Globalization, and Healthcare
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
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.
Poverty, Globalization, and Healthcare
© 2000 Medical Advocates for Social Justice