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YORK - March 26 - [ Problems are outlined in this letter sent
to Coca-Cola CEO Douglas Daft on March 26 2003, 6 months after
Coke first announced its initiative to make affordable AIDS treatment
to its vast workforce in Africa ]
Douglas
Daft, President
The Coca-Cola Company
P.O. box 1734
Atlanta, GA 30301
Re: 6 Months
and Counting: Coca-Cola Africa Foundation and Bottlers in Africa
HIV/AIDS Healthcare Program
Dear Mr.
Daft:
Health GAP
writes this letter: (1) to report continued deficits in the
planning and rollout of the Coca-Cola Africa Foundation and
Bottlers in Africa HIV/AIDS Healthcare Program; (2) to demand
on-going status reports and updates of operational outcomes;
and (3) to request a direct meeting with yourself and other
high ranking corporate executives to discuss our concerns in
person.
As you know,
in June of 2001, during the UN General Assembly Special Session
on HIV/AIDS, Coca-Cola announced efforts in to combat AIDS in
Africa in partnership with UNAIDS. Among the marketing and prevention
initiatives announced was a plan to provide or pay for treatment
of employees living with HIV/AIDS. Pressed by members of the
media to differentiate between the 1,200 direct employees versus
100,000 workers of the Coca-Cola system, Coca-Cola representatives
agreed to negotiate with its business and bottling partners
to provide access to AIDS treatment to the entire Coca-Cola
Africa workforce.
Beginning
in April of 2002, Health GAP and other treatment activists launched
a worldwide campaign against Coca-Cola for its failure to provide
a comprehensive workplace HIV/AIDS care and treatment program
for its workers in Africa and elsewhere employed directly or
indirectly by Coca-Cola's affiliated bottlers and distributors.
After demonstrations in New York, Washington, Atlanta, Boston,
and Barcelona in the summer of 2002, numerous universities taking
part in a "Kick Coke of Our Campus" campaign, an October
17 Global Day of Action on four continents brought additional
pressure against Coca-Cola to commit to a comprehensive and
sustainable workplace program.
Fifteen
months after its initial promise to negotiate with bottlers
on the provision of treatment to all of its workers in the Coca-Cola
system in Africa and shortly before the Global Day of Action,
the company for the first time committed in writing to enroll
all of its African system workforce in an HIV/AIDS healthcare
program that includes antiretroviral therapy, thereby launching
The Coca-Cola Africa Foundation and Bottlers in Africa HIV/AIDS
Healthcare Program. In subsequent correspondence and personal
communications, Coca-Cola representatives promised that all
bottlers and distributors would be enrolled by the end of March
2003.
As Health
GAP continued to engage corporations to adopt workplace policies
of non-discrimination and provision of prevention, care, and
treatment programs for workers and their dependents living with
HIV and as we have continued to follow the development of the
Coca-Cola HIV/AIDS Healthcare Program, we regret that Coca-Cola
has failed to show proof of commitment to the success of the
Program and in particular has failed to address multiple problem
areas that have previously been brought to its attention.
* Prompt
and efficient rollout of treatment programs: Coca-Cola needs
to revise its processes and address problem discussed further
below to ensure a rapid, efficient rollout of treatment in Africa:
-- While
Coca-Cola is in danger of missing its March 2003 deadline of
formally enrolling all bottlers in the cost-sharing scheme,
the real problem is the lack of progress on rolling out actual
treatment programs. Coca-Cola must announce a firm timetable
not only for enrollment of distributors but for implementation
of treatment.
-- Coca-Cola
must report on the number of programs, if any, implemented thus
far and the number of people living with HIV/AIDS who are eligible
for and receiving treatment, which are true indicators of Coca-Cola's
commitment--more so than memos of understanding between it and
its bottlers. Coca-Cola must continuously monitor and evaluate
the overall Program based on standard metrics and should thereafter
regularly and transparently make such reports available to Health
GAP and other stakeholders.
-- Rollout
of the Program will continue to be hampered unless Coca-Cola
streamlines the implementation process and requires distributors
to promptly contract, on standardized terms, with the designated
care coordinator, PharmAccess. Currently PharmAccess, a non-profit
foundation based in the Netherlands, which is contracted with
Coca-Cola to roll out its treatment programs, must negotiate
separate agreements with each of Coca-Cola's bottlers and distributors
individually in each country on all issues from planning to
procurement.
* Quality
of Care: Coca-Cola's insistence on a decentralized process and
the resulting lack off accountability has put the success of
the Program in jeopardy:
-- Coca-Cola
must cease giving mixed messages to bottlers about working with
Pharmaccess or launching a treatment program on their own. Without
universal standards and treatment protocols the quality of care
is threatened and the integrity of Coca-Cola's Program is compromised.
-- Coca-Cola
must centralize the program and put standard operating procedures
in place not only to ensure quality, but also to allow the efficient
procurement of drugs and diagnostics, consistent program-wide
monitoring and evaluation, and reliable system-wide reporting
methods.
