The ethical demands on the developed world of HIV in
sub-Saharan Africa

Abstract

HIV/AIDS is a major health problem for sub-Saharan Africa. There are identifiable prevention and treatment regimes which would greatly ameliorate the situation, but these are beyond the resources of the sub-Saharan countries themselves. The research focus of this thesis is an investigation of the responsibility that the developed world has towards supplying help to combat this disease process.

A series of arguments are adduced in support of the contention that the developed world has responsibility in this area and that that legitimate responsibility is very demanding indeed. These arguments are drawn firstly from a consideration of beneficence, secondly, from considerations of distributive justice, and finally from a consideration of reparative justice and rights based arguments. With beneficence the accent was upon Singer and his child in the pond thought experiment. With distributive justice the focus was upon contractualism, primarily considering Rawls, but then extending this both into health and in a cosmopolitan direction. Where reparative justice and rights based arguments were concerned the arguments were constructed from Pogge, Shue and Ooms.

Major objections to this position were considered and largely rejected arising from the question of over demandingness, from libertarianism and from a consideration of Murphy and the question of fairness in a non-ideal situation.

However it was accepted that there is a place for partiality in moral obligations and that there are reasonable moral duties and prerogatives with regards to self and the needs of those in close relationships with the moral agent involved. Major writers involved in these countervailing arguments included Scheffler and Cullity.

The original extreme demand provisionally accepted was counterbalanced by a consideration of partialist obligations. Nonetheless the overall moral position would be such that the needs outlined in the Millennium Development Goals in regard to HIV/AIDS fall easily within the limits of moral obligations of the developed world.