Business leads the way

Ever since the Unit­ed Nations called for pri­vate-sec­tor help to deal with the glob­al HIV epi­dem­ic in 2001, multi­na­tion­al com­pa­nies have worked on drug dis­cov­ery and dis­tri­b­u­tion, employ­ee test­ing and treat­ment, glob­al edu­ca­tion­al out­reach, and HIV-relat­ed pover­ty and hard­ship. In many cas­es, these efforts have trounced the work of nation­al gov­ern­ments.

“Health issues cross bor­ders,” says Michael Schreiber, man­ag­ing direc­tor of GBCHealth. “No gov­ern­ment has a foot­print in Chi­na, Viet­nam and Thai­land, but a glob­al bank might. Multi­na­tion­als have the resources and geo­graph­ic spread to tack­le HIV every­where.”

GBCHealth, orig­i­nal­ly known as The Glob­al Busi­ness Coali­tion on HIV/Aids, was formed in 2001 to help glob­al com­pa­nies tack­le HIV/ Aids and to facil­i­tate part­ner­ships between com­pa­nies, gov­ern­ments, mul­ti­lat­er­al organ­i­sa­tions and non-gov­ern­men­tal orga­ni­za­tions (NGOs). It part­ners with more than 200 glob­al com­pa­nies and has offices in New York, Johan­nes­burg, Bei­jing, Nairo­bi and Moscow.

Many of those com­pa­nies have set up HIV edu­ca­tion, pre­ven­tion and treat­ment pro­grammes out of self­in­ter­est, ensur­ing that employ­ees stay pro­duc­tive and con­sumers stay healthy. But what­ev­er the moti­va­tion, the col­lec­tive impact has been so great that it has spurred pub­lic pol­i­cy changes. “Think how long it took the South African gov­ern­ment to recog­nise the prob­lem of HIV,” says Mr Schreiber. “With­out lob­by­ing from com­pa­nies oper­at­ing there, it would have tak­en even longer.”

He explains that pub­lic pol­i­cy often lags behind cor­po­rate action because, where­as pol­i­tics dri­ves gov­ern­ments, com­pa­nies are dri­ven by effi­cien­cy. So where­as pub­lic needle­ex­change pro­grammes, for exam­ple, are often con­sid­ered con­tro­ver­sial, sim­i­lar com­pa­ny-wide ini­tia­tives are pop­u­lar because they are seen to work.

The work of GBCHealth’s mem­ber com­pa­nies has evolved dra­mat­i­cal­ly since 2001, a time when access to med­ica­tion and cre­at­ing gen­er­al aware­ness were still fun­da­men­tal chal­lenges. Since the intro­duc­tion of anti­retro­vi­ral drugs, com­pa­nies are focused on increas­ing drug fund­ing and dis­tri­b­u­tion, while advo­ca­cy tar­gets high-risk groups. Com­pa­nies with­out an HIV pol­i­cy are rare and, increas­ing­ly, those oper­at­ing in loca­tions where both HIV and tuber­cu­lo­sis (TB) are preva­lent, such as min­ing firms, are tack­ling co-infec­tion.

Yet the hotspots are con­stant­ly chang­ing. Mr Schreiber cites new­ly resur­gent HIV epi­demics in the Unit­ed States, in Wash­ing­ton DC, for exam­ple, where 3 per cent of the pop­u­la­tion is infect­ed. For 18 months, Pfiz­er sales reps have been hand­ing out lit­er­a­ture to doc­tors there to per­suade them to rou­tine­ly offer patients HIV test­ing. “It’s been a very suc­cess­ful pro­gramme that has changed screen­ing behav­iours, which has ulti­mate­ly meant more peo­ple are get­ting treat­ed,” he says.

Com­pa­nies might be forced to do more now gov­ern­ment bud­gets around the world are shrink­ing

Despite the progress, com­pa­nies are often reluc­tant cham­pi­ons of their own HIV aware­ness pro­grammes. “Many com­pa­nies think that organ­i­sa­tions dri­ven by rev­enue and prof­it are con­sid­ered sus­pect when they talk about any­thing else,” says Mr Schreiber. “If you don’t acknowl­edge new devel­op­ments that ben­e­fit soci­ety, it’s a prob­lem because, when gov­ern­ments see some­thing work­ing, it’s eas­i­er for them to push ahead.”

