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Access to Medicines and the Rhetoric of Responsibility

Published online by Cambridge University Press:  28 September 2012

Christian Barry  and
Kate Raworth
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Abstract

There is no cure or vaccine for HIV/AIDS. The only life-prolonging treatment available is antiretroviral (ARV) therapy. WHO estimates, however, that less than 5 percent of those who require treatment in developing countries currently enjoy access to these medicines. In Africa fewer than 50,000 people–less than 2 percent of the people in need–currently receive ARV therapy. These facts have elicited strongly divergent reactions, and views about the appropriate response to this crisis have varied widely.

The intensity of the debate concerning access to life-prolonging medicines for the treatment of HIV/AIDS, and the heated rhetoric with which they are often conducted, suggest that these disagreements may be rooted in deeper disagreements of value. It is not obvious, however, what disagreements of value are at stake in this debate. By analyzing the statements of scholars, public officials, activist organizations, and private sector representatives, each of whom may endorse very different policy recommendations on access to HIV/AIDS drugs, we have identified and created a typology of the different sources of disagreement in the debate. We conclude that the central disagreements concerning access to medicines arise from competing understandings of how responsibilities for bringing remedy to hardships should be allocated to different agents and institutions. A central lesson that emerges from our analysis is that thinking about “health equity” must extend beyond the explanation and justification of goals, values, and ideals, and engage more honestly with the difficult question of how responsibilities for bringing remedy to health crises should be allocated in complex social contexts.

Type
Articles
Information
Ethics & International Affairs , Volume 16 , Issue 2 , September 2002 , pp. 57 - 70
Copyright
Copyright © Carnegie Council for Ethics in International Affairs 2002

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References

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7 Indeed, the debate is not rooted in disagreements that have been the focus of much recent writing on health equity, such as: the legitimate scope of moral concern (e.g., all persons, groups, compatriots, or community members); whether we should focus on access to healthcare resources, health outcomes, or opportunities for health; and distributive considerations (e.g., whether one ought to use sum-ranking, maximin, or some indicator of inequality as an interpersonal aggregation function for assessing the fairness the current situation).

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