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Page 1: Legal review, conformity assessment and priority-setting ......hpdlo sxegurlw#lor ruj 7kh ,qwhuqdwlrqdo /derxu 2iÀfh zhofrphv vxfk dssolfdwlrqv /leudulhv lqvwlwxwlrqv dqg rwkhu xvhuv
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Legal review, conformity assessment and priority-setting of HIV and AIDS and the World

of Work in Lebanon

Michela MartiniRegional specialist on HIV and AIDS and World of Work

Charbel AounAttorney at Law, ILO Legal Consultant

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Acknowledgments

03HIV and AIDS and the World of Work in Lebanon

This study has been promoted by the ILO Regional Office for Arab States, under the guidance and expertise of Dr. Michela Martini Regional Specialist on HIV and AIDS and World of Work at ILO ROAS.

The research was carried out by Dr. Charbel Aoun, Attorney at Law, ILO Legal Consultant in Beirut. Special thanks goes to him for his meticulous and professional work.

The ILO would like to express its gratitude to all the interviewees at the Ministry of Labour, Ministry of Public Health, and National AIDS Control Programme, employers’ and workers’ representatives, NGOs, and Civil Service Board who contributed with in-depth insights.Without their contributions, this report would not have been possible. A detailed list is provided in the annex of this document.

Special thanks to Dr. Ghassan J.A’war, focal point for HIV and the workplace at the Ministry of Labour and Dr. Mustafa ElNakib, National AIDS Programme Manager for the final review, comments and endorsement of this study.

We would like also to thank ILO/AIDS legal department in Geneva for the assistance and guidance, and particularly

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04 A c k n o w l e d g m e n t s

Anna Torriente, and Ingrid Sipi-Johnson for their reviews and comments. Without their support this study would not have been possible.

Acknowledgement goes also to Maurizio Bussi, Director of Decent Work Team at ILO Beirut and Dr. Syed Mohammad Afsar, Coordinator for Arab States - ILO/AIDS, for their contributions.

It is only through the mobilization of all social partners that we will halt the spread of HIV.

We hope this report will inspire action to protect HIV infected workers in Lebanon, their families and their communities, and to respond to HIV in the workplace without discrimination and stigmatization.

Michela Martini

Regional Specialist on HIV and AIDS and World of Work

ILO Regional Office for Arab States

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Preface

05HIV and AIDS and the World of Work in Lebanon

HIV/AIDS is a pandemic that has far-reaching effects. Not only a public health challenge intertwined with complex social issues, AIDS has become also a global crisis affecting all levels of society. Increasingly affected is the business world, which is suffering not only from the human cost to the workforce but also in terms of losses in profits and productivity that result in many new challenges for both employers and workers.

As early as the 1980s, many governments realized that the fight against the epidemic needed a legislative framework, particularly to address discrimination. The UN system reacted in a number of ways. The 1996 International Guidelines on HIV/AIDS and Human Rights exhort States to “enact or strengthen anti-discrimination and other protective laws that protect vulnerable groups, people living with HIV/AIDS and people with disabilities from discrimination in both the public and private sectors, ensure privacy and confidentiality and ethics in research involving human subjects, emphasize education and conciliation, and provide for speedy and effective administrative and civil remedies.”1

The importance of a legislative framework for establishing and defending basic principles concerning HIV/AIDS in 1 Report of the Secretary General of the Commission on Human Rights, UN document E/CN.4/1997/37. The Guidelines were adopted at the Second International Consultation on HIV/AIDS and Human Rights, Geneva, 1996, and have been updated by Revised Guideline 6, adopted at the Third International Consultation on HIV/AIDS and Human Rights, Geneva, 2002.

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06 P r e f a c e

the workplace was recognized in the UNGASS Declaration of Commitment adopted by the UN General Assembly’s Special Session on AIDS (UNGASS) in June 2001. The Declaration includes this target: “By 2003, develop a national legal and policy framework that protects in the workplace the rights and dignity of persons living with and affected by HIV/AIDS and those at the greatest risk of HIV/AIDS, in consultation with representatives of employers and workers, taking account of established international guidelines on HIV/AIDS in the workplace.”

In 2006, the General Assembly reconfirmed the afore-mentioned commitment through the adoption of the “Political Declaration on HIV/AIDS”, recommitting the Members to combating the disease after a review of progress since the 2001 special session.

In 2010 the ILO adopted the first International labour standard concerning HIV and AIDS and the world of work, Recommendation No.200. This Recommendation establishes that the workplace should play a role in the response to HIV and calls for the adoption of national workplace policies and programmes on HIV and AIDS to facilitate access to HIV prevention, treatment, care and support services.

Recently, in June 2011, one year after the adoption of Recommendation No. 200, the UN Political Declaration on HIV/AIDS: Intensifying Our Efforts to Eliminate HIV/AIDS was adopted to reinforce the global commitment on HIV and AIDS. This last UN declaration calls on governments as well as employers’ and workers’ organizations to collaborate in taking action against HIV and AIDS in the world of work, guided by the ILO’s Conventions and Recommendations, particularly Recommendation No. 200.

“UN Political Declaration on HIV/AIDS: Intensifying Our Efforts to Eliminate HIV/AIDS (2011)” High Level Meeting, New York, June

… Commit to mitigate the impact of the epidemic on workers, their families, their dependants, workplaces and economies, including by taking into account all relevant conventions of the International Labor Organization….

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07HIV and AIDS and the World of Work in Lebanon

including the Recommendation on HIV and AIDS and he World of Work, 2010 No.200 and call upon employers, trade and labour unions employees and volunteers to eliminate stigma and discrimination, protect human rights and facilitate access to HIV prevention, treatment, care and support. (para 85)

The ILO recognizes that laws concerning the world of work provide an ideal channel to contribute in reducing the further spread of HIV and to combat damaging myths surrounding the disease. All countries, whatever their infection rate, can benefit from a legal framework that brings workplace problems into the open, protects against employment discrimination, prevents workplace infection risks and ensures the participation of stakeholders in the mechanisms and institutions that might be created.

One of the missions of the International Labour Organization is to draw up and oversee the application of international labour standards. The ILO in this respect offers its technical advice and backstopping to governments, employers’ and workers’ representatives, civil society and relevant stakeholders in this field.

In this study and report the ILO aims to identify the gaps in Lebanese legislation and troubling discrepancies with the ILO’s legal instruments, as well as to provide relevant guidance.

This report was elaborated through a desk review of laws and information provided by the Ministry of Labour, Ministry of Public Health, National AIDS Control Programme, NGOs, Civil Service Board2 and workers’ and employers’ representatives. We would like to thank them all, because without their willing cooperation, this report would not have been possible.

This study is part of the Research Collection on HIV and AIDS and the World of Work in the Middle East, promoted by the ILO Regional Office for Arab States. 2 The role and function of Civil Service Board (or Civil Service Council), as described in Decree Law 114 of June 12, 1959 and its subsequent amendments, entrusted it with the responsibility of monitoring the implementation of the new personnel law in public sector and actually exercising many powers specifically assigned to it.

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Executive Summary

08 E x e c u t i v e S u m m a r y

BackgroundWhile the subject of HIV/AIDS and the world of work is complex, the aim of our study is to provide a fair evidence based ground for an informed discussion on the legislative framework related to HIV/AIDS in the world of work in Lebanon. The main objective is to identify discrepancies between national legislation and the ILO’s legal instruments and more specifically Recommendation No.200. We also aim to examine how workers living with HIV are treated in practice and the willingness of employers’ and workers’ representatives to tackle HIV as a workplace issue. This study is also intended to establish a national baseline for the analysis of national laws and practices concerning HIV and AIDS in the world of work in Lebanon and to contribute to a more thorough understanding of the roles of ILO’s local tripartite partners (Ministry of Labour, employers’ and workers’ organizations) in responding to the epidemic.

MethodsThis study is a legal review and conformity assessment on HIV/AIDS and the workplace and related identification of concrete discrepancies in national legislation in relation

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09HIV and AIDS and the World of Work in Lebanon

to Recommendation No. 200. The study is divided into three chapters. Chapter one will study the ILO’s legal instruments (Conventions, International Guidelines, Code of Practice on HIV/AIDS and the World of Work, Recommendation concerning HIV/AIDS and the World of Work No.200) related to HIV/AIDS in the workplace. Chapter two will analyze of the laws and regulations in Lebanon, starting with the constitution, employment laws in both private and public sectors, public health laws and all other applicable regulations related to the workplace. In the second chapter, we will also present results from the interviews with employers and workers representatives. In the third chapter, we will comment on the final result and provide final recommendations.

ResultsLebanese Constitution:

Paragraph (b) of the Constitution’s preamble provided that “Lebanon is also a founding and active member of the United Nations Organization and abides by its covenants and by the Universal Declaration of Human Rights”. Lebanon, by agreeing to the Declaration is accountable for protecting and promoting human rights in all its meanings of its citizens. In this sense Lebanon by adopting appropriate legal policies, national laws, institutions and processes in HIV/AIDs related issues will strengthen its regional and international position in protecting PLWHA.

Paragraph (c) of the preamble and Article 7 of the Constitution contain inter alia the equality clause, which provides for equality for everyone before the law and the right to equal protection and benefit of the law. Paragraph (c) of the preamble and Article 7 of the Constitution enable parliament or ministries to enact legislation and take special measures to promote equality and prohibit unfair discrimination in relation to HIV/AIDs infected workers in the workplace.

Article 12 declares that “All Lebanese citizens are equally admitted to all functions without any other cause for preference except their merit and competence and

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10 E x e c u t i v e S u m m a r y

according to the conditions set by law. A special statute governs Civil Servants according to which they belong”. This Article enables parliament or ministries to enact legislation and take other measures to maintain equality among all citizens including PLWHA.

Private Sector employment law:

Discrimination and Unfair Dismissal: Employers may rely on Article 50 of the Labour Law in order to dismiss HIV infected workers. Employers may argue that HIV status is considered a “valid reason” of dismissal in the workplace. The law should be amended and specify explicitly that HIV infected workers can not be dismissed on the basis of their status. While there is no case has been presented to the Lebanese court in this regard, interviews with people living with HIV revealed that dismissal due to HIV status is frequent in practice*.

HIV Testing and Confidentiality: According to Articles 34 and 38 of Decree-Law No. 11802 of January 30, 2004, workers are subject to medical examinations and laboratory tests. The provisions of such Decree-Law should not include HIV testing.

Occupational Health: The Labour Law does contain provisions related to a healthy environment but not specifically for HIV/AIDS in the workplace. (Article 34 of Decree 11802 states that: “…physician of the enterprise shall take all prevention and health measures in the workplace and mitigate the risk of exposure to common diseases, occupational diseases and occupational accidents…”. Thus, these universal precautions achieve the target of workplace safety.

Migration and Work Permit: Migrant workers in Lebanon are subject to a blood screening test for HIV, Hepatitis B, Syphilis, Tuberculosis and Malaria. In addition to these tests, Egyptian and Sudanese workers are subject to Bilharziasis test. Lebanese stakeholders should discuss the possibility of eliminating the mandatory HIV testing, with particular attention to foreign workers. This discussion should focus on available scientific literature, evidence-based practices and public health information and should a thorough evaluation of te advantages and

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11HIV and AIDS and the World of Work in Lebanon

disadvantages of this requirement which compromises the principle of human rights as defined in the Lebanese Constitution and all the other international treates ratified by Lebanon. Data should be produced and analyzed and findings should be used for an evidence-based approach. International experience has shown that mandatory pre-employment HIV testing ineffective in mitigating the spread of HIV infection; furthermore, it gives a false sense of protection to the population, thus driving the HIV epidemic underground. Eliminating mandatory pre-employment HIV testing would align Lebanese Labour Code with international standards and it will open the allow for the promotion of a more integrated and effective HIV prevention strategy.

Sick Leave: The provisions of the Labour Law concerning sick leave are fair enough to cover the progressive nature of common disease. However, there are no special provisions for HIV infected workers in line with international standards. The Law provides that workers who are prevented from performing their duties due to chronic diseases are granted sick leave to regain their health. Sick leaves are allowed under the terms and conditions described by Law and extended if necessary.

Medical management: Antiretroviral treatment is provided by the MOPH for all Lebanese patients and recently to Palestinian refugees registered in Lebanon.

Public Sector employment laws:

The public sector’s employment laws in Lebanon are governed by two main Decree-Laws (D.L.); Decree-Law No. 112 dated June 12, 1959 entitled “Public Sector Staff Regulation”3 ( “D.L. 112”), and Decree-Law No. 5883 dated November 3, 1994 entitled “Workers’ General Regulation ”(“D.L. 5883”). The provisions of D.L 112 apply to the public sector’s employees who are divided into two groups: permanent and temporary employees. The workers in the public sector are not subject to D.L. 112 and are governed by D.L. 5883.

3 Or “Personnel Regulation”

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12 E x e c u t i v e S u m m a r y

On the whole, there are no differences between the two Decree in relation to HIV and AIDS.

Employee’s dismissal: There are no special provisions related to the protection of HIV infected employees in D.L. 5883 and D.L. 112

HIV Testing and Confidentiality Article 4 (paragraph 1-d), of D.L. 112 provides inter alia that each person requiring a job in the public sector is subject to a medical certificate issued by the Official Medical Committee. D.L 112 does not require any lab test; hence HIV testing is not an issue. This also applies to D.L.5883

Occupational Health: There are neither general health provisions nor specific HIV/AIDS provisions related to a healthy work environment in D.L. 112 and D.L.5883. As in the private sector, universal precautions should be taken in order to prevent the spread of the virus in the workplace.

Migration and Work Permit: Not applicable in D.L.112. (Pursuant to Article 4 (paragraph 1-a), the applicant must be Lebanese for a period of 10 years at least.).

As for D.L. 5883, pursuant to Article 4 (paragraph 1), the applicant must be Lebanese for a period of 10 years at least. However, seasonal workers, maids and cleaning workers are exempted from the nationality condition. As discussed previously, HIV testing prior to obtaining a work permit should not be imposed by law.

Sick Leave: The provisions of Article 39 are fair enough to cover the progressive nature of common diseases. However, the expression “incurable disease” must be revised (it has been used since 1959-the year of issuing D.L.112), as HIV/AIDS. As well other diseases (multiple sclerosis, cancer, Alzheimer, etc) so far not curable diseases.

