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HIV aids big business
THE AIDS epidemic is still in its early stages. Caused by
the HIV virus, Aids is the fourth-leading cause of death in the world. A United
Nations report, published to coincide with the 14th International Aids
Conference in Barcelona in July, warned that by 2020 deaths through Aids will
rival the numbers killed in all the wars of the 20th century. A further 65
million people will die, adding to the 20 million lives already claimed, unless
prevention programmes are vastly expanded. The grim truth, however, is that they
won’t be as long as profit drives policy.
The spread of the disease in Africa and throughout the
neo-colonial world is tied to poverty and the exploitation by the advanced
capitalist countries. In Zambia, where life expectancy has fallen from 50 to 37
over the past 15 years, about 63% of the population live on or under $1 a day.
It spends $6.50 per person on health each year. In Zimbabwe, 20% of the 14
million people facing food shortages are HIV-positive, malnutrition further
weakening their vulnerable immune systems.
Of the 40 million people currently living with HIV, 28.5
million are in sub-Saharan Africa. So far, 16 million Africans have died of Aids
– compared with just over 14,000 in Britain and 448,000 in the US. (The
African population was estimated at 720.4 million in 1996, the US at 265.4
million.)
Only 700,000 were receiving anti-HIV treatment by the end of
2001 – 500,000 of these living in high-income countries. In these countries
almost 25,000 people died of Aids in 2001. In Africa, however, fewer than 30,000
were receiving anti-HIV treatment at the end of 2001. Botswana has an infection
rate of 38.8%, Zimbabwe 33.7%, Swaziland 33.4%, Lesotho 31%, Namibia 22.5%. The
global average is 1.2%. According to the US Census Bureau, life expectancy is
projected to fall to 27 by 2010 in Botswana, 33 in Swaziland, 34 in Namibia and
38 in South Africa.
South Africa has about 4.7 million HIV-positive people out
of a population of 40 million. Such is the social and economic devastation being
wrought, that even big business is worried. The mining company, AngloGold, has
started health and education programmes to try to halt the spread of the
disease, which has infected about 25-30% of its 44,000-strong workforce.
However, it will not provide expensive antiretroviral drugs which have succeeded
in vastly improving the quality and length of life of people with Aids.
The reason given was that the company could not supervise
their use outside the mines, nor rely on the public health system. Yet AngloGold
and other mining operations still use the apartheid-era migrant-labour system
where between 20,000 and 30,000 workers live where they work. Given that they go
home for only a couple of weeks a year, the bosses have every opportunity of
ensuring that health facilities are put in place. The mines are surrounded by
squatter camps of sex workers, many of whom are infected with HIV. It is clear
that it is the horrendous living and working conditions, established to maximise
profits, which are perpetuating this deadly cycle.
The bosses have sheltered behind the ANC government’s
inaction in combating HIV/Aids. President Thabo Mbeki has repeatedly voiced
doubt over the connection between the disease and the HIV virus, holding back
expenditure to tackle it.
The frightening reality is that Africa’s current nightmare
is in danger of being replicated throughout Asia and Russia in the near future.
Twelve years ago, South African infection rates were similar to those seen in
India and China today.
There are up to four million people living with HIV in India
– up from 400,000 in 1990 – the second-highest in absolute numbers. Poverty
and the lack of education programmes fuel the rise. About 90% of India’s
HIV-positive women are monogamous and married. Their husbands become infected
after unprotected sex in the cities where they look for work.
The authorities have actually hindered education programmes.
On 7 July 2000, for example, the Lucknow office of the Naz Foundation India (a
charity promoting health for men who have sex with men) was raided by police and
four employees arrested and held for ‘conspiring to commit unnatural acts’.
HIV and Aids prevention material was seized. The men were held in jail for 47
days and the office was shut down for over two months, even though the NFI has a
government mandate to carry out its outreach work.
The UN set up the global fund for Aids, TB and malaria last
year with a target of raising $10bn a year. Anger at the lack of progress –
only $2.1bn was raised in 2001 – erupted at the Barcelona conference. US
secretary of health and human services, Tommy Thompson, was shouted down when he
tried to address the meeting and protesters smashed the European Union stand.
The Roche corporation is being targeted by activists because its latest Aids
treatment is expected to be the most expensive ever, costing at least $12,000 a
year per person.
The pharmaceuticals companies exert massive political
influence. Sarah Boseley, The Guardian’s health editor, reported that, instead
of backing the use of generic drugs, the World Health Organisation (WHO)
"has preferred to negotiate price-cuts with a handful of the drug giants,
which are still higher than the generic prices. The macro-economic commission
was also strongly against generics. One of the papers commissioned for its
discussions by WHO argued that prices were not the block on the wider use of
essential drugs in developing countries, blaming the corruption and lack of
healthcare infrastructures instead. The paper was written by Harvey Bale, head
of the International Federation of Pharmaceutical Manufacturers Associations,
with help from Adrian Otten of the World Trade Organisation". (6 February)
Research into vaccines has been minimal. It is far more
lucrative to produce treatments which have to be taken daily, thus securing a
steady flow of profits. "Total sales of all vaccines last year amounted to
$5bn (£3.25bn) similar to the amount of Aids drugs sold and dwarfed by the
$350bn revenues from pharmaceutical sales". (Financial Times, 10 July)
To add insult to injury, a vaccine is being developed by
VaxGen to tackle the ‘B strain’ of Aids, most common in the US and Europe.
In Africa, the ‘A strain’ is dominant. Therefore, even if the vaccine is
successful – which is far from certain – it would not necessarily work in
the world’s most affected continent.
Brazil shows what can be achieved, even in a capitalist
system. Since generic treatments were made free in 1996, the number of people
dying of Aids has fallen by 50%. The World Bank predicted in 1992 that there
would be 1.2 million HIV-positive people by 2002. The actual figure is 600,000.
Without mass pressure, however, this will remain an isolated case. The
pharmaceuticals industry will ruthlessly pursue short-term profits. And HIV/Aids
will continue to decimate the world’s poor.
Manny Thain
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