South Africa Again Gives the World a Conscience

Last week, Bristol-Myers Squibb gave up its monopoly on a drug to help AIDS sufferers. The giant pharmaceutical company announced that it would no longer block generic-drug makers from selling inexpensive versions of its patented HIV drug Zerit in South Africa or any African nation plagued by the AIDS virus. The decision again highlighted the unparalleled role that South Africa has played in changing the balance between commercial interests and moral values that governs the global behavior of corporations and nations.

South Africa first attracted international attention in 1960, when police massacred 69 blacks protesting the country’s system of apartheid in the township of Sharpeville. It remained in the global limelight until apartheid collapsed under the weight of internal pressure and international sanctions and a majority-rule government, headed by Nelson Mandela, came to power in 1994.

South Africa reemerged as an object of worldwide concern last year because of AIDS. No other country is believed to have more AIDS sufferers: an estimated 4 million adults and children. But that tragic statistic does not fully explain why South Africa has become the primary battleground in a global struggle between AIDS activists and pharmaceutical companies over the cost and availability of anti-AIDs drugs in Africa.

Both in the past, when the issue was racial injustice, and now, when the issue is medical injustice, South Africa’s power to influence global affairs has depended upon determined campaigns that link local activists with their supporters around the world. The turning point in the struggle against apartheid occurred in the fall of 1985, when then-Chase Manhattan Bank announced that it was withdrawing from South Africa. That decision signaled the corporate community’s belated recognition that the costs of being perceived on the wrong side in the clash between whites and blacks were greater than any profits to be made by continuing to defend investments in South Africa. Although the white rulers in Pretoria did not accept defeat until 1990, most analysts point to Chase Manhattan’s withdrawal as the beginning of the end for apartheid.

Future historians are likely to view Bristol-Myers Squibb’s surrender of its Zerit monopoly as a similar turning point in the struggle to create a more just system to provide drugs to poor victims of disease around the world. In announcing his company’s decision to join other drug companies, among them GlaxoSmithKline, in making anti-AIDS drugs more affordable in African countries, Bristol-Myers Squibb Executive Vice President John L. McGoldrick declared, “We seek no profits on AIDS drugs in Africa.”

The drug companies’ motives are not purely altruistic. By giving up patents or slashing prices, they hope to vent the mounting pressure on national governments and international organizations to rewrite the rules on international property rights, which currently outlaw the sale of generic alternatives to patented drugs in most countries.

In the short run, the gambit may work. On the day that Bristol-Myers Squibb made its announcement, South African President Thabo Mbeki informed his country’s parliament that he had decided against declaring his country’s AIDS crisis a national emergency. Mbeki was clearly worried that such a decision would damage South Africa’s reputation and discourage foreign investors. But if Bristol-Myers Squibb had not voluntarily surrendered its drug monopoly, he would have found it very difficult to resist political pressure to act. Had he done so, South Africa would have become the first country to exploit a provision in the World Trade Organization’s Agreement on Trade-Related Aspects on Intellectual Property. The provision allows countries to suspend drug patent protections during medical emergencies.

But the more important lesson to draw from these developments in South Africa is that values, articulated and pushed by an increasingly empowered network of local and international activist movements, have become a decisive factor in the global-policy equation. Groups like the National Assn. for People Living With HIV/AIDS, the Treatment Action Campaign, Oxfam and Medicine Sans Frontiers have led the anti-AIDS movement in South Africa.

True, only governments can enact and enforce laws. But the ability of non-governmental actors to influence them and corporations is now far greater than it was in the early days of the anti-apartheid movement, for a number of reasons:

* The slow but steady public acceptance of the principle of universal human rights.

* The transportation and communications revolution that has allowed activists to link with their counterparts around the world to develop and advocate transnational political interests and loyalties.

* The globalization of popular culture and economic markets and the expanding international activities of state and local governments, all of which have greatly increased the ability of activists to find ways to apply economic and political pressure on corporations and national governments.

* The growing influence of international communities of experts, such as the doctors and researchers working on AIDS. They convened in South Africa last July and forced Mbeki to back off his support for the widely discredited view that HIV might not be the cause of AIDS in Africa.

One policymaker who seems to recognize the new realities is Robert B. Zoellick, the Bush administration’s U.S. trade representative. Last week, in an interview with the Washington Post, Zoellick declared that trade policy must be “fully aligned with our values.” Referring to the anti-AIDS-drug controversy, he said, “I’m convinced, whether it relates to child labor, forced labor or HIV/AIDS--and I’m sure there will be others--that I and my compatriots have to get out in front on these issues.”

But Zoellick, who will be primarily responsible for crafting the administration’s position in future global and regional trade negotiations, will face two major challenges. First, it is doubtful that the business community as a whole is prepared to draw the same kind of larger lessons from the anti-AIDS-drug controversy that Zoellick has. The problem is that companies can easily afford to write off the South African anti-AIDS-drug market. But the costs of accommodating values will be far higher when it comes to making changes in business practices in developed countries, where the economic stakes are far higher. For example, it is inconceivable that a Bristol-Myers Squibb executive would have uttered McGoldrick’s comment without limiting the company’s no-profits commitment to Africa.

Furthermore, for better and worse, the influence and leverage of activist groups almost always derives from their ability to generate controversies that help them mobilize supporters and embarrass governments and corporations. Thus, they have real and legitimate interests in remaining outside of and in opposition to government-led institutions and coalitions.

It is unlikely, then, that it will be possible to create a new global policymaking process that is not driven by public conflict. But we can hope that governments and corporations will more promptly recognize the need to respond to pressures from global civil society than they did in South Africa. *