Public Health Law

The Ministry of Public Health (“MOPH”) has adopted several circulars and decisions in order to control and avoid an HIV/AIDS epidemic in Lebanon; these circulars and decisions are related to the safety of blood, mandatory

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13HIV and AIDS and the World of Work in Lebanon

declaration, confidentiality, non-discrimination and compulsory testing of high-risk group. However, the inclusion of HIV/AIDS in the list (which was initially issued in 1957) of communicable diseases in 1990 is quite concerning. The MOPH has never adopted rules and policies related specifically to the protection of HIV infected workers in the workplace.

Other Lebanese codes

There is much jurisprudence related to privacy disclosure in Article 579 of the Penal Code and Article 264 of the civil procedures. Moreover, the code of medical ethics which was issued in 1994 tackles the issue of medical secrets disclosure. We are not going to analyse these articles in depth, as this study is focusedupon workplace issues.

Interviews with Employers and Employees Representatives

In practice, all of the employers representatives interviewed reported scarce information on HIV and AIDS and maintained that it is not a concern for the workplace. They did not develop policies dealing with HIV in the workplace; however they all confirmed that they would respond to a government requirement in this regard. Workers’ representatives revealed also that they did not call or ask their employers for non-discrimination treatment in hiring, training and promotion. Employers revealed that they did not feel any pressure to tackle HIV in the workplace from workers’ representatives or civil society, including those dealing with people living with HIV.

ConclusionThis study has showed significant gaps between Lebanese legislation and international standards in relation to HIV/AIDS and the world of work, and according to this study not even dedicated policies related to HIV/AIDS and the world of work are in place at the national or sectoral level.

Interviews with stakeholders revealed also that, in practice, workers living with HIV might be subject to discrimination

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14 E x e c u t i v e S u m m a r y

and stigmatization in the workplace. Workers with actual or perceived HIV infection face the risk of dismissal when their HIV status has been known or disclosed. In addition, a lack of information on the transmission of the HIV has led to employers believing erroneously that dismissing workers can inhibit the spread of the infection in the workplace.

The study has identified specific discrepancies between national laws and the Recommendation No. 200. These discrepancies indicate the need to amend some of the laws and issue instructions to clarify provisions that are vague and open to misinterpretation.

Lebanon is advised to consider amending some articles of national legislation and promoting the development of new policies related to the protection of HIV infected workers in the country. Particular attention should be given to national and regional discussion on mandatory pre-employment HIV testing which according to international standard should not be required. This discussion should be conducted through informed consultations with the Ministries of Labour, Health, and Interior, as well as employers and employees’ representatives, NGOs, experts, international organizations. In this regard, the establishment of a multi-stakeholder technical working group on HIV/AIDS and world of work within the Ministry of Labour and in collaboration with the Ministry of Health - National AIDS Control Programme could be an effective tool. The role of workers’ representatives and civil society (particularly associations dealing with people living with HIV/AIDS) should be reinforced to advocate for the rights at work for people living with HIV and tailored seminars should be promoted. The Minister of Labour, employers’ and workers’ representatives should consider the integration of HIV/AIDS education sessions within existing education opportunities and support training on the application of the laws concerning HIV and AIDS and the workplace. The promotion of workplace programmes to contribute in mitigating HIV impact in the workplace and to provide workers with appropriate education on HIV should be discussed in coordination with the Ministry of Health/National AIDS Control Programme.

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Table of Contents:

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Acknowledgments PrefaceExecutive Summary Introduction. HIV/AIDS and the World of Work in Lebanon

. Scope and Objective

. Methodology

Chapter 1ILO Instruments Pertaining to HIV and AIDS and the World of Work

. Discrimination (Employment and Occupation) Convention, 1958, N. 111

. International guideline

. The code of practice on HIV and AIDS and world of work

. The recommendation N. 200 concerning HIV and AIDS and World of Work

Chapter 2Results- Lebanese Legislation and HIV and AIDS and the World of Work

. The Jordanian Constitution

. The provisions of the Lebanese Labour Law (the “Law”) - private sector Discrimination and Unfair Dismissal HIV Testing and Confidentiality HIV Testing and Confidentiality: Occupational Health Migration and Work Permit

Sick Leave

. Public Sector’s employment laws Employee’s Dismissal HIV Testing and Confidentiality Occupational Health Sick Leave Worker’s Dismissal HIV Testing and Confidentiality Occupational Health Migration and Work Permit Sick Leave. Public health laws. Employers and workers representatives interviews

Chapter 3Discussions and Final Recommendations

. Discussion

. Summary of Proposed Amendments

. Final Recommendations

Table of Contents

03

05

18

18

20

21

23

24

27

29

33

33

36

49

55

66

69

55

69

69

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18 I n t r o d u c t i o n

IntroductionHIV/AIDS and the World of Work in Lebanon

The first case of AIDS in the world was declared in 1981. According to the Joint United Nations Programme on HIV/AIDS (“UNAIDS”), there were more than 34 million people world wide living with HIV by the end of 2010 and around half a million people (470 000 [350 000 – 570 000]) were living with HIV in the Middle East and North Africa4.

Many countries, especially in sub-Saharan Africa have been able to slow down the spread of the HIV epidemic. In the Middle East and North Africa, however, this epidemic has been on the rise for the past decade with annual new infections almost doubling (from 47 000 to 84 000). This has put the Middle East and North Africa among the top two regions globally with the fastest growing HIV epidemics.

In Lebanon, the HIV epidemic started in 1984, when the country had its first diagnosed AIDS case. Since then, the number of cases has been slowly but steadily rising which led the Ministry of Public Health to form the National AIDS Control Programme in 19894. By the

4 The National AIDS Control Programme team is composed of a Manager, a Health Educator, a Project Coordinator responsible for the project on vulnerable populations, and a secretary. Three consulting committees must support the NA-TIONAL AIDS CONTROL PROGRAMME, as mentioned above: 1- The National AIDS Committee for the Strategies and National Policies. 2- A Technical Com-

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19HIV and AIDS and the World of Work in Lebanon

end of November 2011, the cumulative total of HIV/AIDS cases reported to the National AIDS Control Programme reached 14555, although the UNAIDS estimates the number of people living with HIV (PLHIV) to be 36007. However, we do not know how many of them are still alive, since the National AIDS Control Programme has only numbered medical files with no names of the patient. Information regarding employment is also unknown because the physicians are not complying with the dedicated medical form provided by the Ministry of Public Health - National AIDS Control Programme which includes this information.

The close involvement of the world of work stakeholders, including the Ministry of Labour, is prominently highlighted in the relevant sections of the new Lebanese NSP 2012-2013 and the role of HIV/AIDS workplace initiatives is clearly defined in accordance with the Recommendation No.200. Direct references to HIV/AIDS in the workplace in National AIDS Control Programme priorities and strategic goals are related to advocacy, and human rights in the workplace. Among others, this includes the review of current laws or regulations pertinent to HIV in the workplace and sensitizing stakeholders, to the appropriate application of the law defending the right of people living with HIV.

In order to provide countries with guidelines and support for the development, adoption and effective implementation of policies and programmes on HIV/AIDS in the world of work, the ILO developed a Code of Practice on HIV/AIDS and the World of Work in 2001 [hereinafter “Code of Practice”] and, more recently, the Recommendation concerning HIV and AIDS and the World of Work, 2010 (No. 200) [hereinafter “Recommendation No. 200”], which was adopted in June 2010. In this context, delegates representing government, employers’ and

mittee for technical assistance. 3- An information, Education and Communication (IEC) committee to help in providing IEC material related to HIV/AIDS. 5 According to the NAP, the reporting of cases has faced many difficul-ties. Infected individuals showed some hesitation in declaring themselves due to the fear of blame or stigmatization. Furthermore, an underreporting by physicians and the lack of community capacities contributed to the inconsistencies of the data. Hence, the true dimension of the problem remains uncertain.

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20 I n t r o d u c t i o n

workers’ of Lebanon participated in the 99th Session of the International Labour Conference. The social partners, employers’ and workers’ representatives supported the adoption of the HIV and AIDS Recommendation while the Government abstained from voting.

After the adoption at the global level of the ILO’s legal instruments, an increasing number of countries have adopted legislation, which deals specifically with employment aspects of HIV/AIDS in the workplace. Some have opted to do this in the framework of specific AIDS laws, equality laws, disability laws or employment or labour relations acts.

Lebanon has not yet adopted special legal policies or instruments related to the protection of HIV infected workers, although the country is affected by the HIV/AIDS epidemic.

In line with the National Strategic Plan 2012-2013, this study aims to provide an analysis of the laws and practices affecting individuals living with HIV in the workplace in Lebanon. The aim is to support government with evidence-informed recommendations to align national legislation with international standards.

Scope and Objective of the StudyWhile the subject of HIV and AIDS and world of work is complex, the aim of our study is to provide an evidence-based ground for an informed discussion of the legislative framework related to HIV/AIDS in the world of work in Lebanon. The main objective is to help government to identify discrepancies between national legislations and the ILO’s legal instruments and more specifically Recommendation No. 200. We also aim to further examine how workers living with HIV are treated in practice.

This study is also intended to establish a national baseline for the analysis of national laws and practices concerning HIV and AIDS in the world of work in Lebanon and to

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21HIV and AIDS and the World of Work in Lebanon

contribute to a more thorough understanding of the roles of the ILO’s local tripartite partners (Ministry of Labour, employers’ and workers’ organizations) in responding to the epidemic.

The core of this study is a legal review and conformity assessment of HIV/AIDS and the workplace and related identification of discrepancies in national legislation in relation to Recommendation No. 200. This includes the right not to suffer discrimination or stigma on the basis of real or perceived HIV status for employment purposes; the right to have a safe and healthy workplace; the right to privacy and confidentiality of all HIV-related information; no mandatory HIV testing or screening for employment purposes; and no mandatory disclosure of HIV status.

This study will attempt to answer the following questions:

Do national laws and regulations in Lebanon take into consideration ILO international labour standards, and more specifically Recommendation No. 200?

Are there any discrepancies between Recommendation No. 200 and the applicable national laws?

Is Recommendation No. 200 applied or respected in practice by companies and employers’ organizations?

What is the status in the workplace of employees living with HIV?

MethodologyThis report relies mainly on primary research and it is divided into three chapters. The first chapter will study the ILO’s legal instruments (Conventions, International Guidelines, Code of Practice, Recommendation, No. 200) related to HIV/AIDS in the workplace.

We shall afterwards study, in the second chapter, the applicable laws and regulations in Lebanon, starting with the Constitution, and moving on to labour law, public

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health laws and all other applicable regulations related to the workplace. What are the gaps and discrepancies between national legislation and the ILO’s legal instruments?

Does the legislation prohibit HIV screening for general employment purposes, i.e appointment, promotion, training and benefits?

Does the legislation require provision of access to information and education about HIV/AIDS for occupational health and safety reasons?

Does the law provide for employment security while HIV-positive workers are able to work (e.g unfair dismissal rules)?

Does the law provide extended sick leave for HIV positive workers?

Is HIV testing imposed by law for foreigners?

Does the law provide for confidentiality of workers’ medical information, including HIV status?

In the second chapter, we will also interview employers’ and workers’ representatives (associations or syndicates) in order to have their opinions and determine whether such representatives have adopted any HIV/AIDS policies or regulations.

In the third chapter we shall comment on the final result and provide final recommendations.

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Chapter 1:

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25HIV and AIDS and the World of Work in Lebanon

ILO Instruments Pertaining to HIV and AIDS and the World of Work

The ILO is the intergovernmental organization dealing with labour issues. The principle of non-discrimination in labour relations is enshrined in the ILO Constitution and many other instruments relating to human rights of workers in the workplace. The ILO, together with other United Nations agencies, is a co-sponsor of UNAIDS.

The major ILO legal instruments and texts relevant to HIV/AIDS and the world of work are the following:

A. Discrimination (Employment and Occupation) Convention” 1958, N.111.

B. International Guidelines.

C. ILO Code of Practice

D. Recommendation No. 200

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1.1 Discrimination (Employment and Occupation) Convention, 1958, N. 111In the context of employment, as agreed in paragraph 9 Recommendation No. 200, the ILO has defined discrimination in the “Discrimination (Employment and Occupation) Convention, 1958, No.111”6 as “any distinction, exclusion or preference made on the basis of race, color, sex, religion, political opinion, national extraction or social origin, which has the effect of nullifying or impairing equality of opportunity or treatment in employment or occupation7. Under the Convention No.111, “each member for which this Convention is in force undertakes to declare and pursue a national policy designed to promote by methods appropriate to national conditions and practice, equality of opportunity and treatment in respect of employment and occupation, with a view to eliminating any discrimination in respect thereof8”. The Convention is predicated on the basis that discrimination is a violation of human rights under the Universal Declaration of Human Rights.

Lebanon has ratified Convention No.111 by the Decree-Law No.70 dated June 25, 1977. Therefore, Lebanon has an obligation to abide by all the provisions and terms of this conventions, and to take all necessary measures to eliminate all forms of discrimination in respect of employment, including discrimination against workers infected with HIV/AIDS.

1.2 International GuidelinesThe ILO, as part of the United Nation’s AIDS Programme, has issued International Guidelines on HIV/AIDS and Human Rights. The guidelines call upon states to use national legislation to deal with the key issues of unfair discrimination based on HIV status. The International Guidelines on HIV/AIDS and Human Rights of 1996 are not binding on states. However, they are useful for governments to combat unfair discrimination in the workplace. The guidelines emphasize the protection

6 Convention No.111 was ratified by more than 195 member states of the ILO. 7 Article 1 (a). 8 Article 2.

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27HIV and AIDS and the World of Work in Lebanon

of human rights as key to safeguard human dignity of workers living with HIV and indicate that a rights-based approach is an effective response to HIV/AIDS in general.

Guideline 1: States should establish an effective national framework for their response to HIV which ensures a coordinated, participatory, transparent and accountable approach, integrating HIV policy and programme responsibilities across all branches of government.

Guideline 2: States should ensure, through political and financial support, that community consultation occurs in all phases of HIV policy design, programme implementation and evaluation and that community organizations are enabled to carry out their activities, including in the field of ethics, law and human rights, effectively.

Guideline 3: States should review and reform public health laws to ensure that they adequately address public health issues raised by HIV, that their provisions applicable to casually transmitted diseases are not applied to HIV and that they are consistent with international human rights obligations.

Guideline 4: States should review and reform criminal laws and correctional systems to ensure that they are consistent with international human rights obligations and are not misused in the context of HIV or targeted against vulnerable groups.

