A prescription for disaster

THE TRAGIC SAGA OF HIV/AIDS IS PERHAPS THE BEST-DOCUMENTED VIRAL PANDEMIC IN HUMAN HISTORY. Its impact on people in the United States has been routinely discussed in U.S. media, but in the developing world—where 95 percent of the worldwide HIV/AIDS population can be found—the toll taken by the virus has not been as well chronicled. But then there is little good news to report—particularly from Africa where 70 percent of the world's HIV/AIDS cases reside.

Thousands were dying while bureaucrats argued over how drug companies could get paid.
More than 23 million people in Africa are infected with HIV. 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. The virus has taken a staggering toll on the 20- to 40-year-old population that should be the most vibrant contributors to African societies, leaving in its wake communities maintained by the very old and overwhelmed by the orphaned very young.

Demographers and economists have begun to talk about a large-scale social breakdown in the making in Africa. It's possible that AIDS alone will cripple the fragile economic and social development in some African regions.

The world community has begun to take notice. The Clinton administration will spend $100 million next year to combat AIDS in Africa. The World Bank and other development agencies are including campaigns against the disease as part of their economic development programs. But a major problem in cash-poor Africa has been finding the resources to pay for the prescription medicine that has proven effective against AIDS in more affluent societies. The chemical cocktail so successful in containing AIDS costs as much as $12,000 a year per patient—an amount few societies in Africa, which spend on average $10 per capita annually on health care, are capable of providing.

When South Africa began to produce low-cost generic versions of some of the anti-AIDS drugs, U.S. pharmaceuticals enlisted their political operatives in Washington to defend "their" patent rights and income from such humanitarian encroachments. This effort was unseemly for at least two reasons:

Some of the drugs being "defended" were developed by government research at U.S. taxpayer expense, and thousands of people were dying each day while bureaucrats argued over how drug companies could get paid. South Africa and drug manufacturers have reached a compromise on this trade dispute, but the larger problem of getting affordable medicine to Africa (to combat AIDS and other maladies) remains.

A "market failure" occurs when an obvious social need cannot be satisfied through the "natural" profit-driven processes of the free market. The church has long worried over such often cruel contradictions.

In Centesimus Annus, Pope John Paul II writes: "It would appear that . . . the free market is the most efficient instrument for utilizing resources and effectively responding to needs. But this is true only for those needs which are 'solvent,' insofar as they are endowed with purchasing power, and for those resources which are 'marketable,' insofar as they are capable of obtaining a satisfactory price. But there are many human needs which find no place on the market. It is a strict duty of justice and truth not to allow fundamental human needs to remain unsatisfied, and not to allow those burdened by such needs to perish."

Delivering medicine to the suffering is a communal responsibility; as such, it should be administered by the only communal authority capable of responding effectively—government. African governments must increase their commitment to fighting AIDS beyond the average 1 percent of GNP they are spending now, and governments from the affluent world must cease protecting the interests of a collection of campaign-contributing drug companies and see to the good intentions of their taxpayers. They must strive—not to place obstacles in the path of African nations seeking low-cost access to drugs and treatments we know are effective—but to facilitate that access as much as humanly possible.

Getting the right medicine to Africa to combat AIDS has been a free market failure; it can be prevented from becoming a free market catastrophe.  

Kevin Clarke is managing editor of online products at Claretian Publications in Chicago.

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