Can AIDS Be Stopped?

During the past two decades, while virtually all Western countries experienced more or less constant economic growth, much of the rest of the world suffered a series of financial catastrophes—from the international debt crisis of 1982, to the Mexican peso crisis of 1994, to the Asian financial crisis of 1997, to the Russian default of 1998. The social consequences of these economic disasters—including impoverishment, mass unemployment, and ill health—have been felt almost entirely outside the West: in Africa, much of Asia, Latin America and the Caribbean, and the former Soviet Bloc.

While the causes of these crises were complex, much public criticism has been directed at some of the institutions that are attempting to estab-lish rules for economic globalization—the World Trade Organization, the World Bank, and the International Monetary Fund. Protest movements have emerged, involving many different, sometimes conflicting, constituencies—from labor unions to environmentalists to college students to non- governmental organizations involved in health, social justice, and human rights. Their grievances more or less converge on a common theme: as Western governments, backed by multinational banks and corporations, push economic liberalization to extremes, they are exacerbating, and even exploiting, the vast social and economic inequalities that exist in the world.

Recently, George Soros, the financier and philanthropist, seems to have joined this chorus. In his new book George Soros on Globalization, Soros concludes that international finance and trade have outstripped the capacity of sovereign states to manage the politics of globalization.1 Especially neglected has been the provision of global public goods, things needed by everyone but not produced by the marketplace, such as clean air and disease control. Instead of proposing to dismantle the WTO, the World Bank, and the IMF, Soros would like to see them strengthened, and complemented by stronger global institutions in social fields like health, such as the World Health Organization, and labor standards, such as the International Labor Organization. Successful globalization, he argues, requires effective global institutions devoted not only to finance and trade, but also to public health, human rights, environmental protection, and other public goods.

At the top of Soros’s list of global social problems in need of attention is HIV/AIDS. Public concern over the global AIDS epidemic, particularly in Africa, has grown enormously in recent years, but there is considerable debate about what the international community can and should do about it. Especially controversial has been the high cost of antiretroviral drugs used to extend the lives of people with AIDS. The pharmaceutical companies that make these drugs price them beyond reach of the world’s poor, but in November 2001 at the WTO meeting in Doha, Qatar, these companies were forced to accede to pressure from developing country governments, nongovernmental organizations, and activists, and allow poor governments to adjust certain rigid patent rules applying to vaccines and drugs in order to protect public health. Despite this apparent triumph of international pressure, far more needs to be done. A coalition of governments and nongovernmental organizations, led by the UN, recently launched the…

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