Investment in treatment and care significantly reduces company health and social expenditure in Abidjan

Graham McKerrow, HIV i-Base

A study comparing the costs of HIV and the costs of treatment and care for employees of a private company in Cote d’Ivoire concludes that investing in the provision of antiretroviral treatment (ART) and care has significantly decreased company expenditure.

SP Eholie presented the findings of a study by colleagues at the Service des Maladies Infectieuses et Tropicales at Abidjan, Cote D’Ivoire. They assessed the impact of HIV and the impact of treatment of employees at a private electricity company at Abidjan with 3,500 employees.

They analysed social impact in the form of absenteeism and employee replacement, and the economic impact in the form of low productivity, cost of care, replacements and funerals over two time periods (1998-1999 vs 1999-2000) before and after the introduction of ARV therapy.

The researchers compared direct and indirect costs of offering care and antiretroviral treatment to HIV positive staff. There were 66 people on treatment. The management team in collaboration with the employees union set up a solidarity fund for ART and the promotion of voluntary HIV counselling and testing.

Eholie reported that the main effects of HIV were absenteeism, employee redeployment to other positions, and social impact in the form of fear and funerals.

The economic effects included low productivity and an increased number of medical consultations and hospitalisations. The average cost of treatment of opportunistic infections was $15,385 per patient. Other costs included $26,154 for solidarity funds and $107,692 for funeral expenses.

Eholie told delegates that sick leave was cut remarkably steeply, from 335 days per month to 22.5, and HIV deaths were down from 16 to nine in the two periods.

Between the two time periods, the costs of caring for positive employees decreased from $338,462 to $153,846, and opportunity costs from $1,539,077 to $61,538.

The researchers conclude: “Company-level strategy including work-based prevention activities, voluntary HIV counselling and testing, and the provision of care and ARVs has significantly decreased the company health and social expenditures.”

Eholie said that the findings advocate comprehensive HIV/AIDS counselling and treatment including ART. He said: “It is better to contribute for life than for death.”

—The Guardian newspaper reported on 7 August that Anglo American has become the first multinational corporation to provide its South African staff with free ART.


S P Eholie, E Bissagnene, A Gaumon et al. The socio economic impact of HIV/AIDS infection and of investment in antiretroviral therapies (ARVs) on a private company of Abidjan, Cote d’Ivoire. XIV International AIDS Conference, Barcelona, 7-12 July. Abstract MoOrB1096.

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