Aids in Africa
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The 20th century began with a grim welcome. The AIDS (Acquired Immune Deficiency Syndrome) epidemic was on track to become the deadliest disease known to mankind. Over the course of 20 years, 24.4 million people had died from AIDS and over 40 million were living with the disease. Globally, AIDS had a tremendous and detrimental impact in Sub-Saharan Africa; where the lack of education and knowledge of safe sex practices led to many of these inhabitants to contract the disease. However, with the impact of AIDS affecting many across the world; treatments for the disease began to emerge. Scientist and pharmaceutical firms began to issue a combination of drugs that transformed an AIDS diagnosis from a death sentence to a treatable disease (Spar and Bartlett, 2005, pg.1).
With the introduction of new drugs and treatments becoming available for AIDS—although there is still no cure; the rate of the conception of AIDS and HIV begins to decline in the United States. Nonetheless, these new life-changing drugs were accompanied with a hefty price tag; approximately $10,000 to $15,00 per year. While the United States and many affluent countries’ citizens could rely on the government or private insurance to help with this expense, poorer countries—especially many African countries’ citizens could not afford to purchase these drugs. With the high market price for AIDS Drugs, and the inability for many citizens in African countries to afford to purchase them, the AIDS epidemic in Africa grew and death tolls rose. Many AIDS activist to begin challenging pharmaceutical companies demanding they either lower the prices for their drugs or allow local pharmaceutical firms to produce generic and cheaper versions of the much-needed drug (Spar and Bartlett, 2005, pg.1).
The Western pharmaceutical industry is built on the foundation of protecting intellectual property rights. By patenting their products, these firms are able to ensure that they recover the cost of research and development and furthermore, producing the drugs. The pharmaceutical firms argue that allowing the generic manufacturing of their drugs will violate their patent obligations. These firms also note that lowering the price of their drugs is not feasible due to the large cost of R&D (Senge, 1990a, pg.7) The two sides of the equations, the pharmaceutical agencies and AIDS activist, hold steady to what they perceive to be the dominant issue instead of coming to a steady solution; they fail to see the whole and rather focus on the singular parts of the problem. It is vital for the pharmaceutical companies and for many African countries to begin the process of systems thinking; the process in which one sees interrelationships (Senge, 1990b, pg. 9).
To incorporate the process of systems thinking into this case; it is important to note a few key elements that would be instrumental in implementing a positive change and hopefully provide a solution to the AIDS epidemic in African countries. The first element is the process of seeing and recognizing interrelationships; or in colloquial terms, the ability to see the bigger picture. When considering a solution to the AIDS epidemic in Africa, it is tempting to come to a conclusion that the pharmaceutical companies should lower their prices or allow for their product to have a generic substitute produced. However, the most feasible and agreeable solution is to have a collective effort from all the participants in this case. The pharmaceutical companies are not the only entity that should be held accountable for the growing AIDS rate in African countries. It’s important to note that the AIDS epidemic is a global issue; and though it is more critical in some African countries, helping to solve this crisis in Africa will only further help the cause in other places. According to Senge “small changes can produce big results—but the areas of highest leverage are often the least obvious” (Senge, 1990a, pg. 6). The small changes have to begin with the stakeholders of this case study, it has to begin with the pharmaceutical companies, the patients, the developing countries government, and even the activist. The pharmaceutical companies could lower their prices to an affordable rate if non-government agencies were willing to fund the remaining part. Additionally, if the government agencies from developing countries were willing to band together in their fight to eradicate and/or contain the AIDS epidemic it would promote solidarity and ultimately solve many issues. Recognizing that the small changes made by multiple individuals working as a unit, is the only way to promote viable and lasting change (Senge, 1990a).
Another component of system think is the ability to move beyond blame. This case study illustrates how easy it is for individuals, groups, and organizations to place blame on one another when undesirable events arise. In this case, blame fell heavy on the Western pharmaceutical firms for the strong stance on their prices, and their inability to waver on their intellectual property rights. The pharmaceutical firms in response place blame on the African countries’ government and lack of critical resources like clean water, availability and quality of medical facilities, and stubborn political and social issues. The continual back and forth of who is the cause of the increasing AIDS rate in Africa does little to yield a progressive result. System thinking introduces the concept of moving beyond blaming others and outside circumstances, to seeing that any issue and the people who suffer from the issue are a singular entity—trying to place blame only distracts from the core causes of the problem (Senge, 1990b, pg. 9).
System thinking also incorporates the ideas of distinguishing levels of complexity, focusing on high leverage and avoiding symptomatic solutions. Distinguishing level of complexity focuses primarily on detail complexity and dynamic complexity. Detail complexity is when there are numerous variables involves; however, dynamic complexity is more difficult to recognize. Dynamic complexity revolves around cause and effects and their relationship with time and space. The ability to recognize dynamic complexity will ultimately yield the cause of a problem. One must recognize the underlying actions in the system that is responsible for causing the symptoms or problems. Yet, what makes this so difficult is when the cause and effect are not close in time and space. In this case, the dynamic complexity or causes of the AIDS epidemic began years before the disease began to disrupt these African countries. The unstable government, shortage of resources like medical care and education, and lack of information are all component of the dynamic complexity that yielded the AIDS Epidemic in Africa (Senge, 1990a, pg.6).
System thinking also highlights the notion of focusing on areas of high leverage.