Introduction
Globalization of Disease: AIDS Ravages the African
Continent
Medical Professionals Helpless Against AIDS
South Africa Struggles to Unite Against AIDS
Living with AIDS
Bibliography
Throughout history, countless numbers of diseases have affected the people
of the world. These diseases, mainly the result of infectious microorganisms,
have traveled from person to person in order to survive. In addition, they
have spread to different countries via immigration of humans and/or infectious
animals and insects. However, infection rates of diseases did not rise significantly.
On the contrary, today, diseases migrate to all corners of the world at alarming
rates because advanced technology such as trains and airplanes has allowed
members of society to visit many foreign places with relative ease. Thus,
the spread of disease has increased.
Perhaps the most modern example of the globalization of disease is the HIV/AIDS
epidemic that is sweeping the world especially in sub-Saharan Africa. AIDS
or Acquired Immune Deficiency Syndrome is causing many social, economic and
political problems for many of the countries that are plagued by it. It is
present in every country although to varying degrees. There seems to be a
pattern in which non-developed countries, that have the least amount of sources
available to fight the disease, are the most effected by it. “Over the
next decade, AIDS will kill more people in sub-Saharan Africa than the total
number of casualties in all of the wars of the 20th century combined (“Prescription,”
2000). Issues such as economic prosperity and a growing number of orphans
are among the most serious problems in this region. In developed countries,
on the other hand, AIDS sufferers are enjoying a longer life expectancy and
a better quality of life.
Gaining access to anti-retroviral drugs is a main concern for all people who
have this virus. In the United States and other Western countries, these expensive
drugs are readily available. In sub-Saharan Africa, however, almost no one
is able to afford the drugs. As a result, the medical professionals within
this region are unable to treat many of the people who have AIDS. In fact,
hospitals have been forced to refuse patients due to overcrowding or the fact
that they simply are not able to treat them because they lack the resources.
As a result, healthcare workers have focused on finding ways to detect, treat
and prevent the disease as easily and as cost effectively as possible.
The problem of treating patients is especially prevalent in South Africa.
Unfortunately, it is not just a problem of a lack of resources. Politicians,
including the president, have expressed controversial views concerning the
cause of AIDS. In addition, the president has slowed the process of gaining
access to anti-retroviral drugs by refusing to work with pharmaceutical companies
that are willing to provide South Africa with free drugs for a designated
period of time. As a result, the many problems that exist in South Africa
due to AIDS are not being addressed properly.
The issue of the AIDS epidemic has become a worldwide or global issue that
every country needs to address. AIDS is not only ruining the lives of many
people in South Africa but it is also affecting every person in the world.
Whether directly or indirectly, this is an issue that cannot be ignored because
it will not disappear. The social, economic and political ramifications associated
with AIDS are devastating and real and no one country can battle this disease
alone.
Acquired Immune Deficiency Syndrome (AIDS) is one of the most deadly diseases
that affect humans today. It has the power to slowly destroy a human being
over an extended period of time. In addition, the rapid spread of this virus
has reached all corners of the world, with 36.1 million people living with
HIV/AIDS worldwide (“UNAIDS/WHO,” 2000). However, some countries
have been better equipped to handle the virus. As a result, the prevalence
of AIDS varies in each region of the world, causing not only an increase in
deaths, but also many social and economic problems.
Perhaps the most devastated region of the world due to the AIDS virus is sub-Saharan
Africa. Here, 3.8 million new infections of HIV occurred in the year 2000
in addition to the 4 million infections in 1999. In North Africa and the Middle
East, HIV infection rates for 2000 are at 80,000, with a total number of HIV
infected individuals at 400,000 (“UNAIDS/WHO,” 2000). Compared
to sub-Saharan Africa, this hardly seems like a problem. However, infection
rates are on the rise. In Eastern Europe, the number of people infected with
HIV has risen from 420,000 people in 1999 to 700,000 people in 2000. In addition,
Asia now has 20% of infections worldwide, making AIDS a growing problem in
this area as well. The Caribbean has the highest HIV rate in the world outside
of Africa and prevalence in Western Europe and North America has risen slightly
over the past year. This is thought to be the result of the wide spread use
of antiretroviral drugs that have prolonged the lives of those with AIDS (“UNAIDS/WHO,”
2000). From the differing infection rates, it is clear that some countries
have a bigger battle with AIDS than others. However, the disease spreads rapidly
and every country is susceptible to harsher outbreaks than it is currently
experiencing.
