The social costs of corporate HIV/Aids policy

At the same time the Treatment Action Campaign (Tac) and Congress of South African Trade Unions (Cosatu) were holding a massive people's conference in Durban to fight HIV/Aids last week, Thabo Mbeki begged for increased commitments for Africa from G-8 leaders in Kananaskis, Canada.

Included amongst those commitments is the UN Global Fund, which according to Kofi Annan should logically reach $10 billion annually to meet Third World demands for inexpensive medicine, more health workers and improved facilities. But the Fund has received less than a tenth of that money, after George W. Bush denied a congressional allocation of $700 million in May.

Mbeki's search for aid, debt relief and investment resulted in "recycled peanuts," according to informed commentators. Mbeki and other African leaders were reduced to expressing "satisfaction" over their 90-minute appearance before Bush and his Northern cronies, which is a rhetorical measure of power imbalances and global inequity.

Mbeki's New Partnership for Africa's Development was bound to attract scepticism, particularly insofar as its corporate-friendly tone and content compels venal government elites across the continent to make themselves attractive for new investment.

Energised activists from the Tac/Cosatu conference will now have to raise the opposite question: how Africa-friendly are multinational corporations, particularly when so many African workers are HIV+, and when the leading corporations turn their back on anti-retroviral treatments?

Done properly, treatments would potentially transform the disease from inexorably fatal into a chronic illness such as diabetes, as has happened in much of the wealthier West.

But thanks to unemployment above 40%--if one counts those who have given up
trying to find a job under prevailing conditions-international and local firms are faced with a terrible option: replace sick workers with desperate, unemployed people instead of providing them treatment.

Perhaps the ethical challenge was expressed most eloquently by financier George Soros, who was asked about treating HIV+ South Africans by an SABC journalist in April. He answered, `I think to provide treatment to the bulk of the people is just not feasible. I think to provide treatment for instance to qualified workers actually saves money, actually saves money for companies.'

The interviewer responded, `Aren't you uncomfortable to talk in a way that is a kind of death sentence to those who we can't afford to treat?' Replied Soros, `I think the cost of providing actual treatment to everyone at the present... I don't think it's realistic. It's not achievable.'

In a more systematic way, the same conclusion was reached after a year of study at Africa's largest company, Anglo American Corporation. Anglo has 160,000 employees, of whom 21% are HIV+. After the pharmaceutical industry withdrew its lawsuit against Pretoria's potential use of imported generic drugs in April 2001, the company announced it would provide anti-retroviral medicines to its workforce, which meant literally tens of thousands of lives could be saved in the short term.

In June 2001, the Financial Times reported that`treatment of [Anglo's]employees with anti-retrovirals can be cheaper than the costs incurred by leaving them untreated.' In August, Anglo's vice president for medicine, Brian Brink, announced a strategy which 'involved offering wellness programmes, including access to anti-retroviral treatment.'

According to one press report, `The company believed that the cost of its programmes would eventually be outweighed by the benefits it received in gradual gains in productivity, [Brink] concluded. Although it was indeed a risky strategy, it was the only one Anglo could pursue in the face of such
human suffering.'

Then last October, Anglo simply retracted its promise, once cost-benefit analysis showed that 146,000 of those workers just weren't worth saving. According to the FT, Brink `said the company's 14,000 senior staff would receive anti-retroviral treatment as part of their medical insurance, but that the provision of drug treatment for lower income employees was too expensive.'

Brink explained the criteria for the fatal analysis: '[Anti-retrovirals]could save on absenteeism and improved productivity. The saving you achieve can be substantial, but we really don't know how it will stack up. We feel that the cost will be greater than the saving.'

His callous feeling became official policy a few months ago. As the Wall Street Journal recorded on April 16, `In a controversial move that could have wide ramifications for how companies in poor countries handle Aids, mining giant Anglo American PLC has put on hold a feasibility study to provide Aids drugs to its African work force, according to people familiar with the situation. When it disclosed its plans for the study a year ago, Anglo garnered wide praise because it was one of the first major corporations to reveal measures aimed at treating Aids cases among its rank-and-file African employees.'

A month later, South Africa's most eloquent pro-corporate commentator, Ken Owen, defended the merits of Anglo's policy in a Business Day column: `I am sceptical about most doomsday economic scenarios generated by the Aids epidemic... For the rest of this decade, at least, the lost workers will be quite readily replaceable from the millions of unemployed, and society will adjust in a myriad of ways to labour shortages. For example, a million domestic workers constitute a reserve pool of labour that can be drawn into
industry.'

Where does this display of corporate arrogance-bordering on culpable homicide--leave the treatment-activist movement? Will the April 2001 victory over Big Pharma and the expected Constitutional Court ruling against Mbeki on access to drugs for pregnant HIV-positive women allow HIV/Aids activists to turn, with their labour and other international solidarity allies, against capital?

The answer may lie in changing the terms of costs and benefits, by making firms socially liable-even if merely through old-fashioned protest--for killing their workers through malign medical-insurance neglect. With Anglo attempting to shine at the World Summit on Sustainable Development in August, opportunities abound for global humiliation of the genocidal tendencies at these mega-wealthy multinational corporations.

(Wits University political economy professor Patrick Bond is editor of 'Fanon's Warning', a new book critical of Nepad, published by Africa World Press and the Alternative Information and Development Centre.)