Another more disturbing advert for sex and health is the HIV/AIDS pandemic. As World Aids Day approached, media corporations such as the BBC put on special programmes about the disease. The role of corporations in either contributing to or alleviating the spread and impact of the disease was not often covered in the mass media. However, a number of initiatives and reports were announced at the time.

On World Aids Day the World Economic Forum (WEF) reported that business was not yet playing a significant positive role in the fight against HIV/AIDS. They surveyed 8000 corporate executives on their perceptions of the impacts of the disease on their business and the appropriateness of their response. 47% believed that HIV will have some impact on their business; this number is much lower in countries that to date have not been hard-hit by HIV. However, while many firms are concerned about current or future impacts of AIDS on their businesses and their communities, the study found that few have implemented measures to counter the threat. Fewer than 6% of responding companies had formally-approved, written HIV policies, but over a third nevertheless believe their current policies and programmes are sufficient and effective. Thus WEF's Dr. Kate Taylor argued that "despite the ground-breaking efforts undertaken by leading companies, a great deal more needs to be done by the broader business community." 8

The United Nations published similar findings just two weeks earlier. The United Nations Research Institute for Social Development (UNRISD), not only looked at corporate perceptions of the problem but also the steps taken towards implementing policies and programmes to combat HIV/AIDS and how these compare with international standards. 9 The study was co-ordinated by co-author of this review, Dr. Jem Bendell. The report documented a wide variation in specific HIV/AIDS prevention and mitigation components of corporate policies and programmes, and the extent of coverage provided to employees and their dependents. It explained that communities, suppliers and subcontractors are rarely covered by policies and programmes, even though most company respondents consider that HIV/AIDS-and the risks it poses to their workplaces and other business operations-must be tackled beyond the workplace. In addition, most companies do not consider how their normal operations and strategies affect poverty, and thus HIV/AIDS. This is despite the UN Declaration of Commitment on HIV/AIDS, which emphasized the importance of poverty and sustainable development on the spread and impact of HIV/AIDS. A new book published in the autumn also suggested the importance of the political economy of HIV/AIDS. 10

The report argued not only that the corporate sector is just beginning to wake up to the risks posed to business operations by HIV/AIDS but that it has still to awaken to its wider responsibilities, which arise from its influence over those conditions that encourage HIV/AIDS prevalence and undermine possibilities for mitigating its effects. That influence derives from some corporations' reliance on migrant labour, subcontracting, exerting downward pressure on production prices and wages, tax management and evasion, as well as negative influence over the international financial and trade institutions. He suggests that dialogue and action on the interface between business and HIV/AIDS has too often focused on the business response to HIV/AIDS, rather than HIV/AIDS' response to business.

The Observer newspaper highlighted this critical analysis when covering the report. 11 However, the report also mapped out a possible way for encouraging wider engagement by large companies. As HIV/AIDS may pose significant risks to current and future corporate performance, so the financial community should increasingly be interested in whether the companies they invest in are attuned to that risk and managing it accordingly. Moreover, as this risk cannot be managed effectively by individual corporate action, it requires an economy-wide response. Therefore the UNRISD report makes the case for joint action from institutional investors such as pension funds, which could institutionalize more progressive corporate responses.

Although the financial community was still not responding as it might, some companies were beginning to address the risks to their business by becoming more involved in the communities they operate in. Tata Steel was awarded a prize for "action in the community" against HIV/AIDS, and explained that it was essential to promote awareness and treatment in the community if long-term risks to business are to be managed. 12 Six other companies - AngloAmerican, Chevron Texaco, DaimlerChrysler, Eskom, Heineken, and Lafarge - joined with them in announcing that they will use their facilities, employees and other infrastructure to expand workplace HIV/AIDS prevention and treatment programs into communities where they operate. 13 Such initiatives are being promoted by groups like the International Labour Office (ILO) and the Global Fund against AIDS, Tuberculosis and Malaria, as a practical response to situations where the State provision of services to communities is limited or non-existent and where some companies operating close to those communities already have HIV/AIDS programmes. Professor Richard Feacham, of the Global Fund, has expressed his hope that public-private partnership and co-investment in health services will be included in future proposals to the Fund. Therefore, we may increasingly see public and charitable funds being provided to corporations to run public health services.