The spread of HIV/AIDS to so many peoples calls into question an important
aspect of the disease. Where did it come from? Many scientists believe that
the virus originated in the blood of chimpanzees in central Africa, possibly
eastern Zaire, in the 1970’s. It was then transferred to humans (“U.S.
HIV,” 1999). Several groups of people do not agree with this theory.
For example, “representatives of many demographic groups, including
African-Americans and gay white men in the United States, have expressed concern
that AIDS might be a conspiracy to destroy them.” In addition, some
residents of Africa feel that AIDS arose from biological warfare of Western
countries, such as the United States, in an attempt to depopulate the continent
(“U.S. HIV,” 1999). The differing views are not causing concern
in the eyes of scientists who are trying to fight the disease. However, they
may be contributing to the growing number of people contracting the disease,
especially in Africa where so many people do not want to think that such a
destructive disease originated on their land.
Regardless of the origin of the disease, HIV/AIDS is a growing epidemic that
is doing the most damage in sub-Saharan Africa. In comparison to the bubonic
plague that killed 30 million people in Europe, AIDS is projected to take
the lives of 71 million people living in sub-Saharan Africa by the year 2010
(“Dying,” 2000). Consequently, the life expectancy in many of
these countries in expected to fall dramatically. Karen Stanecki of the U.S.
Census Bureau projects that by 2010, the average life expectancy in Botswana
will be 29, 30 in Swaziland, 33 in Namibia and Zimbabwe and 36 in South Africa,
Malawi and Rwanda. This is in comparison to a life expectancy of 70 in most
of these countries without the threat of AIDS (Mbeki, 2000, p. 6). These alarming
numbers reflect the fact that many of the valuable teachers, doctors and nurses
in these areas are dying faster than they can be replaced. In fact, according
to a report released by the American Foundation for AIDS Research in 1999,
80% of those people that are dying in sub-Saharan Africa are between the ages
of 20 and 50. This means that the most valuable contributors in the economy
are prematurely leaving (“Dying,” 2000).
With a surplus of workers in Sub-Saharan Africa and a high unemployment rate,
the decrease in the working population may not seem like such a terrible occurrence
aside from the fact that it is coming at the hands of the AIDS epidemic. Martha
Ainsworth, co-author of the World Bank’s 1997 book, “Confronting
AIDS,” states that the loss of workers in the economy may not necessarily
mean a loss of productivity or a decline in economic growth. However, she
does caution that this perspective offers limited knowledge of the entire
picture of AIDS. Gross domestic product (GDP) is the wrong way to measure
the economic impact of AIDS and the issue should be looked at as one of human
welfare. For example, the drop in life expectancy experienced by these countries
is “reversing years of investments in human capital” (Wehrwein,
2000). According to a statement released by the heads of state and government
officials of 10 sub-Saharan countries including Tanzania, Zambia and Zimbabwe,
“The HIV/AIDS epidemic is ‘depleting (the) most educated, energetic
and productive segment of our population, thus draining human capital development’”
(“Hindering,” 1999). The money that businesses invest in their
workers, especially in their education, cannot be replaced simply by replacing
the workers. In addition, the loss of financial support results in even more
poverty for those that are left behind (Wehrwein, 2000).
There are numerous statistics that support the decline in the economies of
those countries in sub-Saharan Africa, with the most compelling being the
outrageously high number of people infected with HIV as compared to the rest
of the world. Based on these statistics, David Bloom, a professor of economics
and demography at the Harvard School of Public Health, states “the whole
economy [in Africa] could unravel.” In addition, Daniel Tarantola, a
senior policy adviser to World Health Organization Director-General Gro Harlem
Brundtland, explains that the decline in the African economy no longer needs
to be supported by any data. The vast amount of sickness, death and infected
women of childbearing years tells the story every day (Wehrwein, 2000). HIV/AIDS
is not something that is hidden. It is a real part of every day life in sub-Saharan
Africa and this is reinforced throughout businesses and the economy.
