A good driver is an asset, one who manages your assets and those of your customer. If you do not look after your assets then you will be throwing money to the wind, a financially insane policy.

The value of a truck and trailer, and the goods that it carries, usually adds up to a lot of money – in many cases millions of rands. These assets are entrusted to and placed in the hands of a driver and sent off to a distant location with the belief that the goods will be delivered to your customer’s customer and your truck and trailer will be returned for the next load. Given that this happens time after time, your truck driver, in real terms, is an asset to your company, and is in fact, in the execution of his responsibilities, an effective asset manager. Looking after your driver therefore makes good financial sense.

However, the susceptibility of long distance truck drivers to ill-health and HIV transmission due to the nature of the work, typically long delays at border posts, and the resulting negative impact for companies, communities and families are well known facts. In spite of the efforts of many international, regional and local initiatives of various non-governmental and governmental organizations, the spread of HIV/AIDS persists. A drivers’ health is an important factor in road safety, and not to forget the management of your assets. SADC as part of the tripartite consortium of Regional Economic Communities (REC) consisting of SADC, COMESA and EAC, is embarking on a road safety programme, in alignment with the United Nations Decade of Action on Road Safety. Drivers’ health and wellbeing is a very important component of this programme.

Issues that need to be addressed, rather urgently, include:

• Lack of sustainability of health service offerings for long distance truck drivers along transport corridors. And, where there are services, the majority of initiatives last as long as there is a funding organization and sponsored technical assistance.
• Lack of company commitment to drivers’ health; i.e. often the commitment only goes as far as providing a policy, but not as far as implementing the policy and providing interventions to effect significant change.
• Comprehensive health approach vs. singling out HIV. Many large companies in the SADC region have done something to reduce the devastating effects of the HIV pandemic on their workforce but very few have extended their programmes to health and wellbeing in general.
• Exclusion from “associated action” for non-associated drivers, i.e. National Road Transport Associations (NRTAs) providing certain health-related services to the employees of their member companies that are not accessible to owner drivers or small companies who are not part of an association.
• Cross-border harmonization with regard to road transport, drive health and wellbeing. Each SADC country seems to have its own set of rules and regulations, its own policies, its own data surveillance etc. This causes problems for drivers who are crossing borders and are in need of medical attention or supplies.

The thought process of how to approach these issues revolves around the sustainability of efforts and greater collaboration between the private and public sector. Most promising in this respect is an existing ‘self-regulation’ initiative in South Africa targeting quality improvements in the transport industry that is in the process of being extended from national to SADC regional level.

The Road Transport Management System (RTMS)
RTMS is an industry-led, government-supported, voluntary self-regulation scheme that encourages consignees, consignors and road transport operators to implement a management system in the form of a set of standards with outcomes that contribute to preserving road infrastructure, improving road safety and increasing productivity. Originally from Australia, RTMS was first adapted to the South African transport industry context and will soon be adapted and implemented in the SADC regional context in order to be introduced in countries along the North-South Corridor – South Africa, Botswana, Zimbabwe, Zambia, the DRC and Tanzania. The Federation of Southern and Eastern Road Transport Associations (FESARTA) is an important driver of this process. As a member of the RTMS National Steering Committee in South Africa, FESARTA actively promotes the extension of self-regulation along the major corridors into the other African countries.

RTMS’s mission is to provide a national management system (standards, auditors, manuals) and implementation support (information portals, recognition, technology transfer) for heavy vehicle road transport to consignees, consignors and transport operators, focusing on load optimisation, driver health, vehicle maintenance and productivity.

Guidelines for driver health management
Although RTMS acknowledges driver health as an essential factor to achieve its goals, the driver health standards to date are more general and not at the same level as the standards for the other factors. As such, a set of guidelines for effective driver health management were developed, the purpose of which is not to burden transport businesses but rather to support desired long-term financial outcomes and increased competitiveness through a reduction in transport costs and improved safety performance of heavy vehicles.

These Guidelines for Driver Health Management in the SADC region were developed in a 4-step process over a period lasting from June 2010 to October 2011.

