FICSA Circular 898 2001

FICSA/CIRC/898,Geneva, 27 April 2001

    HLCM TASK FORCE ON HIV/AIDS IN THE UN WORKPLACE

Geneva and New York, 23 April 2001

  • The Task Force was held as a videoconference in New York and Geneva. Participants included representatives from CCISUA, FICSA, HLCM, JMS Geneva, UNAIDS, UNDP, UNICEF and WHO. Mr. Roger Eggleston, Secretary, HLCM, chaired the meeting.

  • FICSA requested that several items on the programme be taken up prior to the item on the health-related website for UN staff and their dependants. The Chair did not agree to that request.

    I. Regular reporting on the implementation of the ACC policy

  • The HLCM Secretary reported that a revised questionnaire had been distributed to all organizations on 21 March 2001, with a request for reply by 20 April 2001. To date, only four organizations had replied.

  • FICSA commented that the ACC policy, which had been adopted ten years ago (1991), a fact which was also pointed out by UNDP, served as the backbone of the UN system response to staff and dependants living with HIV/AIDS. It was subsequently decided that organizations "report every two years on implementation of the 1991 policy". This reporting was to serve several functions: to identify areas of progress and areas where improvement was needed. The report also assisted in identifying and communicating best practice and served as a reminder to organizations of the importance of keeping the policy considerations in the forefront of their actions regarding the personal and occupational safety of their staff.

  • FICSA stated that it had requested a copy of the draft revised questionnaire before it was distributed. Unfortunately, FICSA did not receive either the draft or the final version of the questionnaire. The HLCM Secretary responded that the Federation's comments had been taken into account in revising the questionnaire, and that it had been an oversight that the Federation had not received a copy of the final questionnaire. A copy would be sent to FICSA.

  • The replies to the questionnaire would be analyzed by the HLCM Secretariat and presented to the next meeting of the Task Force in May 2001.

    II. Feasibility study on the development of a universally accessible health-related website for UN staff and their dependants
  • The Secretary of HLCM began by pointing out several questions which needed to be asked: Do you want to proceed with this project? How do we go about raising the funds needed to implement this? And what should be included on the website?

  • A paper compiled by the HLCM Secretariat - Content for Healthnet - was provided for discussions. The paper included a Health Insurance Information Note prepared by WHO, a compilation of AIDS-related websites, and information prepared by WHO on Post Exposure Prevention (PEP) kits.

  • Participants commented that the material provided by WHO was too specific to that organization's administrative processes regarding health insurance and the PEP kits. It was agreed that information to be posted on the website should be more generic to ensure that it applied to all staff in all localities.

  • The UN Medical Director briefed participants about the content of the new health-related website that would be available in the next month or so. The site would be accessible through the UN intranet. The UN insurance unit also had a site to explain health insurance benefits. FICSA asked whether it would be practicable for the Medical Service site to host the Healthnet, thereby ensuring that staff would know where to find any health-related information, including that related to HIV/AIDS. Dr. Nerula also pointed out that it would be difficult to present information on medical insurance schemes as, at present, there existed 19 different schemes in the system. However, thought could be given to providing links on the website to different schemes.

  • The HLCM Secretary responded that it was necessary to have two separate sites that could be linked. The HLCM Secretariat believed that this approach was the most practicable, as not all staff had access to a site hosted on the UN intranet. FICSA stated that it seemed cost-effective and logical to have only one health-related site targeted to staff, and that, as examples of the feasibility of having both intranet and websites, both JIU and OHRM had already done so.

  • The HLCM Secretary reported that no funds had been made available to set up and maintain the website. The cost of setting up the site had been estimated at $25,000. The HLCM secretariat was in touch with a graduate school in Lausanne (EPFL) to explore the possibility of obtaining the services of a graduate student to set up the site as part of an academic credit. The Medical Director offered the services of a G-5 staff member who will maintain the Medical Service website. Nick Fucile offered to assist, provided that the software, Net It, is used. The importance of maintaining up-to-date links and of having back-up personnel to maintain the site was stressed by the representative of UNDP.

  • The Task Force suggested that links be established between the various health insurance sites throughout the common system since there were 19 different health insurance schemes. They agreed that all information should be made available to local staff, in all working languages. Focus should be on HIV/AIDS information, which should not be duplicated with information that is readily available elsewhere. The AIDS booklet for UN staff should be posted in all available languages, including a Portuguese translation that had been done in either Mozambique or Angola.

