC. The partnership is now examining how the process can be extended to other countries. A concluding meeting with unions from Ghana and Togo examined this possibility, along with a representative from LO‑Norway, a Norwegian trade union centre with HIV and AIDS projects throughout the African continent.

For more information, contact:
Maureen Onyia-Ekwuazi, Senior Assistant General Secretary, Nigeria Labour Congress
Email: maureenonyia75@gmail.com

Lucien Royer, Director, International Department, Canadian Labour Congress
Email: lroyer@clc-ctc.ca

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