Environmental Engineering Reference
In-Depth Information
Part Iv, 'accessingaffordable Medicines', takes up the issue of HIv/aIDS and the
governance and human rights aspects of accessible medicine. In chapter 8, 'coming
to terms with Southern africa's HIv/aIDS epidemic', Hany besada examines the
demographic and economic impacts of HIv/aIDS in Swaziland, botswana, Zambia,
Zimbabwe, and South africa. these countries have some of the highest HIv/aIDS
prevalence and associated mortality rates in the world. However, their governments
have largely failed to reduce social determinants of disease transmission and increase
access to antiretroviral treatment (art) for those infected. besada reviews individual
governmental policy responses to the HIv/aIDS crisis, with a primary focus
on South africa, where HIv/aIDS-related mortality is likely to continue to increase.
South africa shows how inconsistent political leadership can be a major impediment
to disease control. the most prominent indicator of poor domestic health governance
is the consistently low percentage of individuals living with HIv receiving art,
despite concessions by large pharmaceutical companies that have allowed the country
to manufacture low-cost generics domestically. there is also a government failure to
reduce the social stigma associated with HIv infection. Yet there have been positive
developments, such as the decisions of large firms to absorb the cost of ART for HIV-
positive employees and a national HIv/aIDS policy emphasising prevention. while
governments should re-evaluate what strategies have worked in the regional context,
the international community must increase its financial aid to southern african states
to subsidise the rising cost of treatment resulting from increased access to art. It
must also accept some responsibility for the migration of healthcare workers from
southern african states to wealthier countries and offer some solutions.
In chapter 9, 'the renovation of Institutions to Support Drug access', Jillian
clare cohen-Kohler asks how governments can maximise conditions for positive
health outcomes at the same time as economic growth is supported through trade
and incentives for the private sector, such as through the application of rigorous
intellectual property law regimes. She argues that the potential tension between
these objectives arises in the pharmaceutical sector. In a world that has distorted
drug access and where one third of the population lacks regular access to medicines,
there is a morally compelling reason to identify potential institutional obstacles to
drugs irrespective of the potential commercial or budgetary costs. Governments
should not experience any conflicting pressure when they design policies to improve
drug access. access to medicines should be viewed as a fundamental human right
as expressed in international human rights law that places attendant obligations
on states to ensure drug access. article 12 of the Un's International covenant on
economic, Social, and cultural rights outlines the 'right to the highest attainable
standard of health', which includes the right to the availability of essential medicines
as defined by the WHO.
In chapter 10, 'Global Health Governance from below:access toaIDS Medicines,
International Human rights law and Social Movements', lisa Forman explores the
actual power of the human right to medicines to enable access to art for millions of
people with HIv and aIDS throughout the world. She argues that the right to health
in international law holds a transformative potential to overcome the political and
