How Distributive Discrepancies Drive the AIDS Pandemic

HIV/AIDS is a global health issue that has seen differential health outcomes in various regions of the world relative to the accessibility of proper healthcare. The pressing matter becomes clear upon examination of the global distribution of essential HIV medications. While developed countries now have relatively little issue ensuring that such resources are distributed where they are needed, many developing countries lack the financial resources to incentivize for-profit pharmaceutical companies to provide these medications. Because these companies are a business first, they are driven to sell their product wherever it will generate the most revenue. Consequently, this means providing more of their medications to high-income countries whose healthcare institutions can afford to compensate their efforts. Unfortunately, this creates a striking discrepancy between high-income countries where those infected with HIV can live relatively long, healthy lives by using medications to manage their symptoms, and low-income countries where a diagnosis of HIV could equate to a death sentence for its populations.

Another issue in this crisis of distribution arises when we look at the shifting demographics of people infected with HIV. In most developed countries, both the AIDS-related mortality rate and the prevalence of new HIV infections has been steadily decreasing due to a combination of better public health and sexual health education, and the advent of highly active antiretroviral therapy (HAART) in the late 1990s. However, in many developing countries the incidence of HIV/AIDS has been increasing, with certain countries having a rate of infection as high as 30% of their adult population. As the trend in infection undergoes this shift in demographics, it is unlikely that their medications will follow. Rather, the global distribution of these medications is becoming more and more obviously skewed, where developing countries in dire straits are unable to access the magnitude of resources they need to keep their populations healthy because such resources are being spent where they can make a profit, in countries whose need for such resources is steadily decreasing.

Knowing the mechanisms behind this discrepancy begins to denote us some power to ameliorate this issue. While there are policies in place meant to incentivize pharmaceutical companies to lend aid to developing countries, they can be difficult to put into practice because of difficulties with quantification of the impact of these companies that would otherwise warrant the incentive. When neither public health organizations nor the companies themselves have any way to measure the efficacy of the aid being given, it can be easy to forget the moral and ethical obligations at large. But the Global Health Impact project aims to correct this. We track the impact of these essential medications according to their patents. As a result, the companies manufacturing these drugs can then be directly credited with their health impacts. We measure the impact of these companies relative to both their medications’ efficacy in treatment as well as the degree to which they alleviate a given country’s need for said medications. This takes into account both the clinical worth of the drug as a treatment and the social worth of increasing its accessibility. Ultimately, this gives companies, health organizations, consumers, and governments alike a far clearer picture of not only who is doing the most good, but also where, why, and for which diseases in particular. The ease of availability of this data encourages competition to create more effective solutions, and it makes clear that the stakes for providing health aid to these developing countries are far higher than one might expect.

References:

1. Parker, R. (2002). The global HIV/AIDS pandemic, structural inequalities, and the politics of international health. American Journal of Public Health, 92(3), 343-347.
2. Giuliano, M., & Vella, S. (2007). Inequalities in health: access to treatment for HIV/AIDS. ANNALI-ISTITUTO SUPERIORE DI SANITA, 43(4), 313.
3. “Alcoholic Hepatitis - Diagnosis and Treatment - Mayo Clinic.” Mayo Clinic, www.mayoclinic.org/diseases-conditions/alcoholic-hepatitis/diagnosis-treatment/drc-20351394.
4. Hoen, E. T., Berger, J., Calmy, A., & Moon, S. (2011). Driving a decade of change: HIV/AIDS, patents and access to medicines for all. Journal of the International AIDS Society, 14(1), 15.