HIV and AIDS and Economic Injustice: Poverty, Globalization, Pharmaceuticals.



Introduction
            HIV/AIDS poses a great challenge not only to medical science but virtually to all aspects of human life as to social, economic, political, psychological, religious and cultural as well. Therefore it requires response from all disciplines.[1] It related issues, in the worldwide level, also vastly include (i) oppression, social justice and disease; (ii) poverty, racial and sexual discrimination; (iii) liberation, social justice, life and healing; (iv) gender and children’s rights; (v) healing the world, international and human rights; (vi) feminist perspective on women, sin, disease, healing, wholeness and care.[2] This paper tries to highlight HIV/AIDS and economic injustice. 

Economic Injustice
            Economic injustice/inequality refers to how economic production is distributed among individuals, groups, population, or countries. There are three areas on which economic disparity is rampant viz. wealth, income and consumption. It varies between societies, historical periods, economic structures and systems. The term can refer to cross sectional distribution of income or wealth at any particular period or to the lifetime income and wealth over longer periods of time.[3] Economic injustice is a growing social problem in an alarming rate. If the acceleration is not slowed down, the result will be destructive because it can hinder long term growth.
            The domain of HIV/AIDS does not lift up a number of justice concerns. Of them, the most significant issue is that of socio-economic discrimination. Due to the rampant hysteria about HIV/AIDS, people affected by the virus and the disease have been experiencing systematic alienation. Denial of fundamental rights such as housing, health care, education, employment, insurance and the right to live is a subtle form of discrimination. Hence, the HIV/AIDS infected people are called the ‘new Dalits’ or the ‘untouchables.’[4] They suffered socio-economic injustice. Thus, an economic justice perspective is indispensable in ethical discourse of HIV/AIDS. 

Poverty
            Poverty is part of the complex structure of society. The reasons for its existence are many and varied: it is seen as fate or result of sin from religious perspective, for some it is a result of over population, or lack of education. Most of the economists define it as lack of economic growth. C.T. Kurian defined it as “…socio-economic phenomenon whereby resources available to society are used to satisfy the wants of few, while many don’t have even met their basic need.”[5] Amartya Sen explains poverty in relation to the capability of a person who can purchase food and basic necessities of life.[6] So, poverty relate to a condition of life in relation to the ownership and use of resources or capability to have access to basic needs.
            As the HIV/AIDS rate rise, so does the demand for health care. As expenditure increases on this concern, tax-payers bears must bear the burden. HIV/AIDS is not the only urgent issue facing the government; the infrastructure is strained and ineffective in dealing with such health crisis.[7] It was the poor people who will suffer. Although no one is completely immune from the disease, it is the economically poorer sections of society who are at risk. Poverty is both the cause and consequence of HIV/AIDS. Social injustice and legalized inequality that produces poverty are the basic factors in the risk of HIV/AIDS infection. HIV/AIDS feeds on structural problems like poverty. As such, HIV/AIDS can be seen as a product of soci0-economic injustice of poverty, unemployment, marginalization, and disempowerment. Researches estimate that 9/10 people with HIV/AIDS live in areas that are haunted by problems such as poverty, subordination and discrimination of women and sexual minorities, racism, lack of political will, and huge international debt crisis.[8] All these contributed to an environment that intensifies vulnerability of human communities to HIV/AIDS.

Globalization
Globalization is an interaction of socio-economic-political-cultural-religious systems between different countries. Its integration of all these aspects of life gets in touch with almost all human beings practically to the whole world. It is used in three distinct but inter-related senses viz. ICT revolution, cultural and economic globalization.[9] There is no doubt that developments linked with all these have opened up boundless possibilities for human development, new opportunities and enhanced the quality of life. But, while few people remain with wealth and comfort, there are lots of people all over the world with poverty and misery. This imbalance in living led to deterioration in the quality of life.[10] It is a new form of developed countries’ hegemony over under developed countries which have three aspects like economic domination, cultural aggression and political imperialism.[11] If focusing on its economic policy, it is Western neo-colonial idea to control the world; a new form of economics exploitation promoted by liberalization in which WTO, World Bank, IMF and MNCs taking the lead to speed up the process.[12] It can be defines as trans-nationalization, standardization and legitimization of global capitalism in which privatization and profiteering marginalized the majority.[13] It becomes clear that globalization can be seen from many points of view. One thing very certain is that it process cannot liberate the poor from the yoke of misery and hunger, because its underlying principal is maximum profit, capital accumulation and exploitation of labour supported by global hegemony.
In this age of economic and cultural globalization, globalization itself acts as a channel that aids the spread of the dreaded disease. The facets of globalization that is striking in most Third World countries are on the scenario of survival and sustainability of industries that depends on human work force. There is also an intense spirit of promoting tourism, which creates an un-satiable demand for flesh trade. This is a breeding ground for HIV/AIDS. Free movement of work force across national borders has also resulted in an alarming upsurge in sex and drug trafficking.[14] Globalization with FTA and GATT in international level, and NEP in India in 1990s developed a massive migrant population. This also enhances the prospects of the spread of HIV/AIDS. Again, if we look into the labor force movement in international, national and regional level, whom do we see? The poor and the middle class people, they are the vulnerable section who suffered injustice of global economic system.

