Executive Council Statement | Health Care

HIV/AIDS

Chicago, Illinois

Every generation confronts dramatic challenges, and its response shapes the course of history for the generations that follow. Surely, the terrible tragedy of the HIV/AIDS pandemic is among the most compelling humanitarian challenges this generation will confront. And thus far, it must be said that the world is dreadfully failing this test. 

Twenty years into the HIV/AIDS pandemic, new infection rates across the globe are soaring, but the resources being brought to bear pale in comparison to the need. Here in the United States, the growing infection rates within communities of color and among young women cry out for reinvigorated strategies. 

The Centers for Disease Control and Prevention (CDC) estimate that between 800,000 and 900,000 people are living with HIV/AIDS in this country, with 40,000 new HIV infections occurring each year. Yet, the Bush Administration’s proposed 2002 budget could force cuts of nearly $1 billion from public health programs essential to people with HIV/AIDS. It is a sorry indictment of our health care system that many uninsured and underinsured Americans with HIV still do not have access to life-saving medications because they generally do not meet Medicaid requirements until full-blown AIDS disables them. 

Globally, the HIV/AIDS crisis has become a focal point for the consequences of failed policies and decades of neglect. Health care is embodied in the UN’s Universal Declaration of Human Rights. Whether governments and international organizations actually have an obligation to enforce this right is hotly disputed. On March 30, 2001, the Bush Administration stressed in its response to the UN’s draft declaration on AIDS that, “for legal and constitutional reasons, the United States cannot accept a rights-based approach to HIV/AIDS anymore than it can accept a rights-based approach to food, shelter or hunger.” At the UN High Commission on Human Rights meeting in April, the United States alone abstained to an otherwise unanimously supported resolution recognizing “that access to medication in the context of pandemics such as HIV/AIDS is one fundamental element ... of the right ... to health.” 

Today, health is the human right that most visibly marks distinctions of race, economic or social condition. Access to lifesaving medicines and care for people living with HIV and AIDS is largely determined by race, class, gender and geography. The HIV/AIDS pandemic thus illuminates patterns of global injustice; injustice that the trade and development policies of many industrialized countries have done little to alleviate and in some instances have directly perpetuated.

Current trade policies have not lead to equitable and sustainable growth in developing countries.  Instead, by giving private intellectual property rights higher priority than public health, these agreements prevent poor countries from giving access to life-saving medicines. The IMF and World Bank have failed to stimulate robust development in poor countries and have mired developing nations in crushing debt.  Even under current debt relief schemes, many poor countries will spend more on servicing their international debt than they do on basic health care, including treatment and prevention of HIV/AIDS.

Aside from our moral obligation to battle this disease, it is simply common sense to recognize that it is in the world’s economic self-interest. But fighting HIV/AIDS should not only be motivated by economic self-interest. Fighting the disease should be about human beings who have the ability to engage by willingly pulling up their sleeves to help fellow human beings. 

Some argue that trade unions have been late in joining the fight against HIV/AIDS. In the United States this is not the case, many unions quickly responded to the risks of occupational exposure and learned to overcome the discrimination and stigma towards HIV positive co-workers. In the early 1990s, requests for assistance from our international trade union partners steadily escalated. In response, the AFL-CIO has charted a steady course to seek a full continuum of care for all of those living with or affected by HIV/AIDS. 

The same trade union principles which have guided our trade union-based efforts in the United States and expanded upon by ICFTU’s African Regional Organization’s “Gaborone Declaration on HIV/AIDS in the Workplace:  Plan of Action” guide our international efforts today. 

  • We recognize the need to encourage the development of trade union leadership commitment and political will to fight the disease at home and on a global basis;
  • We recognize the need to ensure the human rights of everyone by developing clear-cut workplace policies which ensure freedom from discrimination and stigma of workers and their families who are living with or are affected by HIV/AIDS. To this end, we urge the universal adoption of the recently ratified International Labor Organization’s “Code of Practice on HIV/AIDS and the World of Work.” 
  • We recognize that this unprecedented public health disaster must be met by a multi-sectoral approach with the collaborative efforts of government, labor and employers; and, 
  • We recognize that though the workplace is a venue that offers a potential like no other for providing the “continuum of care”—from increasing awareness, HIV education and prevention leading to care, support and treatment—for workers, their families and the communities in which they live, labor will have to engage many allies in the HIV/AIDS crises. 

The AFL-CIO also supports U.N. Secretary-General Koffi Annan’s call for the creation of a Global Fund to combat HIV/AIDS and other infectious diseases that: 

  • reflects the urgency the pandemic requires with financial resources within the range of $7-10 billion. (This represents the equivalent of a little more than one percent of the world’s annual military spending.) The fund must be transparent and have the ability to respond rapidly and flexibly to meet needs and must contain governance structures which include meaningful representation from civil society and people living with AIDS;  
  • establishes time-specific measurable goals based on direct impacts on the pandemic; and, 
  • provides funding that is not restricted to disbursement through governments, but has the ability to channel funds directly to mass-organizations such as trade unions and support community-based organizations. 

At the same time, we must recognize that no meaningful response to the HIV/AIDS pandemic is possible unless the inherent inequality of opportunity around the globe is addressed.   

  • Global trade rules provide governments with very little flexibility to compromise the rights of an individual patent holder in order to address public health crises such as HIV/AIDS. Trade rules must be revised and clarified to ensure that governments are free to employ parallel importing and compulsory licensing strategies to deliver life-saving pharmaceuticals as part of a plan to treat and prevent HIV/AIDS.
  • Developing countries not only need the freedom to provide these life-saving medicines, but they also require more resources to deliver treatment effectively.  Rich countries, including the United States, must meet the UN development aid target of 0.7 percent of GDP. In addition, the IMF and World Bank must use their existing resources to cancel 100 percent of the debts owed to them by impoverished countries without attaching harmful structural adjustment conditionality; savings from debt cancellation should be administered in a transparent manner to improve health and education services and to invest in development.
  • It is also true that racism and gender inequality exacerbate the unequal impact of HIV/AIDS on different populations. As U.S. trade unions, we must continue, with other international partners, to find ways in which trade union-based strategies for combating gender and racial discrimination can contribute to the fight against HIV/AIDS.