AIDS touches the lives of everyone in Africa. Sadly this fact does not exclude
the numerous children in this area. AIDS, however, touches children in two
ways. First, the children themselves become infected and secondly, the disease
can take the lives of their parents or other relatives. Sub-Saharan Africa
contains 90% of the world’s HIV-infected children, with 470,000 of them
dying annually (Maxwell, 2000). The children can become infected in two ways,
either passed from their mothers or through sexual contact. “Of 30 children
born to HIV-positive mothers, approximately 10 will acquire the virus simply
by being born. Another four will become infected from breast-feeding”
(Maxwell, 2000). As a result, children must live with this disease from the
very beginning of life. Of those who are not infected during the neonatal
period, some will contract the disease by sexual contact. In addition, girls
are at a higher risk of getting HIV than boys. One study found that among
children under 20 years old, girls are three to seven times more likely to
be infected than boys. This may be the consequence of many men who believe
that having sex with a virgin is a cure for AIDS. Also, many girls exchange
sex for favors or payment of school fees (Maxwell, 2000).
Many children in Africa are becoming orphans because their parents are dying
at a young age from AIDS. Sub-Saharan Africa contains 90% of the world’s
AIDS orphans, according to UNICEF. Under normal circumstances, these orphans
will be taken care of by their extended families. However, with the extremely
high number of orphans, the extended family is becoming extremely crowded.
As a result, most of the children suffer “alarmingly higher rates of
malnutrition, stunting and illiteracy” (“U.N. Calls,” 1999).
On the other hand, children do not always have the option of living with a
grandparent or another relative. Consequently, they must form child-headed
households that are extremely vulnerable especially economically (Maxwell,
2000). Therefore, AIDS hinders the lives of children in various ways in which
they have little control over. In fact, no one in Africa seems to have much
control when dealing with AIDS. This epidemic has brought countless economic
and social problems to the area that is proving to be extremely difficult
for Africans to cope with.
The HIV virus is one of the most deadly diseases that the world has ever faced.
It is causing many health care professionals to reevaluate the methods used
to treat infectious diseases. However, AIDS is extremely expensive to treat
and not all doctors have many options in the form of treatment or prevention.
This difference explains why some areas of the world have an extremely high
prevalence rate, such as in sub-Saharan Africa, while other parts have seemed
to somewhat control the disease, like the United States.
In the United States, AIDS drugs are available for doctors to prescribe for
their patients. A “cocktail” of different anti-retroviral drugs
is used that is specific for each individual patient. These drugs, however,
can cost up to $15,000 a year per patient (“Scarce,” 2000). Cost
is of no concern for most residents of the United States, which affords doctors
the option of using the AIDS drugs. The results have been very rewarding.
The rate of new infections has remained steady at 40,000 new cases a year.
In addition, the life expectancy for AIDS patients has increased dramatically
and the quality of life has improved as well. This is despite the fact that
the full effects of the drugs are not yet known because they have not been
used long enough. Although the drugs have had promising results, doctors are
still concerned that the infection rate will again rise. This is because many
Americans are starting to believe that AIDS is a treatable disease when people
still die from it every day. As a result, more and more people are exhibiting
unsafe behavior that could lead to another outbreak (“Scarce,”
2000). If this pattern continues, doctors could have a much more serious problem
to deal with.
In developing countries like those in sub-Saharan Africa, the immense problem
of the AIDS epidemic is very real. Unlike their counterparts in the United
States, doctors in this region of the world do not have the option of using
anti-retroviral drugs. Dr. Robert Janssen, director of the division of HIV/AIDS
Prevention at the Centers for Disease Control and Prevention in Atlanta, reports
that most hospitals have aspirin and Tylenol, but they have few antibiotics
available to treat infections (“Scarce,” 2000). Consequently,
the notion of using expensive anti-retroviral drugs to treat AIDS patients
is not even considered. There is no money available to obtain them. In fact,
most African countries have only ten dollars a year per person to spend on
healthcare. In addition, there are many other problems that also need to be
addressed in Africa, such as malaria or diphtheria. “But seen through
the weary eyes of the beleaguered doctors and nurses who must attend to the
sick people around them, AIDS is just another word for dying, and it’s
just another disease” (Specter, 1998, A1). There is little hope in Africa
once AIDS has been diagnosed.