Guideline 5: States should enact or strengthen anti-discrimination and other protective laws that protect vulnerable groups, people living with HIV and people with disabilities from discrimination in both the public and private sectors, ensure privacy and confidentiality and ethics in research involving human subjects, emphasize education and conciliation, and provide for speedy and effective administrative and civil remedies.

Guideline 6 (as revised in 2002): States should enact legislation to provide for the regulation of HIV related goods, services and information, so as to ensure widespread availability of quality prevention measures and services, adequate HIV prevention and care information,

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28 C h a p t e r 1

and safe and effective medication at an affordable price. States should also take measures necessary to ensure for all persons, on a sustained and equal basis, the availability and accessibility of quality goods, services and information for HIV prevention, treatment, care and support, including antiretroviral and other safe and effective medicines, diagnostics and related technologies for preventive, curative and palliative care of HIV and related opportunistic infections and conditions. States should take such measures at both the domestic and international levels, with particular attention to vulnerable individuals and populations.

Guideline 7: States should implement and support legal support services that will educate people affected by HIV about their rights, provide free legal services to enforce those rights, develop expertise on HIV related legal issues and utilize means of protection in addition to the courts, such as offices of ministries of justice, ombudspersons, health complaint units and human rights commissions.

Guideline 8: States, in collaboration with and through the community, should promote a supportive and enabling environment for women, children and other vulnerable groups by addressing underlying prejudices and inequalities through community dialogue, specially designed social and health services and support to community groups.

Guideline 9: States should promote the wide and ongoing distribution of creative education, training and media programmes explicitly designed to change attitudes of discrimination and stigmatization associated with HIV to understanding and acceptance.

Guideline 10: States should ensure that Government and the private sector develop codes of conduct regarding HIV issues that translate human rights principles into codes of professional responsibility and practice, with accompanying mechanisms to implement and enforce these codes.

Guideline 11: States should ensure monitoring and enforcement mechanisms to guarantee the protection of HIV related human rights, including those of people

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29HIV and AIDS and the World of Work in Lebanon

living with HIV, their families and communities.

Guideline 12: States should cooperate through all relevant programmes and agencies of the United Nations system, including UNAIDS, to share knowledge and experience concerning HIV related human rights issues and should ensure effective mechanisms to protect human rights in the context of HIV at international level.

1.3 The Code of Practice on HIV and AIDS and the World of Work

In 2001, the ILO issued the Code of Practice on HIV/AIDS and the World of Work which provides useful guidelines for employers, trade unions and workers in the workplace. The Code of practice if adhered to, can make a difference in the way workers living with HIV/AIDS are protected from compulsory invasive tests, unwarranted disclosure of their HIV status, and unfair dismissals based on their HIV status. The Code of practice also offers protections of workers against real or perceived unfair discrimination in matters of continuity of employment and benefits; it protects workers against violation of their right to privacy and prevents compulsory HIV testing related to recruitment or retention of employment.

The ILO Code of practice is based on ten key principles:

1. Recognition of HIV/AIDS as a workplace issue: HIV/AIDS is a workplace issue, and should be treated like any other serious illness/condition in the workplace.

2. Non-Discrimination: In the spirit of decent work and respect for the human rights and dignity of persons infected or affected by HIV/AIDS, there should be no discrimination against workers on the basis of real or perceived HIV status. Discrimination and stigmatization of people living with HIV/AIDS inhibits efforts aimed at promoting HIV/AIDS prevention.

3. Gender Equality: The gender dimension of HIV/

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30 C h a p t e r 1

AIDS should be recognized. Women are more likely to become infected and are more often adversely affected by the HIV/AIDS epidemic than men due to biological, socio-cultural and economic reasons. The greater the gender discrimination in societies and the lower the position of women, the more negatively they are affected by HIV. Therefore, more equal gender relations and the empowerment of women are vital to successfully prevent the spread of HIV infection and enable women to cope with HIV/AIDS.

4. Healthy work environment: The work environment should be healthy and safe, so far as is practicable, for all concerned parties, in order to prevent transmission of HIV, in accordance with the provisions of the Occupational Safety and Healthy Convention, 1981 (No. 155).

5. Social Dialogue: The successful implementation of an HIV/AIDS policy and programme requires co-operation and trust between employers, workers and their representatives and governments, where appropriate, with the active involvement of workers infected and affected by HIV/AIDS.

6. Screening for purposes of exclusion from employment or work processes: HIV/AIDS screening should not be required of job applicants or persons in employment.

7. Confidentiality: There is no justification for asking a job applicant or workers to disclose HIV related personal information. Nor should co-workers be obliged to reveal such personal information about fellow workers. Access to personal data relating to a worker’s HIV status should be bound by the rules of confidentiality consistent with the ILO’s “Code of Practice on the Protection of Workers’ Personal Data”, 1997.

8. Continuation of employment relationship: HIV infection is not a cause for termination of employment. Persons with HIV related illnesses, like those with many other conditions, should be

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able to work for as long as medically fit in available, appropriate work.

9. Prevention: HIV infection is preventable. Prevention of all means of transmission can be achieved through a variety of strategies which are appropriately targeted to national conditions and which are culturally sensitive.

10. Care and Support: Solidarity, care and support should guide the response to HIV/AIDS in the world of work. All workers, including workers with HIV, are entitled to affordable health services. There should be no discrimination against them and their dependents in access to and receipt of benefits from statutory social security programmes and occupational schemes.

The ILO Code of Practice itself is not a treaty and thus not legally binding on states.

1.4 The Recommendation No. 200 concerning HIV and AIDS and the World of Work On June 2010, the ILO adopted Recommendation No. 200 which relies on general principles that should apply to all action involved in the national response to HIV and AIDS in the world of work. The Recommendation reflects the need to strengthen workplace prevention efforts and to facilitate access to treatment for persons living or affected by HIV/AIDS. It calls for the design and implementation of national tripartite workplace policies and programmes on HIV and AIDS to be integrated into overall national policies and strategies on HIV/AIDS and on development and social protection. It calls for respect for the fundamental human rights of all workers, including observance of the principle of gender equality and the right to be free from compulsory testing and disclosure of HIV status, while encouraging everyone to undertake voluntary confidential HIV counseling and testing as early as possible. The Recommendation also invites member states to implement its provisions through amendment or adoption of national legislation where appropriate.

31HIV and AIDS and the World of Work in Lebanon

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In Lebanon, the social partners (employers’ and workers’ representatives) supported the adoption of the HIV and AIDS Recommendation while the Government abstainedfrom voting.

The ILO Recommendation’s General Principles:1. The response to HIV and AIDS should be recognized as contributing to the

realization of human rights and fundamental freedoms and gender equality for all, including workers, their families and their dependents;

2. HIV and AIDS should be recognized and treated as a workplace issue, which should be included among the essential elements of the national, regional and international response to the pandemic with full participation of organizations of employers and workers;

3. There should be no discrimination against or stigmatization of workers, in particular jobseekers and job applicants, on the grounds of real or perceived HIV status or the fact that they belong to regions of the world or segments of the population perceived to be at greater risk of or more vulnerable to HIV infection;

4. Prevention of all means of HIV transmission should be a fundamental priority;

5. Workers, their families and their dependents should have access to and benefit from prevention, treatment, care and support in relation to HIV and AIDS, and the workplace should play a role in facilitating access to these services;

6. Workers’ participation and engagement in the design, implementation and evaluation of national and workplace programmes should be recognized and reinforced;

7. Workers should benefit from programmes to prevent specific risks of occupational transmission of HIV and related transmissible diseases, such as tuberculosis;

8. Workers, their families and their dependents should enjoy protection of their privacy, including confidentiality related to HIV and AIDS, in particular with regard to their own HIV status;

9. No workers should be required to undertake an HIV test or disclose their HIV status.

10. Measures to address HIV and AIDS in the world of work should be part of national development policies and programmes, including those related to labour, education, social protection and health and

11. The protection of workers in occupations that are particularly exposed to the risk of HIV transmission.

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Chapter 2:

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35HIV and AIDS and the World of Work in Lebanon

Results- Lebanese Legislation and HIV and AIDS and the World of Work

2.1 The Lebanese Constitution The Constitution was enacted in 1926 and the latest amendment occurred in 1990. As stated in paragraph (b) of its preamble, “Lebanon is also a founding and active member of the United Nations Organization and abides by its covenants and by the Universal Declaration of Human Rights”. The Constitution is the supreme law of the Lebanese Republic and any conduct inconsistent with it is invalid, and all obligations imposed by it must be fulfilled. The Constitution has core values which include human dignity, the achievement of equality and the advancement of human rights and freedoms.

In this section, the Universal Declaration of Human Rights, the equality clause and the right to fair labour practices are briefly examined.

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Universal Declaration of Human Rights

The Universal Declaration of Human Rights (the “Declarations”), adopted in Paris by the United Nations General Assembly in 1948 does not expressly identify HIV/AIDS, but all human rights elaborated in it can promote accountability in HIV/AIDS related issues9. Human rights relevant to HIV/AIDS identified and elaborated in the Declaration include (but are not limited to) the right to non-discrimination and equality, to health, to liberty and security of the person, to privacy, to seek, receive and impart information, to marry and found a family, to work, and the right to freedom of movement, association, and expression. All these rights have particular importance in the context of HIV/AIDS and would imply that no person can be discriminated against on the basis of his/her HIV status.

The preamble to the Declaration stresses that human dignity and equality form the foundations of freedom, peace and justice.

Article 1 of the Declaration provides that every person is born free and equal in dignity and rights. This article furthermore emphasizes the responsibility of individuals to respect each other.

Article 2 and 7 protect individuals against discrimination. Article 2 prohibits discrimination of any kind on the bases of race, color, creed, religion, political or other opinion, nationality or social origin, property, birth or other status. The Committee on the Rights of the Child interpreting Article 2 of the Convention on Rights of the Child has interpreted the expression “other status” to include HIV status of the child or his parents10. Article 7 of the Declaration further prohibits any discrimination, which

9 As stated in Recommendation No.200, page 3, paragraph (3-a): “The response to HIV and AIDS should be recognized as contributing to the realization of human rights and fundamental freedoms and gender equality for all, including workers, their families and their dependants”.10 The Convention on the Rights of the Child was adopted and opened for signature, ratification and accession by General Assembly Resolution 44/25 of 20 November 1989, entry into force September 2, 1990 in accordance with Article 49.

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37HIV and AIDS and the World of Work in Lebanon

may impair equal protection by the law. The Declaration does not use the expression “unfair discrimination”.

Article 5 prohibits inhuman or degrading treatment. It is submitted that this article reinforces the right to dignity and prohibits stigmatization of workers with HIV. The right to privacy and the right to work are recognized.

Article 23 provides that everyone has the right to work. It also provides for the right to equal pay for equal work, the right to just and favorable remuneration including social protection that ensures the existence of human dignity. The Declaration also provides for the right of workers to a standard of living adequate for their health and wellbeing as well as that of their families, including medical care and social security.

Although the Declaration is not a treaty, it is considered to be an authoritative interpretation of the United Nation’s Charter and an authoritative listing of human rights and basic components of international customary law which is binding on all states, not only members of the United Nations. It is a common standard for measuring human rights.

In summary, the obligations of Governments including the Government of Lebanon towards human rights are understood in three ways: obligations to (i) respect rights, (ii) protect rights and (iii) fulfill rights.

To respect a right means that Governments cannot violate human rights directly in laws, policies, programmes or practices. For example, Lebanon cannot arbitrarily deny HIV infected workers the same standard of medical care that is offered to other workers.

To protect a right means that Governments must prevent violations by others, and provide affordable and accessible redress. For example, Lebanon must ensure that private employers do not discriminate against HIV infected workers, and must provide avenues for redress if they are fired because of their HIV status.

To fulfill a right means that Governments must take measures that move towards the realization of rights.

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These measures should be legalized, budgetary, and could include some other types of action. For example, a state must adopt a policy to provide treatment to all individuals. Lebanon for example, should take measures to progressively extend coverage i.e. soliciting support from donors and/or reassessing budget priorities.

Finally, human rights law defines the relationship between individuals and governments; it concerns a government’s obligation to individuals and populations. Every person can make a claim arising as a matter of his or her rights and entitlements, not as a result of privilege or special favour. In short, Lebanon by agreeing to the Declaration, is responsible for protecting and promoting the human rights in all its meanings of its citizens. Lebanon must do so by adopting appropriate legal policies, national laws, institutions and processes in HIV/AIDs related issues.

ii. Equality, Unfair Discrimination:

Paragraph (c) of the preamble and Article 7 of the Constitution contain inter alia the equality clause. Their provisions provide for equality for everyone before the law and the right to equal protection and benefit of the law. Equality is defined to include the full and equal enjoyment of all rights and freedoms. Paragraph (c) of the preamble and Article 7 of the Constitution contain a non-discrimination clause which reads as follows:

Paragraph c:

“Lebanon is a parliamentary democratic republic based on respect for public liberties, especially the freedom of opinion and belief, and respect for social justice and equality of rights and duties among all citizens without discrimination.”

Article 7:

“All Lebanese are equal before the law. They equally enjoy civil and political rights and equally are bound by public obligations and duties without any distinction.”

Paragraph (c) of the preamble and Article 7 of the Constitution enable parliament or ministries to enact

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39HIV and AIDS and the World of Work in Lebanon

legislation and take special measures to promote equality and prohibit explicitly unfair discrimination against HIV/AIDs infected workers in the workplace.

iii. Right to Fair Labour Practices:

Article 12 of the Constitution provides that everyone has the right to fair labour practices with respect to public functions:

“Every Lebanese has the right to hold public functions, no preference being made except on the basis of merit and competence, according to the conditions established by law. A special statute guarantees the rights of state officials in the departments to which they belong”.

Article 12 grants the right to every Lebanese citizen to be equally admitted to all functions without any other cause for preference except their merit and competence and according to the conditions set by law. Such Article enables parliament or ministries to enact legislation and take other measures to maintain equality among all citizens including PLWHA

2.2 The provisions of the Lebanese Labour Law (the “Law”) - Private Sector

The study of this paragraph is subject to Articles 1 and 2 of the Law, which define the employer and the worker as follows:

Article 1: “The employer is any person, natural or judicial, who in an industrial, trading, or agricultural enterprise employs a worker in some capacity against wage or salary, even if this wage or salary is paid in kind or in profit-sharing”

Article 2: The worker is any man, woman or teenager who works for an employer against a wage, according to the conditions listed in the previous article [defining the employer], whether pursuant to a collective, individual, oral or written agreement”.

