The AIDS Conundrum

Commentary by Greg Lewis / WashingtonDispatch.com
February 24, 2004

While many political activists hold drug companies responsible for the suffering of AIDS victims worldwide because of alleged profiteering, in fact, activists themselves bear a significant portion of the responsibility for the very suffering they work to alleviate. There are a number of reasons for the putative shortages of AIDS drugs activists decry, and they include the fact that AIDS, in the United States and other developed countries at least, is an increasingly rare disease which affects a relatively small number of people. But the growing scarcity of drugs to treat AIDS is also due to activist groups' virulent attacks against the very companies they would enlist in support of their cause.

AIDS has been a "cause" in this country for nearly two decades. Groups such as Oxfam, an international organization dedicated to "the global movement for economic and social justice," have spoken out and demonstrated against what they term "price-gouging" by drug companies. I was perplexed, however, by the apparent contradiction between this group's goals and its methods. The contradiction is pretty much summed up in this plea taken from the Oxfam Great Britain website: "People in the world don't want to live on handouts. All they want is the opportunity to work themselves out of poverty. Please help . . . Click here to give £2 a month."

According to United Nations statistics, some 385,000 people in the United States are "living with AIDS," with 20,000 people dying of the disease each year in this country. Worldwide, however, the situation is much more serious. Some 3 million people die each year from AIDS around the world, with fully 80 percent of all AIDS deaths occurring in sub-Sarahan Africa.

Bottom line: Statistically, in the United States and other developed nations, AIDS is simply not a big problem. It is certainly a high-profile problem, but it is not a big problem. There are, to cite just one example of many, 60 times more people suffering from heart disease in our country than from AIDS, and 35 times more people die of heart disease each year than from AIDS. The fact that HIV infection can be completely eliminated by controlling behavior — avoiding the use of intravenous drugs and refusing to engage in high-risk sexual activities constitute a virtually foolproof way to escape contracting the disease — means that in countries with well-developed educational infrastructures the disease is very much under control. The campaign in the west now is not to stop the spread of the disease; rather, it is to increase the life expectancy and improve the quality of life of those who have contracted it.

Broadly stated, this means a constant research effort to understand more completely how the AIDS retrovirus works and how to keep it in check. That effort doesn't come cheaply, and coupled with the fact that a large majority of Americans view getting AIDS as something any sensible person could avoid if he took a few precautions means that there is declining sympathy for AIDS "victims" and reduced support for research spending on the disease that could be better utilized elsewhere.

By politicizing diseases such as AIDS, activists push them into the glare of the spotlight and gain for them far more exposure than mere numbers warrant. There aren't enough people sick with AIDS in America to make the development of new drugs either profitable or morally defensible, but manufacturers are compelled in part by the inflated presence and intensity of AIDS advocacy to pursue AIDS treatments, not that the morality of their political positions has ever been a serious consideration of AIDS activists. In effect, AIDS activists are extorting new drugs out of drug manufacturers by "guilting" them into creating the drugs in much the same way Jesse Jackson exorts money out of corporations by guilting them with charges of racism.

It's also instructive to take a look at what many of the (generally left-leaning) principals in the fight for better AIDS treatment are saying and doing. First, they're demanding that drug companies pour hundreds of millions of dollars of research money into AIDS vaccines and treatments. These are the same rabidly anti-capitalist activists who deplore capitalism and cite large corporations as among the scourges of the earth. Here's Bernard Pécoul of the group Doctors Without Borders: "People are dying [in underdeveloped countries] because the price of the drug that can save them is too high." Pecoul's organization blames greedy drug companies and the capitalist profit motive for this state of affairs.

This analysis is, however, not only faulty, it is based on incorrect assumptions. To the first point: It is not cost but lack of delivery capability that is the real barrier to getting AIDS treatments to people in underdeveloped countries. Many drug companies have licensed their products to generic manufacturers in certain areas of the world so they will become available at lower prices where they are needed most. The prices GlaxoSmithKline charges to not-for-profit organizations for three of its AIDS drugs have now been reduced to less than a dollar a day. In fact, the average cost of all AIDS drugs has dropped nearly 90 percent in underdeveloped countries in the past five years, precisely because major pharmaceutical companies recognize a moral responsibility to the suffering people of those countries.

Even if this weren't the case, there are governments and agencies which are willing to fund purchase of the drugs. President Bush has announced that the United States would commit $15 billion to funding AIDS treatments in Africa. If cost were the only barrier, it would be breachable, and relatively easily. Despite the protestations of AIDS activists, drug companies and distributors are by and large acting in a humane and responsible way with regard to this disease crisis, and the blame for lack of treatment availability cannot be laid at their feet.

Notwithstanding the misuse of statistics which often characterizes the statements of activist groups, AIDS is very much under control in the United States, with the exception of a few difficult-to-reach segments of the population. The upshot of this is that there is not a great financial incentive for drug companies to continue AIDS research. Apart from major players such as Merck, GlaxoSmithKline, and Pfizer, research into AIDS treatments has declined by more than 25 percent over the past five years. Now, however, even the big companies are beginning to balk at committing research money to this disease at past levels. Among the reasons given are the vicious attacks leveled at them by the very organizations that stand to gain the most from their continuing research.

People in developed nations have learned to behave more responsibly in the effort to avoid AIDS, and, as a result, incidences of the disease have declined dramatically in the United States over the past decade. It's a more difficult sell than it was ten years ago to convince drug companies to continue AIDS research. Perhaps if the activist groups lobbying on behalf of AIDS sufferers understood that they needed to work hand in hand with drug manufacturers, those groups would behave more responsibly by soliciting their cooperation rather than denigrating them. The fact that such groups refuse to recognize the need for a partnership rather than an adversarial relationship with drug companies is perhaps the greatest barrier of all in the international fight against AIDS.