Step 1: Situational analysis of the road transport industry
Besides collecting and scrutinizing national H&S and HIV Policies, existing information from various regional and national entities was gathered: from transport associations, Ministries of Health and Transport and Communications, National AIDS Committees, non-governmental organizations (NGOs) such as Trucking Wellness and Northstar Alliance as well as international organizations, such as ILO, IOM, WHO, UNAIDS, etc. This information was synthesized into a desk study informing about the health risks and the response of the Road Transport Sector in the SADC region and specifically in the pre-selected field study countries.
Three SADC member countries were carefully selected according to the following key criteria:

• Form part of the North-South Corridor
• Significant road transport industry
• Existence of road transport associations
• Belong to two different official language groups

The countries of choice were the Democratic Republic of Congo (DRC), Zambia and Zimbabwe. Basic health-related requirements and standards as well as implementation suggestions were developed on the basis of research and empirical data. Survey templates were created to be utilized for conducting in-person, semi-structured interviews with representatives of the companies and relevant stakeholders at the national level, as well for focus group discussions with workers. The questionnaires were designed to obtain feedback from tripartite stakeholders (employers, employees and public sector) about both real and perceived gaps in workplace health and safety, including HIV and TB control. Participants also shared their opinion about the feasibility of implementing minimum health standards. The response was generally positive and encouraging.

Step 2: Validation of health standards to mitigate health risks
The validation process was targeted, firstly, to the health risks experienced in the various countries and, secondly, as to whether the suggested health standards would be appropriate to mitigate these health risks. For the validation of the health standards field research was conducted in DRC, Zambia and Zimbabwe. This included:

• A series of interviews / focus group discussions were held during which health risks were questioned and the minimum health standards and suggested implementation approaches introduced and discussed with different stakeholders
• Comments from companies on the validity of the standards, current initiatives referring to the specific standards, challenges and further ideas on implementation were recorded and consolidated.
• Other stakeholders such as associations, unions, ministries, NGOs and drivers were also invited to comment on the validity of the minimum standards and come up with ideas regarding how companies that commit to the standards could be supported
• A multi-stakeholder workshop was conducted in each field study country to present and validate the research findings.

The questionnaires and interviews were then evaluated and compiled into country reports.

Step 3: Tripartite consensus-building and results sharing
During a consensus-building workshop the research findings and a modified version of the minimum health standards were discussed with representatives of employers, employees and government in the various countries that had been involved. The objective of finding consensus on the standards was achieved through various iterations of talking through the standards and integrating comments and suggestions.

Step 4: Formulation of guidelines on the implementation of standards
These guidelines were formulated as a draft document and circulated to selected stakeholders for final review. It will be further used by SADC and other involved institutions such as FESARTA as well as NRTAs in the course of introducing cross border self-regulation to additional SADC countries.

Integrated approach
Why occupational safety and health with integrated HIV and TB management? Health issues in transport businesses are subject to individual, societal, cultural and environmental influences. In addition, the health of drivers is also influenced by the industry’s business patterns and company specifics. The business pattern of the transport industry focusses on the timely delivery of goods across long distances and through other countries and across borders. This creates a high risk environment in terms of drivers’ health. This comprehensive perspective of health at the workplace taken by the guidelines builds the bridge between occupational safety and health and HIV/AIDS, TB and other diseases. During the past decade, HIV/AIDS workplace programmes have been promoted and established as stand-alone programmes. The purpose of fusing classic occupational safety and health with HIV/AIDS and TB management is to:

• Better use company time and resources (e.g. responsibilities, budgets, activities)
• Increase the legitimacy of HIV/AIDS and TB control as workplace health and safety issues
• Increase interest and engagement of employees in workplace health and safety issues
• Reduce stigma and discrimination of people living with HIV/AIDS

Companies cannot afford to focus exclusively on one or other programme. The burden of infectious diseases as well as increasing rates of chronic ailments, insufficient standardization of workplace safety and fragile public health services requires concerted action from the business sector. Also at the workplace human rights need to be respected. Taking a human rights approach will support HIV/AIDS prevention efforts as well as the protection of workers’ health in general. A collaborative approach promises to yield the best results. Having a healthy workforce must not only be the interest of every employer and the economy of a country – but also of every individual, every family and society as a whole.

The Guidelines for Driver Health Management are intended to provide transport companies, as well as road freight associations, with information on workplace health and safety issues, employee wellbeing, social security and other work related topics, such as decent work conditions. It contains suggestions, ideas, helpful tools and internet references, which will assist in positioning employers to proactively create a healthy working environment for their most important company asset – their workforce.

Note: The Guidelines for Driver Health Management can be obtained from Dr Tomaz Augusto Salomao,
Executive Secretary, Southern African Development Community Secretariat in Gaborone, Botswana.

Acknowledgement: This article was extrapolated from the SADC Guidelines for Driver Health Management, as published in Gaborone, Botswana on November 2011