Issue Paper: International Access to Pharmaceuticals

Caring for Health: International Access to Pharmaceuticals
NOVEMBER 2003

Background
“God creates human beings as whole persons—each one a dynamic unity of body, mind, and spirit. Health concerns the proper functioning and well being of the whole person” (“Caring for Health: Our Shared Endeavor,” Biblical and Theological Perspectives, page 3 [1]). “We of the Evangelical Lutheran Church in America have an enduring commitment to work for and support health care for all people as a shared endeavor” (Introduction, page 2).

Bearing in mind these principles, we consider the effects of HIV/AIDS, malaria, and tuberculosis (TB) in Africa and other developing countries. “Infectious diseases threaten to reverse development gains, reducing life expectancy and cutting productivity and income. Throughout the world, 40 million people are living with HIV and 20 million have died from AIDS. Malaria affects 300 million people in more than 100 countries each year. Tuberculosis is the main cause of death from a single infectious agent among adults in developing countries.” [2]

Ecumenical work on the African continent (in which the ELCA participates) shows that 6,000 Africans die daily from AIDS and 12.1 million African children have been orphaned by AIDS. More people will die of AIDS in Africa over the next decade than have died in all the world's wars of the 20th century. [3] What will this do to the continent’s work force, economy, political stability, and hope for the future?

In this health crisis, we have seen signs of hope. Antiretroviral drugs have helped many, who have access to financial resources, live longer and productive lives with HIV/AIDS. TB and malaria are also able to be addressed using pharmaceuticals.

Dr. John-Wook Lee, the new Director General of the World Health Organization, announced on July 21, 2003, that he will boost the organization’s commitment to combating HIV/AIDS and expanding access to antiretroviral drugs to three million HIV positive people in developing countries by 2005. He addressed the WHO staff saying, “Today, as the HIV/AIDS pandemic enters its third decade, fresh political will and new technologies have created an opportunity to turn the tide of this global killer. The international community must act now. We must scale up an integrated global HIV/AIDS strategy linking prevention, care and treatment, prioritizing poor and underserved areas.” [4]

The ELCA has been addressing the issue through advocacy, financial assistance, and service together with: Church World Service; the Washington Office on Africa; the Ecumenical Advocacy Alliance; as well as The Lutheran World Federation; and the Stand with Africa Campaign. In November 2002, the ELCA Church Council adopted a resolution requesting that pharmaceutical companies in which the ELCA holds corporate shares support national and international efforts to make generic antiretroviral (ARV) drugs accessible to people living with HIV and AIDS in countries in
need. [5]

ELCA Social Policy
The ELCA social statement “Caring for Health: Our Shared Endeavor” (August 2003) develops the Church’s vision of health, illness, and healing. It calls for equitable access as a matter of both love and justice and for international cooperation in public health efforts, including preventing and combating infectious diseases.

Compassion, Conversion, Care: Responding as churches to the HIV/AIDS pandemic; an action plan of The Lutheran World Federation [6] (January 2002) develops the basis for the LWF communion’s need to share in the call to respond to the pandemic because the church itself has HIV/AIDS. This disease and its effects provoke a significant challenge to the whole community. In its action plan, LWF puts forth 12 actions to counter HIV/AIDS:

This work is the framework for international and national advocacy, as well as work within the corporate world.

Corporate Response
Publicly held United States corporations face the pandemic in many ways. It makes good business sense for companies to respond to the epidemic because of the direct impact of HIV/AIDS on business resulting from increased costs, loss of productivity, and overall threats to the foundations of the economies in which they operate. The current and future workforce is placed at increasingly high risk as the epidemic disproportionately affects people during their most productive years. [7] This global response must not merely promote health but give all a fair chance to achieve it (see Challenging Inequities in Health: From Ethics to Action from the Rockefeller Foundation [8]). It is time for the global corporate community to become part of the solution to the health challenges of HIV/AIDS, especially in developing countries. For example, an educational collaboration among a pharmaceutical company’s foundation, a private foundation, and an African government has been initiated to fight HIV/AIDS in that country. They have provided a classroom education package that teaches about HIV/AIDS in ways that help de-stigmatize the disease and support students impacted by the virus.

Shareholder Work History
For over 15 years the community of faith-based shareholders (mainly through the Interfaith Center on Corporate Responsibility) has been working with pharmaceutical companies concerning access to drugs. Since 2001, dialogues have been conducted with a variety of pharmaceutical companies around both domestic access and access in the developing world.

In 2003, the work was expanded to many international non-pharmaceutical companies asking for reports on the effects of the pandemic on their company.

Resolution Guidelines for ELCA

• We support resolutions asking for reports of the health pandemic on operations.
• We support resolutions asking for establishment and implementation of standards for response to the health pandemic.
• We support the development, in consultation with appropriate United Nations agencies, of ways to offer accessible drug treatments to people in developing countries.

[1] Evangelical Lutheran Church in America. Caring for Health: Our Shared Endeavor. Minneapolis, MN: Augsburg Fortress Publishers, 2003. http://www.elca.org/socialstatements/health/

[2] Millennium Development Goals. Combat HIV/AIDS, malaria and other diseases. World Bank Group, 2003.

[3] Church World Services. Global AIDS: Facing the Crisis. Web site, 2003. http://www.churchworldservice.org/FactsHaveFaces/aidsfactsheet.htm

[4] World Health Organization. HIV/AIDS Programme. Web site, 2004. http://www.who.int/hiv/en 

[5] Evangelical Lutheran Church in America. HIV/AIDS Church Council Action 20021120, item 8. Chicago, IL: Office of the Secretary, ELCA, 2002.

[6] Lutheran World Federation. Compassion, Conversion, Care: Responding as churches to the HIV/AIDS pandemic; an action plan of The Lutheran World Federation. Geneva, Switzerland: Lutheran World Federation, 2002. http://193.73.242.125/lwf_documents/hivaids-action-plan.pdf

[7] Global Business Coalition on HIV/AIDS. Why is HIV/AIDS a Business Issue. New York, NY: Web site, 2004.

[8] Rockefeller Foundation. Challenging Inequities in Health: From Ethics to Action. New York, NY: Oxford University Press, 2001.