Pharmaceuticalcompanies receive great and increasing sums of power, due to global realisationthat to reduce the burden of the HIV/AIDS epidemic, public access to medicationis key (Juxtamagazine, 2014).
It could be argued by pharmaceutical companiesthat these official policies are providing an invaluable service due to thelegitimization of these products, which gives control to the pharmaceuticalcompanies and ensures HIV affected countries are dependant. Contemporaryneo-colonialism is represented through this dependence (Juxtamagazine, 2014).The neo-colonial agenda of pharmaceutical companies have underwritten to thehuge inequality between the policies on access to medication and the actual sumof individuals receiving the treatment (Juxtamagazine, 2014). In 1987,zidovudine was released in the United States as the first medication availableto treat HIV. 5 years later, 800,000 people worldwide were receivingantiretroviral medicines. However, in low-income countries, where 95% of globalHIV infections are accounted for (WHO, 2002), less than 40% of the populationwere on this treatment. In contrast, in the developed world antiretroviralmedication is widely accessibly (HIVclinic.ca, 2012).
The production of antiretroviralmedicines within developing countries has been ensured to remain dependant, adecision decided through the cooperation of international intellectual propertylaws and pharmaceutical companies (Juxtamagazine, 2014). The agreement on Trade-RelatedAspects of Intellectual Property Rights (TRIPS) was passed by the World TradeOrganisation (WTO) in 1995 (Elliot et al., 2003). Productions of pharmaceuticalswithin each country is require to grant patents, for 20 years without judgementto accessibility. Profits are often made by the companies holding the patents,as exaggeratedly high prices are charged for the drugs (Juxtamagazine, 2014).
Apotential alternative to branded pharmaceuticals was also introduced as genericdrugs. However, various regulations were introduced to pharmaceutical companiesthrough the TRIPS agreement, which resulted in a discouragement of theproduction of generic medication. The Doha Declaration was introduced andsigned by the WTO in 2001, which allowed members to protect the public healthof their citizens by granting domestic compulsory licenses (Juxtamagazine,2014). Nevertheless, huge pressure from pharmaceutical companies and foreigngovernments were faced by countries attempting to obtain these licenses. Aneo-colonial approach is adopted by pharmaceutical companies by authorising thepatents, which has prioritised market dominance over access to drugs and publichealth. However, in a contrasting perspective,the frequent application of neoliberal policies applied in low-incomecountries, recent research has identified a potential link with the HIV/AIDSepidemic (Lester, 2017). Various global organisations have been criticised intheir response to the disease in an attempt to understand the potential link.
Associations such as; health, commercial sex, poverty, labour migration etc.have been explored and identified as primary issues that are influencing theepidemic (Lester, 2017). Affecting the majority of countries, neoliberalism isconsidered a philosophy equally as it is an economic structure. Anderson (2000)describes neoliberalism as “the most successful ideology in world history”,which allows the examination of healthcare, taxation, macroeconomic policy etc.Despite the general acceptance that neoliberalism has become a vital part ofthe global context, there is also an increasing amount of criticism (Campbell& Pederson, 2001) and this theory is yet to present strengths in regards toHIV/AIDS (Lester, 2017). The theory of neoliberalism aims to enhance theavailability of control within the public sector in comparison to private.
Acommon neoliberal policy is the structural adjustment program, which has beencommonly used to improve the economic structure of a population by the WorldBank and IMF (Lester, 2017). A common theme identified throughout HIV/AIDSprevention research in low-come research is lack of financial support formedicine, health care workers and doctors. Research blames the cuts in nationalbudgets on policies formed by neoliberalism. Particularly in Africa, the WorldBank and IMF have made substantial additions to neoliberal policies, by promotingfree trade and taxation policies. Such institutions were firstly formed bygovernments, with a primary aim to support global economy and balance growth.
Over time, authority has been gained through shareholders allowing theinstitutions to become independent (Lester, 2017). The withdrawal of fundingfrom the health sector for example has been a mutual debated issue, as oftenthe sectors generate no direct economic benefits, and treatment and preventionssuffer and as a result disease prevalence increases. Woods (2006) suggestedthat this particular failure within the World Bank and the IMF is primarilyreliant on the governmental influencing roles which controls agenda and theactions of institutions. Therefore, with this in mind, the overall verdictsdecided are based on what the powerful actors can gain rather than with the needsof the vulnerable in mind (Lester, 2017). The World Bank also plays an importantrole as one of the leading development organisations for international healthand for the global response to HIV/AIDS. The organisation is a unique globalcorporation which consists of 189 countries, offices in over 130 areas andstaff from over 170 countries (World Bank, 2018).
The World Bank aims decreasepoverty prevalence by promotion economic development in low-income countries byforming sustainable solutions (World Bank, 2018). Various structural adjustmentprograms introduced in the early 1990’s encouraged by the World Bank and theInternational Monetary Fund were disapproved by critics due to the recurrentnegative consequences (Parker, 2002). In response to this, the World Bank WorldDevelopment Report (1993) stated that attention was focused on issues relatingto health; increasing the availability of resources and new lending schemes, inhope this introduces new projects concentrating on common developing wordissues (Parker, 2002). The organisation has also been visibly committed toresponding to the HIV/AIDS pandemic (World Bank, 1997).
The internationalfinancial institution provided a total of $1.7 billion in loans to developingcountries available for HIV/AIDS related work by the start of 2001, which bythat time was a vital financial resource in order to globally attempt to fightagainst the epidemic (Parker, 2002).