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Patent Rights Over Human Rights: African Women and US AIDS Policy

Posted on: Thursday, April 6, 2006

Keywords: Women's Health, Combating Violence Against Women

A MADRE Position Paper

Thanks largely to the work of African public-health and social-justice advocates, growing numbers of people around the world know that sub-Saharan Africa is the epicenter of the AIDS pandemic: the majority of AIDS deaths worldwide are in Africa, where 20 million people have already died and nearly two-thirds of the world’s HIV-positive people live. Fewer people know that most Africans living with HIV/AIDS are women, and that young women are now being infected at a rate three to four times higher than young men. For many, this information is absorbed through a mesh of stereotypes that make human misery seem like a natural condition of life in Africa.

But while AIDS-like the Asian tsunami-may have originated in nature, the magnitude of its destruction is a man-made disaster. Consider the following:

  • African governments’ capacity to respond to the AIDS crisis has been hamstrung by US-backed “economic austerity measures” that cut national health budgets by half just as AIDS emerged in the 1980s. Today, the pandemic is the single greatest obstacle to economic development in Africa.
  • To bolster already-huge profits of US pharmaceutical companies, the Bush Administration has prevented the sale of affordable generic drugs that have slowed the spread of AIDS in the global North.
  • Women are made particularly vulnerable to HIV infection because they are denied the power to refuse sex or insist on condom use. As the majority of those living in poverty and the poorest of the poor, women are more likely to contract HIV and more likely to develop symptoms of AIDS soon after they are infected.

AIDS, economic under-development, and women’s inequality are mutually reinforcing crises; combating any one of these requires addressing them together. But too often, public health programs, government policies, and even activists compartmentalize issues, missing critical points of inter-connection that are the keys to effecting change.

One reason for this myopia is that a singular focus on AIDS as a naturally occurring scourge allows policymakers to avoid tackling tough social issues like economic justice and gender equality. Consider the relationship between AIDS and women’s property rights in Kenya. Each year, hundreds of thousands of Kenyan women are widowed by AIDS. Because Kenyan laws and customs bar women from owning and inheriting property, women and their children are often forcibly displaced from their lands and homes when their husbands die. Displacement increases women’s risk of contracting HIV by exposing them to poverty, homelessness, violence, and disease, sometimes compelling them to trade sex for food and shelter. Protecting women’s property rights is an urgent component of HIV/AIDS prevention strategies. But protecting these rights entails challenging law and tradition and spotlighting volatile issues related to land tenure and distribution of resources in an impoverished country.

In fact, any successful prevention strategy must empower women by advancing their social and economic rights. Yet the dominant approach remains the dangerously limited ABC strategy being promoted by the Bush Administration: Abstain, Be faithful, use Condoms. Abstinence is not a choice for women who are raped or coerced into sex. Faithfulness is irrelevant for women whose husbands have multiple partners (for African women, marriage is actually a risk factor for contracting HIV). And condoms presented by the Bush Administration as a “last resort” in the fight against AIDS depend on men’s willingness to use them (and both partners’ willingness to forgo having children). By placing the burden for prevention on individual behavior, the ABC approach allows policymakers to ignore the poverty and inequality that form the breeding ground for AIDS.

President Bush’s first-term promise to spend $15 billion fighting the pandemic, particularly in Africa and the Caribbean, was a ruse. Most of the $15 billion was money that Bush cut from existing programs and reallocated to his initiative. Bush’s own budget request for the program’s first year was $1 billion less than the promised installment of $3 billion. And Bush’s initiative actually undermines effective international efforts to combat AIDS through the UN Global Fund to Fight AIDS, Tuberculosis and Malaria. Instead of paying its fair share to the Fund ($3.5 billion), the US is replicating some of the Fund’s efforts while pushing ideologically motivated abstinence programs over the proven “safe sex” approach, and promoting expensive drugs patented by US pharmaceutical companies instead of lower-cost generics.

Effective programs that combine HIV/AIDS treatment and prevention have been developed and implemented in numerous countries. But rather than support the best of these efforts, the Bush Administration has put AIDS policy into the hands of evangelical activists and drug-company lobbyists. In Africa, less than one percent of people with HIV/AIDS have access to the anti-retroviral drugs that have extended millions of people’s lives in the global North. Universal access to treatment is an achievable goal, but it requires the Bush Administration to act through the World Trade Organization to override corporate patent rights. MADRE has long asserted that the logic of human rights dictates that -- contrary to the dogma of neoliberalismnot everything should be commodified. Clearly, HIV/AIDS treatment programs should ensure that all infected people have access to affordable generic drugs, including drugs that prevent mother-to-fetus HIV transmission. And treatment programs must be designed to overcome the gender discrimination that results in men being given preferential access to health care.

HIV/AIDS prevention and treatment programs should be fully funded and implemented without interference from religious fundamentalists. An obvious source of funding for such programs is the $15 billion a year that African countries currently devote to debt servicing. That amount is four times more than most African governments’ budgets for health and educationthe most critical sectors in the fight against AIDS. Africa’s debt is largely illegitimate (resulting mainly from loans made by Northern creditors to bolster repressive regimes during the Cold War). A 2004 study by the Debt and Development Coalition Ireland demonstrates that the World Bank and International Monetary Fund can afford to cancel poor countries’ debt without much impact on their operations. However, these institutions’ largest shareholder, the United States, is opposed to unconditional debt cancellation. In fact, the US leverages the debt to ensure that African governments implement policies that are compatible with US interests.

Current US-Africa policy reflects the Bush Administration’s most narrowly defined self-interest: acquiring African oil and using African governments as “strategic allies” in the “war on terror.” Yet, the single biggest threat to Africa is unquestionably the AIDS pandemic, which has killed millions, increased poverty, undermined development, exacerbated global economic inequalities, and destabilized whole countries. Fighting AIDS through a combination of treatment and prevention should therefore be the centerpiece of US-Africa policy. Such a policy must prioritize human rights over patent rights and recognize women’s human rights, in particular, as critical in the fight against AIDS.

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