The Law gives effect in general to the rights entrenched under the Constitution and obligations incurred by the

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Lebanese Republic as a member state of the ILO. The purpose of the Law is to give effect to the protection against unfair labour practices; it establishes the Labour Arbitration Court11 (the “Court”), which has jurisdiction to determine disputes and other labour relations issues. The Law seeks to achieve equality in the workplace and promote fair treatment in employment by eliminating discrimination, unfair dismissal, etc. The Law does not apply to the personnel of the public sector; we shall study separately the Decree-Laws related to their status in paragraph 2.

Discrimination and Unfair Dismissal

Regarding discrimination and unfair dismissal, there are specific provisions in the law related to HIV/AIDS status. In order to clarify any gaps and between the discrepancies, ILO’s legal instruments, our study will be based on two main articles (Articles 50 and 74 of the Law) related to the dismissal of a worker in the workplace. It should be noted that Article 50 concerns solely is concerned with open-ended contracts (contracts with unspecified duration), fixed term contracts (contracts with specified duration) are not subject to this Article. We will focus our study on the provisions governing the open-ended contracts, given that such provisions could be subject to various interpretations by the employers and the Court.

Article 50 guarantees the right of workers not to be unfairly dismissed and the right not to be subject to unfair labour practices. Pursuant to paragraph (a) of this Article, any employer has the right to terminate an open-ended labour contract without “abuse of right” and after notifying the worker12. In case of misuse or abuse of right 11 According to the Law, the Labour Arbitration Board is the only court competent to resolve disputes arising from labour relations. 12 Pursuant to Article50 of the Law, the employer and the worker have the right to terminate at any time such contract concluded between them, provided that such termination is justified. However, both parties are required to advise the other of the intent to terminate the said contract: 1- One month in advance in case a period equal to less than three years has elapsed since the commencement of the work. 2- Two months in advance in case more than three years and less than six years have elapsed. 3- Three months in advance in case more than six years and less than twelve years have elapsed. 4- Four months in advance in case twelve years or more have elapsed.

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on the part of the employer, the latter must indemnify the worker. However, the Law does not define the term “abuse of right’”; such term is subject to interpretation by the employers and the Court. The Law only prohibits termination of employment in case of misuse or abuse of right. As such, the Law may leave room for employers who may argue that their termination of an employment contract on the basis of HIV status should not be considered as abuse of right.

In addition, paragraph (d) of Article 50 enumerates (but is not limited to) five cases which could be consideredas “abuse of right” as follows:

“d- Dismissal shall be considered as being the fact of misuse or abuse of right if it occurs in the following cases:

1. For a non-valid reason or for a reason in no way pertaining to the employees’ fitness or behavior within the establishment or to sound management and smooth running of the establishment.

2. For having adhered or not to a given trade union, or for having engaged in a legal trade union activity, within the laws and regulations in force or within the framework of a group or individual labour agreement.

3. For being a candidate to the elections, or for having been elected as member of a trade union office or having represented the establishment’s labour force, throughout the period of such representation.

4. For having lodged, in good faith, with the competent services, a complaint regarding the implementation of the provisions of the present law and of texts referring thereto, or having brought a case against the employer on the same basis.

5. For having exercised his individual or public liberties within the framework of the laws in force.”

Pursuant to paragraph (d), the dismissal shall be automatically considered as unfair if it occurs for any reason mentioned above. However, the term “for a non-valid reason” provided in paragraph (d) line (1) is

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not clearly defined by Law, which may leave rooms for employers to argue that it is legal for them to terminate the open-ended contract of a sick worker, including an HIV infected worker, on a ground that health or HIV status is considered to be “a valid reason” of dismissal.

On the other hand, Article 74 of the Law enumerates the cases whereby the employer could terminate the employment contract without being obliged (i) to pay any indemnity or (ii) to send any prior notice to the worker:

“Any worker can be dismissed from work without notice and without paying him/her any indemnity in the occurrence of the following cases:

1. If the worker commits a usurpation of a nationality.

2. If the worker was hired under a probation period and the employer refused him within a period of three months.

3. If it is evidenced that the worker intentionally has committed any act or negligence aiming to cause any material damage to the employer. It must be noted that in this case, the employer must inform the Ministry of Labour within 3 days from the date of evidencing these infringements.

4. If the worker, and despite the notices addressed to him, has committed three material infringements to the internal regulations within one year.

5. If the worker has been absent, with no valid reason, for more than 15 days in one year, or for seven consecutive days. The employee should explain the reasons of his absence within 24 hours of resuming his work and the employer should every time notify the employee in written form of the days that are considered as absence without valid reason.

6. If the worker was imprisoned for one year or more for committing a crime or for committing a felony in the premises of the work or when undertaking the work or if the worker has been condemned for the acts that are provided for under Article 344 of the Criminal Code.

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7. If the worker attacked the employer or the manager at work.

In light of Article 74, the employer has the right to terminate the labour contract without paying any indemnity to the worker if any of the conditions listed above are met.

Finally, given that HIV/AIDS status is not specifically included in Article 74, termination of employment of an HIV infected worker should be considered illegal by the Court. However, as mentioned above, employers still have room to rely on Article 50 in order to argue that HIV status should be considered as a “valid reason” for dismissal from the workplace.

Discrimination and Unfair Dismissal in practice:

The Court has powers to determine all matters related to the interpretation of the Law and the workers can approach it whenever disputes arise. The Law does not prohibit workers with HIV from resort to the Court in order to claim indemnity in case of unfair dismissal; this means that they can approach the Court in case of disputes relating to HIV status in the workplace. However, while conducting our research, we did not find before the Lebanese Courts legal cases related to HIV status, although the number of infected workers that were dismissed on the basis of HIV status is elevated in the country.

Interviews held with the main NGOs dealing specifically with the HIV epidemic and people living with HIV in Lebanon, reveal that there are many HIV infected workers who were dismissed on the basis of their status.

Mrs. Nadia Badran from SIDC “Soins Infirmiers et Développment Communautaire13” reveals that AIDS 13 In 1987, SID (initials after its French name “Service Infirmier à Domicile”) as-sociation was founded in Sin El Fil. It started as a provider of primary health care through home based nursing care approach, which services responded to demands from all over the country. In 1992, SID was officially registered by the decree 9/1992 Ministry of Interior Affairs. The SID team elaborated several health Programmes, which were expanded and modified to meet the needs of the various communities that they serve. As a result, SID became in 1992 SIDC (initials after its French name “Soins Infirmiers et Développement Communautaire”) and its Programmes expanded to community development Programmes involving health behaviours and

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stigma and discrimination exist in Lebanon. Mrs. Badran mentioned that “AIDS stigma and discrimination occur in most regions and companies in Lebanon. A lot of workers have been dismissed because they were HIV positive, although they were fit to work. Such workers were discriminated against in the workplace and did not have the courage to disclose their status to anyone. In the workplace, people living with HIV are suffering from their co-workers and employers, such as social isolation and ridicule, or experience discriminatory practices, such as termination of employment. Fear of an employer’s reaction can cause a person to live with HIV anxiety. Stigma and discrimination associated with HIV/AIDS have powerful psychological consequences for how people with HIV/AIDS come to see themselves, leading in some cases to depression, lack of self-esteem and despair.”

HIV positive women workers reveal that “it is always in the back of your mind, if I get a job, should I tell my employer about my HIV status? There is a fear how they will react to it. It may cost you your job; it makes you uncomfortable. Yet you want to be able to explain why you are absent, and going to doctors”.14IHiH

“I am aware of the absence of any HIV law that protects HIV positive workers in the workplace. I was dismissed from my job and did not have the courage to disclose my case to anyone”; 15HIV positive male worker.

In short, HIV stigma and discrimination exist in the workplace in Lebanon. In order to be in compliance with the ILO’s legal instruments, the Law must explicitly prohibit the dismissal of an HIV infected worker simply on the basis of his/her HIV status16. This does not mean that a worker living with HIV/AIDS may not be dismissed. A worker living with HIV/AIDS may be dismissed

disease prevention. SIDC has developed its Programmes to take their actual form, and to reflect its principles and beliefs in activities addressed to youth, adult and elderly population and vulnerable groups. Four main Programmes are currently car-ried out: Nursing Programme - HIV/AIDS Programme - Drug Programme - Youth Programme. 14 This interview was done by Mrs. Nadia Badran from SIDC. 15 This interview was done by Mrs. Nadia Badran from SIDC. 16 “Real or perceived HIV status should not be a cause for termination of employ-ment”, ILO Recommendation N.200, page 5 paragraph 11.

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on the basis of misconduct, incapacity or operational requirements where necessary17. However, the worker may not be dismissed simply because he/she is living with HIV or AIDS. People living with HIV during the preliminary phases normally show no signs of illness and can perform their jobs without any problem. It is therefore not reasonable but rather unfair to exclude such persons from employment solely on the basis of their HIV status17. The Law must recognize that there may be instances where a worker living with HIV/AIDS is no longer able to perform his or her job functions as a result of ill-health. In other terms, a worker’s state of health should not be an acceptable motive for dismissing him/her, unless there is a very strict relationship between the worker’s present state of health and the common occupational requirements of a given job. In this situation, a dismissal on the basis of ill health may be fair, but nevertheless shall be conducted in accordance with the provisions of the Law18. On another hand, the Law must provide that where such a worker is undergoing legal proceedings, the worker’s HIV status must be kept confidential before the Court and should not be disclosed outside of those proceedings.

HIV Testing and Confidentiality:

HIV testing raises complex social, ethical and legal questions in a labour market that is very competitive. The questions relate to the right to privacy, non-discrimination, confidentiality of information as well as the right of access to information.

17 “Persons with HIV- related illness should not be denied the possibility of con-tinuing to carry out their work, with reasonable accommodation if necessary, for as long as they are medically fit to do so. Measures to redeploy such persons to work reasonably adapted to their abilities, to find other work through training or to facilitate their return to work should be encouraged, taking into consideration the relevant International Labour Organization and United Nations Instruments”, ILO Recommendation N. 200, page 5 paragraph 13. 18 More than 15 countries have incorporated in their legislation a prohibition of any kind of discrimination based on health status including people who are HIV positive or who have contracted AIDS including Colombia, Costa Rica, Ecuador, Finland, France, Italy, Hong Kong, New Zealand, Philippines, Portugal, South Af-rica, Thailand and Zimbabwe. Several member States specifically define disability to include individuals infected by HIV/AIDS, e.g. Australia, Canada and the United Kingdom. ILO Governing Body document G.B.285/2, paragraph 26.

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In Lebanon, HIV testing prior to employment or during the work period is not explicitly required by Law19. However, the Decree-Law N. 11802 (the “Decree”) of January 30, 2004 entitled “The organization of prevention and occupational safety and health in all Institutions that are subject to the Labour Law”20 contains provisions related to the workplace medical test and examination.

Article 34 of the Decree provides inter alia that all institutions - which are subject to the Labour Law and employ more than fifteen workers must have a doctor in their establishment in order to monitor the workers’ health conditions. Article 34 provides in its paragraph (2) that the workers’ pre-employment medical examination is mandatory regardless, of the number of workers in the establishment.

Article 38 provides that all workers in the establishment are subject to the following tests and examinations:

Pre-employment medical examination;

Periodical medical examination during the work period;

Laboratory test in order to monitor the evolution of the worker health condition;

This article also discusses two very important issues for the workers’ health

Improvement of working conditions in accordance with human physical activity

The doctor’s decision job after an occupational accident or occupational disease or to change his work if needed

Articles 34 and 38 of the Decree do not specify the required examinations and laboratory tests. Is HIV testing included?

19 In exception of the work permit case which is applied for foreigners. 20 Article one of the Decree-Law N.11802 cancelled the Decree-Law N.6341 dated October 24, 1951 related to the organization of prevention and occupational safety and health in all institutions that are subject to the Labour Law.

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According to the ILO’s legal instruments, HIV testing should not be required at the time of recruitment or as a condition of continued employment. The Code of practice states that any routine medical testing, such as testing for fitness carried out prior to the commencement of employment or on a regular basis for workers, should not include mandatory HIV testing21. Pursuant to the ILO Recommendation, HIV testing or other forms of screening for HIV should not be required of workers, and testing must be genuinely voluntary and free of any coercion22.

Forcing someone to undergo HIV testing is an invasion of privacy and a violation of human rights23 and indirectly of Lebanese constitution, and also openely contradicts the ILO’s legal instruments. HIV testing prior to employment or during the work period should not be imposed by Law and the provisions of the Decree N. 11802 mentioned above should not include testing for it. The tests and medical examinations required must be clarified

HIV testing in practice:

The Interview in Lebanon with Mrs. Nadia Badran revealed that some employers in Lebanon require HIV testing prior to employment.

“HIV testing prior to employment is imposed by some companies in Lebanon, medical tests and examinations include sometimes HIV testing. When an HIV infected worker is required to provide an HIV test, such a worker does not fill a job application because he/she is aware that his/her application will not be accepted,” she said.

21 The ILO Code of Practice and the World of Work, in its paragraph 8.122 ILO Recommandation No. 200 page 7 paragraph 24, 25, 26 23 The UN Human Rights Committee in 1998 elucidated the right to privacy in Article 17 of the International Covenant on Civil and Political Rights, clarifying that the gathering and holding of personal information on computers, data banks and others devices, whether by public authorities or private individuals or bodies, must be regulated by law and that such information must never be used for purposes in-compatible with the Covenant, like employment discrimination; General Comment No. 16, reproduced in Compilation of General Comments and General Recom-mendations adopted by Human Rights Treaty Bodies, UN document, Geneva, HRI/GEN/1/Rev.2 of 29 March 1996.

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“I was asked to do an HIV test prior to employment in order to fill an application for a Lebanese Bank. I did not have the courage to complete the application and provide them with the test”, HIV infected male worker.

In order toprevent any misinterpretation, Article 5 of the Agreement mentioned above should be more detailed by specifying that HIV testing prior to employment is not required; this will not leave room for some banks in Lebanon to ask for HIV testing prior to employment.

Occupational HealthA healthy and safe workplace serves the interests of both employers and workers. A healthy working environment includes the prevention and management of associated occupational hazards including exposure to HIV infection.

The risk of HIV transmission in the workplace is minimal. However, occupational accidents involving body fluids might occur, particularly with health care workers.

The Law does not contain provisions related to a healthy environment which are specific to HIV/AIDS in the workplace. When the Law was passed in 1946, its provisions were very general regarding a healthy work environment.

Pursuant to Article 61 of the Law, every employer shall provide and maintain a working environment that is safe and without risk to the health of his/her workers.

