“Food Handler with HIV infection” – Understanding HIV and the legal provisions related to the food industry

Dr. Praveen G Pai, TE-CST, TSU-KSACS; May 2022

 

Background:

Human Immunodeficiency Virus (HIV) is a group of virus that cause Acquired Immunodeficiency Syndrome (AIDS) in human beings. Recently, there has been rumours circulating in social media claiming packed food, juice and even contaminated food products from hotels have caused transmission of HIV. Four decades back when HIV was detected for the first time, it was linked with drug abusers and homosexuals and people were not sure of the route of transmission. The disease had huge stigma that people were discriminated and denied of basic human rights. Over the past two decades, advances in treatment options were tremendous and currently HIV infection has become a chronic manageable condition. However, though severe forms of sigma and discrimination are not found, stigma still persists. Recently, reports from positive networks and medical officers in ART centres suggest that food handlers who are tested positive for HIV are denied “Health Card” which is mandatory or them to work in any food handling centre including street vending to food processing units and hotels. Health card is made mandatory for all food handlers under the Food Safety and Standards Act of 2006 through the Food Safety and Standards Authority of India (FSSAI).

 

The Problem

Acquired lmmune Deficiency Syndrome (AIDS) is caused by a group of viruses called Human Immunodeficiency Virus (HIV). HIV harms the immune system making the patient more vulnerable to additional infections, especially diarrhoeal diseases, lung infections and also cancers. Millions of individuals all over the world are thought to be infected with the virus and the number is raising quickly. It is inescapable that several of these individuals will certainly be as food handlers.

The existing scientific evidence, the United States Centers for Disease Control and the World Health Organisation and National AIDS Control Organisation (NACO) verifies that there is no recognized threat of transmission of HIV/AIDS throughout the preparation or serving of food or beverages. It has been stated that a recognized danger of HIV transmission to co-workers, customers, or consumers from a person with HIV infection within industries such as food-service establishments is not documented ever. People living with HIV infection need not be excluded from work in food handling industry unless they have other infections or health problems (such as diarrhoea or hepatitis A) for which any kind of food-service worker, despite HIV infection condition, must be limited. The Food Safety and Standards Act of 2006 suggests that all food-handlers comply with suggested criteria and methods of good individual hygiene as well as food cleanliness where the employer has a big role to play. It is for that reason it is important that the food sector, the consuming public as well as the media all understand that transmission of HIV/AIDS by food as well as drinks is not a risk. However, individuals with HIV/AIDS are most likely than others to acquire one of those diarrhoeal illness that can be transmitted by food, and also other infections or lesions. In this occasion, the food handlers ought to be taken care of according to the standards provided by the Department of Health.

 

How the virus spreads

AIDS is caused by one or more of a group of retroviruses, which are been called Human Immunodeficiency Virus. Human beings are ought to be considered the single reservoir of the virus; neither food items, (including food animals), neither animals, nor pet dogs, nor pests are a source. HIV is spread by sexual contact with an infected individuals, sharing injection needles with an infected person, injection of infected blood or blood items and also by transmission from mother to child. HIV cannot be spread by touching, coughing, sneezing or by insect bite. The virus has a long incubation period of upto 5-8 years and therefore the development of the disease differs from one person to another; some individuals can unwittingly carry the virus without showing any kind of symptoms or signs. It appears possible that all HIV carriers will certainly develop into AIDS at some point if appropriate treatment and follow-up is not done.

Survival of the virus outside the body

The virus dies just gradually at room temperature while it will survive well when frozen. Nonetheless, it is really sensitive to warm and it is damaged at 55 degrees Celsius and above. It is conveniently inactivated at both reduced and high pH. The HIV virus is quickly destroyed by the generally used concentrations of all biocides, consisting of hypochlorite, ethyl alcohol and isopropyl alcohol. When accidents occur, the safety measures adopted to stop the spread of viral hepatitis as well as other blood borne infections will also prevent the spread of HIV. First aiders must cover any type of open cuts or abrasions by themselves using gloved hands and ideally to be wearing an apron. Spilling of blood and other body liquids must be flooded with a biocide as well as mopped up with paper towels. All these non-reusable products ought to be disposed off in plastic bags as well as securely taken care of, preferably by incineration.

Implications for the food dealers

Food handlers that carry HIV are not a risk to their workmates or to the items that they manage. They need to not be restricted from working with foods or beverages or be restricted from using telephones, equipment, office tools, and bathrooms, showers, eating facilities or drinking fountains. They may hence function usually, unless obviously they develop a second infection such as a diarrhoeal disease, which will prevent them from managing food. In that event, the employee as well as the employer must adhere to the guidelines released by the Department of Health: "Food Safety and Standards Act" (2006).

 Legal provisions related to food handlers and HIV

In the context of employment, especially with food-handling by people living with HIV, the following are of importance –

·       The Constitution of India, 1950, guarantees every citizen certain rights such as in Article 39 that asks the states to ensure an adequate means of livelihood for all the citizens including the HIV/AIDS patients; The Article 42 put forth the responsibility of states to make appropriate provisions for securing just and humane conditions of work.

