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The World's Epidemic

“Today’s leaders will be judged by history as to how they combated the AIDS epidemic.” So challenged Peter Piot, the Executive Director of UNAIDS, to a crowd of students, faculty, and business leaders this past Thursday at the Kennedy School’s Arco Forum.

Mr. Piot was the keynote speaker of last week’s two day workshop that brought together business executives with government officials, activists, and academics to better understand the potential roles and responsibilities that businesses have in addressing the HIV / AIDS crisis in Africa and Asia. Reflecting the cross-sectoral challenge of the crisis, the sessions were coordinated by faculty from the Business School, the Kennedy School, and the School of Public Health.

The workshop was the first in a series of four sessions that will conclude back in Cambridge this September after meeting in Beijing, China and Durban, South Africa this spring. The work sessions aim to help businesses understand the extent of the crisis, to challenge them to think broadly about the boundaries of their business, and to identify effective partnerships for addressing the impact of HIV / AIDS in the workplace and beyond.

Following opening remarks by University President Lawrence Summers, Barry Bloom, the Dean of the School of Public Health, put the extent of the crisis in perspective.

Forty two million people are infected with HIV / AIDS across the globe and almost 15,000 people are dying each day from the virus.

The pandemic has hit hardest in southern Africa with one out of five adults infected in South Africa and one out of three in neighboring countries such as Botswana. While the incidence has yet to hit comparable rates in Asia, it appears to be at the same place Africa was a decade ago. UNAIDS estimates that by 2010, 10 to 15 million people will be infected in China and 20 to 25 million in India.

As Piot summarized in startling clarity, “Nothing less than life and death for millions of people is at stake.”

With this staggering challenge clear, the two day workshop set out to create a forum for business executives from more than 25 companies to share current practices and challenges. The participants were involved in panel discussions, breakout groups, and even an HBS case study of Heineken’s HIV / AIDS policies facilitated by Professor Diana Barrett of the Business School.

Many of the participating companies have been deeply affected by HIV / AIDS in the workplace and have recognized a need to act. Coca-Cola estimates that of its 57,000 employees in Africa — most of whom are employed by partner bottlers — 9.3% or approximately 5,335 employees are in infected. The costs to the company are multiple and considerable: absenteeism, funeral expenses, training of 2-3 people for each job, operational disruptions, and low morale.

Coke has been the target of a vigorous global protest campaign. While it is providing treatment for the 1200 employees of the corporation, it faces significant obstacles to treating the employees of its partner bottlers who operate independently across 53 countries. Coke does not own these bottlers and contends that it cannot dictate their policies. More importantly, it points out that it does not have the capabilities to undertake the necessary comprehensive prevention and treatment programs.

As Robert Lindsay, VP of the Coca Cola Africa Group commented “Eighty-four percent of our bottlers are ready to support treatment programs for their employees – we need partners, we need eighty doctors for two years, we have the money but we don’t have the capacity.”

Like Coke, many of the participants clearly recognize that the success and effectiveness of any HIV / AIDS program will have to involve partnerships between businesses and government, nonprofit organizations, and trade unions. Companies like Heineken and Anglo-American have worked closely with organized labor to set up comprehensive programs.

Piot noted that serving your own employees was the “bottom line responsibility for each business,” but challenged businesses to push the “boundaries of enlightened self-interest” and to think beyond the workplace.

For some companies, this means a moral reckoning that they have unique capabilities to address the crisis. Bill Roedy of MTV International has commented that MTV is “very well-suited for the fight.” Last year, MTV in partnership with UNAIDS aired a global program to educate youth about prevention. Ajat Gupta, Managing Director of McKinsey & Company, over a dinner interview with David Gergen of the Kennedy School, explained to attendees how the consulting firm would begin assisting governments in the implementation of HIV / AIDS related programs.

For other companies, a decision to go beyond the workplace reflects a concern for the long-term viability of the African and Asian markets.

Lindsay asked the attendees what they thought “Coke would do if a competitor came into one of its markets and threatened to take 20-30% of its sales away – this is what AIDS is doing in Africa.” As such, Coke has pledged to use its extensive distribution network to distribute condoms and its marketing expertise to help with prevention campaigns.

After two days of discussions, an executive from Merck summed up a sentiment shared by many of the attendees: “The need to act is clear and the financial resources will be committed. But the limiting factor now is not financial, it is human capital.”

The complexity of the partnerships required to change the trajectory of this horrible tragedy require great leadership. This will be the true challenge for the global business leader of the 21st century.

March 3, 2003
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