AIDS around the world
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AIDS and HIV has reached epidemic proportions in many developing countries. It is serious enough for the United States to consider it a threat to its national security and in some nations has had a large impact on mortality rates and the economy.
On this page:
Scale of the AIDS Epidemic
A Disease Largely of Poverty
For a long time now, AIDS has been understood to be a disease largely of poverty:
For wealthier people in industrialized countries, there is a better chance to afford the very expensive treatment that is available.
However, for the vast majority of HIV and AIDS sufferers in the developing countries, such treatment is not available. The spread and epidemic of AIDS is also largely a result of poverty and debt conditions, some of which has been brought on upon by the economic policies of western backed institutions:
(For more about the causes of poverty, debt and the various trade and economic conditions that have fostered such an environment, visit this web site’s section on Trade, Economy, & Related Issues7.)
Corporate reaction to the AIDS/HIV epidemic
For information about the shocking corporate reaction to some developing nations’ attempts to try and provide drugs for their populations, go to this site’s section on Pharmaceutical Corporations and AIDS9.
You can also visit this web site’s section for information about corporations and medical research10 in general.
Rich only seem to care when it affects them?
For many years, wealthier countries were criticized for not acting on this issue sooner. (It seemed it only became a major international concern for wealthy countries around the time the US announced AIDS/HIV as a potential national security issue.) Some have also argued that once wealthy nations realized they had escaped the worst, their interest diminished somewhat:
Also see this site’s section on AIDS in Africa12 for more on this aspect.
Education for Prevention is Key
While there are many criticisms of external parties, as mentioned above, on top of that, there are still issues within affected societies to over come. In many nations, corruption is a hindrance. There is still the stigmatization in many places, of a disease such as AIDS. There are various cultural issues and barriers to overcome to help spread the awareness and provide treatments and, equally important, introduce preventative measures.
In some countries, there are social taboos, denial and even old patriarchal beliefs that prevent open discussions.
Furthermore, as mentioned above, many of the poor nations are also affected by the IMF and World Bank structural adjustment policies, which force nations to cut back on health, education and other services—the very things that are vital here.
And while pharmaceutical companies’ research on cures—and the way that they are doing it—is raising appropriate criticisms and concerns, this attention also diverts the much needed emphasis on prevention as summarized by the following:
Funding for tackling global AIDS problem is also needed
In June 2001, a global AIDS fund16 was finally set up.
However, there have been criticisms about the funds that have been contributed by the wealthiest nations. For example, the two largest donors—U.S. and U.K—gave 200 million dollars each in the first year. While it was welcomed at the time, it was also criticized as not enough17. $200 million is roughly what Sub-Saharan Africa spends each week on debt repayment. (You can also listen to this Democracy Now! radio show interview18 on the topic, from June 28, 2001.)
Christian Aid echos those concerns, but also adds that more fundamentally, the AIDS fund ignores the root causes:
Tackling root causes is important because ignoring those would lead to the same problems recurring. The fund therefore, while perhaps still welcome (because we still need to deal with the immediate and massive problem) will always be fighting an uphill struggle.
Furthermore, there have also been continued concern over issues such as patents, pricing and so on. This is captured well by Philippe Riviére, who is worth quoting at length:
The mention of the Gates Foundation above also raises notes about philanthropy, its pluses and minuses.
Private donations, especially large philanthropic donations and business givings, can be subject to political/ideological or economic end-goals and/or subject to special interest. A vivid example of this is in health issues around the world21. Amazingly large donations by foundations such as the Bill and Melinda Gates Foundation are impressive, but the underlying causes of the problems are not addressed, which require political solutions. As Rajshri Dasgupta comments:
As another example, Bill Gates announced in November 2002 a massive donation of $100 million to India over ten years to fight AIDS there. It was big news and very welcome by many. Yet, at the same time he made that donation, he was making another larger donation—over $400 million, over three years—to increase support for Microsoft’s development suite of applications and its platform, in competition with Linux23 and other rivals. Thomas Green, in a somewhat cynical article24, questions who really benefits, saying
And being a monster MS [Microsoft] shareholder himself, a (Emphasis is original.)
Big Win in India will enrich him [Bill Gates] personally, perhaps well in excess of the $100 million he’s donating to the AIDS problem. Makes you wonder who the real beneficiary of charity is here.
India has potentially one tenth of the world’s software developers, so capturing the market there of development platforms is seen as crucial. This is just one amongst many examples of what appears extremely welcome philanthropy and charity, but may also (not always) have other motives. It might be seen as horrible to criticize such charity, especially on a crucial issue such as AIDS, but that is not the issue. The concern is that while it is welcome that this charity is being provided, at a systemmic level, such charity is unsustainable and shows ulteria motives. Would Bill Gates have donated that much had there not been additional interests for the company that he had founded?
