SOUTH AFRICA 24 April 2002. A giant faced a dying man in court. The giant told the man that he could not have the lifesaving drugs he needed because it had profits to protect. The giant was GlaxoSmithKline (GSK), the second biggest pharmaceutical company in the world.

The dying man, an HIV sufferer had been told to go onto a waiting list for treatment. He was in court trying to force GSK to cut the cost of its drugs and GSK was fighting back. In a capitalist system, money - or more precisely, profit - overrides all other considerations.

Years before, when the race was on to find a cure or treatment for HIV, research centres and big pharmaceutical companies used the meteoric rates of infection in Africa as a lever to win research grants worth millions of dollars.

In 1997 Sub-Saharan Africa had 21 million people infected with HIV, one million of them children. Africa has 10% of the world’s population but 70% of the world’s HIV sufferers. Pharmaceutical companies used these harrowing statistics to portray themselves as would-be health saviours of the African people.

New treatments

Massive amounts of cash were sunk into research. It produced triple combination therapies (3CT), treatments which attack the life cycle of the virus at three separate stages.

The effects seemed miraculous. Previously, serious illnesses such as AIDS-related dementia were fatal. 3CT brought many back, apparently from the brink of death, into a state of good health.

In the history of diseases and cures, the treatment was also remarkable for the speed with which it was developed - a clear illustration of what humankind is capable of when given the necessary resources.

The sick in Africa may have provided useful leverage but when the treatments were developed it was the prosperous West which felt the benefits. In the USA, in 1996, AIDS was the eighth leading killer disease. By 1999, new treatments helped it fall out of the top 15.

Yet even these statistics hide class distinctions separating survival rates. Healthcare in the USA is largely private. Treatments cost between $1,000 and $15,000 per person per year. In the richest country in the world and in the poorest, surviving HIV depends on status.

In Africa within a short hop of developing 3CT, the big pharmaceutical companies were on another campaign - to prevent impoverished governments from copying the drugs rather than buying their expensive brands.

They used the courts and the patent laws as their weapons - law suits take years to resolve. As the head of one USA AIDS charity said: "Glaxo fiddles while Africa burns".

Though many of us did not buy into the idea of big pharmaceutical companies having a big heart, there was at least an expectation that treatments developed with the help of public funds would slow the huge rates of infection in Africa.

GSK made a staggering £1.593 billion in pre-tax profits in 2002, a 17% hike in just the first three months of the year. Its world-wide market for AIDS drugs is estimated at around £2 billion.

Anyone can catch HIV, the virus does not distinguish on the basis of class or status, but the virus itself does not kill. It weakens the immune system, leaving the sufferer open to life-threatening disease.

Disease of poverty

HIV therefore is a disease of the poor. The more stressful and unhealthy the sufferer’s environment, the more open to disease they become. A healthy diet, clean water, a decent home, proper sanitation, all become critical to an HIV sufferer.

In Africa such basic necessities are not available to most of the population. Capitalism demands that the majority live at subsistence level so that their desperation can be exploited by a few.

With 80% of the world’s poorest countries on the African continent, the bottom of the pile currently lies mainly in Africa.

One-hundred and eighty million people in Africa live on less than $1 per day - the UN’s official mark of poverty. The desperation this creates is essential for the spread of AIDS. In the past, diseases endemic to some parts of Africa did not find sufficient opportunities to travel and take hold.

More recently, social and economic changes forced many to become migrant workers, chasing jobs across the vast continent. Unemployed women in the sprawling townships were pushed into prostitution. Wars have added to the turmoil, displacing millions.

Without adequate education and with no control over their lives, preventative healthcare is impossible. HIV thus found optimum conditions for its deadly expansion.

Another major obstacle stands in the way of medicine reaching the masses. Many African leaders refused to accept, acknowledge or deal with the link between HIV and AIDS, or the threat that it poses, even as members of their own families were treated for infection.

Recognising this threat would have meant taking responsibility for conditions they helped create. Better then to deny the problem.

Five big pharmaceutical companies eventually bowed to pressure and cut the cost of 3CT drugs. Nonetheless, the treatment remains unavailable to most.

In 2001, 2.2 million African people lost their lives to AIDS and a further 3.5 million were newly infected. The levels of poverty are getting worse.

Only when the masses are able to take control of their living conditions and only by ridding themselves of hypocritical leaderships can we conquer the diseases that prosper in poverty.

In a socialist world a threefold change would occur: no mass poverty, healthcare provision based on need not status and society run democratically.

This triple combination would allow us not only to rid ourselves of all curable and treatable diseases but would also eliminate the unequal conditions they depend on.

From The Socialist, paper of the Socialist Party, the CWI in England and Wales.

Committee for a workers' International publications

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