Gordon Nary

Recent attention given by the UN Security Council to potential regional and global security consequences of the HIV pandemic in Africa-along with growing media attention to the millions of AIDS orphans who are the living legacy of our failure to stem the transmission of HIV are again directing our attention to a disaster of unprecedented magnitude in human history. We have watched this tragedy with its predictable results unfold day by day, month by month, and year by year for nearly twenty years. Some of us have ignored the pandemic as irrelevant to our lives. Some have politicized this disease to advance their own agenda. A few have sacrificed much to help prevent new infections and to minister to those already infected. Most of us have been numbed by the inevitability of what we knew would occur, unsure of what our individual and collective responsibilities should be in this growing crisis.

We too often think of the HIV pandemic as a disease only, rather than as a symptom of dehumanizing poverty. This poverty is, in part, a legacy of centuries of theft of the material and human resources of the nations of the South. Globalization, like its Promethean prototype, is a gift with unlimited potential for both good and harm. When based on social justice, globalization can contribute to the economic liberation of the non-industrialized world. When social justice is ignored, globalization may further widen the gargantuan chasm between the world of privilege and the world of poverty.

Any action by the UN Security Council that reduces further infection and the suffering of those already infected has great merit because of the infinite value of human life. However, to ignore our ethical responsibilities and act only out of economic and political self-interest begs the question of whether we can develop a new global economy based on social justice. The answer depends on whether we believe in the dignity and value of all human life, which is the cornerstone of social justice and human rights. Without that belief, there can be no social justice. Without that belief, there are no human rights. The HIV pandemic tests our personal and collective beliefs in both God and humanity. Our actions and inactions are a reflection of what we believe or what we choose not to believe.

If we fail to act on our beliefs, then our beliefs are exercises in self-righteousness. They are worn on our sleeves momentarily, like the ribbons we purchase from innumerable charities that sometimes appear to swarm on us from everywhere, asking for donations for crippled children, war veterans, and diseases affecting every bodily organ and function. We may give these charities a few coins and wear their ribbons often with some secret smugness as a press-on stigmata of concern. We then discard the ribbon in the trash within moments when we return to the privacy of our homes. Belief in social justice that is not backed-up by commitment and action is simply a disposable penny ribbon that is trashed in the private recesses of our hearts.

The UN Security Council resolution signals an opportunity for the leaders of the pharmaceutical and biotech industries to demonstrate their commitment to social justice by exploring new ways to expand our highly-effective drug and biotech development systems to better meet some of the needs of the world's poor. Our current drug development model is designed to meet the needs of the privileged fifteen percent of the global population who can afford to purchase these drugs. This design is essential to maintain this model's continued success, and it would be harmful to the future of drug development to change it. For the leaders in these industries, commitment to social or distributive justice mandates that they share their talent for the development of new agents designed to better meet the needs of the eighty-five percent of the global population who do not have the financial resources to access drugs.

The pharmaceutical and biotech industries have the talent and ability to create a new paradigm for drug discovery, development, manufacturing, and distribution that can better address the fundamental needs of the world's poor. The industry's most important challenge is to develop an alternate or supplemental philosophical approach to our current drug development process. This new paradigm would set the stage for long-term investment by governments and global agencies such as the World Bank, in regional consortia in the nations of the South dedicated to new models of drug and biotech development. These models could take better advantage of the often overlooked resources of these nations and would be responsive to their limited economies.

I was fortunate to have been included in an unexpected audience with Pope John Paul II at the Vatican in November 1999 arranged by the Pontifical Council for Pastoral Assistance to Health Care Workers. Pope John Paul used the occasion to address the need for social justice in the global drug development process. The potential for the Vatican's leadership to encourage new directions in drug development based on the ethical obligations of social justice and beneficence could be a catalyst for the development of this new paradigm. The pharmaceutical and biotech industries have the talent to create programs that eventually could provide greater access to pharmaceutical and biotech miracles by the nations of the South, and could help stimulate often dormant economies that have contributed to the massive poverty that drives the HIV pandemic.

February 01 , 2000

Gordon Nary is executive director of Medical Advocates for Social Justice.