Furthermore, the Lebanese Government had issued several Ministerial Decisions and one Decree related to a healthy work environment. However, none of them is related to HIV/AIDS:

Ministerial Decision N. 225 dated December 3, 1955 entitled “The protection of workers in Naher El Mout Quakers”.

Ministerial Decision N. 10 dated January 25, 1956 entitled “Conditions of health prevention in the press”.

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Ministerial Decision N. 129/2 dated April 22, 1963 “Defining some preventive and safety measures in bakeries

Ministerial Decision N. 384/1 dated August 5, 1966 entitled “Terms of prevention and safety at work in mills.

Ministerial Decision N. 27 dated December 13, 1980 “Imposing public safety in commercial establishments in Beirut city.

Ministerial Decision N. 493/1 dated September 3, 1997 “Application of the provisions of ILO Convention No. 120 Hygiene (Commerce and Offices) Convention.

Decree N. 11958 dated February 25, 2004 Entiteled“The organization of protection, prevention and safety in construction.

As for HIV/AIDs, the ILO Code of Practice24 and Recommendation No. 200 25 provide that employers should ensure a safe and healthy working environment for their workers. In order to be in compliance with the ILO’s instruments, Lebanese legislators and employers must take the necessary measures to prevent the spread of the virus in the workplace. This will include the establishment of an environment that facilitates optimal physical and

24 ILO Code of Practice page 7 paragraph (h): “Risk reduction and management: Employers should ensure a safe and healthy working environment, including the application of Universal precautions and measures such as the provision and main-tenance of protective equipment and first aid. To support behavioural change by individuals, employers should also make available where appropriate, male and fe-male condoms, counselling, care, support and referral services. Where size and cost considerations make these difficult, employers and/or their organizations should seek support from government and other relevant institutions.”25 ILO Recommandation No. 200 page 7 paragraphs 30 & 31: “30. The working environment should be safe and healthy, in order to prevent transmission of HIV in the workplace, taking into account the Occupational Safety and Health Con-vention,-155, 1981and Recommendation 164, 1981, the Promotional Framework for Occupational safety and Health Convention 187, 2006, and Recommendation 197, 2006, and other relevant international instruments, such as joint International Labour Office and WHO guidance documents. 31. Safety and health measures to prevent workers’ exposure to HIV at work should include universal precautions, accident and hazard prevention measures, such as organizational measures, engi-neering and work practice controls, personal protective equipment, as appropriate, environmental control measures and post-exposure prophylaxis and other safety measures to minimize the risk of contracting HIV and tuberculosis, especially in occupations most at risk, including in the health care sector.”

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mental health in relation to work and adaptation of work to the capabilities of staff in light of their state of physical and mental health, and may include measures for the reasonable accommodation of staff with HIV-related issues. Workers also need to take additional measures where they come into regular contact with human blood and body fluids. Such additional measures are recognized in the ILO Code of practice (paragraph 5.2 (i))26.

Migration and Work PermitAccording to the International Convention on the Protection of the Rights of all Migrant Workers and Members of Their Families, a migrant worker is “a person who is to be engaged, or has been engaged in a remunerated activity in a State of which he or she is not a national”. The convention establishes sub-categories of migrant workers, including “frontier worker”, “seasonal worker”, “seafarer”, “itinerant worker”, “worker on an off-shore installation”, “project-tied worker”, “specified-employment worker”, and “self-employed worker”27.

An increasing number of countries require migrant workers to be tested for HIV prior to entry. Travel for work and migration are areas where fear of HIV/AIDS rather than evidence-based decisions had led to the introduction of restrictions. According to UNAIDS, a number of countries in 201028 and 2011 lifted their HIV related restrictions on entry, stay and residence: for example, the United States of America (January, 2010); China (April, 2010); Namibia (July, 2010) and Fiji (August, 201129).

26 ILO Code of Practice page 7 paragraph 5.2 (i): “Workplaces where workers come into regular contact with human blood and body fluids. In such workplaces, employers need to take additional measures to ensure that all workers are trained in Universal Precautions, which they are knowledgeable about procedures to be fol-lowed in the event of an occupational incident and that Universal Precautions are always observed. Facilities should be provided for these measures.” 27 The Convention was adopted by the United Nations General Assembly resolu-tion45/158 of 18 December 1990. 28 The UNAIDS Report on the Global AIDS Epidemic 2010. 29 The Joint United Nations Programme on HIV/AIDS (UNAIDS) applauds a decision by the Government of Fiji to lift its restrictions on entry, stay or residence based on HIV status. With this reform - officially announced on August 26, 2011

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After the removal of Fiji’s restrictions, UNAIDS counts 47 countries, territories and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. At least 130 countries have no such restrictions as shown in in annex 1.

According to UNAIDS, this is an indicator of the discrimination still faced by people living with HIV in today’s highly mobile world. This practice contradicts the ILO Code of Practice30 and Recommendation No. 20031. In consonance with the Code of Practice, and on the specific topic of migrant workers, the ILO Committee of Experts has stated that “the refusal of entry or repatriation on the grounds that the worker concerned is suffering from an infection or illness of any kind which has no effect on the task for which the worker has been recruited, constitutes an unacceptable form of discrimination”. 32

By Lebanese law, migrant workers require a visa to enter Lebanon, and must be guaranteed by a Lebanese employer. A work permit is supplied by the Ministry of Labour (“MOL”), and foreign workers then use it to acquire a residency permit33. The MOL requires that migrant workers34 to be tested for HIV prior to obtaining

by the President of Fiji at an AIDS conference in South Korea - Fiji joins a growing list of countries that are aligning national HIV legislation with international public health standards. www.unaids.org 30 The code of practice of HIV/AIDS and the world of work made it clear that all the principles listed in it apply to all workers and to all workplaces. Therefore, it is inconsequential whether the worker is seeking employment within his or her own country or searching for work abroad.31 ILO Recommendation N. 200 page 7 paragraph 25: “HIV testing or other forms of screening should not be required of workers, including migrant workers, jobseekers and job applicants”; Paragraph 27: “Workers, including migrant workers, jobseekers and job applicants, should not be required by countries of origin, of transit or of destination to disclose HIV related information about themselves or others. Access to such information should be governed by rules of confidentiality consistent with the ILO code of practice on the protection of workers’ personal data, 1997, and other relevant international data protection standards”.32 ILO, 1999, article 266. 33 Pursuant to Article 7 paragraph (1) of the Labour Law, maids’ workers are not governed by the Lebanese labor law. Their status is governed by a contract between the worker and the employer. 34 Including house maids

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a work permit. The migrant workers are subject to a blood screening test for HIV, Hepatitis B, Syphilis, Tuberculosis and Malaria. In addition to these tests, Egyptian and Sudanese workers are subject to a Bilharziasis test35.

The available data on the basis of compulsory testing of migrant labour have resulted in the perception that HIV is a problem within the migrant workers community in the country and among some Lebanese returning from work abroad. The current policy and practice of compulsory testing of migrant workers need to be readdressed. As the to experience in other countries has shown, compulsory testing is ineffective in preventing the spread of HIV in the country and fuels a false sense of security in the population. Compulsory HIV testing contributes to driving the epidemic underground with those in need not coming forward for help for fear of stigma and discrimination.

Lebanese stakeholders shall discuss to lift the HIV pre-employment mandatory testing with particular attention to the foreigner workers. This discussion should focused on available scientific literature, evidence-based practices and public health information and should address an in -depth evaluation of pro versus contra in relation to this requirement which compromise the principle of human rights as define in the Lebanese constitution and all the other international treats ratified by Lebanon. The lift of HIV pre-employment mandatory testing will align Lebanese labour code to international standard and it will open the scenario toward the promotion of a more integrated and effective HIV prevention strategy.

Sick LeaveProvision for sick leave that adjusts to the progressive nature of HIV infection and the onset of AIDS is a form of reasonable accommodation in the workplace. The ILO Recommendation No.200 sets out that “temporary absence from work because of illness or care giving duties related to HIV or AIDS should be treated in the same way

35 Decision number 263/1 dated June 22, 1995 in its article 2 alinea 4.

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as absences for other health reasons, taking into account the Termination of Employment Convention, 1982.”36 The Code of Practice refers more specifically to time off for medical appointments and flexible sick leave37. The Code pf practice mentions also that employers should provide that, where workers with an AIDS- related condition are too ill to continue working, alternative working arrangements including extended leave should be offered; when these have been exhausted, the employment relationship may be terminated by either party in accordance with anti-discrimination and labour laws and respect for general procedures and full benefits38. By Lebanese Law (Article 40), the worker shall be entitled to a sick leave as follows:

1. Half a month with full pay, and a half a month with half pay between three months service up to two years.

2. One month with full pay, and one month with half pay for more than two years up to four years.

3. One month and a half with full pay, and one month and a half with half pay for more than 4 years up to six years.

4. Two months with full pay and two months with half pay, for more than six years up to ten years.

5. Two months and a half with full pay and two months and a half with half pay, for more than ten years.

In Lebanon, the provisions of the Law concerning sick leave are fair enough to cover the progressive nature of a common disease. However, there are no special provisions for HIV-infected workers. Sick leave should be allowed under the terms and conditions described by the Law and extended if needed.

36 ILO Recommandation N.200 page 5 paragraph 11. 37 ILO Code of Practice on HIV/AIDS and the World of Work page 8 paragraph (j). 38 ILO Code of Practice on HIV/AIS and the World of Work page 7 paragraph (e). * Dr. Leila Haber is physician in charge of the NSSF doctors

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Medical management:

Antiretroviral treatment is provided by the MOPH for all Lebanese patients and recently to Palestinian refugees registered in Lebanon. Dr. Leila Haber* mentioned that after a Ministerial Decision 1/635 of 3 September 2004 NSSF Beneficiaries receive their antiretroviral drugs on an out-patient bases from the MOPH (like other public sector employees, e.g. COOP, Army, etc). All the in-patient medical expenses for AIDS patients including opportunistic infections and other related complications are covered by NSSF except retroviral infection which is also provided by MOPH.

Public Sector’s Employment Laws

The public sector’s employment laws in Lebanon are governed by two mains Decree-Laws Decree-Law No. 112 dated June 12, 1959 entitled “Public Sector Staff Regulation”39 (the “D.L. 112”), and Decree-Law N. 5883 dated November 3, 1994 entitled “Workers’ General Regulation ”(the “D.L. 5883”).

Provisions of the D.L. 112 and compliance with the ILO’s legal instruments. The provisions of D.L. 112 apply to the public sector’s employees who are divided into two groups: permanent and temporary employees. The wage-earners in a public sector are not subject to the D.L. 112 and are governed by D.L. 5883.

Employee’s Dismissal

Pursuant to Article 67, the employee shall be dismissed from work (i) when required by law, or (ii) by decision rendered by the Disciplinary Council40 or (iii) in any of the following cases:

1. Reaching the retirement age;

2. Job cancelling;

39 Or “Personnel Regulation”40 The present disciplinary system in Lebanon, which was established in 1965, entrusts the responsibility of disciplining public officials to a Central General Dis-ciplinary Council.

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3. Behavioral incompetence of the employee;

4. Reorganization of the departments.

The provisions of the D.L.112 in relation to the dismissal are specific and could not be interpreted in different manners by the employer.

HIV Testing and Confidentiality

Article 4 (paragraph 1-d), of D.L. 112 provides inter alia that each person seeking a job in a public sector is subject to a medical certificate issued by the Official Medical Committee41. The provisions of Article 4 do not give any details related to the medical certificate, however the trend of issuing a medical certificate is as follows: the candidate will undergo a chest x-ray at one of the MOPH dispensaries (nowadays any approved X-ray department) then the candidate submits the X-ray report to a medical committee assigned by the MOPH, and a clinical physical exam is carried out-No lab tests are required for working in the public sector .If the candidate is healthy he will undergo the specialty competence exams. The medical certificate requirement would contradict the ILO’s legal instruments if it included HIV testing. However, we have been informed - after interviewing the concerned persons at the Civil Service Board headquartered in Beirut - that HIV testing is not required in practice by the official medical committee.

Occupational Health

There are neither general nor particular health provisions pertaining to HIV/AIDS for a healthy work environment. Hence universal precautions should be taken by legislators in order to attain a healthy workplace environment

Migration and Work Permit

(Pursuant to Article 4 (paragraph 1-a), the applicant must be Lebanese for a period of 10 years at least). Not Applicable41 The Official Medical Committee is composed by three doctors in each district appointed by a decision of the Minister of Public Health.

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Sick Leave

Article 39 related to sick leave provides inter alia for the following:

1. The employee has the right to benefit from a paid sick leave for a period not exceeding one month.

2. If the employee’s absence surpasses one month without interruption, or one month on several stages during a three months working period, the sick leave could be entirely paid for a three months period renewable and after obtaining the opinion of the official medical committee. Pursuant to Article 39, the total number of leaves must not surpass nine months in one year or eighteen months during five continuous years.

If the absence surpasses nine months during one year or eighteen months during five continuous years, the official medical committee shall review the employee’s case. If the employee’s disease could be cured within a two years period, he/she will be entitled to a half paid sick leave for a period not exceeding one year and will not be entitled to work except after obtaining the opinion of the medical committee. If the disease could not be cured within a two years period, or if the medical committee judges that the employee cannot undertake his/her job anymore, the employee will be dismissed from work or led to retirement in accordance with the laws and regulations in force. The provisions of Article 39 are fair enough to cover the progressive nature of a common disease.

The provisions of D.L 5883 comply in general with the ILO’s legal instruments

Worker’s Dismissal

Pursuant to Article 28 of D.L. 5883, worker’s dismissal may occur at any time and (i) with one month notification if the worker has been working for six months to three years, (ii)with two months notification if the work period exceed three years. The decision of dismissal must be justified. If the HIV-infected worker was dismissed by a justified decision pursuant to Article 28, such dismissal would be in contradiction to the ILO’s legal instruments.

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It is preferable to include specific provisions related to the protection of the HIV-infected workers.

HIV Testing and Confidentiality

Article 4 (paragraph 1-d), of D.L. 5883 provides inter alia that each person seeking a job in the public sector must submit a medical certificate issued by the Official Medical Committee. The provisions of Article 4 do not give any details related to the medical certificate. The medical certificate requirement would contradict the ILO’s legal instruments if it included HIV testing. However, we have been informed - after interviewing the concerned persons at the Civil Service Board headquartered in Beirut - that HIV testing is not required in practice by the official medical committee.

