‍Gaps in workforce health strategies exposed

By: Old Mutual Corporate

Over the past three decades, South Africa has achieved a significant reduction in adult HIV incidence, while AIDS-related deaths have declined since their peak in 2004. This success has been underpinned by a large-scale public antiretroviral rollout, decisive political leadership, and consistent support from international donors.

Now, however, significant cuts to donor funding — most notably from the US government through USAID — are placing that progress at risk. South African employers may face a rise in tuberculosis (TB) cases, increased disability claims, and mounting absenteeism as the impact of funding reductions begins to surface, warns Brice Salence Nunes, Head of CVP Group Assurance at Old Mutual Corporate.

“With reduced funding, a critical layer of support — particularly in education, awareness, and HIV testing — is being removed from the healthcare system,” says Salence Nunes. “This puts early intervention at risk and creates fertile ground for preventable infections like HIV to escalate — with real consequences for workforce health and productivity, especially in high-density or mobile sectors.”

HIV and TB are closely linked, as people living with HIV are significantly more vulnerable to developing active TB. “While HIV remains a long-term health challenge, TB is highly contagious and poses a more immediate threat to workplace stability because it spreads so easily and requires a relatively short but intensive treatment period — typically lasting six months,” she adds.

The Role of Business

"With the more prominent and extensive donor-funded prevention programmes falling away, much of this gap will now need to be filled by the private sector — particularly by those with a vested interest in workforce health and wellbeing,” says Blessing Utete, Managing Executive at Old Mutual Corporate Consultants.

“Organisations that fail to invest in education, testing, and support programmes upfront may end up paying for it later in the form of rising sick leave and declining productivity. With reduced donor support, the public sector’s capacity to scale outreach and prevention is constrained,” he adds.

“Employers can play a meaningful role — making a clear business case to move beyond fragmented wellness programmes and adopt integrated employee benefit solutions that address physical, financial, and emotional well-being. Prevention is significantly more cost-effective than cure.”

Lessons in prevention

While public health efforts have been central to South Africa’s HIV response, some of the most effective workplace interventions have come from employer-funded programmes — particularly in mining and manufacturing.

Through onsite clinics, routine screenings, treatment adherence monitoring, and ongoing education, these industries have significantly reduced infections and improved workforce stability. “Mining and manufacturing have taken proactive steps by investing early and independently in comprehensive workplace health strategies — a contrast to sectors like retail and transport, which are still evolving their employer-led health systems,” says Salence Nunes

“These sectors — historically epicentres of HIV and TB risk — have shown what’s possible through sustained investment in employee health,” she continues. “These were not donor-driven interventions — they were privately funded, business-led responses to operational risks. Rather than waiting for external support, these industries recognised the cost of inaction early on and embedded health into their workforce strategies. Their success sends a clear message to other sectors: proactive investment in employee wellbeing is not only possible — it’s good business.”

Practical Steps Employers Can Take

Old Mutual Corporate Consultants recommend several actionable steps that employers can implement immediately:

• Host wellness days to encourage voluntary testing and early detection. These are proven to boost the uptake of screening services and reduce stigma around HIV and TB in the workplace. Hosting wellness days and encouraging people to go for testing really makes a difference.
• Use mobile health services to reach remote or decentralised employees. Sectors like retail and logistics can replicate successful mobile clinic models used in mining.
• Communicate medical benefits and entitlements clearly. Many employees are unaware of what they can access—or avoid using due to stigma. Member education is important, as stigma attached to diagnosis prevents employees from utilising benefits.
• Partner with service providers for counselling and adherence support. Specialised health organisations that offer workplace-based chronic disease management and return-to-work coaching can help employers navigate difficult health conversations and support employees living with long-term conditions — with compassion, clinical expertise, and consistency.
• Early intervention programmes often lead to better outcomes. The strategic implementation of appropriate medium-term measures related to wellness and early detection plays a significant role in the management, claims experience, and cost optimisation of group risk benefits offered by employers. These measures are essential to ensuring that benefits remain sustainable.

The withdrawal of donor-funded programmes is more than a public health concern—it’s a systemic risk to workplace productivity. “Employers who fail to act may find themselves absorbing rising costs in the form of absenteeism, disability claims, and staff turnover,” concludes Utete. “The success of employer-funded responses in mining and manufacturing proves that business-led health strategies are not only viable, but essential — particularly as public funding declines. Employers across all sectors now have an opportunity to lead where it counts.”