HIV/AIDS has been referred to as a holocaust of the poor. But it is a holocaust that can be prevented if the millions of sufferers in the developing world are given access to life-saving, anti-retroviral drugs. The World Health Organisation (WHO) has called this a global health emergency. It is spear-heading it’s ‘3 for 5’ campaign, where the goal is to give at least 3 million HIV sufferers in the developing world access to anti-retroviral treatment by the year 2005.
There is encouraging evidence to suggest that once a treatment programme is instituted, the positive spin-offs multiply. Firstly, people who would have died of AIDS now have the chance of living a normal life. Secondly, it encourages people to be tested who before believed there was little benefit in knowing their HIV status and indeed, many down sides. This has helped to prevent further infection. Thirdly, it has reduced the stigma attaching to HIV/AIDS and encouraged greater openness and discussion of the disease.
The slowness in giving the poor anti-retroviral drugs pivots around the price the big pharmaceutical companies want to charge for the drugs, and the price developing countries can pay. The big pharmaceutical companies argue that the high price is necessary to recoup the huge financial outlay in developing the drugs. But developing country governments are unable to pay this price. The WHO Director-General, Dr LEE Jong-wook has said, "Business as usual will not work. Business as usual means watching thousands of people die every single day.”
In South Africa, where a fifth of the economically active population are infected, the government took matters into its own hands. It threatened to allow cheap, generic versions of the patented drugs to be sold in its country. The big pharmaceutical companies took the government to court and for 3 years legal argument ensued. Finally, in 2001 the pharmaceutical companies backed down, and agreed to market their drugs at a more affordable price in South Africa. But while this can be seen as a victory for the human rights of poor people over the profits of commercial companies, the political will and capacity to distribute and monitor drug therapy has yet to be demonstrated in South Africa. The government has been equivocal in its response to HIV/AIDS, with the country’s president, Thabo Mbeki, publicly questioning the link between HIV and AIDS. This has sown confusion in a country with one of the world’s highest infection rates and in which the health system is in disarray.
On balance, while progress has been made in winning the right of the poor to drug therapy, and the amount spent on fighting HIV/AIDS has risen from $2.8 billion in 2002 to an estimated $4.7 billion in 2004, it is not a one tablet solution. It involves a life time programme of care. To this end, the WHO, in partnership with other development agencies, are putting in place programmes to effectively administer and monitor drug treatments in developing countries. This involves a long term commitment of resources, building the health systems of developing countries and a dedicated team of health professionals. But it also requires the political will of the government of the affected country to fully commit to fighting the disease. Vigorous action by the publics of affected countries is necessary to ensure this. Such political will needs to be found and the WHO’s ‘3 for 5’ target achieved, for the consequences of failing are too bleak to contemplate.