Jennifer Wallace International Relations Theory Professor Wanis-St. John February 10, 2003 A Constructive Look at the United States’ Role in the HIV/AIDS Crisis
The UNAIDS Humanitarian Unit Annual Update published for 2002 stated that HIV/AIDS is a threat to global security and stability. Theories of International Relations that regard security questions on a state level, such as classical realism and neorealism, cannot easily offer a framework for addressing a problem such as AIDS. How does the United States balance its domestic interests of trying to maximize gain for private enterprise and a free-market capitalist economy with its role as an active global peace keeper, especially when the threat is not the typical security issue? Is AIDS a substantial enough security threat to change the current identities and interests of states, who are still the most powerful actors in institutions? A look at Alexander Wendt’s article on the social construction of power politics may help explain how developed states can see past decision making in relative gains so that they make policy decisions that aid developing nations harder hit by AIDS. In order to simplify the analysis, we will consider US policy regarding assisting the developing countries of sub-Saharan Africa, currently the region most directly affected by AIDS. In their annual report, UNAIDS implies that the member states of the United Nations have agreed that “our traditional sense of security linked to war, invasion and defense has become a constituent of modern notions of security associated to freedom from want and freedom from fear. Many more people now die of AIDS than as a result
of war and conflict” (UNAIDS 1). For this to be true, member-states must embrace a norm concerning breadth and depth of what providing security entails. How can a self-interested state convince itself and its population that a health problem on another continent can threaten its own national security? If the US were to consider the sub-Saharan AIDS epidemic in the simplest manner through relative gains, one could posit that what hurts them must help us, since all gains and losses are in a zerosum framework. Clearly this interpretation would receive enormous rebuttal both domestically and internationally, since it does not coincide with the present societal norms ratified through the United Nations Declaration of Human Rights. Since AIDS has emerged as a global problem in a time where international institutions are already present, the individual state has little choice but to consider the issue-linkage between AIDS, economy, society and security- and how these can be addressed multilaterally. Wendt defines constructivists as having an “intersubjective conception of process in which identities and interests are endogenous to interaction, rather than a rationalistbehavioral one in which they are exogenous” (394). His article combines constructivism with liberalism to affirm that international institutions can affect state identities and interests. To show how states can constructively modify their identities and interests using an institution as a catalyst, I will first identify how AIDS forces the need for norm modification regarding security. AIDS in sub-Saharan Africa can affect the economy of the United States in a number of ways. The US prides itself on having a capitalist economy, where private enterprise, although not entirely free from government intervention, has relatively few constraints. The pharmaceutical industry of the US has a special concern regarding US
policy on the international AIDS issue. With the establishment of the World Trade Organization and the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), the drug industry received numerous rights regarding patented medicine and its distribution. In a report by the International Intellectual Property Institute, prepared for the World Intellectual Property Organization, the authors concluded that even if pharmaceutical companies donated medicine to the sub-Saharan companies, donor governments would still have to provide considerable financial contributions so that the developing countries could maintain a stable healthcare environment. The IIPI report clarifies that the unwillingness of drug industries either to donate large quantities of medicine or to relinquish substantial patent rights is not the primary impediment of the AIDS crisis, but that developed states must take huge initiatives in aiding sub-Saharan Africa. (IIPI 1). The IIPI neglects that however the US government and its domestic pharmaceutical industry decide to coordinate, US private enterprise suffers through government intervention. If it becomes difficult for the drug industry to make enough profits to promote further research and development, then the innovation needed to continue looking for better medicine and a cure for AIDS may dwindle. Milton Freedman, a moderate-liberal, comments that “the great advances of civilization . . . have never come from centralized government . . . government would replace progress by stagnation, it would substitute uniform mediocrity for the variety essential for that experimentation which can bring tomorrow’s laggards above today’s mean” (3-4). The US policy makers must balance the role of promoting a free-market economy and the role of cooperative and humanitarian international actor. The simplest way would be to show how the sub-Saharan AIDS epidemic can effect the economic and
health security of US individuals, thus in turn affecting their human rights as well. The United Nations brochure on HIV/AIDS states that AIDS affects mostly young adults, in turn affecting the potential of economic and political development. From a classic liberal perspective, this shows that available international wage labor is losing its quality and quantity, and the cost of training skilled labor increases with the decrease in life expectancy. This hurts both the developing state and the developed state. In January 2000 the United States held the United Nations Security Council presidency, where it became the first actor to address a development issue- AIDS in Africa, as a global security concern (IIPI 7). This marked a significant attempt at modifying the norm concerning collective security. Wendt states that “a fundamental principle of constructivist social theory is that people act toward objects, including other actors, on the basis of the meanings that the objects have for them” (396). The United States set the precedent of perceiving AIDS as a domestic and global threat; since a rational state maintains its security for survival, this seems to imply that United States will do as much as necessary to confront AIDS. Liberals admit that states should play a role in providing law and order and protection of individual rights (Freedman 27). Therefore, the US government can put constraints on private enterprise in order to protect the population from the threat of AIDS. Constructivist theory states “it is collective meanings that constitute the structures which organize our actions” (Wendt 397). How can the United States’ action in the United Nations influence a change in the meaning a collective security threat enough so that the institutional processes of the United Nations will promote coordination? Wendt states the actors define their interests in the process of defining situations; the United