In addition, as award-winning investigative reporter and author Greg Palast also notes, the World Trade Organization’s Trade-Related Intellectual Property Rights (TRIPS),
the rule which helps Gates rule, also bars African governments from buying AIDS, malaria and tuberculosis medicine at cheap market prices. He also adds that TRIPS is killing more people than the philanthropy saving25. What Palast is hinting towards is the unequal rules of trade and economics that are part of the world system, that has contributed to countries such as most in Africa being unable to address the scourge of AIDS and other problems, even when they want to. See for example, the sections on free trade26, poverty27 and corporations28 on this web site for more on this aspect.
Some two years on from the setting up of the Global Fund, and in 2003, the Fund is still facing cash short falls, and growing criticism about the way the U.S. and Europe have not been providing the money they claim to offer.
In May 2003, the US Congress passed a bill pledging $15 billion over the next five years to fight HIV/AIDS, tuberculosis and malaria around the world. This was preceded by a prominent announcement by President Bush in his State of the Union speech. But behind the headlines, the five year plan has come under attack for largely by-passing the Global Fund, precisely set up as a functional and working multilateral program to fight fight AIDS, Tuberculosis and Malaria. Furthermore, the Fund has been facing an immediate fiscal shortfall of $700 million in 2003 alone, because the U.S. and other donors have not committed their fair share.
Bush’s announcement of $15 billion sounded very welcome. It also showed up Europe to be lagging behind on their commitments too.
Even France’s President Jacques Chirac conceded that Mr Bush’s pledge was as Linda Bilmes noted in the Financial Times (July 6, 2003
30). The same article also noted that
historic and that Europe
must do more on HIV
In reality, nothing like $15bn will ever be spent because of the failure to ask for the required amounts for each budget request. The article continues:
The above-mentioned $200 million is just 6.6% of what the Fund says it needs in 2004 ($3 billion)32 as detailed by Global AIDS Alliance, an organization dedicated to fighting global AIDS. The previous link is to a web page that introduces a PDF-formatted report33, very critical of Bush’s $15 billion emergency plan. Amongst the criticism is that:
- The announcement of $15 billion dollars and the way it was presented was misleading:
While President Bush describes the Emergency Plan for AIDS Relief as a $15 billion response, which the general public, glancing at the headlines, can easily misinterpret to mean $15 billion all at once. Those with the patience to look into it find that the proposed spending is spread out over five years and that the $15 billion figure includes both existing spending levels as well as the President’s new proposal.
- The pace of action so far has actually been quite slow
- Other parts of the 2004 budget would be cut, which could also help in fighting poverty and other issues that are related to AIDS:
Cuts in the President’s FY04 budget request include Refugee Assistance (-2.8 percent), Development Assistance (-2.5 percent), other Global Health programs (-14.3 percent), and International Disaster Assistance (-18.3 percent). These cuts hurt the AIDS effort because AIDS is closely related to other health crises and rooted in poverty and inequality, oppression of women and girls.
- Hurting the Global Fund (as also mentioned above)
fuzzy mathto arrive at the $15. Amongst the criticism is that this amount was presented as a means to fight AIDS, yet some of this money also goes to research and fight other illnesses and disease. But,
the point is not that research and funding for the fight TB and malaria are unnecessary. On the contrary, this funding is important and needed. It’s that this spending cannot count as progress toward spending goals that are specific to AIDS services. The spending target the US and other nations agreed to in the Declaration of Commitment at the UN General Assembly Special Session on HIV/AIDS (June 2001), $7 to 10 billion in annual spending by 2005, deliberately excludes research spending as well as spending on other diseases. The spending target is based on careful projections of what is needed to finance AIDS services alone. (Since 2001, the UN has revised its estimate of what is needed to fight AIDS. In October 2002 UNAIDS and the World Health Organization said $10.5 billion in annual spending would be needed by 2005
for a barebones package of prevention, treatment, care and supportand $15 billion in annual spending by 2007 to fight AIDS specifically.)
- That even though the amount sounds high, the U.S. is actually not contributing its fair share. For example, Even though in the past significant resources have been contributed to fight other major diseases
President Bush describes the US as doing its fair share [in the fight against AIDS]… Yet, under the President Bush spending plan, the US will provide just $1.55 billion by 2005 for direct AIDS programs; that’s only 14.8% of what the UN says will be needed globally by that date for what it calls a
barebones packageto fight AIDS ($10.5 billion in annual spending). Even two years later, under the President’s plan only $2.64 billion will be provided for direct, on-the-ground AIDS programs, still only 17.6% of what the UN says will be needed globally by 2007 to fight AIDS specifically ($15 billion in annual spending on AIDS services).
