Health workers are at the frontline in providing prevention, treatment and care for people living with HIV and TB throughout the world. They are at risk of occupational exposure to HIV and TB but often themselves lack adequate access to protection and treatment. To address this gap, new international guidelines are being launched by the International Labour Organization (ILO), the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).
The new guidelines are important particularly for health workers in areas with high prevalence of HIV and TB, such as doctors, nurses and midwives, technical staff such as pharmacists and laboratory technicians, as well as health managers, cleaners, security guards and other support workers. There are an estimated 60 million health workers throughout the world.
"These guidelines directly aim to ensure that health workers have access to universal and standard precautions, preventive therapy for tuberculosis, HIV post-exposure prophylaxis, treatment, compensation schemes for occupational infection, and social security or occupational insurance at the workplace," says Assane Diop, ILO executive director for the social protection sector.
While UNAIDS, ILO and WHO have been championing universal access and making sure people have the right to access prevention, treatment, care and support for HIV and TB services, not enough attention has been paid to the needs of health workers. These guidelines help fill the response gap to reach toward the universal access objective.
"WHO recognizes health workers' risk of acquiring HIV or TB and the need for comprehensive occupational health and safety procedures," says Dr Hiroki Nakatani, WHO assistant director-general for HIV/AIDS, tuberculosis and malaria. "These new guidelines provide key recommendations to protect health workers, patients and their families from the significant threat of HIV and TB in all our health facilities."
The 14 action points provided in the guidelines are based on respect for workers' rights as well as practical workplace health and safety programs to ensure a safer work environment, active participation of health workers as well as public and private health services employers. The guidelines also address challenges such as the high level of stigma and discrimination associated with both diseases.
"Health workers are one of our most precious resources in the global response to both HIV and TB," says Dr Paul De Lay, UNAIDS deputy executive director. "These new guidelines can ensure that health staff have access to the highest standards of TB and HIV prevention, treatment and care so they can stay healthy and continue caring for others."
The new guidelines also drew strong support from the ILOs employer and worker constituents, with Mr. Antonio Peñalosa, Secretary-General of the International Organization of Employers (IOE), calling them "a useful tool to assist the health care sector in staff retention and motivation."
Sharan Burrow, general secretary of the International Trade Union Confederation, called them "a major breakthrough," adding, "With these guidelines, the ILO, WHO and UNAIDS are providing an important and scientifically sound basis for safe working environments that prevent health workers infections caused by exposure at work."
Recent surveys show that health workers prefer convenient and cost-effective solutions, including having dedicated HIV and TB services at their workplaces, and linking them to other occupational health services.
The guidelines which were developed jointly by experts from ILO,WHO and UNAIDS are based on systematic literature reviews, international consultations and an assessment of current practices in 21 country-based studies. They bring together a vast body of evidence and existing guidelines from the ILO, WHO and UNAIDS that now includes a specific and coherent focus on protecting health workers.