States defined AIDS as a security threat and thus defined its interest. Constructivist theory also states that an actor can have multiple identities, and each is “an inherently social definition of the actor grounded in the theories which actors collectively hold about themselves and one another and which constitute the structure of the social world” (Wendt 398). The theory further states that “an institution is a relatively stable set or ‘structure’ of identities and interests” (Wendt 399). The United States seemed to lessen the importance of its role as promoter of a free market economy and strengthen its role as global humanitarian. Both identities are highly integrated, however in the current situation the ranking has shifted. By altering its personal identity and interests, the US declaration of AIDS as a threat to global security will force the structure of the United Nation as an institution to redefine its framework of rules and norms. One may ask why the United Nations is the institution chosen for this issue. Aside from the nearly all-inclusive member base of states it contains, international regime theory argues that institutions are easier to adapt than to build from scratch (Lepgold 229). The reasoning behind this argument may also be found in constructivist theory, which states that “the meanings in terms of which action is organized arise out of interaction” (403). Using an already present institution to address new issues at least gives the actors the knowledge of how the interactive process has operated in the past. Constructivism argues that decisions should be made not on the basis of worst-case scenario, but on the basis of probabilities, gathered through the analysis of interaction. Therefore, the United States can gain assurance that collective security interaction will occur more so when taking place within the confines of an already established institution.
The founding of the United Nations itself can show how states have adapted their interest of security from a “competitive” security system, or from an “individualistic” security system, to a “cooperative” security system, where “national interests are international interests” (Wendt 400). Wendt also explores conditions that would not be favorable for reconstructing institutions and the identities and interests of its acting members. He states that “any social system confronts each of its members as an objective social fact that reinforces certain behaviors and discourages others. Donor governments are not likely perform in a manner altruistic enough to confront AIDS in sub-Saharan Africa unless they are assured that realist power-politics will not penalize them for the action. Wendt states a second condition that “systematic change may also be inhibited by actors’ interests in maintaining relatively stable roles and identities,” which can be shown in the conflict of US domestic economic interests and its current role in international relations (411). Alexander George discusses the significance of a policymaker’s personal judgment for decision making (George 23). Through means of personal judgment and choice, actors can change their identities in an institution or society. Wendt states “the fact that roles are ‘taken’ means that, in principle, actors always have a capacity for ‘character planning’- for engaging in a critical self-reflection and choices designed to bring about change in their lives” (419). After an actor makes the personal decision to go against the norms of an institution, he can influence other actors to change their actions as well through his own practice and “altercasting” (Wendt 421). The United States, represented by President Clinton at the 2000 Security Council meeting, chose to initiate a change in its identity and interests regarding the AIDS epidemic. For its proposed norm
change for the institution, the next logical step, according to constructivism, would be “to make unilateral initiatives and self-binding commitments of sufficient significance that another state is faced with ‘an offer it cannot refuse’” (Wendt 421). Although the US has not yet set the best example regarding the credibility of its promises for sufficient enough funding for the AIDS issue, it has at least started the practice, along with all of its imperfections. Wendt summarizes that: The process by which egoists learn to cooperate is at the same time a process of reconstructing their interests in terms of shared commitments to social norms. Over time, this will tend to transform a positive interdependence of outcomes into a positive interdependence of utilities or collective interest organized around the norms in question. (417) Constructivist theory gives an adequate outline for how states may perceive AIDS as a security issue calling for completely collective security. This is sorely needed to address the AIDS epidemic, for it is a security threat that does not respect sovereignty or territorial boundaries.
Bibliography UNAIDS Humanitarian Unit Annual Update 2002 http://www.unaids.org/security/index.html International Intellectual Property Institute “Patent Protection and Access to HIV/AIDS Pharmaceuticals in Sub-Saharan Africa.” 2002 www.iipi.org HIV/AIDS Brochure “More than a Health Crisis” www.un.org/Overview/SG/aidshiv.html UNAIDS BP Digest Document –HIV Causes and Consequences http://www.unaids.org/bestpracticedigest/files/HIVcausesandconsequences.html United Nations Security Council Resolution 1308 (2000) www.un.org Confronting AIDS: Public Priorities in a Global Epidemic http://www.worldbank.org/aids-econ/confront/summary/index.htm Alexander Wendt, “Anarchy is What States Make of it: The Social Construction of Power Politics,” International Organizations, vol. 46, no. 2, Spring 1992. Alexander George, Bridging the Gap; Theory and practice in Foreign Policy, United States Institute for Peace Press, 1993. Milton Freedman, Capitalism and Freedom. Chicago: University of Chicago Press Lepgold, Joseph. 1998. “NATO’s Post-Cold War Collective Action Problem.” International Security, 23:78-106.