  • On the issue of interactivity, by which staff would be able to send queries through the site to administrators and medical personnel on health and benefits questions, the HLCM Secretary stated that this type of service would not be made available right away. FICSA expressed its disappointment at this development, since one of the main selling points of the Healthnet had been the fact that field staff would be able to interact with a specialist at a headquarters duty station.

  • On this item, it was agreed that:

    1. a cost estimate should be made for setting up and maintaining the site;

    2. the information on the site should be available at first in English, French and Spanish;

    3. participants would provide comments on the 'Content for Healthnet' document;

    4. the site should include a generic description of insurance coverage, in particular for HIV/AIDS;

    5. AIDS hotline numbers in various countries should be included;

    6. the South African Theme Group paper should be posted;

    7. a survey should be carried out jointly with the Medical Service;

    III. Medical insurance coverage for national staff in the UN system
  • Insurance coverage varied throughout the organizations. The Task Force reiterated the concerns expressed at its earlier meetings and ACC sessions: the need for staff and their dependants to know exactly what their insurance coverage is; and the need to ensure that, whatever the organization's health insurance arrangements may be, staff members of all organizations in all locations will be treated equitably in terms of reimbursement levels for the cost of treatment of major illnesses, including HIV/AIDS.

  • The Task Force re-iterated its recommendation that the insurance scheme reimbursement ceilings be reviewed. The representative from UNICEF was particularly concerned with both the ceiling and the 20 per cent cost for the staff member until the deductible figure is reached. She pointed out that this problem was particularly acute for local staff in the field - against their salaries, this out-of-pocket expense was a burden. She wondered whether the ceilings imposed were actually preventing staff from submitting claims.The HLCM Secretary pointed to the need to recruit a consultant for this work, and FICSA asked for a copy of the Terms of Reference, in order to be able to comment.

  • The Task Force also reiterated its earlier request that administrations review carefully recruitment and contractual practices in respect of staff hired on repeated short-term contracts especially with regard to the applicability of health insurance provisions.

    IV. Continuing prevention measures
  • FICSA repeated a request made during an earlier Task Force meeting that an actuarial study be carried out to determine the costs to the organizations of NOT providing care and treatment. The participant from WHO commented that the organization had hired a consultant to look at national contracting staff. Several participants informed the meeting that national staff were in some cases not accessing the treatment to which they were entitled, perhaps because of confusion around the payment ceilings, and also because of the stigma associated with the disease. The representative from UNDP commented that more prevention work is needed in the field, in all areas, including dental. She also pointed to the discrepancies caused by differences in contractual arrangements under both the 100 and 200 series staff rules.

  • It was recommended that a letter be sent to the heads of HR departments on the subject of distribution of HIV/AIDS information.

    V. Access to care and drugs
  • The Task Force agreed that the Guidance Note for the United Nations Resident Coordinator System should be distributed; the Key Step document should also be sent to all Resident Coordinators. FICSA suggested that the job descriptions of the Resident Coordinators be revised to include the duties outlined in the Guidance Note. It was also suggested that the performance appraisal reports address whether these responsibilities are being enforced. FICSA also requested that administrations ensure that the Facilitation Guide on AIDS and HIV-infection is distributed to all Resident Coordinators.

    VI. Post Exposure Prevention (PEP) treatment starter kits
  • Several participants reported that the PEP kits had been widely distributed, and were replaced when they expired. Recently no staff member had required a PEP kit. A request had been received from the International Rescue Committee (IRC) for the kits.

    VII. Training of administrative staff in existing social security provisions
  • The Task Force agreed that a generic curriculum needed to be developed. It should include the following topics: confidential treatment of claims, benefits and procedures, and where to access data on entitlements. The participant from UNICEF informed the Task Force that she would look into the development of training modules with that organization's head of training.

    VIII. Continuing prevention measures
  • Discussions focused on the publication "AIDS and HIV Infection: Information for United Nations Employees and Their Families" - its distribution and availability in languages, and the Facilitation package. The Task Force was informed that OHRM (UN) was developing an orientation programme for all staff that was available on CD-rom. The programme was four hours long. It was also suggested that a check be made with the training section of DPKO to see what awareness packages were being distributed to troop-contributing countries and that there is a UNAIDS/DPKO collaboration on a pocket guide giving out information on awareness training. The HLCM Secretariat would look into the possibility of including a component on HIV/AIDS on the CD-rom.

    IX. Follow-up

  • The Task Force agreed to hold its next meeting in May, prior to the UN General Assembly Special Session on AIDS.

  • Round Table
  • At the recent IAAG meeting, the possibility of a Round Table on HIV/AIDS in the UN Workplace was discussed. No follow up action on this item was reported at this meeting, and the IAAG minutes recording the decision were not yet available.