UN CARES
THE UN’S WORKPLACE POLICY
AND PROGRAMME ON HIV/AIDS
“We all need to understand HIV better. As Secretary-General, I am determined to lead the United Nations family – in ensuring that we prioritize action on HIV, and that we make the UN a model of how the workplace should respond to it.”
Ban Ki-moon, UN Secretary-General
This statement was made by the Secretary-General at the launch of UN cares in May 2008. It highlights his personal commitment and leadership to ensure the UN is a socially responsible employer and model of good workplace policies and practice on HIV. This is closely linked to the responsibility of the UN and its staff to be informed and aware about HIV/AIDS and its implications for our work.
Why be concerned?
Geneva-based staff may wonder why they
should be concerned about HIV/AIDS in a
region where the epidemic is largely under
control. Although prevalence in most of Europe
is below 1% – which is the threshold
for an epidemic – infection rates are on the
increase in a number of countries. While
HIV/AIDS has become a chronic treatable
condition, it can still not be cured; there
may be side effects or even resistance to
treatment. What is more, the disease is still
heavily stigmatized. Within the UN, 1.4% of
staff are estimated to be living with HIV –
many of them may not be open about their
status for fear of discrimination.
A Swiss study has shown that 70% of people living with HIV are working full-time. However, the vast majority of them do not reveal their status at work, for fear of being avoided by colleagues, losing out on promotion or being dismissed on other pretexts (Pärli, Caplazi & Suter 2007). These fears have negative consequences for the individual and his or her work environment. If people know their status and feel comfortable to make it known to selected managers and colleagues, their needs can be taken into account and arrangements made to ease their working situation. For example, if at a certain time a person needs more frequent medical appointments, days of sick leave, or adjustments of their tasks, these needs can be more sensitively understood and planned for – to the benefit of the individual and the whole team.
Fear of stigma may also lead to withdrawal and loneliness, and may discourage individuals from seeking medical help and support. Many misconceptions leading to stigma stem from lack of information, so it is in the best interest of all staff to be informed about modes of transmission as well as ways in which HIV cannot be transmitted. Such knowledge not only enables us to protect ourselves in our private lives but also helps prevent stigma and create a more accommodating work environment.
As UN staff any one of us – men and women – may be vulnerable to HIV infection, often without realising it. Many of us live apart from our families, or travel for extended periods, finding ourselves in unfamiliar and sometimes difficult social and working environments where we may experience loneliness, new demands and stresses. Others may try new partnerships, marry and settle down here in Geneva. It has been said that love can be a ‘risk factor’ for HIV, too. We do not expect to be harmed by those we love and trust, or cause harm ourselves; but being unaware of one’s HIV status can put others at risk. Furthermore, many of us have children and teenagers who grow up in international Geneva, who may already be travelling the world, and are exposed to new experiences. Parents have a responsibility to empower their children to make informed decisions, to be aware of the risks they may encounter and the ways they can protect themselves.
The UN cares about its staff
The UN has long recognized the impact of
HIV/AIDS on its staff as well as on its work,
and adopted the ‘United Nations HIV/AIDS
Personnel Policy’, applicable to all UN system
organizations, as early as 1991. Since
the approval of the original policy, various
organization-specific and inter-agency efforts
have been introduced to address HIV in the UN system workplace. Since 2001,
the ILO Code of practice on HIV AIDS and
the world of work has provided a common
policy framework for all such programmes.
To ensure coherence and efficiency, and
to avoid duplication on the operational
level, UN Chief Executives decided to consolidate
activities into a single harmonized
programme to meet the needs of the entire
UN system in the spirit of “Delivering as
One.” In May 2007, UN Secretary-General,
Mr. Ban Ki-moon, launched UN Cares as the
common UN system workplace programme
on HIV/AIDS. It reinforces efforts to mainstream
HIV/AIDS in UN organizations, and
highlights the role of the UN workplace during
World AIDS Day.
UN Cares Minimum Standards:
an implementation framework
UN Cares is an inter-agency programme
designed to reduce the impact of HIV on
the UN workplace by supporting “universal
access” to a comprehensive range of information
and services for UN personnel and
their families. These are summarized as the
ten UN Cares Minimum Standards, to be
achieved by 2011.
The first three standards are related to information. Taken together, they represent the Learning strategy which has been in place since 2002. As part of this strategy, and now integrated in UN Cares, it is required that all staff have information on prevention of transmission, on how to access treatment and other services, and on UN policies and benefits related to HIV. For example, it is important to be aware that HIV tests are not required of those seeking employment with the UN and that neither HIV infection nor AIDS-related illness can be considered a basis for terminating employment as long as the employee is fit to work.
Over the years, a range of learning materials and tools have been developed. The booklet Living in a world with HIV and AIDS has been translated into all official UN languages, as well as many others. It is available, together with other educational material, including e-learning courses and videos, on the UN Cares website (http://www.uncares.org). The UN Cares Services Directory provides information on services available at all duty stations, including those provided by the UN medical service and outside the UN (accessible via www.uncares.org, login with your agency and your continent as password). Confidential one-to-one advice is offered by the HIV staff counsellor in New York, Nick Fucile, who can be reached at +1-212-963-4782 or fucile@un.org.