Occupational Health

There are no specific HIV/AIDS provisions related to a healthy work environment in the workplace for a healthy working environment in general. Hence the universal precautions for body fluids contact must be implemented by the legislator in the workplace.

Migration and Work Permit

Pursuant to Article 4 (paragraph 1), the applicant must be Lebanese for a period of at least10 years. However, seasonal workers, domestic workers and cleaning workers are exempted from the nationality condition. According to Article 4, seasonal workers, domestic workers and cleaning workers may be of foreign nationality. As previously discussed, HIV testing is required in Lebanon in order to obtain a work permit. HIV testing prior to obtaining a work permit should not be imposed by law.

Sick Leave

Pursuant to Article 16, the worker shall be entitled to a sick leave as follows:

1. Half a month with full pay, and half a month with half pay for between three months and two years of service.

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2. One month with full pay, and one month with half pay for between two years and four years of service.

3. One month and a half with full pay, and one month and a half with half pay for between four 4 years and six years’ of service.

4. Two months with full pay and two months with half pay, for between six years up and ten years’of service.

5. Two months and a half with full pay and two months and a half with half pay, for more than ten years’ of service.

The worker shall be dismissed from work if the sick leave surpasses five months during the same year or ten months during five continuous years. The provisions of Article 16 are fair enough to cover the progressive nature of a common disease. However, according to D.L 5883 the worker shall be dismissed from work if the sick leave surpasses five months during one year or ten months during five continuous years. This is considered in contradiction to ILO’s legal instruments; According to ILO’s legal instruments extended leave should be offered with reasonable accommodation.

It is preferable to include specific provisions for those suffering from chronic diseases including HIV/AIDS infected workers.

Public Health Laws

The “MOPH” has adopted several circulars and decisions in order to control and avoid HIV/AIDS epidemics in Lebanon; these circulars and decisions are related to the safety of blood, mandatory declaration, confidentiality, non-discrimination and compulsory testing of high-risk groups. The MOPH had never adopted rules and policies related to the protection of HIV-infected workers in the workplace, such as guidelines for HIV/AIDS based on respect for workers’ rights, or practical health and safety programmes to ensure a safer work environment. However, two major circulars adopted by the MOPH

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could be interpreted as protection against discrimination in the workplace: Circular No. 35/1 dated 1988 and Circular No. 91 dated 1991.

Circular 35/1 dated 1988: This circular refers indirectly to the non-discrimination’s right of the workers in the workplace. It provides inter alia, in Article 6 paragraph 1, that the Lebanese State confirms that the AIDS prevention programme protects the rights and dignity of the human and that all efforts will be made to prevent social discrimination between infected and non-infected citizens. Paragraph 2 of Article 6 provides furthermore that all efforts must be made and cooperation should occur in order to support and provide the best care for infected persons.

Circular 91 dated 1991: This circular refers indirectly also to the protection of HIV infected workers in the workplace. Pursuant to the circular, there should be no discrimination against HIV-infected persons. The patients are part of society and should benefit from social services as well. The confidentiality of AIDS test should be respected. Counselling and other services should be available.

The provisions of these two circulars provide indirectly general principles related to the protection of infected workers in the workplace. According to some interviews, it appears that these principles are not being applied and people living with HIV are at risk of being denied treatment and care.

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Other circulars adopted by the MOPH specific to HIV/AIDS are the following:

Decision 150/1-1990: This decision provides that AIDS is a communicable disease the reporting of which should be obligatory. The reporting should be confidential and done by the treating physician to the prevention department at the MOPH.

Decision 148/1-1990: This decision provides that every blood donor should be screened for HIV, Hepatitis B and STDs, and all infected blood should be discarded.

Decision 236/1-1991: People engaging in risky behaviour, specifically sex work-ers, intravenous drug users and prisoners should undergo HIV tests every 3 months.

Decision 438/1-1993: This decision provides that every director of a blood bank or laboratory should confidentially declare any HIV positive test, using a spe-cial confidential declaration form available at the prevention department or the National AIDS Control Programme. This Programme has the responsibility of receiving and analyzing the reporting forms.

Decision 439/1-1993: This decision provides for sanctions on doctors who do not report HIV-positive tests.

Decision 857/1: This decision provides that a Premarital Medical Examination is obligatory, and that the form is free of charge, but the tests and examinations are at the expense of the person asking for marriage. It provides also the different diseases to be tested for.

Circular 73-1994: This circular provides the procedures that should be followed by laboratories and doctors. It stresses the issue of confidentiality and explains how to proceed in case of a positive test results. The procedures are based on international standards.

Decision 14/2-1997: This circular provides the procedure of reporting an HIV-positive result and the various locations of the reporting forms.

Decision 853/1-1996: This provides that the Quarantina building will be assigned for the prevention of communicable diseases among them AIDS.

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Inclusion of HIV/AIDS in the list (which was initially issued in 1957) of communicable diseases in 1990 raises a lot of concern. According to this decree the physician should inform the concerned authorities about any communicable disease including the name of the infected patient

Other Lebanese codes

1. Penal Code: Article 579 gives the right to disclose secrets (even medical) .There is no clear penalty for people who disclose secrets. Moreover, these are no provisions concerning the punishment for acts of discrimination at work and in employment.

2. Civil Code: Article 264 “if the information reveals a felony or intentional misdemeanour (as wife protection or homosexual relations or through prostitution)

3. The Medical Professional Code of Ethics issued in 1994, states clearly that the names of patients with STDs should not be disclosed unless they refuse treatment.

Interviews with Employers and Workers Representatives

The overall goal of the interviews was to determine the capacity of the private and public sectors in Lebanon to assist in fighting the epidemic of HIV/AIDS. The study was based on structured interviews with two key groups: employers’ and workers ‘representatives.

We attempted to answer many questions and to survey the employers’ and workers’ opinions through structured interviews with five employers’ representatives (Associations and Syndicates) and five workers’ representatives. These interviews helped us to better understand the opinion of the employers and workers’ representatives with respect to the HIV epidemic in the workplace.

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In each case we asked permission to interview the president of the Syndicate or Association. In some cases, we could not interview the president for one reason or another, but we were referred to a representative who is knowledgeable in matters of HIV/AIDS policy.

Interviews with Employers’ Representatives

The question of whether or not employers should be involved in the fight against HIV/AIDS is a crucial one in Lebanon. During our study, we interviewed up to five employers representatives (Associations and Syndicates) which represent a large number of employers in Lebanon.

To what extent are Lebanese employers providing HIV education and treatment services? Do employers representatives in Lebanon (Associations or Syndicates) have a written policy concerning HIV infected workers? Would the employers’ representatives respond to Government regulations in developing HIV/AIDS policies?

A detailed list of Syndicates and Associations Interviewed is contained in Annex 2.

AIDS Mortality and Level of Concern about HIV/AIDS:

While interviewing the employers’ representatives, all of them stated that they were unaware of significant AIDS mortality in the workforce. Most of them do not rank HIV/AIDS as one of the most important management issues in Lebanon. They have never offered an AIDS prevention training session in the past. The interviews reveal that the level of concern about HIV/AIDS was low. For employers’ representatives, HIV/AIDS is simply not a workplace issue at this time. When asked to rate the importance of HIV/AIDS as an enterprise level concern, most of the persons interviewed responded that HIV/AIDS is “NOT AN ISSUE” or “MENTIONED OCCASIONALLY BUT NEVER CONSIDERED IMPORTANT”.

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63HIV and AIDS and the World of Work in Lebanon

Corporate Policies towards HIV Positive Workers:

All of the employers representatives interviewed reported that they did not develop policies dealing with HIV-positive individuals. They did not expressly call for non–discrimination treatment in hiring, training and promotion. Some of them believe that the employer has the right to ask for pre-employment HIVtesting in order to be aware about the workers health condition. Many of them mentioned that many people do not know how HIV/AIDS is transmitted. They revealed that employing a person with HIV may cause problems with clients and fellow workers.

None of them expressed a willingness to sponsor HIV/AIDS education for their workers.

Pressures for Change:

Employers’ representatives revealed that they did not feel outside pressure to develop HIV/AIDS policy or to offer HIV/AIDS treatment benefits. All of them said that they did not feel pressure from workers to add HIV/AIDS benefits.

Public Awareness:

Most of the persons interviewed revealed that many employers in Lebanon might refuse to adopt HIV/AIDS policy (nondiscrimination, pre-test employment, unfair dismissal…) due to a lack of awarness of how HIV/AIDS is transmitted. The persons interviewed explained that an education programme that discusses how HIV is transmitted is crucial in Lebanon for both employers and workers. Education for employers, workers, their families, and the community is important in order to provide accurate and up-to-date information on how HIV/AIDS is transmitted.

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Government Regulation:

These representatives did indicate that they would respond to a government requirement, for example, to adopt an HIV policy.

In conclusion. It appears that employers did not perceive HIV as a workplace concern, mainly due to the lack of proper information and awareness but also because they did not feel any pressure from other stakeholders including workers representatives and civil society. Despite the low awareness, employers would respond to a government requirement to endorse or develop a specific policy.

Interviews with Workers’ Representatives

We interviewed up to five workers representatives (Associations and Syndicates) in Lebanon, representing a large number of workers in both, the public and private sectors.

Does your organization (Associations or Syndicates) have a written policy concerning HIV-infected workers? Does your organization sponsor any training on HIV/AIDS prevention and treatment, or sponsor any support groups for HIV-infected workers? Are you aware of any discrimination related to HIV-infected workers? Would you respond to Government regulations in developing HIV policies?

Annex the detailed list of Syndicates and Associations interviewed is contained in Annex 2.

AIDS Mortality and Level of Concern about HIV/AIDS:

While interviewing these representatives, all of them stated to be unaware of significant AIDS mortality in the workforce. All of them do not rank HIV/AIDS as one of the most important concern issue in Lebanon. Most of them have never offered an HIV/AIDS prevention training session in the past. International Public Service (“IPS”)

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65HIV and AIDS and the World of Work in Lebanon

representative mentioned that IPS had offered an AIDS prevention training and Programme in many countries in the world but not in Lebanon until now. The interviews reveal that the level of concern about HIV/AIDS was low.

Corporate policies towards HIV positive workers:

All of the workers representatives interviewed reported that they did not develop policies dealing with HIV positive individuals. They did not call or ask their employers for non –discrimination treatment in hiring, training and promotion. Most of them did not recall that they are willing to sponsor HIV/AIDS education for their workers.

Pressures for change:

All of the workers’ representatives revealed that they did not feel pressure from their workers to develop HIV/AIDS policy or offer HIV/AIDS treatment benefits. The persons interviewed believed that HIV infected workers in Lebanon may not disclose their cases to the syndicate or association to which they belong in order not to be discriminated against in the society. Most of them considered while that there may be discrimination in the workplace, such discrimination had never been revealed to the Syndicate or Association. In addition to any shame in revealing that they are infected, workers worry that employers may discriminate against them in the future (in promotions and layoffs) if they disclose their HIV status to fellow workers.

Public Awareness:

The persons interviewed explained that an education programme that discusses how HIV is transmitted is crucial in Lebanon for fellow workers. Education for fellow workers, their families, and the community is important in order to provide accurate and up to date information on how HIV/AIDS is transmitted.

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Government Regulation:

These representatives did indicate, however that they would respond to a government requirement, for example, to adopt an HIV policy with their employers. A classic starting point is through the development of policy guidelines on AIDS. Whether done for a company or an employer’s organization, the process of drafting guidelines can help in facing the disease and is a necessary first step towards fighting stigma and discrimination, which are key obstacles to fighting AIDS effectively. Such policy guidelines are all the more effective when produced in partnership with workers.

In conclusion. Workers, like employers, showed a poor understanding of HIV/AIDS and little awareness and recognition of HIV/AIDS as a workplace issue. They confirmed that no dialogue in this regard has started with employers. They reported also that no concerns have been brought to the attention of the workers’ representatives from civil society, or from associations representing PLHIV nor from individual case.

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Chapter 3:

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69HIV and AIDS and the World of Work in Lebanon

DiscussionThe aim of this study has been to assist the Lebanese government to better analyze national work-related legislation in regard to HIV and AIDS and to compare them with international standards.

This study has showed significant gaps between Lebanese legislation and international standards in relation to HIV and AIDS and the world of work. According to this study; dedicated policies related to HIV and AIDS and the world of world are in place at neither the national nor the sectoral level.

Interviews with stakeholders revealed also that, in practice workers living with HIV might be subject to discrimination and stigmatization in the workplace. Workers with actual or perceived HIV infection face the risk of dismissal when their HIV status has been known or disclosed. In addition, lack of awareness of the modes of HIV transmission has led to employers believing erroneously that dismissing workers can inhibit the spread of the infection in the workplace.

Discussion and Final Recommendations

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The study has identified specific discrepancies between national laws and Recommendation No. 200. These discrepancies indicate that there is a need to amend some of the laws and issue instructions to clarify provisions that are vague and open to misinterpretation. These discrepancies can be grouped in two categories which might be amended using different legislative tools.

The first category of discrepancies is characterized by laws with a non-discrimination principle but with unclear definitions in the text which might lead to misinterpretation and consequently wrong application (as reported in this study). This is the case the requirement of a pre-employment medical examination to check the “fitness to work” of the workers. At present, there is no exhaustive list of proper medical examinations thus leaving room for employers to ask for HIV testing which should not be included. PLWHA confirmed that they were asked to present the HIV test along with the other medical examinations to apply for some job positions. In this category we can refer also to unfair dismissal due to the unclear definition of “valid reason” and the need to stipulate that HIV status should not be considered a “valid reason” for dismissal. The call for updating the list of occupational health diseases is also in this category. This degree of inconsistency between international standards and national laws can be amended through regulations, and communications.

The second category of discrepancies deals with laws which include principles of discrimination. This is the case with mandatory pre-employment HIV testing for migrants. At the global level and after 30 years of the HIV epidemic, the scientific community, public health experts and international organizations have agreed on well-defined guidelines which reject the use of compulsory HIV testing on grounds that this constitutes a violation of human rights as well as having been demonstrated ineffective in controling and mitigating the HIV epidemic. Furthermore, compulsory HIV testing of migrants creates a false sense of security among the public and drives the epidemic underground with those in need not coming forward for medical assistance due to fear of stigma and discrimination. For these reasons, Lebanon

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should consider revising the requirement of mandatory pre-employment HIV testing.

