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Zimbabwe's seven-year economic crisis has forced private companies to make some difficult decisions about workplace programmes for HIV-positive staff. How do you provide life-prolonging antiretroviral (ARV) medication, care and support, when you're struggling to keep your business afloat?

"We are meeting real challenges in carrying out HIV/AIDS programmes at workplaces, and this inevitably comes from the macroeconomic problems that the country is going though," Nyika Mahachi, the HIV/AIDS programme advisor at the Zimbabwe AIDS Prevention Support Organisation (ZAPSO), told IRIN/PlusNews.

ZAPSO is a non-governmental organisation (NGO) addressing the epidemic in the workplace. "Because of the [economic] meltdown, companies are feeling the pinch; business is declining, profits are shrinking," he said, and the costs of running the programmes were too high.

New official figures released in November 2007 found that HIV prevalence rates have fallen by 10 percent over the past 5 years. The Zimbabwe Ministry of Health and Child Welfare based the new seroprevalence rate on HIV infection in pregnant women attending antenatal clinics, and estimated the level among the adult population at 15.6 percent, according to a UN statement.

Zimbabwe is suffering shortages of food, fuel, power, medicines and basic commodities; inflation is approaching a staggering 15,000 percent, and the country also has one of the world's highest rates of HIV infection.

"Companies are struggling to keep operating, and where they are expected to fork out money for HIV/AIDS programmes they easily back down, feeling that they could be throwing money into a bottomless pit at a time when they should be resuscitating their businesses," Mahachi said.

Although it was generally recognised that "a healthy workforce tends to promote production", he alleged that most companies "would rather have employees die [of AIDS] and then have them replaced" than meet the costs of running workplace HIV programmes.

Production had declined precipitously over the years and operations had suffered huge losses, so HIV/AIDS programmes were also being undermined by staff turnover, said Simplicius Samudzimu, executive director of a supermarket chain in the capital, Harare.

"Employees are leaving our company at an alarming rate to look for better-paying jobs both locally and abroad, and these include the committees tasked with coordinating and implementing the HIV/AIDS programmes ... there are too many disruptions, information is sometimes lost and levels of commitment differ," Samudzimu said.

Frequent changes in the committees also caused staff members to lose faith in the company's programme and seek help elsewhere. Even when the programme was still operating, HIV-positive staff often stayed away from work due to illness and being unable to raise enough money for transport.

"I pity those who have already fallen ill because the company does not have money to buy ARVs and, since it is failing to remit money to our medical aid scheme, the patients are being turned away when they seek help from hospitals and clinics," said Samudzimu.

Simon Phiri, the transport manager at a haulage company, said although their drivers who worked on cross-border routes were at risk of contracting HIV, and some of them were already living with the virus, his company had not bothered to start a programme to educate workers because they were preoccupied with the losses they were making.

"In the past five years we have grounded 10 trucks because we could not secure the foreign currency for new spares, and management thinks it would be a luxury to start an HIV programme for the workers, most of who are always on the road," he said.

Despite all these woes, there are companies that have recorded relative success. A workers' committee member at Barclays Bank said they had a vibrant committee that was providing counselling and treatment to its workers with the help of an NGO.

"Right from top management to the ground floor, people are committed to the programme," the workers' committee member, who did not wish to be named, told IRIN/PlusNews. "And I am happy to say there is hardly any stigma against those who have come out in the open about their HIV status, and one of them is actually a boss here."

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