It will take more than awareness to slow the HIV pandemic in Africa.
This week, the rock star Bono and a host of other celebrities are promoting the US launch of 'Product Red', the private sector's campaign to fight AIDS. Some of the profits on products sold in this initiative, as agreed by their manufacturers, will go to the Global Fund to Fight AIDS, Tuberculosis and Malaria, specifically to confront AIDS in Africa. The arrival of iPods, phones and clothing that will highlight the AIDS pandemic and provide financial support for the global fund is to be welcomed.
The publicity surrounding the US launch — which follows a similar process earlier this year in Britain — may convey the impression that large global corporations are at the forefront of the fight against AIDS. But a closer look at the situation reveals that this is rarely the case (see page 738).
For two decades, AIDS activists and officials have implored the private sector to join the fight against AIDS. In reality, that effort remains overwhelmingly dependent on public funding and public officials. In all but a few cases, the private sector has been a minor player. The Product Red campaign is one sign that this may finally be changing — but much more needs to be done.
To be fair, the drug industry, often in partnership with major economic players such as oil companies, is actively involved in research, diagnostics, counselling and treatment in places where the pandemic is most severe. Other large corporations — such as mining company Anglo American and the brewer Heineken — provide high-quality monitoring and treatment programmes for their employees and, sometimes, for their families.
But for reasons of treatment cost and the scale of effort required, these initiatives have taken a long time to get going. Private companies must urgently be encouraged to increase their efforts to take some of the load off governments.
What's more, employers' responses to the pandemic need to reach beyond the provision of medical assistance. Some of the responses needed are more obvious than others. For example, cement company LaFarge is changing its transport logistics to avoid having several hundred African truck drivers sitting outside its plants for hours or even days at a time awaiting delivery. A more general problem that needs to be discussed and confronted is the web of sexual relationships that exists within some companies.
There are professional skills in the private sector that have not been significantly tapped. In their enlightened self-interest, private companies could be working with governments to apply their expertise in large-scale logistics and financial management to the mammoth task of constraining the epidemic. But even where money is theoretically available, there are bottlenecks. In the Ivory Coast, for example, a Merck scientist called on the company's internal financial expertise to help unclog some issues with resource allocation, only to be told that it would take eight months.
There are many other impediments to private-sector engagement, particularly AIDS politics and suspicion among public officials and at non-governmental organizations. Business expertise would be more readily brought to bear on the pandemic if public-health officials and other parties could agree among themselves what administrative actions need to be taken to fight AIDS.
Nevertheless, such actions are being identified in many hard-hit countries, and corporations and their skills are sometimes being harnessed to implement them. Some of those involved in Product Red, such as the clothing retailer Gap, already lead by example at their own factories in Africa.
Yet there is a nagging concern among AIDS officials that global attention may be drifting away from the pandemic, at a time when the need to confront it aggressively has never been greater. Businesses, not just in Africa but elsewhere, need to be planning for the battle now, so they can act before it is too late.
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