The health care system in Africa is trying desperately to handle the numerous
patients it has. However, this is becoming increasingly more difficult. In
South Africa, 50% of the beds in all hospitals are occupied by AIDS patients
(Wehrwein, 2000). In other areas of sub-Saharan Africa, hospitals are extremely
overcrowded, and some of the patients are forced to sleep on mats on the floor
next to beds that have other patients in them (“Scarce,” 2000).
How can doctors and nurses adequately care for patients in such conditions?
Healthcare workers often become sick at the hands of AIDS. Consequently, “the
lack of resources and personnel make hospitals and clinics hard pressed to
train new staff to fill those new positions” (Voelker, 1999). Also,
there is not enough time and money to handle the growing number of people
with AIDS. As a result, doctors are forced to become more selective in who
receives treatment. Dr. Iwan Bekker, head of pediatrics at a South African
hospital states, “When a baby gets bad we won’t admit it for a
second time, but will tell the mother to take it home and let it die”
(“Scarce,” 2000). Sometimes, there is no other option. If there
is nothing that can be done to treat a patient, doctors must send them away
in order to keep space available for those people that can be treated in some
way.
Despite the overcrowded hospitals and increasing number of AIDS patients,
doctors fear that they still do not know the extent of the disease in Africa.
This can be partly because most men in Africa are not being tested for the
virus and may be unknowingly passing it on to women. This is being done through
several different avenues. For example, the mobile work force and rapid urbanization
of cities has led to areas in which there is an estimated 40% to 50% of the
population with AIDS. In addition, soldiers in war are likely to have sex
with prostitutes, 90% of whom are believed to have AIDS. Furthermore, many
men believe that having sex with a virgin is a cure for AIDS, thus infecting
girls as young as 12 (“Dying,” 2000). Therefore, the spread of
AIDS is facilitated because of careless or ignorant behavior on the part of
many of the citizens in Africa, which makes it extremely difficult to slow
down and treat.
Another problem that is hindering any advances that can be made in treating
AIDS is the failure of many people to believe the disease exists or is a threat
to them. In fact, 30% of African women believe that if a man looks healthy,
he could not have HIV or AIDS (“Dying,” 2000). This means that
women are willingly having sex with men because they do not believe that he
has AIDS although he may never have been tested for it. As a result, HIV will
continue to spread to unsuspecting victims daily. This denial about AIDS,
health care workers say, is as difficult to battle as the disease itself (“U.S.
HIV,” 1999).
With the number of AIDS infections increasing every day, one of the main goals
of health care providers in Africa is to establish an accurate estimation
of how many people are actually infected with HIV. Consequently, Calypte,
a U.S. drug manufacturing company, is going to work with African Medical Solutions
(AMS), in an attempt to distribute an HIV-1 urine test in South Africa. The
test is designed to detect antibodies present in the urine after exposure
to HIV-1. With the test being cheaper and safer than blood testing, the goal
is that many more South Africans will be willing to get tested (“Urine,”
2000). However, there are a few obstacles in getting this test to the majority
of the people in South Africa. These include the “vast size of the country,
remote population, poor infrastructure and relatively few trained healthcare
providers.” Most people feel the solution is the creation of “container
clinics” and “mobile clinics” that will bring HIV testing
and education to the people instead of the people having to go to hospitals
or clinics (“Urine,” 2000). If this can be accomplished satisfactorily,
then doctors will have a better understanding of the prevalence of the disease.
However, the next step is finding a way to treat the numerous AIDS patients,
which proves to be much more difficult than discovering who needs to be treated.
Since many countries in Africa do not have the resources to obtain anti-retroviral
drugs for its AIDS victims, new organizations are developing that are promoting
a new twist on the treatment of AIDS. For some time, traditional methods of
treatment and prevention of HIV/AIDS has been implemented in Africa. In fact,
many health practitioners feel that “traditional medicine is in a real
sense carrying the burden of clinical care for the AIDS epidemic in Africa”
(Bodeker, et al, 2000). In light of this information, many people feel that
medical doctors should begin to work together with traditional healers in
an attempt to combat AIDS. As a result, Traditional and Modern Health Practitioners
Together Against AIDS (THETA), an organization based in Uganda, has organized
a task force that is focusing on the collaboration of both forms of treatment
for AIDS. There is already evidence that traditional medicines such as herbal
treatments have an effect on treating this disease. Doctors from Uganda, Nigeria
and Tanzania have documented instances that show some effective treatment
of AIDS or AIDS related illnesses (Bodeker, et al, 2000). As a result, there
is a good feeling amongst doctors and other medical personnel that something
is being done to help treat HIV.
