A new book says globalization has determined the scale and scope of the HIV/AIDS epidemic and will shape international political, economic, and social relations in the early decades of the new century.
The book, AIDS in the 21st Century, says the course of the epidemic can be linked to global inequality. Co-author Tony Barnett is a professor of development studies at the University of East Anglia in Norwich, England.
"Globalization, of course, is nothing new. Globalization is a process going on for the last 1,500 or 2,000 years," he said. "I suppose ever since human beings have been around we have been globalizing things. But the pace has quickened in the last 50 years."
Professor Barnett says the book is a wake-up call for rich nations to realize that all is not well in the world and AIDS is a symptom of how bad things really are. He says the epidemic highlights what he described as the bankruptcy of national and international health policies.
"Among us in the richer nations, there is a tendency to think that, like everything else, it can be, if not cured, it can be dealt with," he said. "And of course anti-retrovirals [drugs], which are very, very expensive, are out of reach for most of the people in the world who can benefit from them. So, from the point of view of those of us who have the good fortune to live in relatively well off countries it is easy to forget the majority of the world's population who are open to this infection, who have no hope of any kind of cure, unless the prices are brought down quite dramatically."
The Joint U.N. Program on HIV/AIDS, UNAIDS, estimates 40 million people are infected with HIV, the virus that causes the disease. It says AIDS has caused the deaths of more than 20 million people during the past two decades. The vast majority of HIV infections and deaths are in African and other developing countries.
Professor Barnett says many of the world's multi-national corporations rely on cheap labor in developing countries. He warns their workforce is at great risk of poor health.
"Those people are very, very susceptible to infection because their living conditions are bad," he said. "They do not have good health care, they are in unstable relationships, they are labor migrants, all those kind of things. So, there is a direct link from the low paid factory worker in some part of the Pacific or Southeast Asia and the fashion item in a Manhattan store or a London store and the price that you pay for it, and the profit margins which are gained by the company which is selling that item in the end."
He says, what he calls, faceless multi-national corporations and bureaucracies must bear responsibility for improving health care systems in the countries where they do business.
The co-author of AIDS in the 21st Century says another problem with the globalization of the disease is the growing number of AIDS orphans. Estimates of their numbers over the next 10 to 15 years range from 40 million to 100 million.
"If you have large areas of the world where you have a large orphan generation which has been uncared for, which has no commitment to its society and the society cannot really give anything to it, then those orphans are one day going to reach for a gun," he said.
Professor Barnett urges immediate steps to fight the epidemic, including making AIDS fighting drugs much more affordable and widely available in developing countries. But he says for the drugs to be effective, health infrastructures in those countries must be improved. And much larger investments must be made in research for an AIDS vaccine. He says, so far, responses have been half-hearted.