Shocking the Conscience of the World: International Norms and the Access to AIDS Treatment in South Africa

Abstract

This paper examines the emergence and institutionalization of a new international norm supporting greater access to lifesaving drugs in developing countries, particularly for HIV/AIDS drugs in South Africa. In order to decrease the price of life-saving HIV/AIDS drugs, the government of South Africa passed amendments allowing for the domestic production of generics and the importation of more affordable HIV/AIDS drugs. Although these amendments were arguably in compliance with international laws governing the protection of intellectual property rights, the United States government and a worldwide coalition of pharmaceutical companies opposed the legislation and actively sought its repeal. Over time, however, the positions of both the U.S. government and the pharmaceutical companies changed in response to a growing worldwide awareness of the HIV/AIDS crisis in South Africa. Activist groups played a key role in mobilizing public sentiment in support of greater access to HIV/AIDS drugs. Largely due to the concerted campaigns of activist groups, the norm was institutionalized in bilateral relations between U.S. and South Africa, as well as in international statements such as the Doha Declaration. However, the norm has failed to become completely internalized within South Africa's domestic political sphere. To this day, the HIV/AIDS problem in South Africa continues relatively unabated.