·       National Policy on HIV/AIDS and the “World of Work” Policy: The Ministry of Labor & Employment has developed the "World of Work" and the "National Policy on HIV/AIDS" at the 43rd Session of the Standing Labor Committee. This Policy was established by the Ministry of Labor & Employment after consultations with ILO (International Labor Organization), NACO (National Aids Control Organization), and also Social partners. The policy focuses on creating understandings concerning AIDS along with working on encouraging actions in order to stop the spread of AIDS. It likewise intends to make the work environment supportive and encouraging for those people working while living with HIV. The goal of the policy is to curb the stigmas involved with this entire disease and also bring in an environment of equal treatment and opportunities at the work environment. It aims to create an open space devoid of these social stigmas and discriminations as well as protect against the spread of HIV amongst co-workers and also make individuals aware of the issues concerning the same. As per the policy, persons with HIV infection can function as long as they are fit. If there is a test performed, the person can wish to stay anonymous throughout the procedure.

·       The Indian Employers’ Statement of Commitment on HIV/AIDS: Facilitated by ILO and NACO, various employers’ associations of India signed a commitment for non-discrimination of HIV infected persons in workplace and that HIV testing shall not be a re-requisite for an employment that also include food-handling industry. The commitment was signed in 2005 by senior national leaders representing organisations such as All India Organisation of Employers (AIOE), The Associated Chambers of Commerce and Industry of India (ASSOCHAM), Confederation of Indian Industry (CII), Employers’ Federation of India (EFI), Federation of Indian Chambers of Commerce & Industry (FICCI), Laghu Udyog Bharati (LUB) and the Standing Conference of Public Enterprises (SCOPE).

·       The United Nations Declaration of Human Rights: The United Nations, with time, has created a great deal of action in order to provide equality as well as human rights to all people consisting of AIDS patients. The United Nations Declaration of Human Rights offers the right to equal rights to all humans including those with HIV infection. It additionally sets specific provisions taking care of equal opportunity of work, individual liberty, opportunity, and also protection. Numerous conventions focus on removing discrimination and also stigmas connected to patients' civil liberties, specifically AIDS. Everyone including those people living with HIV can work and take part in the cultural as well as social life in the community. The UN conventions time after time have stressed that all individuals including AIDS patients have to be dealt equally before the law and should be equally entitled to protection by the law. This sets the truth that it is not just in India, but globally people living with HIV find it tough to enjoy equality in legal rights and opportunities.

·       Legal provisions under Indian law- Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (Prevention and Control) Act, 2017: Section 3 of the Act deals with the rights of HIV infected persons against discrimination and right to employment. The act clearly states that no person shall discriminate against the protected person on any ground including denial of, or termination from employment or occupation, unless, in the case of termination, the person, who is otherwise qualified, is furnished with a written assessment of a qualified and independent healthcare provider competent to do so that such protected person poses a significant risk of transmission of HIV to another person in the workplace, or is unfit to perform the duties of the job. The act also directs that HIV testing should not be a pre-requisite for obtaining or continuing an employment or using any other service or facility. The Act also prescribes punitive actions against those who discriminate or stigmatise a person with HIV infection – that include heavy penalty/fine to be paid along with imprisonment. This means that, it is unlawful to deny “Health card” to a person with HIV infection that can result in denial of employment. While denying employment or Health-card, HIV status of the person will be disclosed in the process which again is unlawful.

·       Food Safety and Standards Act (2006): This is an Act “to consolidate the laws relating to food and to establish the Food Safety and Standards Authority of India (FSSAI) for laying down science based standards for articles of food and to regulate their manufacture, storage, distribution, sale and import, to ensure availability of safe and wholesome food for human consumption and for matters connected therewith or incidental thereto”. The Section 26 of the Act that deal with the responsibilities of the food business operator, in its clause (3) states that “No food business operator shall employ any person who is suffering from infectious, contagious or loathsome disease”. The Act came into force only after the National Policy on HIV/AIDS and the “World of Work” Policy was put into action; and hence the national policy on HIV/AIDS would stand valid and included. The Act restricts only those persons suffering from infectious or contagious disease that may be spread via food or beverages which is not the case with HIV. The term “loathsome disease” could be considered for diseases with an external appearance that can cause aversion or an unpleasant feeling of disgust or repulsion such as in a visible skin diseases, disfigurement, and mal-odour from wounds and lesions etc. It has to be noted that HIV infection per-se do not have any loathsome condition.

Conclusion

Health authorities around the world all agree that transmission of HIV/AIDS via food and beverages is not a recognized danger. This situation requires to be explained to all employers and also employees in all branches of the food/drink sector and to the consuming public. It requires to be emphasised to individuals with HIV/AIDS that they have to comply with the other health and safety demands appropriate to all food handlers. They are most likely than others to acquire among those diarrhoeal illness that can be transmitted by food, and also various other infections or sores.

For the question whether HIV/AIDS be transmitted by food, as per the World Health Organization (WHO) and current available scientific literature, HIV cannot be transmitted through food or water. In fact, the said virus cannot live long outside the human body. In a situation where small amounts of HIV-infected semen or blood get contaminated in food or water, cooking, exposure to the air, and the acid inside stomach would destroy the virus. Hence, based on available scientific evidence, food is not a source of HIV infection. In this occasion, it has to be understood that the food industries have to abide to the prescribed standards of FSSAI and the food handlers also need to be managed according to those standards without discriminating people living with HIV. The health authorities should not deny “health-card” to any person (a mandatory requirement to work in food-handling industry as per FSSAI) on the basis of his or her HIV status.

Way forward, there is a need for sensitisation and creating awareness among policy makers, government officials, political leadership, healthcare workers and enforcement agencies apart from civil society; without which, the discrimination and stigmatisation of people living with HIV will continue.