To provide up to date information, and to create awareness about rights and responsibilities in relation to HIV and AIDS, UN Cares training sessions are held in several UN agencies in Geneva, including UNAIDS, WHO and ILO. Some UN organizations have made participation in such training mandatory for their staff; UN Secretary-General, Mr. Ban Ki-moon, has himself attended a session in New York. In Geneva, there are currently two options available, both of which are conducted by trained, volunteer facilitators: the interactive HIV learning sessions and Wild Fire, an innovative role-play approach (see box). Sessions especially targeted at spouses and families are offered by some agencies.
UN Cares Minimum Standards four to ten relate to services, for example the provision of condoms or access to confidential voluntary counselling and testing which is offered at UN medical centres, or at recommended facilities listed in the UN Cares Services Directory. In addition, medical service staff can provide information and advice about how to protect oneself during missions and how to access services at other duty stations. Accidental exposure to blood, which may or may not be HIV-infected, can occur through accidents in the home, on the road, or at work. HIV risk can be reduced through practising universal precautions and avoiding direct contact with blood. Gloves should be available in all UN first-aid kits. In case of occupational exposure to HIV, for example a needle-stick injury to a health worker, or in the case of sexual assault, starter kits for postexposure prophylaxis (PEP) are available at all UN duty stations in the field. In headquarters locations they can be accessed through the emergency departments of hospitals. In Geneva, this is the Cantonal University of Geneva Hospital (http://www.hug-ge.ch/). PEP involves one month of antiretroviral medication and may reduce the risk of becoming infected with HIV. To be effective, PEP must be started within 72 hours of exposure, and, as it can have severe side effects, it has to be closely supervised by medical experts. In principle, insurance has to cover HIV-related costs for UN staff members like any other chronic illnesses: 80% or more depending on the agencies.
Finally, managers on all levels have to commit to support implementation of these standards. They should encourage their teams to participate in the learning sessions and create an atmosphere in which staff members feel safe in addressing even personal issues in as far as they affect their work. The coverage of the UN Cares programme is extensive and comprises staff of over twenty organizations in the UN system in 117 countries. It is driven at country level by UN agencies in the UN Theme Group or Joint AIDS Team. The programme is led by a global coordinator based in New York, and supported by regional coordinators and a Task Force of focal points representing all participating UN agencies at both country and headquarters levels.
UN Plus – focal point for staff
members living with HIV
Harmonization within the UN system is further
enhanced through collaborative partnerships
between UN Cares and UN Plus,
the UN staff association of people living with
HIV and AIDS (www.unplus.org). Founded
in 2005 by thirty-two HIV-positive UN employees,
its membership has increased to
more than 150 worldwide. A newly-established
women’s forum now also addresse the special needs of its female members.
UN Cares Minimum Standards
- Information about UN policies and benefits
- Information about preventing transmission of HIV and accessing services
- Learning and training activities on stigma and discrimination
- Access to male and female condoms
- Voluntary counselling and testing
- Insurance covering HIV-related expenses
- Confidential handling of personal information
- First aid using universal precautions
- Rapid access to PEP starter kits
- Managerial commitment
With UN Plus, staff members can find confidential advice, for example on the issue of travelling. A number of countries still practice HIV-related travel restrictions; some twenty even require proof of HIV-negative status upon entry and a medical examination can be required as a prerequisite for granting work and residence permits. Persons who are HIV-positive may be denied entry or the right to stay. Restrictions such as these can make it difficult for HIV-positive United Nations employees to attend conferences and meetings or to rotate to other duty stations. UNAIDS, UN Plus and several other organizations advocate for the removal of such discriminatory laws which are contrary to the ILO Code of practice and contravene human rights.
UN Plus also advocates for improved policies to accommodate the needs of HIV-positive UN staff members. It systematically evaluates issues of interest to members, including, for example, insurance policies in different agencies and for different contract types.
UN Cares and UN Plus have been working together closely on issues related to UN staff, and in developing information material, organising training sessions and events. In 2009, they are partnering on a “Stop Stigma” campaign to disseminate key anti-discrimination messages. This campaign complements the 2009 World AIDS Day theme of ‘Universal Access and Human Rights’ and it is imperative to protect human rights and promote access for all to HIV prevention, treatment, care and support.
UN Cares: a strategy to prevent HIV
and promote staff wellbeing
HIV/AIDS is one of the biggest global challenges
of our time. This has been recognised
by its inclusion in the Millennium
Development Goals: goal number 6 aims
at halting and reversing the trend of the expanding
HIV epidemic by 2015.
HIV and AIDS concern us all. As UN staff we have a special responsibility to address this issue in our work, to protect our colleagues, families and ourselves. Working in diversity has many dimensions which include creating a compassionate and safe environment that welcomes and cares for all people living with chronic conditions such as HIV/ AIDS. Each and every one of us can make a small contribution to increase wellbeing and satisfaction at our very special workplace – the United Nations.
1 Special thanks for substantive contributions from Jill Caughley (ILO), Susan Leather (ILO), Eva Lustigová (WHO), Marika Maillot (ILO), Bhatupe Mhango (UNAIDS), Laurie Newell (UN Cares, UNFPA), Alan Silverman (UNAIDS), Y. Chanyalew (ILO), A.S. Mohamed (ILO).