AIDS strikes at some countries' ability to govern

Poor nations devastated by AIDS are coming under pressure to funnel what few drugs they can afford solely to their political and military elites, a move likely to stir unrest among the rest of the population, a Council on Foreign Relations study said on Monday.

"There are countries right now where members of parliament and the cabinet are getting access to retrovirals, even though they are not available to the society at large. There are also countries where military leaders are getting access while the rank-and-file are not," said council senior fellow and study author Laurie Garrett.

But such solutions are both misguided and unsustainable over time, because the power structure will be undermined as soon as the rank-and-file realize the elite get to live a long time and they don't, Garrett told a news conference.

HIV "is taking its toll far faster than the professional ranks can be replenished with fresh trainees," with desperately needed teachers and health workers among the hardest hit, her report found.

With the epidemic still in its infancy and at least 39 million HIV-infected people expected to die over the next five to 10 years, "this depletion of elite workers, professionals, political leaders and managers is expected to reach crisis proportions in many countries by 2010, challenging the ability of the state to perform even rudimentary aspects of governance," it said.

Peter Piot, executive director of UNAIDS, the U.N. umbrella agency for AIDS, and former U.S. Ambassador Richard Holbrooke, addressing the same news conference, suggested the U.N. Security Council declare AIDS a worldwide emergency.

"An emergency would definitely help to lift the global response to it to another level. If something is an international emergency, then every single country has to declare this an international emergency," Piot said.

Drug companies could be expected to strongly oppose such a move as World Trade Organization rules allow governments declaring a public health emergency to produce generic versions of patented medicines if no agreement can be reached with the company holding the patent.