* Treatment
Uptake: Throughout Africa, efforts to enroll people living with
HIV/AIDS in treatment programs is compromised by stigma and
discrimination and by a lack of treatment literacy:
-- Coca-Cola
must ensure that bottlers and distributors are upholding the
promise of confidentiality of all medical records without which
uptake of services is likely to suffer. Voluntary and confidential
HIV testing must be provided with clear statements on a universal
policy of non-discrimination.
-- Coca-Cola
must ensure that bottlers and distributors are implementing
a policy of non-discrimination and non-stigmatization and foster
a workplace and community ethos of care and concern for people
living with HIV/AIDS.
-- Coca-Cola
must support workplace treatment literacy campaigns which will
help educate system workers about the feasibility and pragmatics
of treatment and that encourages voluntary counseling and testing.
* Universal
rollout: Coca-Cola needs to extend the coverage of AIDS treatment
to Coca-Cola system workers in other developing countries.
-- The
current slowdown in Africa further delays the availability of
AIDS treatment to Coca-Cola workforce in developing countries
outside of Africa. Coca-Cola has hundreds of thousands of system
workers in other developing countries, including countries with
growing AIDS crises, and these workers too, and their dependents,
are entitled to meaningful access to life-saving treatment.
* 10% co-pay
for worker: Activists predict that the announced 10% co-pay
provisions will deter uptake of treatment, especially in light
of the relative low wages of workers, the relative high cost
of ARV treatment, and the possibility of multiple cases of HIV
infection in a particular family. Although Coca-Cola has promised
in writing that it "will not let inability to pay be a
barrier to treatment," it has failed to address activist
concerns that co-pays will negatively impact uptake. Accordingly,
we demand that Coca-Cola:
-- publicize
the costs of annual treatment against average bottler salaries
in each country;
-- monitor
uptake to be certain that 10% co-pay requirements are not negatively
affecting uptake;
-- review
and revise its 10% co-pay provision if reporting shows that
treatment uptake has suffered; and
* Cost-sharing
with bottlers: Coca-Cola has announced that its bottling "partners"
will need to cover 40% of program costs, but that "cost
sharing will not serve as a barrier to participation by all
bottlers in Africa." Coca-Cola must confirm its willingness
to negotiate with smaller and mid-sized bottlers about their
cost-sharing percentage and further than Coca-Cola is willing
to reconsider such percentages in the future as more workers
take advantage of costly ARV treatment programs.
* Cheapest
medicines: Coca-Cola has committed to expand its potential sources
of pharmaceutical products beyond those provided by GlaxoSmithKline,
depending on national intellectual property and drug registration
status. Coca-Cola should commit further to the principle of
utilizing low-cost generic producers wherever possible in order
to decrease costs to bottlers and workers.
* Sustained
corporate commitment: At present, Coca-Cola's commitment to
the Africa HIV/AIDS Healthcare Program is through its charitable
arm, the Africa Foundation. To solidify and ensure the Program's
success:
-- Coca-Cola
must publicly issue a formal corporate-level commitment to sustaining
the Program indefinitely. Activists rightfully question Coca-Cola's
long-term commitment to the Program in light of the statement
by Robert Lindsay, VP of Public Affairs & Communication
for the Africa Group, that the "Foundation will likely
withdraw because the financial burden [on the bottlers] will
become less."
-- As stated
previously, Coca-Cola must integrate HIV/AIDS workplace policies
and protocols into its system-wide operations as a minimum standard
for its bottling partners in Africa and must formally state
its commitment and generate timeline for extending coverage
for AIDS treatment, as part of a comprehensive HIV/AIDS workplace
policy, for its operations in developing countries outside of
Africa.
* Meetings
with Health GAP and public reports to stakeholders: After a
long delay, Coca-Cola reluctantly agreed to sponsor a meeting
between Health GAP and other activists with Robert Lindsay from
the Africa Foundation. At this point, given the need for a higher
level corporate commitment from Coca-Cola, we request a meeting
with the President and with Deval Patrick, Executive Vice President
and General Counsel, in order to discuss these programmatic
concerns and demands for expanded commitment. In addition to
requesting a meeting, and in light of ongoing operational concerns,
we also request a system of regular and transparent reports
every three months of operational milestones. The treatment
of workers living with HIV/AIDS, and their dependents, is too
important to fall to the back burner or to suffer unnecessary
delays and problems because of poor information flows and limited
external accountability.
Sincerely,
Sharonann
Lynch and Brook K. Baker, Health GAP
cc:
Clyde Tuggle, Senior Vice President, Public Affairs and Communications
Deval L. Patrick, Executive Vice President and General Counsel
Alexander Cummings, Jr., Chief Operating Officer for Coca-Cola
Africa Robert Lindsay, Vice President, Public Affairs &
Communication, Africa Group
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