Not all com­pa­nies are wall­flow­ers in this area. Take MAC Cos­met­ics, which launched the MAC Aids Fund back in 1994, and ploughs the pro­ceeds from its Viva Glam range into HIV/Aids pro­grammes. It is now the largest non-phar­ma­ceu­ti­cal fundrais­er for HIV/Aids organ­i­sa­tions glob­al­ly, fund­ing pro­grammes pro­vid­ing nutri­tion­al sup­port, hous­ing, health­care assis­tance, test­ing, and those tack­ling trans­mis­sion among young peo­ple, abused women and pris­on­ers, to name but a few.

One of the hall­marks of MAC’s Viva Glam cam­paigns, which have to date raised £150 mil­lion (US $235 mil­lion) for the fund, is its celebri­ty spokes­peo­ple who appear in high­im­pact adver­tis­ing and cham­pi­on the cause. RuPaul was the first spokesper­son in 1998, but there have been 20 since, includ­ing Elton John, Christi­na Aguil­era and Cyn­di Lau­per.

The cur­rent spokesper­son is Lady Gaga, who is pas­sion­ate about the cause and approached the com­pa­ny about get­ting involved. “Gaga is 25 years old,” says John Dem­sey, chair­man of the MAC Aids Fund and group pres­i­dent of Estée Laud­er Com­pa­nies, which owns the MAC brand. “The first spokes­peo­ple were affect­ed by Aids when they were already adults. Now our spokes­peo­ple have grown up in a world know­ing noth­ing but Aids. They speak authen­ti­cal­ly to their gen­er­a­tion, where there’s a lot of com­pla­cen­cy.”

Lada Gaga’s glob­al influ­ence, demon­strat­ed by her 16 mil­lion Twit­ter fol­low­ers and 45 mil­lion Face­book friends, has led to record-break­ing sales. In the UK alone, the cam­paign­raised £1.3 mil­lion in MAC’s 2011 fis­cal year, a 91 per cent increase over 2010. That cash sup­ports UK and South African pro­grammes, includ­ing one by UNICEF, which has already pre­vent­ed 50,000 moth­er­to- child trans­mis­sions of HIV.

How­ev­er, accord­ing to Mr Dem­sey, the com­pa­ny was not always so pub­lic about its work. “We were a lit­tle on the fence about how much we want­ed to tell peo­ple at first,” he says. “We didn’t want to seem self-con­grat­u­la­to­ry, but if we don’t sell the lip­stick, we can’t raise the mon­ey or give it away.”

He says that the tightrope which com­pa­nies often tread, when both high­light­ing and prof­it­ing from such a cam­paign, are irrel­e­vant in MAC’s case because 100 per cent of Viva Glam pro­ceeds go to the MAC Aids Fund. “If peo­ple ben­e­fit from oth­er cor­po­rate giv­ing, that’s great, but we are not sell­ing some­thing we earn mon­ey from, whether that is med­ica­tion or food sup­ple­ment. This was done for pure­ly altru­is­tic rea­sons.”

Still, the Viva Glam celebri­ty cam­paigns are cen­tral to MAC’s brand iden­ti­ty and cor­po­rate brands undoubt­ed­ly ben­e­fit when con­sumers endorse their approach to glob­al con­cerns. Mr Schreiber thinks that, if more com­pa­nies approached HIV/Aids pre­ven­tion from the top down, much as they appoint chief sus­tain­abil­i­ty offi­cers to cham­pi­on envi­ron­men­tal con­cerns, they would quick­ly reap still greater ben­e­fits, spend­ing less while win­ning over con­sumers.

Com­pa­nies might be forced to do more now gov­ern­ment bud­gets around the world are shrink­ing. That prob­lem is com­pound­ed by com­pla­cen­cy over the epi­dem­ic, even though Aids remains a top-ten cause of glob­al mor­tal­i­ty, which has meant infec­tion rates in some devel­oped coun­tries have increased.

“From the late 1990s to the ear­ly-2000s, this was a fash­ion­able cause to sup­port, but now most gov­ern­ments and organ­i­sa­tions are com­pla­cent that there is a cure for Aids, and that this is a man­aged health­care issue when that’s not the case,” says Mr Dem­sey. “That puts a tremen­dous respon­si­bil­i­ty on us.”

Yet hav­ing met orphans of the dis­ease and patients around the world, he’s seen first-hand how the fund­can rad­i­cal­ly improve people’s lives. “You can intel­lec­tu­alise this and dis­cuss how coun­tries have been robbed of their man­pow­er,” he says, “but until you grasp the ter­ri­ble human cost, you will nev­er under­stand the whole pic­ture.”

Ever since the United Nations called for private-sector help to deal with the global HIV epidemic in 2001, multinational companies have worked on drug discovery and distribution, employee testing and treatment, global educational outreach, and HIV-related poverty and hardship. In many cases, these efforts have trounced the work of national governments.