[corp-focus] Shame and Determination on World AIDS Day

[Robert Weissman]

Shame and Determination on World AIDS Day
By Russell Mokhiber and Robert Weissman

Today, December 1, is World AIDS Day, a chance to take stock of how the
world is doing at confronting the worst pandemic of the last 500 years.

It is an unbearably grim situation. The death toll and shattering of
communities across Africa -- and increasingly other areas where the
epidemic is skyrocketing -- defies description. And yet world leaders,
in rich and poor countries alike, are letting the problem worsen, as
they let corporate greed, ideology, homophobia and incompetence get in
the way of solutions.

The only good news is that activism has stopped the situation from being
worse than it is, and holds out hope of making it a lot better.

Quick reminders of how bad things are --

For those who relate to numbers: Roughly 40 million people worldwide
have HIV/AIDS, and the number is rising fast. More than three million
people are dying from AIDS-related each year, and that number is rising
fast, too. The average life expectancy in many southern African
countries, the region worst hit so far, has plummeted to less than 40.
In St. Petersburg, Russia, infection levels rose 100 times between 1998
and 2002.

If the numbers don't move you, check out the heart-rending report in the
Sunday New York Times on how the HIV/AIDS epidemic is laying waste to
Lavumisa, a village in Swaziland. Here's a short excerpt:

"Sixteen-year-old Nkuthula Madlopha wanted to be a police officer.
Instead, next year she will till her grandparents' fields, filling in
for her dead parents. Her brother will herd livestock.

"Their grandmother, Vayillina Madlopha, wanted a quiet old age. Instead,
at 80, she is a new mother. 'I thought my daughters-in-law would be
serving me food, washing for me and cleaning the yard,' she said. 'Now I
must start afresh.'

"Eleven-year-old Ntokozo wanted to be a third grader. Instead, he lies
on the floor of his one-room hut, his knees swollen like baseballs and
his mouth pitted with sores. His mother, who died in May, infected him
with H.I.V., either during her pregnancy or later as he helped tend her
oozing sores. His sister, Nkululeko Masimula, 26, wanted a job. ' I
wanted to have my own business; to be a hairdresser or a wholesaler,'
she said. Instead, she tends her brother and their 61-year-old
grandmother. She sells the family's chickens to raise money for food.
Finding the $20 a month required to take her brother to the nearest
antiretroviral drug site, 60 miles away, is a pipe dream."

And a review of the miserable response of the world's governments and
institutions --

A few developing countries have stepped up and instituted prevention and
treatment programs that are at least remotely commensurate with the
scale of the tragedy.

By and large, however, developing country governments have failed to
devote serious resources or political capital to stopping the spread of
the epidemic, reinvigorating public health systems, providing
life-saving treatment to people living with HIV/AIDS, or stopping the
violence against women and redressing the power imbalances that are
responsible in considerable part for the epidemic's deadly surge among
women and girls.

The performance of rich countries -- who don't have the same resource
constraints to fall back on as an excuse -- is equally appalling.

In April 2001, UN Secretary General Kofi Annan called for the creation
of a global fund of $7 billion to $10 billion annually to address
HIV/AIDS. (To put this number in perspective: the United States now
spends $35 billion a year on pet supplies.) The fund was in fact
established, as the Global Fund to Fight Against AIDS, Tuberculosis and
Malaria.

The Global Fund is an imperfect institution. Among other problems, it
has been slow to move the money it has received.

But the Global Fund is among the best things going in international aid.
It doesn't waste money on a huge bureaucracy or overhead, and hasn't let
consulting firms capture money intended to assist people in the
developing world, and it works to involve people living with HIV/AIDS
and nongovernmental groups in the process of developing project proposals.

The Global Fund's big problem is that it is criminally underfunded. It
has committed $3 billion in its three years of existence. In November,
because of funding shortfalls, the Fund decided to delay its next
funding round for two months, until September 2005. This was a victory
over those, led by the United States, who wanted to delay the next grant
round indefinitely.

The rich countries simply have not been willing to pony up the monies
needed to address the epidemic, with more than enough blame to spread
around among Europe, Japan and the United States.