Pharmaceuticals          
            The pharmaceutical industry develop, produces, and markets drugs or pharmaceuticals for use as medications. Pharmaceutical companies may deal in generic or brand medications and medical devices. They are subject to a variety of laws and regulations that govern the patenting, testing, safety, efficacy and marketing of drugs. Advertising is common in healthcare journals as well as through more mainstream media routes. In some countries, notably the US, they are allowed to advertise directly to the general public. Pharmaceutical companies generally employ sales people to market directly and personally to physicians and other healthcare providers. In some countries, pharmaceutical companies also employ lobbyists to influence politicians.[15] In pharmaceutical business, worldwide corporate families and multi-national companies are in the steering wheel
            There is clear division between the rich and the poor nations when it comes to the questions of research in HIV/AIDS and access to medicines and treatment of the victims. The protagonist of economic globalization use, with dexterity, the mechanism of IPRs agreement as a neo-colonial tool to dominate the global market and thereby extend their hegemonic control over the Third World economy as well. This has detrimental consequences for the poor, especially in the arena of health care. A study by ORG confirms that not less than 44% of drug marketed in India is under US patents. With this, more than 99% of drugs marketed in India is patented by MNCs.[16] Third World countries therefore, find it increasingly difficult to get drug manufactured in their home countries because of provisions and conditions in TRIPs agreement. Due to unfair competition from the monopoly patent holders, indigenous manufacturing firms cannot even endeavor to produce drugs locally. Thus, the pharmaceutical situation is critically serious in the case of HIV/AIDS (ART, other medicines) where drugs were to fight the disease. They are far too costly for the poorer countries and people did not afford to meet their needs. This injustice issue touches human life issue. 

Conclusion
The people with HIV/AIDS suffered economic injustice with globalized market economy. Since resources and business chains are in the hands of profit making first class people by means of MNCs and Finance Institutions, lower and middle working class are the victims of this imbalance economy because of lesser opportunity. In this sense, HIV/AIDS issue must be treated as an issue of injustice because majority of the patients comes from economically poor and socially oppressed section of the society. What next then? It is the duty of all responsible persons to heal the world, to work out in our best capacity so that justice can be done.


[1] Samson Prabakar & George Mathew Nalunnakkal, eds., HIV/AIDS: A Challenge to Theological Education, Reprint (Bangalore: BTESSC/SATHRI, 2009), v.
[2] K.M. George, “The Threat of HIV/AIDS: Some Theological Considerations,” in Samson Prabakar & George Mathew Nalunnakkal, eds., HIV/AIDS: A Challenge to Theological Education., 3.
[3] https://en.wikipedia.org/wiki/Economic_inequality (17.7.2015).
[4] George Mathew Nalunnakkal, “HIV/AIDS: Towards an Ethic of Just Care,” in Samson Prabakar & George Mathew Nalunnakkal, eds., HIV/AIDS: A Challenge to Theological Education., 21-22.
[5] C.T. Kurian, “Planning and Social Transformation,” in Thomas M.J., Understanding Social Analysis (Kolkata: Sceptre, 2013), 8.
[6] Amartya Sen, “Poverty and Famine Deprivation: An Essay on Enlightenment,” in Thomas M.J., Understanding Social Analysis., 8.
[7] Banner Makan, “Christian Response to HIV & AIDS,” in Razouselie Lasetso, ed., Health and Life: Theological reflections on HIV & AIDS (Jorhat: ETC Proramme Coordination, 2007), 8
[8] George Mathew Nalunnakkal, “HIV/AIDS: Towards an Ethic of Just Care,” in Samson Prabakar & George Mathew Nalunnakkal, eds., HIV/AIDS: A Challenge to Theological Education., 24.
[9] M.A. Oomen, Globalization in the Contemporary World: Towards a Christian Understanding (Mavelikara, Kerela: Vichara Books, 2009), 14.
[10] A. Wati Longchar, Returning to Mother Earth: Theology, Christian Witness and Theological Education (Kolkata: PTCA/SCEPTRE, 2012), 167-8.
[11] Michael Amaladoss, ed., Globalization and its victims: as seen by the victims (Delhi: VIDYAJYOTI/ISPCK, 1999), 239.
[12] M. Stephen, Introducing Christian Ethics (Delhi: ISPCK, 2003), 243.
[13] M.A. Oomen, Globalization in the Contemporary World., 10.
[14] George Mathew Nalunnakkal, “HIV/AIDS: Towards an Ethic of Just Care,” in Samson Prabakar & George Mathew Nalunnakkal, eds., HIV/AIDS: A Challenge to Theological Education., 24-25.
[15] https://en.wikipedia.org/wiki/Pharmaceutical_industry (17.7.2015).
[16] George Mathew Nalunnakkal, “HIV/AIDS: Towards an Ethic of Just Care,” in Samson Prabakar & George Mathew Nalunnakkal, eds., HIV/AIDS: A Challenge to Theological Education., 25.

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