JOHANNESBURG, 25 June (IRIN) - The Ethembeni Care Centre in northern KwaZulu-Natal is set in a pleasant forest clearing just outside the industrial hub of Richards Bay. The region is in the eye of the HIV/AIDS storm in a province soon to experience negative population growth due to the disease. The hospice is currently home to nineteen patients, most are dying of AIDS-related illnesses. Volunteers lay their frail bodies out on the veranda every morning so they can enjoy the view and listen to the birds, between frequent bouts of TB-induced coughing.

Ethembeni is the first industry-funded AIDS hospice in South Africa, and its symbolic of changing attitudes towards the epidemic on the part of sub-Saharan Africa's biggest business community. "Although Ethembeni works with the terminally ill, this place is also a place of hope, HIV-positive workers come here to get well," Jenny Richards, health and welfare manager at the Zululand Chamber of Business Foundation told IRIN. The centre came about after concerned employers in the area joined together to address rocketing rates of HIV/AIDS infection in the workforce.

An International Monetary Fund (IMF) survey of South Africa, released in March, noted with concern that HIV/AIDS was threatening to adversely impact on much of the economic and social progress achieved to date. The United Nation's joint programme UNAIDS has estimated that South Africa's economy would be 17 percent smaller in 2010 than it would have been without AIDS. By then, the disease would have cost the country about US $22 billion. Johannesburg-based Deutsche Securities told IRIN that the costs to the South African economy would begin to rise significantly as HIV spreads among skilled workers, leading to lower productivity, bigger claims on benefit schemes and higher replacement costs of employees.

At the recent regional gathering of the World Economic Forum (WEF) in Durban, leaders heard how HIV/AIDS would devastate industry unless it was tackled head on. "It's late, but not too late," was the message from the forum. Experts agree that industry's "head in the sand" attitude towards HIV/AIDS is slowly changing.

One reason for the new realism is that HIV/AIDS is now manifesting itself at professional and managerial level in many companies in the region. "When unskilled workers were dying off, companies could in a way, live with AIDS, but now it has crept into management, replacing those staff is much more difficult and expensive," said Gillian Gresak of KnowAids, a Johannesburg-based HIV/AIDS education and counselling project.

South Africa's great mining houses have been badly affected by HIV/AIDS, and they are taking the lead in confronting the illness. Mining giant Anglo American is negotiating with an Indian pharmaceutical company to buy cheap generic AIDS drugs for its HIV-positive workers, estimated at 30 percent of the work force. "We recognise it's a big problem and somebody has to get up and show the way," Anglo South Africa's Senior Vice-President (Medical) Brian Brink, told IRIN. "There's too much talk and not enough action and the private sector must get on and do it," he added.

The company has almost finished drafting a treatment plan, which would include free or heavily subsidised drugs. Research has shown that providing workers with drugs is cheaper than paying for absenteeism, loss of productivity, hospitalisation, funerals and replacing and retraining staff.

National Union of Mineworkers (NUM) spokesperson, Lennox Mekuto told IRIN that Anglo's plans to provide miners with AIDS drugs should form part of a comprehensive strategy that looked at treating mineworkers' families as well as changing behaviour. Analysts agree that Anglo American's decision to provide subsidised drugs to workers represents a major change in thinking on the part of big business and is likely to be replicated in other companies.

Amid giggles, Monica Ismael, a shop steward in a Durban clothing factory, demonstrates how to use a condom to a dozen shy machinists. "My husband says skin-to-skin is best and that if I insist on a rubber he'll leave me," one woman complains to the class. Monica has been running her workshops every lunchtime for the past 18 months, trying to get the safe-sex message across in her work place. "My sister died of AIDS and its tragic how many have died here in this factory, mainly I think, through ignorance," she told IRIN. Her classes show how a successful partnership between unions and employers can help stem the spread of HIV/AIDS. "The company gives me paid time off to run the classes because they think it's important and also I can get through to the girls because I know them," she said.

The South African government has refused to provide drugs through the public health system for those living with HIV/AIDS despite major pharmaceutical companies dropping a joint lawsuit aimed at blocking a 1997 law allowing the import or production of cheap generic drugs. Health Minister Manto Tshabalala-Msimang maintains that even though such drugs are now cheaper, providing them to the millions infected remains unaffordable.

Although some large companies are waking up to the impact of HIV/AIDS, according to experts, there's still a long way to go. "Big business is now responding with programmes of prevention and care, but the problem is such companies are only part of the economic make up of South Africa, small industries are just not getting to grips with it," Alan Whiteside, director of the HIV/AIDS research division of the University of Natal told IRIN.

Tumi Molefe runs a cleaning business in central Durban and employs 12 women. She told IRIN that although she was concerned about AIDS, there was no way she could pay for AIDS education or continue to allow staff time off for funerals. "I assure you we would go bust within a month," she said. Economists note that regional growth will be driven by small and medium sized companies, and that they are likely to proliferate at the expense of large firms in the future. This makes HIV/AIDS prevention and care in this sector of the economy even more pressing, Whiteside argues.

It's companies like Tumi's that are being targeted by the Zululand Chamber of Business (ZCB), who recently launched subsidised HIV/AIDS training for employees in small enterprises. "Usually staff in this type of business have few employee benefits because the company simply can't afford it," Tony Wilde, Executive Manager of ZCB told IRIN. He added that lack of unionisation among workers in small businesses meant they often were not in a position to benefit from union-driven AIDS education and prevention programmes.

But Alan Whiteside believes that big companies need to do much more to help small and medium enterprises in tackling the epidemic. "Large businesses should link up with their smaller counterparts and say we're doing this, how can we help you?," he said. Whiteside also wants to see compliance regulations, wherein a small scale supplier, for example, would have to demonstrate that it had a progressive HIV/AIDS policy before doing business with a large corporation.