In 1997 the death rate from AIDS in the USA halved. This was with the advent of combination therapy involving protease inhibitors. But in a country like Uganda, where AIDS may have originated, the cost of this treatment at around 1,500 dollars a month per patient is impossible. It would require more than the total government budget to treat all sufferers from AIDS in the country.
In the countries of Southern Africa the proportion of the population with HIV infection is up to 20%. 35% of children of child-bearing age in the cities may be HIV positive.
The plague can be treated in a country like the USA, but not in a third world country. In such a country less expensive methods of social control may be helpful. In Tanzania a social approach to health has concentrated on clean water and early treatment of all genital infections, and this has been associated with a dramatic fall in the incidence of AIDS. But this needs money and planning too.
Another approach urgently needed is a vaccine. But the R and D budget for expensive medicine which can be marketed as a commodity by the monopoly capitalist pharamaceutical companies is 20 times that of the budget for the development of an effective vaccine.
While the bankers of the west have generously offered to help the world avoid recession, by lowering interest rates for their own capitalists and population, the logic of deficit financing on a rational global level escapes them, for projects such as this, which would hardly be massively inflationary.
In a country like Russia too the requirements of finance capital are what really matter. The main clinic in St Petersburg for AIDS had a monthly budget of 20,000 dollars for medicines. Because of the bankruptcy of the national currency in the hands of the international financiers, this budget has been cut to 2,000 dollars a month. With the cost of treatment for AIDS for one person per month being what it is, this means that the staff now have to decide who is to die.
But there is no shortage of capital for the more systematic spread of western tobacco products.
AIDS in a number of ways is a disease of capitalism. Although perhaps a chance viral variant in Africa, it has spread in a continent undergoing massive change as a result of the capitalist revolution. The countryside is impoverished and commodity exchange is rapidly eating into old values. Civilisation is in the form of communications from town to town along the lorry routes, and the women try to compensate for their disadvantged position by prostitution. Rapid urbanisation intensifies the problem. The lack of basic health standards makes the population extremely vulnerable to the spread of this infection.
Advanced capitalist international travel then spreads it around the world. But with the extreme gradients of economic development between the North and the South, the North can afford the complex social engineering to compensate for the ecological challenge, whereas the South is facing a disaster of Mathusian proportions. It enters the consciousness of the North only in the form of anxiety about sex in tourist areas.
While capitalism is good at developing and marketing commodities, this is a situation that needs a social co-ordinated response at a truly global level. And if deficit financing is now OK at a global level, why cannot it be spent on projects such as this? In billions of dollars?
Ultimately only one answer: the private ownership of the means of production. That plus the relatively privileged position of the population of the west.
Chris Burford
London.