The cooperation of different organizations in the treatment of AIDS is a useful
step in controlling the epidemic. However, prevention is still a critical
aspect of this process and some people fear that effective prevention methods
will not be available soon enough. Seth Berkley, MD, president of the International
AIDS Vaccine Initiative, states, “We need new prevention technologies,
and the most critical one is a vaccine” (Voelker, 1999). A vaccine seems
to be the only hope of stopping the spread of HIV despite the promotions of
changing sexual behavior. These programs are not effective because people
do not want to change their way of life. As a result, health professionals
are waiting for a vaccine. And after 10 years of research, only one vaccine
has made it to phase 3 clinical trials. However, there is no guarantee that
it will even work. Another problem is that the vaccine only targets certain
strains of the virus. Unfortunately, these strains are not the ones that are
prevalent in Africa. Therefore, Jose Esparza, Phl, leader of the UNAIDS vaccine
team, suggests modifying the vaccine so that it will work on the strains in
Africa (Voelker, 1999). Unless this happens, the desperation present in the
health care system now may turn to complete panic because the vaccine will
not be helping those who need it the most, sub-Saharan Africans.
South Africa has one of the most catastrophic AIDS infection rates in the
world. However, this is not solely due to rapid spread of the virus. It is
also the result of the political views expressed by the government, in particular
President Thabo Mbeki (Rostron, 2000). This controversial attitude has hindered
some of the progress that South Africa could have made in combating the disease.
Not only is the South African government and President Mbeki’s stance
causing a dispute in international relations specifically with pharmaceutical
companies, but it is also resulting in the refusal of some South African residents
to heed the warnings of AIDS awareness programs (Rostron, 2000). Hence, South
Africa has been unable to decisively deal with the problem at hand.
On January 21, 2000, President Thabo Mbeki telephoned David Rasnick, a biochemist
that resides in San Francisco. Rasnick reports that President Mbeki wished
to discuss any theories Rasnick may have regarding the cause of AIDS. These
theories include that AIDS is not caused by the HIV virus and that the combination
of drugs used to treat AIDS in wealthy countries is actually toxic (“Flirting,”
2000). As a result, Mbeki’s actions have been dictated by his views.
For example, in the spring of 2000, President Mbeki opened an AIDS conference
consisting of AIDS experts and scientists in Pretoria, South Africa. The conference
was assembled to discuss methods to fight the epidemic ravaging South Africa.
However, “Mbeki insisted that nothing should be blindly accepted in
the anti-AIDS fight and the diverging theories about the disease be discussed”
(“S. Africa,” 2000). In addition, Mbeki stressed that poverty
is the most important factor contributing to AIDS and that everything cannot
be blamed on a single virus (Karon, 2000). Professor Anna-Lise Williamson
Ph.D., a Principal Specialist Scientist at the University of Capetown who
is currently working on developing an AIDS vaccine, adds that the debate Mbeki
has raised is having a negative impact on the country. It is prohibiting the
general population from understanding the facts about AIDS. And the lack of
an aggressive campaign against AIDS is severely detrimental to a country where
millions of people are going to die because of the disease (Williamson, 2001).
Another example that Mbeki’s actions illustrate his views is his refusal
to provide pregnant women with the anti-HIV drug AZT. AZT is widely used to
prevent mother-to-child transmission of HIV. However, Mbeki is concerned that
the drug is too toxic. In response, Dr. Eric Gomaere of Doctors Without Borders
says, “Of course AZT is toxic. But AIDS is even more toxic” (“Africa
II,” 2000). In short, AZT must be toxic to combat such a virulent disease;
however, South African women are not gaining access to this drug because of
the president.
Despite the attitude President Mbeki has towards AIDS, he understands that
something must be done to try and control its rapid spread in South Africa.
