HIV/AIDS

AIDS, which is caused by the human immunodeficiency virus (HIV), has emerged as the paradigmatic disease for ethical analyses addressing issues in infectious disease control and public health. The ethical issues surrounding HIV/AIDS are best divided conceptually into two parts: life before and life after the advent of life‐preserving therapies. This division provides a natural way to categorize how ethical issues were dealt with not only historically by comparison to recent times, but also in terms of mapping out the ethical relevance of HIV/AIDS in relation to high‐income countries (HICs) and low‐ and middle‐income countries (LMICs). With the attempt to eradicate polio and smallpox and the development of effective vaccines and antibiotics, the threat of serious infectious diseases – besides the incidence of occasional outbreaks or areas of endemic tuberculosis – was considered to be minimal by the late twentieth century. However, with the emergence of HIV/AIDS, a whole series of medical and ethical issues associated with infectious diseases that were thought to be outdated returned with force. HIV/AIDS also brought many of the political, economic, and social dimensions of health to the fore, involving central ethical issues of background justice that extend well beyond the individual patient–doctor relationship. With the demonstrated ability to devastate entire populations, HIV/AIDS also has great ethical relevance for policy and regulatory debates on public health and needs to be discussed keeping in mind background conditions of justice, insofar as they pertain to the economic and health inequalities that exist between populations.