AVAC, one of the many front groups for the massive HIV sector of Big Pharma, produced an interesting statistic in a recent newsletter. Over 2 billion dollars was spent on HIV prevention research and development in 2012 globally, almost all of it from the US and the EU. But out of the 100,000 participants in clinical trials, almost 70% were African.
It could be argued that Africans have the most to gain from the results of these trials, given that they have the highest HIV burden, globally. But it has taken a long time for prices to drop to a level where foreign aid money has been able to provide these drugs to a substantial number of Africans who are in need of them. The majority of people in need of HIV drugs do not receive them; many have died waiting and many will continue to die.
But more importantly, the majority of people in Africa with health needs will suffer from or die from something else before they are ever in need of HIV drugs. This is partly because most of their health needs have nothing to do with Big Pharma. The bulk of Big Pharma’s profits are still made in Western countries. Big Pharma can make a lot of money out of developing countries, but generally only when they can successfully lobby governments of wealthy countries to shell out for their products.
And when it comes to HIV, as well as health more broadly, which goes way beyond HIV alone (even in Africa, believe it or not), much of the spending is on drugs, and not on health facilities, personnel, water and sanitation, non-communicable diseases, etc, many of which relate to living conditions and factors that can not be controlled with drugs or other Western commodities. In other words, the drugs and other commodities may be beneficial, but they are of limited use on their own, and they are not accessible to the majority of people who need them.
When it comes to HIV drug trials, Big Pharma need people living in a country with high HIV prevalence as research fodder. In countries where HIV prevalence is low it would be much harder and would take much longer to show an effect. On the minus side, it means that drugs which are intended to be primarily of benefit to wealthy Westerners have only been tested on people who live in very different conditions from Westerners, and who face very different risks.
Of course, recruiting Africans for clinical trials makes good business sense, which is the only kind of sense that is relevant to Big Pharma. They are cheaper, and ethical guidelines and other protections are not generally enforced. Regulation designed to protect people costs Big Pharma money and they would prefer to spend money on lobbying and marketing and the like, than on protecting people who are not even good customers (this link is to a Guardian article that gives some background).
Is this an instance of dehumanization? I would argue that it is more of a consequence of dehumanization of Africans that makes it possible for Big Pharma to recruit an increasing number of clinical trial participants in poor countries. Just as another consequence of dehumanization is that we in the West accept explanations of HIV transmission in Africa because we have for so long been fed on stories about ‘African’ sexuality, Africans eating cow dung, Africans renting used condoms, and many more.