SocialismToday           Socialist Party magazine

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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