AIDS@30: 9—The problems of globalisation, commercialisation, and the loss of community-based vision

16 Nov 2011 09:36

Other factors involved in such failures have been the nature of the globalisation of treatment activism, including the involvement of international bodies such as the World Trade Organisation, the UN, etc., and the relative loss of political leverage in dealing with bodies that are not answerable to the electorate. They are therefore rather immune to the effects of political shame.

On the international scene, we have seen marvellous dreams laid out, such as the Doha Declaration on Trade-related Aspects of Intellectual Property Rights, or TRIPS, and the authorisation to manufacture generics in the situation of a pandemic, only to have this advance then crippled by licensing issues through back-room dealing from pharmaceutical companies.

The increasingly transnational character of treatment-advocacy has meant that there’s been a much increased challenge to community-based organisations. And there has been a lack of vision among experienced Western treatment-activists to foresee a future for civil empowerment and medical democracy since effective medication has come on line. Over the past 15 years, the game has required exponentially more expertise, but treatment-activists and community-based organisations have not kept up. I do understand it to a degree, as I know the reality of burnout, but it still reflects a failure to recognise that vision is still needed in the privileged West.

This failure of vision has happened in tandem with the commercialisation of community-based organisations and the complacency of activists-turned-executives who actually have few educational resources to deal with the new realities post-96 and post-2000. They have little knowledge of the wider picture of medicine, public health, or science and thus no idea how to move the agenda forward other than by looking at the unintelligent and default issues of profit and market-share. Such executives need to skill up and smarten up, or move on if they’ve been in place too long and are too complacent and closed-minded to do what is necessary. We’ve had over ten years now to do this in the West and I don’t see any vision, except for those organisations working primarily with the global South.

So where should the West be heading? This is where we come to medical failures …

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