A movement for global health equity

A movement for global health equity?
This text has stressed that the limited vision of what is currently deemed possible, whether in the halls of power or in the midst of great privatism, is not immutable - just as resources need not always be ‘scarce’ or technologies static. Prevailing notions of the possible may be expanded by new experience, strong partnerships, and strategic advocacy. We have recounted a number of efforts to reimagine the possible in global health, and this chapter will describe a couple more. Some stories are of visionary policymakers; some are about people living with AIDS and their allies, including students; many involve a wide range of individuals and organizations. These are stories of courage in the face of seemingly insurmountable challenges. While moving from inspiration to action may be risky - fraught with unintended consequences - it can be done by accompanying, over the long term, the intended beneficiaries of the action, while cultivating habits of critical self-reflection. One powerful form of engagement in global health work, discussed in chapter 5 but warrants further analysis, links evidence to advocacy and activism.
Advocacy and activism: grassroots efforts
Advancing global health equity demands broad-based and transnational movements. Meaningful reforms in domestic and foreign policy rarely come about without sustained advocacy efforts. The roots of the abolition of the slave trade in the British Empire in 1807 can be traced to a decades-long grassroots movement spawned by a small group of Quakers and a young Baptist minister. The anti-apartheid movement targeting the South African government during the 1980s and early 1990s mobilized concerned individuals and groups from the slums of Johannesburg to the campuses of American universities. These and other campaigns highlight the ability of informed and dedicated advocates, including students, to bend the arc of history toward justice a little more rapidly.
The past few decades have also furnished examples of effective global health activism focused on increasing access to modern medicine and advancing a broader movement for social and economic rights. Activists, along with health practitioners, researchers, and policymakers, were a key part of the coalition that reimagined the global AIDS effort – and got the rest of the world to do the same. This chapter briefly reconsiders three notable advocacy campaigns in the recent history of global health.
AIDS coalition to unleash power
The U.S. Food and Drug Administration granted federal approval to the first AIDS drug in March 1987. The long-awaited azidothymidine (AZT) – branded as Retrovir – was soon released by pharmaceutical company Burroughs Wellcome with a price tag of $8,000 per patient per year. The most expensive medicine in history, Retrovir was inaccessible to many Americans needing treatment, especially the poor and otherwise vulnerable, not to mention those in other countries. Burroughs Wellcome defended the price by citing high research and development costs as well as plans to continue research. But with 33,000 new U.S. cases of HIV/AIDS reported in 1987 anf an additional 250,000 then expected by 1991, many urged price reductions to make the drug more widely available.
People living with HIV/AIDS and their friends, families, caregivers, and allies came together in early 1987 in New York city to form the AIDS Coalition to Unleash Power-ACT UP- an organization that aimed to combat ‘the government’s mismanagement of the AIDS crisis’. Only weeks after its founding, activists staged their first demonstration, on March 24, 1987, protesting Burroughs Wellcome’s profit model and the drug-approval policies of the FDA, which, they argued, contributed to the limited supply ad high price of Retrovir.