Boston Globe
5/26/2003

  WASHINGTON -- The United Nations, which has long called on corporations and countries to extend HIV/AIDS care and treatment to those in the poor world, is now under attack by AIDS advocates for not practicing what it preaches with its subcontractor workers.

The issue has arisen from drawn-out negotiations for people who work full time at the UN's Kenya compound but are employed by an outside contractor. AIDS activists say the UN has failed to ensure that those subcontractors receive HIV/AIDS medical coverage and has also failed to raise the issue throughout the UN system.

The Global AIDS Alliance, which was contacted by some of the workers in Kenya, prodded the UN privately for eight months but decided in recent days to go public and give extensive documentation on the impasse to the Globe in hopes of securing health benefits for those in Kenya and in similar situations at other UN offices.

''We want the UN to be the beacon of human rights in the world, and this shows they are not,'' said Paul Zeitz, director of the AIDS alliance, a worldwide advocacy group based in Washington. ''This is about getting your house in order. . . . The UN is using a double standard: one for itself and one for the rest of the world.''

In one of the documents passed on by the alliance, the UN's special adviser for HIV/AIDS in Africa, Stephen H. Lewis, said in an Oct. 19, 2002, e-mail that the UN Kenya office needed to quickly address the matter. He sent the message to UN officials in Kenya; Mark Malloch Brown, UN Development Program administrator; and Peter Piot, head of UNAIDS.

''If we are contracting out cleaning and related services to employers whose labour policies in general are egregious, and in particular around HIV/AIDS are unacceptable, we could find ourselves [legitimately] vulnerable to public criticism,'' Lewis wrote.

An official at the UN spokesman's office, asked about the Kenya negotiations, said that UN policy is not to provide health care for consultants or those who work for contractors. ''It is incumbent for those people to pay their own taxes, health insurance, and life insurance,'' said the official, who spoke on condition of anonymity. ''That is written in the contract. That is across the board. They are responsible.''

UN officials in Kenya say they are still working out details for new contracts with five businesses that would ensure a ''living wage'' for all workers, which is defined as enrolling ''staff members in a medical insurance scheme for outpatient and inpatient cover.''

In Kenya, more than 243 subcontractors work in the UN Gigiri compound and take care of building maintenance, electrical maintenance, cleaning, landscaping, and cafeteria food service.

Zeitz and one of the workers said the living wage coverage does not yet include treatment for HIV/AIDS, other sexually transmitted diseases, or opportunistic infections. It also doesn't include counseling for those infected with HIV.

So far, the UN in Kenya has renewed two of the five contracts with the outside companies after determining that the living wage conditions already existed; last week, a task force on HIV/AIDS-related assistance endorsed the living wage package and said that it should be enforced in future negotiations.

The UN case in Kenya, say Zeitz and other advocates, closely parallels that involving Coca-Cola and other large employers in Africa who have been targeted by activists for not providing HIV/AIDS care to workers and subcontractors. A campaign against Coca-Cola resulted in the company's decision to give benefits to its bottlers, who are not direct employees but work as subcontractors. Robert A. Lindsay, Coca-Cola Africa's vice president of communications, declined to comment on the issue in an e-mail message.

''I think this is incredibly hypocritical of the UN,'' said Sharonann Lynch, a member of Health GAP, which spearheaded the campaign against Coca-Cola. ''UNAIDS is charged with setting policy regarding HIV/AIDS. That means Peter Piot is out in the world talking about the need to mobilize resources to fight HIV/AIDS. How can they leave their own workers behind?''

Lynch, who said she was not aware of the situation inside the UN until contacted by the Globe, said that her organization is considering similar campaigns ''against international agencies that refuse to provide care.'' One target, she said, may be the UN.

Despite UN official policy on consultants or contractors, Johanne Girard, chief of human resources at UNAIDS in Geneva, said in an interview that her organization has been advocating HIV/AIDS care for all UN workers -- including subcontractors in poor countries with high HIV/AIDS rates.

''We are fighting, pushing, insisting, advocating that there is some coherence between our messages and our actions,'' Girard said. ''We are trying to live up to the recommendations of what the world should be doing. . . . If we are going to be effective in our fight against HIV/AIDS, it starts at home.''

Girard said she has twice brought up the Kenya situation recently in meetings attended by human resources officials from a spectrum of UN agencies. ''We need to be a socially responsible employer, and so we need to be pushing the rest of the community outside,'' she said.

Told of Girard's statements, Zeitz of the Global AIDS Alliance replied, ''That's a first step. But what are they doing about it? Why aren't they attacking this problem systemwide?''

Lewis, the HIV/AIDS adviser to UN Secretary General Kofi Annan, said that he had believed the issue with Kenya was resolved following a meeting with UN officials in Nairobi last month.

But told that the UN would follow living wage requirements in the contracts, Lewis immediately dismissed that approach.

''Living wage is a concept that you can compare with minimum wage,'' he said. ''In a country like Kenya, where the minimum wage is not a living wage, you have got to . . . include premiums for health insurance, and that is way beyond what these contracts reflect. Otherwise, it is not going to work.''

Paul Andre de la Porte, the head UN administrator in Kenya, said in an e-mail reply to questions that bureaucratic issues have tangled up the process.

''Here in Kenya we have 85 different UN bodies and offices, with different budgetary approval processes and authorities, and getting them to agree on HIV/AIDS insurance and coverage for subcontracting parties does not present any problems of principle but it does present many practical problems,'' he wrote.

A cleaner at the UN compound in Kenya, who spoke on condition of anonymity because she feared losing her job, said that she is paid the equivalent of $53 a month.

''They only give us salary, there is no insurance,'' she said in a telephone interview from Nairobi. ''If I have a medical problem, I have to pay it out of my salary, and hospitals are so expensive here.''

In Lewis's Oct. 19 e-mail, he wrote that the UN was probably operating like all businesses -- looking for the lowest costs.

But he added, ''In the presence of AIDS we have an obligation . . . to do everything in our power to negotiate the best possible set of protections into our contracting out arrangements,'' Lewis wrote. ''I don't get the sense that that's now happening. get the sense that in the classic traditional ways, we're simply trying to get the best financial deal.''

John Donnelly can be reached at donnelly@globe.com

This story ran on page A1 of the Boston Globe on 5/26/2003.