ILO constituents (Ministry of Labour, employers’ and workers’ representatives) , with assistance from the ILO office, can play a key role in supporting the national AIDS response in Lebanon based on the guidelines of the new international labour standard on HIV/AIDS Recommendation No. 200. The need to revise national legislations and align them with international standard should go in parallel with the development of national or sectoral policies on HIV and AIDS and the world of work based on the principles of Recommendation No. 200 in order to provide stakeholders with clear guidance for mitigating the impact of HIV in the world of work, thus reducing stigma and discrimination. This policy should come as the result of extensive consultation and social dialogue between all the relevant stakeholders and be built on the basis of concrete negotiations. Experience shows that this leads to the adoption of provisions addressing HIV/AIDS that are feasible and more sustainable. The development of such a policy will be welcomed by employers and workers who declared during the interviews of this study that they would respond to a government requirement to endorse or develop a specific policy on HIV and AIDS and in the workplace.

It appears clear that employers did notperceive HIV as a workplace concern, mainly due to a lack of proper information and awareness but also because they didn’t feel any pressure from other stakeholders, including workers’ representatives and civil society. In this regard, Lebanon should reinforce the role of relevant stakeholder to advocate the rights at work.

Summary of Proposed AmendmentsWith specific reference to the study findings, outlined below are the proposal amendments to key provisions in Lebanese legislation pertaining to HIV and AIDS and the workplace. These amendments should improve the status of individuals living with HIV who are either seeking

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work or currently working in Lebanon:

Article 50 of the Labour Code should be clarified to ensure that employers can not consider HIV status as a “valid reason” for dissmisal.

Instructions related to Article 34 and 38 of the D.L. No.11802 (January 30, 2004) of the Labour Code concerning the private sector and the D.L. No.112 and N.5883 should also be issued to define the nature of the regular medical examination employees are required to undergo. The instructions should ensure that HIV testing is not imposed on employees, regardless of the sector in which they work. This amendment should be clear and explicit in order to encourage PLHIV to apply for work in the private and public sectors.

The requirement for all migrant workers to undergo HIV testing in order to obtain a work permit should be better discussed and instructions should be amended. Workers should not be required to undergo compulsory testing and disclosure of their HIV status for purposes of recruitment and employment. Testing should be free from any form of coercion and must be genuinely voluntary including for migrants. Eliminating mandatory pre-employment HIV testing should be promoted in parallel with the reinforcement of voluntary counseling and testing and an education campaign.

Lebanon should review and clarify some articles of the penal and criminal laws and correctional systems to ensure that they are consistent with international human rights obligations and are not misused in the context of HIV or by targeting vulnerable groups.

The tables of occupational diseases annexed to the private laws should be updated, to include infection with HIV or HIV-related illnesses.

It would be preferable to include specific reference toHIV and AIDS in Article 40 of the Lebanese Labour Code and Article 39 D.L. No.112 and D.L. No.5883 which should be improved to enable

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workers living with HIV to take extended sick leave if needed. This should include measures of reasonable accommodation and other suggestions of Recommendation No. 200.

Final Recommendations.According to the study’s findings, the following recommendations should be considered to ensure the rights of people living with HIV/AIDS in accordance with ILO standards and to promote the role of the world of work in mitigating the impact of HIV on workplace.

1. The response to HIV and AIDS should be recognized as a workplace concerns, and the world of work should take action to mitigate the impact of HIV in the workplace and to promote the rights at work for all workers including those with HIV/AIDS. This will contribute to the achievement of the decent work agenda and its principles of human rights, fundamental freedom and gender equality for all, including workers, their families and dependents. It will also contribute to the implementation of the National Strategic Plan on HIV/AIDS. Seminars should also be organized with stakeholders.

2. A dialogue should be initiated aimed at the amendment of the laws and the development of a national or sector-specific policy on HIV and AIDS and the world of work based on the principles of the Recommendation No.200.

3. The Ministry of Labour in close collaboration with its social partners and the Ministry of Health, could take steps to establish a working group on HIV and AIDS and the world of work within the Ministry of Labour in order to discuss possible amendments tothe law according to the findings of this study possible policies in this regard.

4. Specific training on the implementation of the Lebanese laws and their proposed amendments in regard to HIV and AIDS in the workplace should

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be encouraged to avoid misinterpretation. Those seminars should be tailored for labour inspectors, human resource managers, judges and lawyers; particularly in sectors such as banking, constructions, tourism and transportation which are key sectors in the Lebanese economy. As in other countries, the workforce of these sectors is vulnerable to HIV and AIDS.

5. HIV and AIDS awareness should be promoted in social dialogue and within existing training activities targeting employers’ and workers’ representatives

6. Consultations should be initiated with all concerned to begin a review of HIV testing policies to bring them in line with the principles contained in the ILO Recommendation No.200.. Tailored seminars which should include data analyses concerning HIV/AIDS and the workplace in Lebanon should be encouraged in collaboration with ILO and UNAIDS.

7. The role of worker’ representatives in advocating for the rights at work of PLHIV and in mitigating the impact of HIV on workers should be strengthened. In this regards customized training should be promoted to integrate existing skills amongst member of syndicates in Lebanon.

8. Considering the vigorous role of Lebanese civil society, particularly NGOs dealing with PLHIV, the role of these associations in the advocacy process should be reinforced, and training should be provided to increase their knowledge on work-related issues and to increase their capacity to advocate for rights at work.

9. Partnership between the private sector and associations trained on HIV awareness promotion and education should be encouraged, with the aim of starting up education campaigns in the workplace which might mitigate stigma and discrimination amongst co-workers in the workplace and help to prevent new HIV infection amongst workers.

10. HIV and migration is a sensitive issue across the

74 C h a p t e r 3

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region, particularly compulsory HIV testing for migrant workers. It is thus recommended to reinforce the regional dialogue in this regard. Regional seminars or workshops on HIV and migration should be promoted in collaboration with ILO and UNAIDS and other concerned organizations together with national representatives to review the situation and to arrive at a recommendation for a humanitarian approach on migrant workers to be considered and adopted by the national governments. A Lebanese delegation should make efforts to participate in such events and provide national data and analysis.

11. Whether or not the law implicitly permits, international norms are clear: “Nowhere should HIV positive workers be dismissed from work or discriminated against because of their status. These are among the basic conditions of employment that should be respected”

12. Already the number of people infected with HIV in Lebanon by 2011 has reached 1455; the question is how many of them need national policies to be adopted urgently in expanded responses by governments?

75HIV and AIDS and the World of Work in Lebanon

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BIBLIOGRAPHY

Universal Declaration of Human Rights, adopted in Paris by the United Nations General Assembly in 1948.

The International Convention on the Protection of the Rights of all Migrant Workers and Members of Their Families, adopted by the United Nations General Assembly Resolution45/158 of 18 December 1990.

Convention on the Rights of the Child, entry into force on September 2, 1990.

Discrimination (Employment and Occupation) Convention, 1958, No. 111, International Labour Organization, Geneva.

Code of Practice on HIV/AIDS and the world of work, International Labour Organization, Geneva.

Recommendation concerning HIV/AIDS and the world of work, No.200, International Labour Organization, Geneva.

UNAIDS Report on the Global AIDS Epidemic 2010.

International Organization of Employers, “Employers Handbook on HIV/AIDS/A Guide for Action”, May 2002

Franklyn Lisk, “Working Paper ILOAIDS- The Labour Market and Employment Implications of HIV/AIDS”, ILO- International Labour Office

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Decree-Law No. 5883 dated November 3, 1994

Decree-Law No. 6341 dated October 24, 1951

Ministerial Labour Decision No. 225 dated December 3, 1995

77HIV and AIDS and the World of Work in Lebanon

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Ministerial Labour Decision No. 10 dated January 25, 1956

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Joint United Nations Programme on HIV/AIDS, www.unaids.org

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International Labour Organization, www.ilo.org

World Health Organization, www.who.int

78 B i b l i o g r a p h y

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الفصل الثالث:

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٧٣ الفصل الثاني

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٦٩ الفصل الثاني

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٣٩ تتألّف اللجنة الطبية الرسمية من ثالثة أطباء يف كل محافظة يعيّنون بقرار صادر عن وزير الصحة العامة.

٦٧ الفصل الثاني

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الوطني الصندوق أطباء عن املسؤولة الطبيبة هي الهرب ليىل الدكتورة * ٣٧للضامن االجتامعي.

نظام موظفي القطاع العام٣٨ النظام التأديبي الحايل يف لبنان تأسس عام ١٩٦٥، وتعهد مسؤولية تأديب

موظفي القطاع العام إىل مجلس التأديب املركزي.

فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٦٦

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٣٦ مدونة مامرسات منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية واإليدز وعامل العمل، الصفحة ١٣، الفقرة (هـ).

٦٥ الفصل الثاني

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رقم ٢٠٠، الصفحة ٦، الفقرة ١١.٣٥ مدونة مامرسات منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية

واإليدز وعامل العمل، الصفحة ١٤، الفقرة (ي).

فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٦٤

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منظمة مامرسات مدونة مع يتمىش مبا الرسية احرتام لقواعد املعلومات هذه مثل عىل البيانات حامية ومعايري ،١٩٩٧ للعامل، الشخصية البيانات حامية بشأن الدولية العمل

الدولية األخرى ذات الصلة."٣١ منظمة العمل الدولية، ١٩٩٩، املادة ٢٦٦

للامدة (٧) الفقرة (١) يستثنى من أحكام هذا قانون العمل الخدم ٣٢ وفقاً يف بيوت األفراد. ويخضع وضع هؤالء للعقد املربم بني العامل وصاحب العمل. خارج عن

موضوع الدراسة.٣٣ من ضمنهم العامالت املنزليات

٦٣ الفصل الثاني

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٢٨ "يشيد برنامج األمم املتحدة املشرتك املعني بفريوس نقص املناعة البرشية/اإليدز (UNAIDS) بقرار حكومة فيجي عىل رفع القيود املفروضة عىل الدخول إىل البلد والبقاء أو اإلقامة فيها عىل أساس وضع اإلصابة بفريوس نقص املناعة البرشية. ومع هذا اإلصالح - الذي أعلنه رئيس فيجي رسمياً يف ٢٦ آب/أغسطس عام ٢٠١١ يف مؤمتر اإليدز يف كوريا الجنوبية - تنضم فيجي إىل القامئة املتزايدة بالدول التي تعمل عىل اتساق قوانينها www. ".الوطنية ملكافحة فريوس نقص املناعة البرشية مع املعايري الدولية للصحة العامة

unaids.org٢٩ نّصت مدونة مامرسات منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية واإليدز وعامل العمل بوضوح عىل أّن جميع املبادئ املدرجة فيها تنطبق عىل جميع العامل ويف جميع أماكن العمل. لذلك ال فرق إن كان العامل يبحث عن عمل يف بلده األصل

أو خارجه.٣٠ توصية منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية واإليدز رقم ٢٠٠، الصفحة ٩، الفقرة ٢٥: " ينبغي أالّ يُطلب من العامل، مبن فيهم العامل املهاجرون والباحثون عن عمل واملتقدمون إىل وظيفة، إجراء اختبار كشف فيام يخص فريوس نقص املناعة البرشية أو غري ذلك من أشكال الكشف عن فريوس نقص املناعة البرشية." والفقرة ٢٧: " ينبغي أالّ تطلب بلدان املنشأ أو بلدان العبور أو بلدان املقصد من العامل، مبن فيهم العامل املهاجرون والباحثون عن عمل واملتقدمون إىل وظيفة، اإلفصاح عن معلومات تتصل بفريوس نقص املناعة البرشية، سواء تعلق األمر بهم أو بغريهم. وينبغي أن يخضع الحصول

فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٦٢

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٢٦ مدونة مامرسات منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية واإليدز وعامل العمل، ، الصفحة ١٤، الفقرة (ط): "أماكن العمل التي يتعامل فيها العاملون بشكل منتظم مع الدم البرشي وغريه من السوائل العضوية: يف مثل هذه األماكن، ينبغي ألصحاب العمل اتخاذ إجراءات إضافية لكفالة تدريب جميع العاملني حسب االحتياطات يف حادث وقوع حالة يف اتباعها الواجب اإلجراءات بجميع معرفتهم من والتأكد العامة لهذا والتسهيالت املرافق وتوفري العامة لالحتياطات مراعاتهم من دوماً والتأكد العمل

الغرض."كانون ١٨ يف املؤرخ ٤٥\١٥٨ العامة الجمعية بقرار االتفاقية اعتمدت ٢٧

األول/دميسرب عام ١٩٩٠.

٦١ الفصل الثاني

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1966� f<������=&*�i%*�5�µ�42f�8�384�1��E4�«4*5K�4*|E]�¢0f�º*�µ����G*�µ�jHÏ��G*K�jMfE§G*��K}7^�£*§¡<�l±

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��E4�j©�8§kG*K�24j©GKzG*����G*�j��¡H�mf�64fÁ�jIKzH� T��¡-�£&* �¨�<�5zM(¶*�j<f¡º* ����I��6KÒ�G�£fk����wº*�20025��f¤©D�Ó�Hf��G�j¡H%*K�j©t�8���<�jc©+����G*�ift�8&*�¢���M�£§©If¡g�G* ����G* �ift�8&*K �£§<}�º* ��nkÈ �£&* ��/&* �¢HK٢٤ مدونة مامرسات منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية واإليدز وعامل العمل، ، الصفحة ١٤، الفقرة (ح): "الحد من املخاطر وإدارتها: ينبغي ألصحاب العاملية واملقاييس االحتياطات تطبيق ذلك يف مبا وصحية، آمنة عمل بيئة تهيئة العمل سلوك تغري تشجيع إىل وسعياً األولية. واإلسعافات الحامية معدات وصيانة توريد مثل الواقي الذكري للنساء والرجال، عالوة عىل األفراد، ينبغي ألصحاب العمل أن يوفروا أيضاً الخدمات هذه تقديم يصعب وحينام والتوجيه. والدعم والرعاية االستشارية، الخدمات بسبب حجمها وتكلفتها، ينبغي ألصحاب العمل و/أو منظامتهم السعي للحصول عىل دعم

من الحكومات وغريها من الهيئات ذات الصلة."٢٥ توصية منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية واإليدز رقم ٢٠٠، الصفحة ٩، الفقرتان ٣٠ و٣١: "٣٠. ينبغي أن تكون بيئة العمل آمنة وصحية، توخياً ملنع انتقال فريوس نقص املناعة البرشية يف مكان العمل، مع مراعاة اتفاقية السالمة اإلطار واتفاقية ، ١٩٨١ املهنيتني، والصحة السالمة وتوصية ، ١٩٨١ املهنيتني، والصحة والصحة للسالمة الرتويجي اإلطار وتوصية ،٢٠٠٦ املهنيتني، والصحة للسالمة الرتويجي املهنيتني، ٢٠٠٦ ، والصكوك الدولية األخرى ذات الصلة، مثل الوثائق اإلرشادية املشرتآة بني مكتب العمل الدويل ومنظمة الصحة العاملية. ٣١. ينبغي أن تشمل تدابري السالمة والصحة وتدابري العامة االحتياطات العمل يف البرشية املناعة نقص لفريوس العامل تعرض ملنع الوقاية من الحوادث واملخاطر مثل التدابري التنظيمية وعمليات املراقبة التقنية ومامرسات العمل الوقائية ومعدات الحامية الشخصية، وعند االقتضاء، تدابري املراقبة البيئية والعالج الوقايئ بعد التعرض للفريوس وتدابري السالمة األخرى للتقليل إىل أدىن حد من خطر اإلصابة بفريوس نقص املناعة البرشية والسل، ال سيام يف املهن األآثر تعرضاً للخطر، مبا يف ذلك يف

قطاع الرعاية الصحية."

فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٦٠

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٥٩ الفصل الثاني

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��©;§k�G��g��H��}�F٢١ مدونة مامرسات منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية

واإليدز وعامل العمل، يف فقرتها ٨-١.٢٢ توصية منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية واإليدز

رقم ٢٠٠، الصفحتان ٨ و٩، الفقرات ٢٤، و٢٥، و٢٦.يف الحق ١٩٩٨ عام يف اإلنسان لحقوق املتحدة األمم لجنة أوضحت ٢٣الخصوصية يف املادة ١٧ من العهد الدويل الخاص بالحقوق املدنية والسياسية، كام أوضحت أن جمع املعلومات الشخصية وحفظها عىل أجهزة الكمبيوتر، وبنوك البيانات، وأي أجهزة أالّ ويجب القانون، ينظمها أن يجب األفراد أو العامة السلطات جانب من سواء أخرى التوظيف؛ يف كالتمييز العهد، مع تتعارض ألغراض أبداً املعلومات هذه مثل تستخدم التعليق العام رقم ١٦ الوارد يف تجميع التعليقات العامة والتوصيات العامة التي اعتمدتها هيئات معاهدات حقوق اإلنسان، وثيقة األمم املتحدة، جنيف HRI/GEN/١/Rev.٢، يف

٢٩ آذار/مارس عام ١٩٩٦.

٥٧ الفصل الثاني

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فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٥٦

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التمييز أنواع من نوع أي عىل حظراً قوانينه يف بلداً ١٥ من أكرث أدرج ١٨عىل أساس الوضع الصحي مبا يف ذلك التمييز ضد األشخاص املصابني بفريوس نقص املناعة البرشية أو اإليدز باإلضافة إىل كوستا ريكا، كولومبيا، واإلكوادور، وفنلندا، وفرنسا، وإيطاليا، وهونغ كونغ، ونيوزيلندا، والفلبني، والربتغال، وجنوب أفريقيا، وتايالند، وزميبابوي. وعرّفت عدة دول أعضاء مصطلح العجز ليشمل األفراد املصابني بفريوس نقص املناعة البرشية/

الدولية العمل منظمة إدارة مجلس وثيقة املتحدة. واململكة وكندا، كأسرتاليا، اإليدز، GB٢٨٥/٢، الفقرة ٢٦.

١٩ باستثناء حالة ترصيح العمل املطبقة عىل غري اللبنانيني٢٠ املادة األوىل من املرسوم االشرتاعي رقم ألغت املرسوم االشرتاعي رقم ٦٣٤١ الصادر يف ٢٤ ترشين األول/أكتوبر عام ١٩٥١ واملتعلق بتنظيم الوقاية والسالمة والصحة

املهنيتني يف جميع املؤسسات الخاضعة لقانون العمل.

٥٥ الفصل الثاني

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١٥ أجرت السيدة نادية بدران من جمعية العناية الصّحية هذه املقابلة.١٦ "ينبغي أال تكون اإلصابة بفريوس نقص املناعة البرشية أو شبهة اإلصابة به إلنهاء االستخدام." توصية منظمة العمل الدولية بشأن فريوس نقص املناعة البرشية سبباً

واإليدز رقم ٢٠٠، الصفحة ٦، الفقرة ١١.املناعة نقص بفريوس مرتبط مبرض املصابني األشخاص حرمان ينبغي "ال ١٧مقتىض حسب معقول تكييف مع بعملهم االضطالع يف االستمرار إمكانية من البرشية الحال، ما داموا قادرين صحياً عىل القيام بذلك. وينبغي تشجيع التدابري الرامية إىل إعادة توزيع مثل هؤالء األشخاص عىل وظائف مكيفة بشكل معقول مع قدراتهم والبحث عن عمل آخر من خالل التدريب أو تسهيل عودتهم إىل العمل، مع األخذ بعني االعتبار صكوك بشأن الدولية العمل منظمة توصية الصلة." ذات املتحدة واألمم الدولية العمل منظمة

فريوس نقص املناعة البرشية واإليدز رقم ٢٠٠، الصفحة ٦، الفقرة ١٣.

فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٥٤

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توسيعها تم عّدة صحية برامج "سيد" فريق وضع الداخلية. الشؤون وزارة عن الصادر أصبحت لذلك، ونتيجة تغطيها. التي املختلفة املجتمعات احتياجات لتلبية وتعديلها Soins” بالفرنسية اسمها من األوىل (األحرف "(SIDC) "سيديك ١٩٩٢ عام يف "سيد" Infirmiers et Développement Communautaire“) وتوسعت برامجها لتصبح برامج لتنمية املجتمعات املحلية وتشمل السلوكيات الصحية والوقاية من األمراض. وقد وضعت "سيديك" برامجها التخاذ شكلها الفعيل، وتعكس مبادئها ومعتقداتها يف أنشطة موجهة إىل أربعة برامج فئات الشباب والكبار واملسنني والفئات الضعيفة من السكان. وتجرى حالياً برنامج البرشية/اإليدز – املناعة نقص فريوس مكافحة برنامج التمريض - برنامج رئيسة:

مكافحة املخدرات - وبرنامج الشباب.١٤ أجرت السيدة نادية بدران من جمعية العناية الصّحية هذه املقابلة.

٥٣ الفصل الثاني

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٤٧ الفصل الثاني

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فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٤٦

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��¤k¡- �£&* �f¤¡�È �¶ �mfH§�¸* �£&* �ª¡�M ��§�¸* � *Ì0* � T£(*�K&* �rH*ÊG*K&* �mf�6f©��G*K&* �ÓI*§�G*�µ�,}7fgH�£f��I(¶*��§�0�¥¡�È �¶ �£f¡gG � T£&* ��fnº* ��©g�6 �¨�< �f¡J �|F{IK ��mf�64f�º*�j<f¡º* ����I ��6KÒ�+ �Ó+f��º* ��f��G* �£fH|0 �Nf©:fgk<*١١ اعتمدت اتفاقية حقوق الطفل وفتح الباب أمام التوقيع واملصادقة عليها واالنضامم إليها مبوجب قرار الجمعية العامة لألمم املتحدة ٤٤\٢٥ الصادر يف ٢٠ ترشين

األول/نوفمرب ١٩٨٩ ودخلت حيز التنفيذ يف ٢ أيلول/سبتمرب عام ١٩٩٠وفقاً للامدة ٤٩.

٤٥ الفصل الثاني

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واإليدز البرشية املناعة نقص لفريوس التصدي مبسألة االعرتاف "ينبغي ١٠الجنسني بني واملساواة األساسية والحريات اإلنسان حقوق إعامل يف تساهم بوصفها للجميع، مبن فيهم العاملوعائالتهم وُمعالوهم." توصية منظمة العمل الدولية بشأن فريوس

نقص املناعة البرشية واإليدز رقم ٢٠٠، الصفحة ٤، الفقرة (٣-أ).

فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٤٤

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٤٣ الفصل الثاني

النتائج – القوانين اللبنانية وفيروس نقص المناعة البشرية

وا4يدز وعالم العمل

٢٫١ الدستور اللبناني

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فيروس نقص المناعة البشرية وا4يدز ومكان العمل في اYردن ٤٢

الفصل الثاني:

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فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٣٤

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١٫٢ المبادئ التوجيهية الدولية بشأن فيروس نقص المناعة البشرية/اXيدز

وحقوق اXنسان

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٣٣ الفصل ااالول

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١٫١ اتفاقية منظمة العمل الدولية بشأن التمييز (في االستخدام والمهنة)، ١٩٥٨

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العمل منظمة يف عضواً دولة ١٩٥ من أكرث ١١١ االتفاقية عىل صادقت ٧الدولية

٨ املادة ١ (أ)٩ املادة ٢

فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٣٢

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٣١ الفصل ااالول

صكوك منظمة العمل الدولية بشأن فيروس نقص المناعة البشرية

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فيروس نقص المناعة البشرية وا4يدز ومكان العمل في اYردن ٣٠

الفصل االول:

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٢٥ المقدمة

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صحي، ومثقف مدير، من اإليدز ملكافحة الوطني الربنامج فريق يتألف ٥اإلصابة، لخطر املعرضة السكانية الفئات حول املرشوع عن مسؤول للمرشوع ومنسق عىل اإليدز ملكافحة الوطني الربنامج استشارية لجان ثالث تدعم أن ويجب رس. وأمني النحو املذكور أعاله: (١) اللجنة الوطنية لإليدز تعنى باالسرتاتيجيات والسياسات الوطنية، واالتصال والتثقيف املعلومات ولجنة (٣) التقنية، املساعدة لتقديم التقنية واللجنة (٢)

للمساعدة يف توفري املواد املتعلقة بفريوس نقص املناعة البرشية/اإليدز.٦ وفقاً للربنامج الوطني ملكافحة اإليدز، واجه اإلبالغ عن الحاالت الكثري من الصعوبات. وأظهر بعض األشخاص املصابني تردداً يف اإلعالن عن أنفسهم بسبب الخوف من اللوم أو الوصم. وعالوة عىل ذلك، ساهم عدم التزام األطباء باإلبالغ املنتظم وغياب قدرات املجتمعات املحلية يف تناقضات البيانات. وبالتايل، فإن البعد الحقيقي لهذه املشكلة ال يزال

غري واضح.

فيروس نقص المناعة البشرية وا4يدز ومكان العمل في لبنان٢٤

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المقدمة

٢٣ المقدمة

فيروس نقص المناعة البشرية/اXيدز وعالم العمل في لبنان

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٤ تقرير برنامج األمم املتحدة املشرتك املعنى بااليدز بشأن وباء اإليدز العاملي لعام ٢٠١٠:

٢٠١٠ UNAIDS Report on the Global AIDS Epidemic

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قوانين التوظيف في القطاع العامأحكام المرسوم رقم ١١٢:

صرف الموظفإختبار الكشف عن ا4صابة بفيروس نقص المناعة البشرية ومبدأ السرية

الصحة المهنيةالهجرة وتصريح العمل غير قابل للتطبيق

ا4جازة المرضية

أحكام المرسوم رقم ٥٨٨٣:صرف الموظف

إختبار الكشف عن ا4صابة بفيروس نقص المناعة البشرية ومبدأ السريةالصحة المهنية

الهجرة وتصريح العملا4جازة المرضية

قوانين الصحة العامةقوانين لبنانية أخرى

مقابالت مع ممثلي أصحاب العمل والعمال

الفصل الثالث:المناقشات والتوصيات النهائية

. ملخص التعديالت المقترحة. المناقشة

. التوصيات النهائية

قائمة المراجع

الملحق ١الملحق ٢

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05

05

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المحتويات جدول شكر وتقدير

التمهيدالملّخص التنفيذي

الخلفيةالمنهجية

النتائجالخالصةالمقدمة

فيروس نقص المناعة البشرية/ا4يدز وعالم العمل في لبناننطاق الدراسة وهدفها

المنهجية

الفصل اYول: صكوك منظمة العمل الدولية ذات الصلة بفيروس

نقص المناعة البشرية/اXيدز وعالم العمل. اتفاقية منظمة العمل الدولية بشأن التمييز (في االستخدام والمهنة)، ١٩٥٨ (رقم ١١١)

. المبادئ التوجيهية الدولية بشأن فيروس نقص المناعة البشرية/ا4يدز وحقوق ا4نسان

. مدونة ممارسات بشأن فيروس نقص المناعة البشرية/ا4يدز وعالم العمل

. توصية بشأن فيروس نقص المناعة البشرية وا4يدز وعالم العمل، ٢٠١٠ (رقم ٢٠٠)

الفصل الثاني:النتائج – القوانين اللبنانية وفيروس نقص المناعة

البشرية واXيدز وعالم العمل

الدستور اللبناني

أحكام قانون العمل اللبناني (القانون). القطاع الخاص

التمييز والصرف التعسفي

إختبار الكشف عن ا4صابة بفيروس نقص المناعة البشرية ومبدأ السرية

الصحة المهنية

الهجرة وإجازة العمل

ا4جازة المرضية

العالج الطبي

03

05

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المحتويات: جدول

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السلطات املوكلة إليه تحديداً.

٠٩ تمهيد

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E/ املتحدة األمم وثيقة اإلنسان، حقوق للجنة العام األمني تقرير ١حول الثاين الدويل االستشاري االجتامع يف التوجيهية املبادئ اعتمدت .٣٧/١٩٩٧/٤.CNفريوس نقص املناعة البرشية/اإليدز وحقوق اإلنسان يف جنيف يف عام ١٩٩٦، وتم تحديثها بواسطة املبدأ التوجيهي رقم ٦ املنقح واملعتمد يف االجتامع االستشاري الدويل الثالث حول

فريوس نقص املناعة البرشية/اإليدز وحقوق اإلنسان يف جنيف يف عام ٢٠٠٢.

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تمهيد

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مراجعة قانونية وتقييم المطابقة وتحديد اYولويات في ما يتعلق بفيروس نقص

المناعة البشرية وا4يدز وعالم العمل في لبنان

ميكيال مارتينياالختصاصي ا4قليمي في فيروس نقص المناعة البشرية وا4يدز وعالم العمل

شربل عونمستشار منظمة العمل الدولية، بيروت

منظمة العمل الدولية/المكتب ا4قليمي للدول العربية

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