Academic journal article Ethics & International Affairs

International Obligation and Human Health: Evolving Policy Responses to HIV/AIDS

Academic journal article Ethics & International Affairs

International Obligation and Human Health: Evolving Policy Responses to HIV/AIDS

Article excerpt

The world is in the early stages of what will be the greatest health crisis since the advent of modern medical technologies. Millions of people--particularly people in many of the world's poor countries--are infected with HIV. The vast majority of these people will go without modern medical intervention or substantial treatment, and will rapidly develop AIDS. The extent of this problem presents profound moral and ethical questions for the world's wealthy people and countries, for it is they who are most able to assist the poor in managing and reversing this human tragedy.

Over the last century or more, there has been a gradual shift in global attitudes toward reducing suffering among the world's poor. Governments have

come to regard many forms of international assistance as the right thing to do (if not a legal obligation). For example, when famine strikes, governments and citizens of the developed countries generally recognize that they ought to respond because they have a surplus of food and the means to deliver it to those who are starving. Doing so is relatively easy and painless for those providing aid, yet it brings tremendous benefit to those in need. The degree to which assistance is provided varies, of course, but few would argue that the starving should be ignored. Similar feelings of duty in the developed world arise with regard to natural disasters and adverse environmental changes, among other issues, and governments of the rich countries (and indeed many of their private citizens and nongovernmental groups) respond accordingly with increasing frequency, robustness, and speed. HIV/AIDS presents the world with another problem requiring assistance from the world's wealthy.

Nevertheless, developed countries have been very slow to respond to the international dimensions of the HIV/AIDS problem. They have instead focused on the relatively few people within their own borders at risk for HIV or suffering from AIDS. The rhetoric has started to change--the United States, for example, has pledged some funds in recent years, and it has become less vocal in its opposition to providing affordable drugs to the world's poor suffering from the epidemic--but the developed countries have not backed this rhetoric with substantial new funds to assist the poor countries in coping with and reversing the HIV/AIDS epidemic, and they continue to participate in activities that exacerbate the crisis and associated human suffering. This essay looks more closely at the global HIV/AIDS problem, especially in the developing world. We discuss what has been done and what can be done to stop the spread of HIV and reduce the suffering from AIDS. We identify some reasons why more has not been done, and we show why more ought to be done. Explicit in this discussion is the clear need for action from the world's wealthy countries to address the HIV/AIDS epidemic. Indeed, the developed world should view assisting the world's poor in dealing with this problem as a moral obligation. We summarize the evolution of developed countries' attitudes and actions toward aiding poor countries in several issue areas and demonstrate that the willingness to provide aid has increased over time. Finally, we argue that for reasons of morality (among others), this willingness to assist ought to be extended to the global HIV/AIDS crisis.

The Problem of Societal Devastation

It is hard to overstate the dimensions of the problem of HIV/AIDS in the developing world, particularly in sub-Saharan Africa. Worldwide, AIDS has already killed more than 22 million people and left more than 13 million children orphaned, according to the Joint United Nations Program on HIV/AIDS, more commonly referred to as UNAIDS. (1) Approximately 36 million people are currently infected with HIV, and an average of 16,000 new infections is believed to occur daily. (2)

Studies of the demographics of HIV infection have correctly emphasized geography. …

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