Law against morality? Access to anti-AIDS drugs in Africa*

Abstract

The issue of access to antiretrovirals (ARVs), the compounds used in combination therapies to treat AIDS, has given rise to an international debate of economic, political, and philosophical significance. This essay proposes to deconstruct the moral issues raised by the international NGOs against the economic and legal arguments of the pharmaceutical laboratories. The African continent, which, with 70% of cases, is paying the heaviest price for the AIDS pandemic, will provide the prism through which these issues will be approached. After a brief chronology of the process by which ARVs have shifted from being the commercial monopoly of the pharmaceutical companies to the “public good” advocated by the NGOs, we are led to consider the African state. In a domain in which many different dynamics are at work, the sub-Saharan countries play with international norms (or evade them) according to circumstances influenced less by epidemiology than by power relations and manifestations of political weakness in this multipolar context. Between economics and politics, morality and law, the “biopolitics” embodied in the AIDS pandemic reveals an Africa under great strain. Once described, the “moral” responsibilities of the one side, like the vigorous collective mobilisations of the other, also impel us to highlight the responsibilities of the African states in the face of the most sudden drama Africa has ever experienced in so short a space of time.