“There’s more to AIDS in Africa than access to drugs.” We’ve heard that, many of us. Our African partners, as they reflect upon their priorities and capacities, frequently remind us of that fact. For quite different motives, pharmaceuticals have argued the same. And discouragingly, the government of South Africa has added its own twist to the argument. And it’s true; there is more to confronting AIDS in Africa than access to drugs.
Why, then, do medications remain such an active, even contentious, part of the debate about AIDS in Africa? They do so for these reasons:
First, the lives of millions of human beings are at stake. If we are unwilling to make drugs available when it is indeed possible to do so, and likely to save lives by doing so – true in many African settings as elsewhere – then it is unethical, even criminal, to “write off” a continent by denying access to medicines.
Second, there is the conviction that prevention and treatment complement one another. This is especially true when one of the key features of prevention programs involves awareness as to whether or not a person is HIV-positive. That requires testing. But if stigma is attached to being HIV-positive – as it is in much of Africa – and one’s relations with family, community, and employment hinge upon being free of HIV/AIDS, then why be tested? Without the possibility of treatment, there is little incentive.
And third, health care and AIDS treatment should not be an economic commodity, the preserve of the wealthy. US trade policy continues to show greater concern for the protection of intellectual property than for the lives of those suffering with AIDS. As a minimum, the US should not retaliate against African nations that seek to use legitimate international trade provisions to secure affordable medicines.
In short, faith-based advocacy groups in the US have been drawn into the issue of drugs not because we believe it is the single answer to AIDS in Africa, but because US policy has been so negative toward including treatment as part of an AIDS agenda for Africa.
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