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Helping Lesotho's factory workers to stitch up HIV and AIDS
The health of Lesotho’s garment sector – and its workers – affects the lives of hundreds of thousands of people in a country with the third highest HIV prevalence in the world. Women employees in this sector are most at risk and are usually the only breadwinners, supporting their own and extended families back home.
Garment factory owners, government and even rock stars, have recognised HIV and AIDS as a major threat to productivity. With the help of DFID, they have joined forces to combat the disease in the largest job sector in Lesotho, through an initiative called The Apparel Lesotho Alliance to Fight Aids (ALAFA).
By having access to free condoms, advice and anti-retroviral therapy in their workplace, as many as 4,500 workers are already seeing a difference in their lives. One garment-worker says: “It used to take me all day to receive treatment at government clinics because the queues were too long. Now I go to the doctor I choose after work and I am finished there within one hour”.
What is at stake?
The Lesotho garment sector is the largest employer in Lesotho with 46,000 workers. 80% are women, most of whom are the head of households and providers for over 10% of the population of Lesotho. Two-thirds of Lesotho’s most vulnerable households are headed by women, with a downturn in remittances from male household members due to the decline in the mining industry in South Africa.
Lesotho’s HIV and AIDS prevalence rate is estimated at 23%. The preliminary report from the first Lesotho Demographic and Health Survey (DHS) finds that infections are peaking at 43% for women (in the 35 – 39 age group) and 41% for men (in the 30 – 34 age group). Women employees in the garment sector are in the most high risk category.
How does ALAFA work?
The intervention brings together the local and international private sector to provide a comprehensive prevention and treatment programme for the entire garment sector workforce. A DFID funded programme, ComMark Trust, supported the research, development and launch of the programme.
The intervention is in the very early stages of rolling out its treatment programme, but about 4,500 workers in the pilot programme are already benefiting from this approach. They are able to consult medical practitioners on-site, and no longer have to queue up at government medical clinics, saving themselves and the factories lost time.
On the prevention side, 60,000 condoms were distributed to three factories within three months – a very encouraging sign in a scenario where condom distribution previously had been completely haphazard or non-existent. Condom distribution will be ongoing and rolled out to other factories.
ALAFA is also developing, in conjunction with local service providers, best practice guidance on Peer Education. Peer educators will receive training based on standardised materials and ongoing coaching and mentoring to maintain a common standard throughout the industry.
All these interventions will help to reduce new HIV infections, improve the care and treatment of people living with HIV and have a wide-ranging impact on morbidity and mortality among the apparel industry workforce and their dependents.
Why is ALAFA so unique?
The programme is unique because it specifically targets the entire and most productive sector, and largest employer in Lesotho. It directly benefits women-headed households. It is distinctive because of the public, private nature of the programme. A successful example has been the partnership between the Ministry of Health and Private Medical Practitioners to ensure quality delivery of Anti-Retroviral Treatment (ART).
DFID funding has helped to develop ALAFA’s institutional capacity and enhance coordination of the private sector – a major challenge in a highly competitive environment and a sector prone to negative publicity around labour standards.
ALAFA has very strong support from international and local businesses and as a result has attracted significant international interest and funding. A number of major US clothing brands that source in Lesotho have made financial commitments to ALAFA. It is an example of the market giving back resources to the very poor people who are manufacturing the goods.
Who is involved?
In the three months since the programme’s launch in May 2006, ALAFA has raised funding commitments in excess of £310,000 from brands, retailers and donors. These include GAP Inc, who has made an amount of $120,000 available. This is part of the Project Red campaign, initiated by Bono, lead singer of the rock band U2 and prominent development activist.
The DFID-funded ComMark Trust has been instrumental in coordinating the range of partners involved in this initiative. ComMark has worked with the garment industry in Lesotho since 2002 and is recognised as a key partner by government and the factory-owners. DFID’s contribution to the programme is £200,000. Other international donors have also joined the initiative, with Irish Aid contributing €100,000 to ALAFA for 2006.
Bono, who shared the stage with British High Commissioner Paul Boateng at the launch, stated: “It was a remarkable thing to see where garment workers can come forward and say “test me” – because there is no point in coming forward if you cannot get access to drugs and I think the ALAFA programme is an absolute paradigm shift in the way business should be done”.
Relevant links
Making Commodity and Service Markets Work for the Poor in Southern Africa. Read
the underlying research that led to the establishment of ALAFA at
www.commark.org
Gap Inc. is producing t-shirts for their Product (Red) Campaign in Lesotho. A
percentage of profits will be donated to the Global Fund to Fight AIDS,
Tuberculosis and Malaria. Read more athttp://gapinc.com/red/
ALAFA has been included in Lesotho’s proposal for funding for Round 6
submitted to theGlobal Fund to Fight AIDS, Tuberculosis and Malaria