Mail & Guardian (Johannesburg) - June 30, 1995

PAUL Truyens' response to Cheryl Carolus' criticism of the life insurance industry's policy on HIV and Aids, (M&G June 15 to 22), cannot go unanswered.

Truyens' argument that the life assurance industry is justified in excluding people from all forms of life assurance -- and thus in cutting them out from access to financial services such as home loans -- is short- sighted and irrational. It also fails to meet the central thrust of Carolus' argument, which is that life assurers in South Africa owe a duty of social responsibility to our society as a whole. In this the life assurance industry is at present abjectly failing.

Everyone in South Africa will be affected by Aids. To draw a distinction between the "rights" of the "non- infected" versus the "infected" is misleading and counterproductive. This issue requires the co-ordinated efforts of government, labour and business if we are to emerge from apartheid without recreating a new regime of discrimination.

The current policy of insurance companies threatens to undo efforts towards understanding and resolving the impact of Aids, both on the lives of individuals and on the nation as a whole. Carolus and her husband wanted to secure a home loan -- not to obtain life assurance. An HIV bar would not only brand her permanently uninsurable, but also ban her from home ownership.

This has significant implications for racial matters. As African and coloured South Africans are now finally able to become home owners, these new requirements frustrate their access. Conversely, current home owners (who are disproportionately white) are not forced to undergo testing, forgo their rights of privacy, risk the inevitable threat to confidentiality of test results, nor face direct and unfair discrimination.

In addition, the preponderance of black persons with HIV among the rising national levels renders any policy of HIV exclusion inherently suspect. This criticism focuses on the effect, not necessarily the intent, of such a policy.

It is critical to the nation's economy that HIV status becomes de-linked from financial services such as housing bonds, education insurance, and basic loans. Many economic forecasts already predict financially deleterious effects because of the premature loss of highly productive lives in the Aids epidemic. This factor is made significantly worse by insurance companies closing off all persons with HIV from access to financial security.

It is medically established that a person with HIV may lead a healthy, asymptomatic, fully productive life for more than 15 years after acquiring the virus. Denying people with HIV from access to economic opportunities and services is thus not only ethically unjustifiable but financially irrational. There are currently an estimated 1,2-million cases of HIV in South Africa, with a projected rise to 10-25 percent of our total population. Denying financial viability to a significant portion of our domestic labour force is an exercise in economic injustice.

If persons with HIV are uniformly excluded, Truyens' "current policy holders" (who largely resemble the white home owners) will still have to pay -- through the taxes and trade-offs incurred by shifting the burden to public assistance. Further, if Truyens' calculations regarding the impact of Aids on the life assurance industry are correct, continued discrimination is pointless. Since HIV exclusions primarily apply to individual policyholders and not the vast body of group-based insurance, the system will be overwhelmed anyhow. Moreover, since nothing prevents an individual from contracting HIV the day after becoming insured, the industry's approach can only safeguard against those already diagnosed.

If the insurance industry is interested in safeguarding itself from the Aids epidemic, it should cease discrimination. The National Academy of Science in the United States has warned that "(t)he general threat of discrimination in employment or insurance ... may deter individuals in high-risk groups from being tested to ascertain their antibody status. Since knowledge of antibody status may prompt some individuals to adopt healthier behaviour, social disincentives to testing should be minimised."

The National Convention on Aids in South Africa (Nacosa) holds a similar view, which is also endorsed by the Department of Health. The Nacosa National Aids Plan recognises that discrimination encourages denial and failure to seek education or change behaviour: "Combating all forms of discrimination is therefore crucial to preventing or limiting the spread of Aids."

Goodman works for the Aids Law Project at Wits University's Centre for Applied Legal Studies

In any event, one of the few reliable studies on the economic impact of Aids in South Africa states that "current evidence suggests that the degree of exposure will not be sufficient to constitute a threat to the viability of insurance companies, especially in view of their substantial reserves". (Jonathan Broomberg et al, The Economic Impact of Aids in South Africa, September

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