As a result, he has been lobbying for the pharmaceutical companies with patents
on the anti-retroviral drugs used to treat AIDS to lower their prices. As
it stands now, the cost of treating an AIDS patient can be as high as $12,000
a year. This is far more than any South African can afford whose average income
is less than $3,000 per year (Davis, 2000, p. 31). Pharmaceutical companies,
however, have been reluctant to lower their prices. Instead, they would rather
provide certain drugs to South Africa for free but only for a certain period
of time. This strategy could possibly force those who start using the drugs
to find a way to continue, despite the cost. For example, Pfizer, Inc., located
in New York City, is offering to give poor South Africans the meningitis drug
Diflucan. Meningitis is a lethal brain infection that occurs in almost one
out of ten HIV patients. Selling at $13 to $17 a day, Diflucan can greatly
contribute to keeping AIDS patients healthier for a longer period of time
(“Drug,” 2000). In addition, the German pharmaceutical company,
Boehringer Ingelheim, is prepared to provide South Africa with Viramune, also
known as Nevirapine, which helps prevent mother-to-child HIV transmission
for the next five years. This drug has the potential to save as many as 110,000
neonatal infections within that time frame (“HIV/AIDS II,” 2000).
The implications the anti-retroviral drugs can have for slowing the spread
of HIV and AIDS is tremendous. However, South Africa is unsure if it will
agree to these offers. The government is skeptical because they have heard
reports that nevirapine is linked to the death of five women in a South African-based
clinical trial. Also, “South African Health Minister Manto Tshabalala-Msimang
said…she was ‘suspicious of the timing and method of the announcement.’”
She also noted, “What’s very strange is that we met with them
last Friday and they did not (for) even one minute indicate they were going
to make such an announcement” (“HIV/AIDS II,” 2000). Consequently,
South Africa may never even benefit from these offers although they are in
desperate need of the drugs.
The predicament of the South African government is not an easy one to solve.
Is it more feasible to make deals with an untrustworthy pharmaceutical company
or to do nothing and allow thousands of South Africans to die without any
hope of treatment? For South Africa, the answer is neither. Instead, in 1997
“the South African government passed an amendment to its Medicines and
Related Substances Act, under which the Ministry of Health could begin compulsory
licensing and ‘parallel importation’ of affordable drugs.”
Parallel importing allows South Africa to import medicines from countries
that would charge much less than a drug company would. Similarly, compulsory
licensing provides South Africa with the power to compel a drug company to
authorize local manufacturers to produce generic forms of drugs that can drastically
reduce the cost (Davis, 2000, p. 31). This seems like a great solution to
an important problem. However, 40 major drug companies jointly filed a suit
against South Africa with the plea that these steps expropriate their patent
rights. On the other hand, the World Trade Organization contends that both
parallel importing and compulsory licensing are legal for countries faced
with a national emergency, under the Trade-Related Intellectual Property Rights
(TRIPS) agreement (Davis, 2000, p. 31). Therefore, South Africa must await
the results of a trial that is currently going on involving this suit.
The trial between South Africa and the 40 major pharmaceutical companies began
on March 5, 2001 with each side prepared to present its case. The drug companies
seem to have numerous reasons as to why South Africa should not be allowed
to implement parallel importation and compulsory licensing as well as offering
justifications for the high prices of AIDS drugs. It appears that the main
argument offered involves the price of the drugs. The drug companies contend
that selling cheap generic drugs could undermine the industry’s pricing
system as well as the ability to fund new research, which comes from the profits
made by selling the drugs (Maykuth, 2001). This is especially true if patients
in the United States and other western markets start demanding cheaper prices
(Warner, 2001). Next, the drug companies feel that South Africa is simply
violating its commitment to world-trade treaties. In addition, many believe
that less developed nations must first learn to manage their drug-supply systems
more closely (Maykuth, 2001). If this does not happen, many problems could
arise from a flood of new drugs in the South African market. For example,
AIDS drugs that were donated to poor black communities would only be sold
to more affluent white communities, thus defeating the purpose of donating
the drugs (Warner, 2001). As a result, many drug companies say that even if
South Africa were given an endless supply of drugs for free, most people with
AIDS would never get treated (Maykuth, 2001). Lastly, if generic drugs were
administered improperly, more resistant strains of the virus could erupt that
would create a much more serious situation than what already exists (Warner,
2001).
