One of the most troubling things about the AIDS epidemic is that it could have been stopped so easily by rolling out life-saving antiretroviral drugs (ARVs) early on. Not only do ARVs prevent HIV from developing into AIDS, they also reduce transmission rates and increase people’s willingness to get tested.
But Western pharmaceutical corporations have colluded in pricing these essential drugs way out of reach of the poor. When they were first introduced, patented ARVs cost up to $15,000 per yearly regimen. Generic producers were able to manufacture the same drugs for a mere fraction of the price, but the WTO outlawed this through the 1995 TRIPS agreement to protect Big Pharma’s monopoly.
It was not until 2003 that the WTO bowed to activist pressure and allowed southern Africa to import generics, but by then it was too late – HIV prevalence had already reached devastating proportions. In other words, much of the region’s AIDS burden can be directly attributed to the WTO’s rules and the corporations that defended them. And they are set to strike again: the WTO will cut patent exemptions for poor countries after 2016.
This dearth of basic drugs has gone hand in hand with the general collapse of public health institutions. Structural adjustment and WTO trade policies have forced states to cut spending on hospitals and staff in order to repay odious debts to the West. Swaziland, ground-zero in the world of AIDS, has been hit hard by these cuts. When I last visited I found that many once-bustling clinics are now empty and dilapidated. Neoliberalism has systematically destroyed the first line of defence against AIDS.
The point I want to drive home is that the policies that deny poor people access to life-saving drugs and destroy public healthcare come from the same institutions and interests that helped create the conditions for HIV transmission in the first place.