For analysts of corporate citizenship and international development, this raises a number of issues. To what extent is the corporate provision of health services an appropriate response to the right the health? Is it sustainable, when the business could leave, or its management change its approach to these issues and curtail the programmes? To what extent will such projects help promote and not undermine the development of public services, independent of the continued involvement of the corporation? As corporations may become recipients of funding from charitable and/or government sources then how this money is dispersed will be keenly watched. Is it cost effective? Are the supported programmes compliant with all laws and best practices such as those established by the ILO? Some of these concerns were already being raised. The conclusion from one workshop on this issue was that: "companies should not take on Government responsibilities but rather support Communities to be self-reliant." 14

Debates about corporate citizenship and HIV/AIDS parallels broader debates about the role of public-private partnerships in achieving social objectives. In November, at the UNRISD conference on corporate responsibility, in summarising her forthcoming report, Ann Zammit highlighted growing concern about such partnerships for the way they can undermine alternative approaches to dealing with the systemic problems with the global economy that create maldevelopment. On the AIDS issue, the charity Action Aid has already accused pharmaceutical companies of using charitable donations of drugs as part of a strategy to undermine calls for curtailing patents and promoting domestic production capacities in developing countries.

A number of groups had been campaigning for an interpretation of the Trade Related Aspects of Intellectual Property (TRIPS) Agreement, and accusing corporations of unhelpful lobbying, an issue covered in previous World Reviews in the Journal of Corporate Citizenship, and the section 'Accountability is Responsibility.' Responding to this campaign Hank McKinnell, CEO of the major pharmaceutical company Pfizer wrote that he supported "the efforts of the WTO to allow the poorest nations in the world to manufacture or import drugs needed to combat epidemics like HIV/AIDS at the lowest possible cost." 15 However, the President of Oxfam America, Raymond Offenheiser countered that:

"Pfizer and other drug companies lobby heavily for provisions in the WTO patent rules and bilateral/regional free trade agreements that block availability of generics, so that in the absence of competition they can have a monopoly market position and the resultant monopoly profits. In countries where resources devoted to healthcare are scarce, lack of competition and monopoly pricing by branded drug companies means that medicines are priced out of reach of the majority of patients. To help patients in poor countries, Pfizer should stop lobbying for policy outcomes that undermine their access to essential drugs." 16

These exchanges were in the run up to Cancun ministerial of the World Trade Organisation (WTO) where a decision on TRIPS and access to medicines needed to be reached. One was reached, which was called "historic" by WTO Director-General Supachai Panitchpakdi saying it would allow "poorer countries to make full use of the flexibilities in the WTO's intellectual property rules in order to deal with the diseases that ravage their people." 17 However, there was resistance to the agreement by many poorer countries until the very end.

Campaigners argued that the agreement means that countries wanting to import cheap generics must jump through multiple hoops to prove they are in need, unable to afford patented drugs and incapable of producing the medicines domestically. Meanwhile, there is no guarantee that there will be a sufficient supply of drugs for them to buy, since the deal also puts up hurdles for countries wanting to export. "A 'gift' tightly bound in red tape," declared a coalition of NGOs, including Médecins Sans Frontières (MSF) and Third World Network. 18 A key concern was that after 2005, it will become even more difficult for countries such as India to export generic copies of patented drugs. The "deal was designed to offer comfort to the US and the Western pharmaceutical industry," said Ellen Hoen of MSF. "Unfortunately, it offers little comfort for poor patients. Global patent rules will continue to drive up the price of medicines." 19

This debate again highlighted concerns about corporate involvement in the trade policies of governments. This concern extended into the area of the fight against HIV/AIDS, when the Senate approved the former CEO of drug company Eli Lilly, Randall Tobias, to head up the US response to HIV/AIDS. Campaigners pointed out that this company is a member of the industry group lobbying against a Canadian initiative to use the agreement reached at the WTO to begin exporting cheap drugs. "Tobias's appointment is a bit like trusting the CEO of ExxonMobil to lead a government effort to promote solar power" wrote Naomi Klein. 20

The dual questions of intellectual property and corporate lobbying were yet to feature in the discourse of those promoting corporate responses to the pandemic. For example, a November search of the website of the Global Business Coalition on HIV/AIDS for a discussion of TRIPS and the WTO process returned no relevant results. The issue is too important to be left off any serious assessment of corporate citizenship for much longer. If the concept of corporate citizenship is to mean anything, it must imply the obligations as well as rights embodied in the notion of citizenship. Property rights, including intellectual property, are upheld by political communities because they are functional to the societies that mandate those political communities. With rights come obligations to those who are affected by the exercising of that right and the society that upholds that right. Therefore, when property rights conflict with other rights, such as the right to life, or health, then we have a problem. More awareness of the political dimensions to the concept of corporate citizenship would be therefore be useful if it is to be a serious concept for scholarship and a progressive one for society.