AIDS activists who are lobbying on the side of South Africa, share concern
with the pharmaceutical companies that generic drugs, which are administered
improperly, may result in the development of new strains of the virus (Warner,
2001). However, there is still a great belief that AIDS patients are entitled
to four basic things: AIDS medication, nutritional supplements, clean water
and HIV tests (Collins, 2001). As a result, they are trying desperately to
help South Africa prevail in court. There is serious doubt in the minds of
activists as well as the South African government officials that providing
cheap generic drugs to the country will hurt the earnings of the drug companies
(Maykuth, 2001). In addition, HealthGap Coalition, an activist group, is trying
to steer the argument to that of a moral issue. It feels that there should
be free market competition between brand name drugs and low cost generics,
so that South Africa can afford to purchase some type of drug for its many
sufferers (Collins, 2001). It also helps that the people of South Africa are
behind their country’s fight with the drug companies. Professor Williamson
claims that there is “little sympathy for the drug companies and their
intellectual property” (Williamson, 2001). This support could go a long
way in helping South Africa win the case.
The outcome of this trial is going to have numerous consequences for both
sides. However, winning the trial is not a solution for South Africa. It is
only one battle that has been won in the war against AIDS. “Any real
solution needs to go beyond drugs, to prevention programs, clinics and doctors
and nurses to treat patients” (Warner, 2001). Clearly, the best way
to treat a disease is to never get it. And if South Africa is going to stand
any chance of curbing the disease, prevention must play a key role. After
that, the focus can be on providing doctors and nurses with the skills and
tools they need to have a chance fighting AIDS.
The AIDS epidemic has been ravaging the world for decades; however, many people
are not aware of the prevalence of the disease outside of their own environment.
For example, many citizens of the United States do not realize that AIDS is
such a pressing issue in sub-Saharan Africa because they are focused on the
effects it is having in their own town, state or region. On the other hand,
sub-Saharan Africa is very aware that AIDS exists outside of Africa because
every day there is a struggle to secure drugs to treat this disease from companies
that are largely based in the United States or Western Europe. Also, there
is the internal struggle of how to care for the growing number of orphans
and how to build a strong economy when so many people in the prime of their
lives are dying from AIDS.
The health profession is trying to combat the AIDS epidemic in Africa in order
to help restore some order to the country and give the people some hope. However,
many obstacles stand in the way. For example, there is little access to anti-retroviral
drugs in sub-Saharan Africa making treatment almost impossible. Health care
professionals have a feeling of desperation in them to help the people of
their country and also themselves, since they are not immune to AIDS. As a
result, there is a lot of effort being put into testing, treating and preventing
AIDS. This is the main priority of doctors and nurses because they do not
have any other options.
South Africa is not unlike any other country in sub-Saharan Africa. It is
being ravaged by AIDS and there is little that can be done to prevent it.
The country is being further hindered by the political stance of President
Thabo Mbeki who does not believe that HIV is the sole cause of AIDS. Instead,
he is convinced that AIDS is the result of poverty as well. As a result, the
many people in South Africa are becoming confused as to what AIDS is and what
they need to do about it. Also, Mbeki’s views are hindering the ability
of South Africans to gain access to medicine to help treat the disease. This
has put South Africa in a courtroom where they are fighting major pharmaceutical
companies for their right to import cheap generic drugs or manufacture their
own drugs. Yet, thousands of people are still dying of AIDS every day in South
Africa.
The AIDS epidemic is taking the lives of people in South Africa, as well as
every other corner of the world. It is causing various social and economic
problems in these areas because it touches every aspect of life. AIDS has
the ability to take over someone’s life until it finally kills them.
As a result, it is an extremely pressing issue in the medical field. A cure
and/or vaccine for this disease is the only way to stop it from completely
destroying everything that society has built, especially in South Africa.
The future of the world, in particular sub-Saharan Africa, depends on the
development of effective drugs, prevention programs, clinics and competent
doctors and nurses to treat patients. This, however, takes a great deal of
money to accomplish. Jeffrey Sachs, a Harvard economist and chairman of the
World Health Organization’s Macroeconomics and Health Committee, believes
that it is the job of the richer nations of the world to provide the funds
to implement such things for the entire world. He also feels that drug companies
will eventually lower their prices, which will be beneficial in this process
as well (Warner, 2001). However, nothing will be accomplished unless developed
and non-developed countries work together for a common goal, the eradication
of the AIDS epidemic.
