SOUTH AFRICA: Sacrificing
AIDS victims for corporate profits
BY PATRICK BOND
JOHANNESBURG — During the last few days of June, at the same time
as the Treatment Action Campaign (TAC) and Congress of South African Trade
Unions (COSATU) were holding a massive people's conference in Durban to
take forward the struggle against HIV/AIDS, President Thabo Mbeki begged
for increased investment commitments for Africa from the G8 leaders, meeting
in Kananaskis, Canada.
Included among those commitments was the Global Fund to Fight Aids,
Tuberculosis and Malaria, which according to the United Nations should
logically reach US$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 10th of that money, after US President
George Bush denied a congressional allocation of US$700 million in May.
Mbeki's search for funds and investment is likely to be futile, notwithstanding
misleading hype over a new Marshall Plan for Africa. His New Partnership
for Africa's Development (NEPAD) is notable for how corporate-friendly
Mbeki hopes African governments will make themselves to attract new investment,
especially in privatised infrastructure.
The occasion of the TAC-COSATU conference should raise the opposite
question: How Africa-friendly are multinational corporations, particularly
when so many African workers are HIV+?
Set aside, for the moment, the ongoing distractions from loony HIV/AIDS
dissidents who continue to have Mbeki's ear, judging by his recent circulation
within the ruling African National Congress of a bizarre 114-page denialist
tract. Even if Mbeki changed his mind, there are at least three deeper-rooted
structural reasons why Pretoria is hampered in rolling out treatment to
five million HIV+ South Africans.
Done properly, such treatment would potentially transform the disease
from inexorably fatal into a chronic illness, like diabetes.
Financial market pressure
One reason is the pressure exerted by international and domestic financial
markets to keep Pretoria's state budget deficit to 3% of GDP. Recall the
telling remark of the late Parks Mankahlana, Mbeki's main spokesperson,
who once justified to
Science magazine why the government refused
to provide relatively inexpensive anti-retrovirals to pregnant, HIV+ women:
“That mother is going to die and [her] child will be an orphan. That child
must be brought up. Who is going to bring the child up? It's the state,
the state. That's resources, you see.”
Instead of saving lives, Mbeki's finance ministry adopted higher priorities
— slashing corporate taxes from 48% in 1994 to 30%; redeploying state resources
so as to import roughly R60 billion [US$6 billion] worth of high-tech arms;
and repaying roughly US$25 billion worth of apartheid-era foreign debt
and a bit more in apartheid domestic debt, which could have been declared
odious in legal terms.
Such examples of fiscal laxity the local and international bankers generally
approved, in contrast to expanding state health spending and other social
expenditure, which the bankers have explicitly not supported.
The second structural reason is the residual power of pharmaceutical
manufacturers to defend their rights to “intellectual property” (monopoly
patents on life-saving medicines). This pressure did not end when the Pharmaceutical
Manufacturers Association withdrew its notorious lawsuit against Pretoria
in April 2001.
Indeed, Big Pharma's power was felt in the debate over essential drugs
for public health emergencies at the Doha World Trade Organisation summit
last November, and since.
Corporate pressure helps explain why it is only Zimbabwean President
Robert Mugabe's regime that, as of May, dares offer generic anti-retroviral
medicines to HIV+ citizens. In Mugabe's case, ironically, the drugs are
available mainly through urban clinics which are still operative to a low-income,
working-class, population which Mugabe normally treats with extreme repression.
The third structural reason for the ongoing HIV/AIDS holocaust in South
Africa is the vast size of the reserve army of unemployed labour, for this
feature of capitalism allows companies to replace sick workers with desperate,
unemployed people instead of providing them with treatment.
The latter point deserves elaboration, simply because so many lives
are at immediate risk, and so much evidence has mounted recently that corporate
South Africa's preferred approach is, in essense, mass murder by denial
of medical benefits.
Perhaps the principle was expressed most eloquently by financier George
Soros, who, when asked in April by the South African Broadcasting about
treating HIV+ South Africans, 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?”
“I think [of] the cost of providing actual treatment to everyone at
the present”, replied Soros. “I don't think it's realistic. It's not achievable.”