- There is
no clear plan to deepen debt relief for poor countries, despite the clear mandate contained in the AIDS Bill to do so, especially for AIDS-stricken countries.The issue of third world debt is agreed by many to be a contributing factor that makes the AIDS problem even worse. As detailed in the AIDS section on this site, what makes this even worse is that much of this debt is unfair debt that the third world should not be paying anyway.
- The U.S. has pushed via the WTO and outside of it, to prevent poor countries from producing cheaper, generic drugs to help tackle AIDS.
The criticism above from Bilmes, about determining how the fund will be used is also criticized by others, revealing other concerns. For example, writing in a guest editorial for OneWorld.net, Louise Richards, chief executive of War on Want writes that:
Richards observes how politics comes into play in things like aid and charity. This is an enormous topic in its own right, but this site’s section on U.S. and Foreign Aid36 begins to look at this in more detail, on things like how aid is often tied to political agendas, that often end up benefiting the donor, not always the recipient.
In the same article, Richards also notes the influences of the pharmaceutical industry, and adds to the above that
The USA’s bilateral pledge casts a long shadow over the current round of trade talks. Back at [the World Trade Organization round at] Doha in November 2001, developing countries were promised a deal to ensure their access to cheap drugs to fight public health emergencies. Since the poorest countries have no pharmaceutical industries, they depend on imports from countries with a generic drugs industry, especially India. But from 1 January 2006 countries such as India have agreed to implement the World Trade Organization’s full Trade Related Intellectual Property Rights (TRIPs) agreement, making the export of generic treatments illegal.
In addition, President Bush had picked a former top executive of a major U.S. pharmaceutical company to head the U.S.’s global AIDS initiative37, leading to further accusations of a commercial agenda, and lack of real experience in the issues that matter. (As well as the previous link, see for example, similar criticisms38 from Health GAP and Global Treatment Access Campaign, two organizations campaigning for global access to affordable medicines.)
A meeting in October 2003 resulted in donor countries pledging just $620 million for 2004, far short of the $10.5 billion needed per year39, as sharply criticized by an article from Inter Press Service.
Such political pressure from corporate, ideological and related interests have been part of on-going issues for a number of years now while people are suffering from AIDS and other diseases that could otherwise be easily addressed. The corporations and medical research40 part of this site looks more into how large pharmaceutical companies have tried to thwart efforts of developing countries.
For more information:
- Related articles elsewhere on this site
- OneWorld and its partner organizations have been reporting on the issue of AIDS in developing countries for a number of years now. They have a number of major sections from where you can start:
- World Health Organization46 — within the WHO site, you will find many resources and links to other web sites.
- UNICEF’s Progress of Nations, 1999, has a section on the AIDS Emergency47.
Deadly Conditions? Examining the relationship between debt relief policies and HIV/AIDS.A report48 by Medact and the World Development Movement.
- UN Development Program’s report,
Poverty & HIV/AIDS in Sub-Saharan Africa49
AIDS and the World Bank: Global Blackmail?50looks into some of the global politics at play and the effects of some reactions from South Africa’s president, Thabo Mbeki.
- Durban 2000 March51 for HIV/AIDS treatment is a march against pharmaceutical giants and governments—planned to coincide with the opening day of the 13th International AIDS Conference in Durban, South Africa in July.
- The Panos Institute has a section on HIV/AIDS52 that provides a number of articles and resources.
- A number of articles from ZNet53.
- UNAIDS54, The Joint United Nations Programme on HIV/AIDS, provides a lot of informations, statistics and reports.
The Epidemic and the Media55from the MediaChannel.org provides a collection of articles looking at the role of the media in this issue.
AIDS and the Poverty in Africa56, from The Nation Magazine, May 21 2001, looks at the relationship between poverty, and the lack of consideration of such aspects that has gone into current scientific research to explain the causes of the AIDS epidemic in Africa.
- Health GAP57, an organization campaigning for global access to affordable AIDS medicines.
- Global Treatment Access Campaign58, an organization also campainging for affordable medicines for a variety of diseases.
- Global AIDS Alliance59 an organization dedicated to fighting global AIDS.
(Note that listed here are only those hyperlinks to other articles from other web sites or elsewhere on this web site. Other sources such as journal, books and magazines, are mentioned above in the original text. Please also note that links to external sites are beyond my control. They might become unavailable temporarily or permanently since you read this, depending on the policies of those sites, which I cannot unfortunately do anything about.)