A decade ago AIDS was regarded primarily as a health issue. Today it is widely considered a development crisis affecting all social and economic sectors. The International Labour Office (ILO) supports the fight against HIV/AIDS because the very core of its work is being threatened by the epidemic. Its primary goal is to promote opportunities for decent and productive work in conditions of freedom, equity, security and dignity. Each of ILO's four strategic objectives - workers' rights, employment promotion, social protection and social dialogue - is directly undermined by the spread of HIV and its impact on the world of work. Because HIV infections are concentrated among adults, the epidemic affects the labour force even more acutely than the population in general, with far-reaching implications for families, enterprises and national economies. The ILO has a strategic role in the global response to HIV/AIDS through its capacity to mobilise its tripartite constituents - governments, employers and workers - and through its direct access to the workplace.

The impact of HIV/AIDS on the world of work

The majority of the 40 million people infected with HIV are in the prime of their working life: an estimated 25 million workers aged 15-49 years are living with HIV/AIDS. In high-prevalence countries, by 2020 the labour force will be between 10 and 30 per cent smaller than it would have been without AIDS. This affects the world of work in many ways. Workers are losing jobs and livelihoods, either because they become too sick to work or because they are dismissed on the grounds of their HIV status; many individual workers and their families suffer from stigmatisation and discrimination, as the epidemic undermines fundamental rights. Employers are losing skilled workers and seeing productivity fall. At the same time, labour costs are rising sharply due to increased health provision, recruitment and retraining costs, and funeral expenses. Savings are reduced, affecting investment, and market demand contracts for many goods and services. Finally, a contracting tax base, increased public spending, and a loss of skills combine to slow economic growth: the Gross Domestic Product of several African countries is expected to fall over the next decade, according to the World Bank.

The extent of the social and economic dependence on the economically most productive population becomes clear as children, especially girls, are forced out of school and into labour, sometimes under dangerous and exploitative conditions. A culture of blame falls on women in many countries, in addition to the greater part of the burden of care, and AIDS widows are rejected and marginalised. Health services and social security systems become overwhelmed with the needs of those with AIDS. Finally, poverty is growing and the Millennium Development Goals are under threat.

The ILO Programme on HIV/AIDS and the World of Work

The ILO Programme on HIV/AIDS was established in response to requests from its constituents worldwide and on the basis of the analysis of country needs by its field offices. The Programme was formally established in November 2000 with the aim of reducing the spread of HIV/AIDS, mitigating its impact in the world of work, and protecting the rights and dignity of workers and their families affected by the epidemic. It focuses on the following areas:

• research and policy analysis regarding the social, economic, and labour force consequences of HIV/AIDS
• advocacy at all levels regarding the implications of the epidemic for enterprises and for workers' rights
• technical cooperation support for employers' and workers' organisations
• setting standards and providing advisory services to guide national and workplace policies and programmes on HIV/AIDS.

In close collaboration with governments, employers and workers from all regions, ILO has developed a Code of Practice on HIV/AIDS and the World of Work, which was formally launched at the UN General Assembly Special Session on HIV/AIDS in June 2001. It was welcomed by heads of state, workers' and employers' organisations, UN partners, NGOs and a range of other stakeholders, including representatives from the private sector such as the Global Business Council. Using a rights-based approach, the Code establishes principles and provides practical guidance to governments, employers and workers, as well as other stakeholders, in the following key areas:

• prevention through education, gender-aware programmes and practical support for behaviour change
• protection of workers' rights, including employment protection, confidentiality, gender equality, entitlement to benefits and non-discrimination
• care and support, including confidential voluntary counselling and testing, as well as treatment in settings where local health systems are inadequate.

The Code applies to all employers and workers in the public and private sectors, and all aspects of work, formal and informal. The Code is not only intended for countries where the epidemic has a strong grip: it is also designed to prevent infection rates from increasing in relatively unaffected countries. The Code can be used as a basis for national workplace policies, guidelines for enterprises, collective agreements and training programmes. It can be an instrument for advocacy, in particular for strengthening the involvement of the private sector in action against HIV/AIDS, as well as a guide to the development and implementation of programmes in the community.

The UN's Special Session on HIV/AIDS endorsed ILO's role as a key partner in the global fight against HIV/AIDS by including provisions on the world of work in the Declaration of Commitment. The Declaration contains a call for workplace-based action and commits governments to adapting the national legal and policy framework accordingly. ILO's contribution to the UN response was strengthened through its co-sponsorship of the Joint UN Programme on HIV/AIDS (UNAIDS) since October 2001.

Implementing the ILO Code of Practice

ILO is working with several governments to develop or adapt their national labour legislation and AIDS policies on the basis of the Code, and is advising employers' and workers' organisations on sectoral and workplace policies and programmes. A training programme is being developed and an education and training manual is in preparation. Pilot programmes on HIV/AIDS and the world of work are being put in place in selected countries in collaboration with social partners and UN agencies. The Code has been used in the training of labour inspectors in Senegal; a joint programme with UNIFEM has been drawn up to address the issue of informal work and the care economy in relation to HIV/AIDS; and a project agreed with the Commonwealth Secretariat on the education sector in Botswana. The Code has been translated into over 20 languages in response to local demand.

ILO has developed its own personnel policy on HIV/AIDS based on the Code and other UN agencies - notably UNESCO, UNIDO and UNICEF - have approached ILO with an interest in developing personnel policies for their own employees. Copies of the Code (in English, French and Spanish) and the ILO Personnel Policy can be downloaded from the ILO website.