The Bush administration has worked hard to subvert the Global Fund.
Although the relevant Senate committees had agreed in 2004 to spend $550
million on the Global Fund, in the final appropriations process the
administration maneuvered, pressured its Congressional allies, and
succeeded in slashing the final Global Fund commitment to $350 million.

(To prevent a re-occurrence of this fiasco, activists are mobilizing
today to demand that Congress next year appropriate $1.5 billion to the
Global Fund and provide $330 million to the Fund as part of an emergency
spending bill expected this winter. To join this effort, simply call
Senator Majority Leader Bill Frist at 202-224-3344 and tell him how
important it is to fund the Fund.)

The administration dislikes the Global Fund in part because it is
multilateral, in part because it supports the use of low-cost, quality
generic drugs, and in part because of its readiness to fund condom programs.

So instead of supporting the global initiative, the administration has
invested billions in a bilateral program. The program will hopefully
deliver results eventually, but it has been slow to get off the ground,
duplicates work already accomplished by the Global Fund and other
bodies, and is reluctant to support use of generics.

Indeed, the United States is actively working to undermine the prospect
of generic production of AIDS and other drugs. In a host of free trade
agreements, the United States is demanding on behalf of Big Pharma that
countries agree to rules that will delay introduction of generic
competition for years or even a decade or more. Given that the generic
price of first-line AIDS drugs is now less than 2 percent of the price
of brand-name drugs just five years ago, this is a big deal.

Meanwhile, although they are reluctant to put new monies into developing
countries, rich nations are quite happy to suck resources out.

The sub-Saharan African countries hardest hit by HIV/AIDS happen to be
the poorest and most indebted. Together, they owe $300 billion to the
World Bank, the International Monetary Fund and rich country creditors.
There is no prospect of them ever paying off this debt. But they do send
billions in interest payments to rich country financial institutions.

The bottom line of this collective global failure: The World Health
Organization estimates that 6 million people in the developing world
need AIDS drug therapy immediately -- and face certain death if they do
not get it. WHO set a target of 3 million to get treatment by 2005 ("3
by 5"). Less than 8 percent of the 6 million are getting treatment,
nearly a third of them in a single country, Brazil.

And the epidemic continues to spread, and intensify.

As bad as things are, they could be worse. Activism and generic
competition has dropped the price of lifesaving treatment drugs
dramatically -- from $10,000 a year per person to $140. The resulting
lowered costs made it possible to talk about provision of treatment in
developing countries, and created the conditions in which billions of
dollars could be mobilized in aid.

The list of things that need to be done to improve the situation is very
long. But the top priorities in rich countries are clear, and
achievable, if enough people demand they be met:

* Getting sufficient funding to the Global Fund;
* Stopping trade agreement provisions that extend drug company
monopolies and delay generic competition; and
* Canceling the debt of the poorest countries -- something that is now
actually on the agenda of the G7 group of rich countries.

Concludes Brook Baker of Health GAP:

"People with AIDS and their allies have moved from the outrage of
nothing being done to the miasma of things being done far too slowly and
poorly to boot. Whatever specific campaigns that activists mount to
expand and improve the global response, we must not do so without
referencing the larger picture. The paucity and ineptitude of the global
response is an indictment of a world order where businesses set global
policy, where governments neglect social obligations, and where
multilaterals and international NGOs curry favor from stingy,
domestic-policy-crazed donors.  The message on World AIDS Day 2005 is
one of shame and of determination -- shame at our collective inability
to raise the world from its lethargy and determination to show more
pragmatic solidarity with the individuals, communities and nations
wracked by this lethal plague."


Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime
Reporter, http://www.corporatecrimereporter.com. Robert Weissman is
editor of the Washington, D.C.-based Multinational Monitor,
http://www.multinationalmonitor.org, and a member of Health GAP. They
are co-authors of On the Rampage: Corporate Predators and the
Destruction of Democracy (Monroe, Maine: Common Courage Press;
http://www.commoncouragepress.com).

(c) Russell Mokhiber and Robert Weissman

This article is posted at:
<http://lists.essential.org/pipermail/corp-focus/2004/000187.html>