Heineken to offer antirerotviral drug coverage to African workforce

Heineken brewery is at the “leading edge of an effort by multinational [companies] … to forestall a wipeout of Africa’s labour force,” by guaranteeing antiretroviral drug coverage to its African workforce of 6,000 and their “immediate dependents,” Forbes reports.

Over the last year, Heineken has offered antiretroviral drugs to its employees in Rwanda and Burundi, and is beginning the programme in Nigeria, Ghana, the Democratic Republic of the Congo and the Republic of the Congo. Countries with “rickety hospitals and laboratories,” such as Sierra Leone and Chad, or countries where Heineken has a minority stake in breweries, such as Angola and Morocco, will be last, Forbes reports.

Heineken has hired not-for-profit PharmAccess, which trains local doctors to administer the antiretroviral drugs, to run the $2 million-a-year programme. In one brewery that employs 600 workers, Heineken was losing an average of 10 workers or dependents a year to AIDS-related deaths, but last year it lost only one worker, who refused the drug treatment. “If we don’t do anything and say, ‘Okay, let nature take its toll,’ then within seven years 20% of your senior management (in Africa) is gone,” Hans van Mameren, head of Heineken’s AIDS programme, said. However, the programme “has been a struggle” because only 30% of the workforce in Rwanda has taken an HIV/AIDS test, Forbes reports. Furthermore, Heineken’s medical staff “has to make up rules as it goes along” because the eight-page company AIDS manual does not specify exactly what constitutes a dependent; in some of the countries it is legal to have up to four wives, according to Forbes.

Heineken must also deal with the Nigerian government, which charges a 20% import duty on all medications, and airlines that do not want to carry HIV-infected blood from countries without good laboratories for testing. Other problems include ensuring that employees do not resell the drugs and ensuring that employees pay a “token contribution” toward treatment in order to encourage HIV-positive patients to maintain their drug regimens, Forbes reports. “We can’t give drugs away for free, or we become an NGO,” van Mameren said (Sansoni, Forbes, 2/3).

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