Africa II: ’60 Minutes II’ Looks at Growing AIDS Crisis. (2000,
June 28). American Health Line, Lexis-Nexis Database.
AIDS Hindering Development Efforts in Africa, Leaders Say. (1999, September 14). Medical Industry Today, Lexis-Nexis Database.
A Prescription for Disaster. (2000, April). U.S. Catholic, 65, 46.
Bodeker, G., Kabatesi, D., King, R. & Homsy, J. (2000, April 8). A Regional Task Force on Traditional Medicine and AIDS. The Lancet, Proquest Database.
Christensen, J. (2000). CNN.com In-Depth. AIDS: Africa in Peril. AIDS in Africa: Dying by the Numbers. Retrieved on March 1, 2001 from the World Wide Web: http://www.cnn.com/SPECIALS/2000/aids/stories/overview/
Christensen, J. (2000). CNN.com In-Depth. AIDS: Africa in Peril. Scarce Money, Few Drugs, Little Hope. Retrieved March 1, 2001 from the World Wide Web: http://www.cnn.com/SPECIALS/2000/aids/stories/treatment/
Collins, H. (2001, March 5). AIDS Activists Target a Disparity of Care. Philadelphia Inquirer.
Davis, L.J. (2000, January/February). A Deadly Dearth of Drugs. Mother Jones, 25, 31-33.
Drug Firm to Give Away AIDS Drug to South Africans. (2000, April 4). Medical Industry Today, Lexis-Nexis Database.
Flirting With Strange Ideas. (2000, April 17). Newsweek, 135, 36.
HIV/AIDS II: Company Offers Free Drugs to Some Nations. (2000, July 10). American Health Line, Lexis-Nexis Database.
Karon, T. (2000, July 24). When the President Is a Dissident. Time, 156,
39.
Maxwell, J. (2000). CNN.com In-Depth. AIDS: Africa in Peril. Africa’s
Lost Generation. Retrieved March 1, 2001 from the World Wide Web: http://www.cnn.com/SPECIAL/2000/aids/stories/women.children/
Maykuth, A. (2001, March 4). Where AIDS is Rampant and Help Scarce. Philadelphia Inquirer.
Mbeki, T. (2000, July 24). South Africa Hosts World AIDS Conference As Continent Reels From Disease’s Effect. Jet, 98, 6.
Rostron, B. (2000, October 16). Deadly Dissent of a Would-Be Galileo. New Statesman, 129, 21-22.
S. Africa President Mbeki Opens 2-Day Experts Conference On Combating AIDS. (2000, May 22). Jet, 97, 17.
Specter, M. (1998, August 6). Doctors Powerless as AIDS Rakes Africa. The New York Times, p. A1 & A6.
UNAIDS/WHO: Release World AIDS Epidemic Update. (2000, November 29). American Health Line, Lexis-Nexis Database.
U.N. Calls on Africa to Devote More Resources to AIDS Fight. (1999, September 16). Medical Industry Today, Lexis-Nexis Database.
Urine Test to Detect HIV-1 on Way to S. Africa. (2000, June 8). Medical Industry Today, Lexis-Nexis Database.
U.S. HIV Births are Falling; U.K. Offers Routine Testing. (1999, August 16). Medical Industry Today, Lexis-Nexis Database.
Voelker, R. (1999). Poor Nations Ravages by AIDS Need the Right Resources Now. The Journal of the American Medical Association, 282, Proquest Database.
Warner, S. (2001, March 6). The Quandary for Drug Giants Amid AIDS Epidemic. Philadelphia Inquirer.
Wehrwien, P. (2000). CNN.com In-Depth. AIDS: Africa in Peril. AIDS Leaves Africa’s Economic Future in Doubt. Retrieved March 1, 2001 from the World Wide Web: http://www.cnn.com/SPECIALS/2000/aids/stories/economic.impact/
Williamson Ph.D., A. Associate Professor. Principal Specialist Scientist. Division of Medical Virology. University of Capetown. “Re: Help with AIDS Research.” Personal Communication: Email to Brooke Milot. March 21, 2001.
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