Ten years ago, attempts by businesses to talk about AIDS in the workplace were enough to make workers down tools. But after a decade in which Swaziland's AIDS epidemic has devastated its workforce, labour and management are finally starting to work together to reduce the spread of the disease.

"AIDS is as much an economic problem as a health problem in Swaziland," said Musa Hlope, former executive director of the Federation of Swaziland Employers and Swaziland Chamber of Commerce (FSE/SCC).

Under Hlope's administration, the federation set up the Business Coalition Against HIV/AIDS (BCHA), which organises AIDS testing and awareness programmes at member businesses.

"There is more awareness of AIDS in the workplace. Business owners know now how AIDS is affecting the bottom line," said programme officer Khosi Hlatshwayo. Management's awareness of the impact of AIDS on their businesses has tended to precede labour's willingness to accept the reality of the disease.

Ten years ago, the director of a refrigerator company with the largest factory in Matsapha Industrial Estate, outside the commercial hub of Manzini, told the local press that one-quarter of his workforce was infected with HIV.

"Management thought they were being enlightened and speaking in their workers' interest by divulging health conditions in the press, but it stirred great resentment," said Sandra Nkwanyane, an HIV voluntary testing officer in Manzini.

"Either he was speaking anecdotally, based on the absentee rate and doctors' visits by his workers, or he had some personal health information about his workers that the workers didn't know about. They downed tools in protest," she said. "The workers condemned him for humiliating them, because they said people would think they worked at 'the AIDS factory'."

Company management insisted that HIV was prevalent on its premises to the same degree as at other Swaziland companies. This was statistically proven when nationwide HIV surveys were conducted, but the assertion won little appreciation from the rest of the country's business community. Workers returned to building refrigerators after management issued an apology.

Ten years later, health workers say the positive change is striking.

This week, the country's largest value-added agriculture concern, timber processor and paper pulp manufacturer Sappi Usuthu, commenced a management and employee HIV-testing programme, with 2 full workdays set aside so 800 employees could be tested.

"You cannot manage what you don't know," said Jan Burder, acting general manager of the company, who was first in line to have blood drawn by BCHA counselling officer Mandla Malaza.

"The responsibility of curbing this pandemic does not only lie with the doctors, hospitals or government, but requires every individual to become involved," Burger told employees.

The workers seemed to agree, judging by the numbers entering the company's voluntary counselling and testing programme, administered by BCHA.

Turning point

A key selling point in encouraging participation, according to Nkwanyane, was guaranteeing confidentiality. "What set off workers at the refrigerator factory 10 years ago was this fear that their medical condition would be made public. We have worked hard over the years to convince people that their medical records are their own private possessions, and nobody has access to them without permission."

More than a quarter of Swazi adults are HIV-positive, according to a recent Ministry of Health household survey. Dr Alan Brand, a South Africa-based motivational speaker living with HIV, is working with BCHA's AIDS programme to address workers around the country on sensitive cultural issues that have accelerated the spread of the virus.

In Swazi culture, people with unknown mental or physical ailments are said to be possessed by "tilwane", or "wild animals", he said. "We need to say there is no 'monster' at the heart of AIDS, because our responses to HIV and AIDS are very important, and the word 'monster' has got every aspect of stigma loaded into it."

Brand tells workers' groups that managing HIV is easier than managing a disease like cancer, because HIV management is largely a matter of observing an antiretroviral (ARV) drug regimen and maintaining a healthy diet.

Worker acceptance of HIV testing, or even of speaking about AIDS in public, is one benchmark of a changing attitude toward the disease in the country.

Though AIDS is still widely regarded as a source of shame for infected individuals and their families, more HIV-positive people are coming forward publicly and, despite the stigma, more Swazis are voluntarily being tested, according to The AIDS Information and Support Centre (TASC) in Manzini.

"There are too many funerals; every weekend is taken up by these funerals. It is not allowed to say the person died of an AIDS-related illness, but people know the symptoms. They are concerned now, and they come and take the test," a TASC counsellor told IRIN/PlusNews.

AIDS programmes, both government and non-government, received a boost this week with the announcement that the Global Fund to fight AIDS, Tuberculosis and Malaria had approved a sum of US$81 million for Swaziland's AIDS fight in its seventh round of grants.