Anglo American
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 Big Pharma withdrew
from its lawsuit in April 2001, Anglo announced it would provide anti-retroviral
medicines to its work force, which meant literally tens of thousands of
lives could be saved in the short term.
Anglo is also self-promoting “corporate social responsibility” by playing
host to global business representatives at next month's Johannesburg World
Summit on Sustainable Development (WSSD) — notwithstanding its role in
the recently exposed Lesotho mega-dam corruption scandal, its contribution
to the rand's 2000-01 crash through repatriation of profits and dividends
to its new London financial headquarters, its devastation of the Zambian
copper belt by recently closing down the largest (privatised) mines, its
contribution to the spread of HIV/AIDS via its migrant labour system, and
its countless other historical and contemporary contributions to apartheid,
ecological devastation and labour exploitation.
How serious was Anglo about the anti-retroviral medicines promise? In
June 2001, the London Financial Times reported on Anglo's “plans
to make special payments to miners suffering from HIV/AIDS, on condition
they take voluntary retirement”. But in addition to bribing workers to
go home and die, Anglo told the FT, “treatment of employees with
anti-retrovirals can be cheaper than the costs incurred by leaving them
untreated”.
“Can be” was the caveat, as Anglo headed down the slope of denialism.
A month later, Johannesburg's Business Day newspaper asked cost-benefit
questions of AngloGold chief executive Bobby Godsell, who replied: “My
first response as CEO is I don't carry in my head in rands or cents the
cost of AIDS… HIV positivity is a subterranean syndrome.”
Although Godsell professed a “confident commitment” to dealing with
AIDS and “acting responsibly towards employees”, the leader of the mineworkers
union, Gwede Mantashe, disagreed: “They do not have an AIDS policy. They
have had a lot of undeserved and undue publicity.”
Good publicity continued, however. In August 2001, Anglo's vice-president
for medicine, Brian Brink, bragged in Business Day about a “strategy
[which] involved offering wellness programmes, including access to anti-retroviral
treatment”.
Cost-benefit analysis
That report stated: “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 in October, Anglo simply retracted its promise, once cost-benefit
analysis showed that 146,000 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.”
The callous feeling became official policy a few months ago. As the
April 16 Wall Street Journal reported: “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.”
Godsell passed the buck, blaming everyone but Anglo: “We're making very
heavy weather of the pilot study, with a variety of obstacles relating
to both industry and national politics, as well as very limited support
from drug companies.”
A month later, South Africa's most eloquent pro-corporate commentator,
Ken Owen, defended the merits of Anglo's policy: “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 sickening display of arrogance leave the treatment-activist
movement? Will the 2001 victory over Big Pharma and the expected Constitutional
Court ruling against Mbeki on access to drugs for pregnant HIV+ women allow
key strategists to turn, with their labour allies, against capital-in-general?
The answer may lie in changing the terms of costs and benefits, by making
firms socially liable for killing their workers through malign medical
insurance neglect.
A good precedent exists. After being regularly hounded by activists
and accused of genocidal tendencies by serious commentators and the media,
Mbeki allegedly made an HIV/AIDS policy u-turn in April, by finally agreeing
to provide medicines to pregnant women and rape victims.
But the change in mindset came only once public pressure and embarrassment
became overwhelming, and foreign journalists threatened to distract attention
from Mbeki's G8 fundraising mission. (And it may be only temporary, unless
watchdogging pressure is maintained.)
But the structural problems associated with rampant South African neo-liberalism
mean that not much progress can be expected from Pretoria until HIV/AIDS
activists and trade unionists adopt a more radical advocacy agenda that
gets behind the greed of Big Pharma and the insanity of Mbeki's AIDS-denialism.
Such a strategy would expose Anglo's cost-benefit analysis — and would
add to the cost side of the company's equations some explicit social punishment
for proceeding with a frugal employee benefits program that can only be
termed culpable mass homicide.
With the WSSD, opportunities for global humiliation of Anglo's — and
South African corporate capital's — own genocidal instincts abound.
[Wits University 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.]<|>
From Green Left Weekly, July 3, 2002.
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