A Framework for Fighting AIDS

In the U.S. and other developed nations, AIDS is no longer seen as a death sentence. Yet in Africa thousands still can’t get the medications that make this miracle possible. Political science doctoral candidate Matthew Kavanagh is studying the intersection of global health, international law, political economy, and human rights, and working to rebalance the equation.

Kavanagh came to Penn after about a dozen years with human rights and global health NGOs. He had realized when he and his colleagues were deep in day-to-day matters, it was hard to step back and figure out the big picture. “So I’ve come to Penn with kind of that broader question,” he says. “What are the big things that will actually move us forward, that we might not be able to achieve tomorrow but might give us a bigger vision for the long term?”

He is looking most closely at treatment for HIV and AIDS, which he sees as sitting at the nexus of global inequality. “I got drawn into the politics of it,” he says, “but also by knowing people fighting for access to those medicines, who were themselves facing death without being able to get them.”

Kavanagh recently wrote an online piece for Foreign Policy in Focus and is revising a longer article examining World Trade Organization policies on intellectual property that impact access to medicines and textbooks, and so touch human rights like health and education. As an example, he cites the drug Kaletra, developed by Chicago’s Abbott Laboratories. A generic version of the drug is manufactured in India, and much of what is produced there goes to Africa for HIV treatment. Kaletra is not patented in India because the law there includes a challenge process to weigh the costs and benefits of the patent.

However, Kavanagh says, U.S. policy makers are pushing India to change the intellectual property laws in ways that would prevent this, and new trade agreements in the region would make exactly this kind of generic drug production much harder. (In a bit of irony, he says, one of the biggest customers for India’s generic Kaletra is the U.S., which spends about $6 billion a year on anti-HIV programs in Africa.)

“As we think of this tension between intellectual property, which is arguably necessary to have innovation, and the needs of health, how do we strike that balance?” asks Kavanagh. “My answer, writ large, is that we need to think about this in a human rights framework.” Doing so, he says, would give countries an obligation to not impose policies they know will mean people won’t have access to medicines.

“This is part of what’s driven me into the academic world, to ask some of these questions,” he says. “For example, there is no real empirical evidence that patent protection of medicine in low- or middle-income countries is good for innovation and growth in these countries, and a fair amount of empirical evidence mounting that these rules are bad for health. That’s data that really needs to get out to political decision makers.”

Which brings him back to his reason for coming to Penn. “There’s too big a disconnect between policymakers and the academic world,” he says. “We in the policy world are not often data-driven, right?  And we in the academic world often don’t speak to the actual policy decisions that are being made in ways that are accessible. And that’s really the kind of role that I would like to play on human rights and global health.”