Read the article and answer the following questions. The number of people living with HIV has grown by a factor of 4.5 times since 1990 when approximately 7.5 million people were HIV-positive. According to the World Health Organization (WHO), there were approximately 33 million people living with HIV worldwide in 2008, including 30.8 million adults and 2.2 million children. An additional 2.7 million people are newly infected with HIV every year, which represents a daily new infection rate of 7,397 persons. Two million people die every year as a result of AIDS, which represents a daily death rate of 5,479 persons. Most new infections and deaths are due to inadequate access to HIV prevention and treatment services. As a result, the WHO has concluded that the HIV pandemic remains the most serious of infectious disease challenges to public health. The HIV epidemic outside of sub-Saharan Africa, while serious, remains primarily concentrated among at-risk populations, such as men who have sexual relations with other men, drug users, and sex workers and their partners. However, the epidemic in sub-Saharan Africa is generalized throughout all strata of the population. More than 22.5 million people in sub-Saharan Africa, 5 percent of the entire adult population in the region, are infected with HIV, an increase of more than 4.5 million since 2001. Nine states in the region have adult infection rates in excess of 10 percent. These states are Botswana (25.2 percent), Lesotho (23.5 percent), Malawi (12.7 percent), Mozambique (12.5 per- cent), Namibia (15.3 percent), South Africa (16.2 percent), Swaziland (25.9 percent), Zambia (15.6 percent), and Zimbabwe (18.1 percent). By comparison, the highest infection rate in the Western Hemisphere is Haiti at 2.2 percent of the adult population. Despite declines in the rate of new infections, the death toll as a result of AIDS increased from 1.4 million in 2001 to 1.6 million in 2007. Seventy-six percent of all deaths due to AIDS worldwide occur in sub-Saharan Africa, and more than 25 million people living in the region have perished to date in the pandemic. These deaths have resulted in 11.4 million orphans. Treatment of people infected with HIV has benefited in recent years with the development of antiretroviral drugs (ARV). ARVs are medications used to treat infections by retroviruses such as HIV. When several such drugs, typically three or four, are taken in combination, the approach is known as highly active antiretroviral therapy (HAART). HAART first became available in the developed world in 1996 and resulted in an 84 percent drop in the HIV/ AIDS death rate. At a cost of $15,000 per person per year, ARVs were too expensive for the majority of HIV patients in the developing world. Five years after HAART was introduced, fewer than 8,000 people in sub-Saharan Africa were receiving ARVs. Widespread introduction in the developing world could only occur if the price of ARVs was reduced. In early 2000, an Indian pharmaceutical company began to produce generic ARVs that were identical to the brand name drugs produced by companies in the developed world but significantly cheaper. This sparked a price war between branded and generic drug manufacturers, which resulted in the lowering of prices for ARVs. By June 2001, ARVs were available in generic form from Indian manufacturers for as little as $295. By 2008, the price had fallen to $88 per person per year. In addition to lowering prices, branded manufacturers of ARVs responded by filing lawsuits against generic manu- facturers. The first such lawsuit to proceed to trial, the so-called "AIDS Medicine Trial," opened in Johannesburg, South Africa, in March 2001. The Pharmaceutical Manu- facturers' Association of South Africa and 39 global drug companies filed this action in 1998 challenging a 1997 South African law that permitted the national health minister to ignore patent rights to obtain essential medicines, including ARVs, at cheaper prices through the purchase of generic alternatives or purchasing name brand drugs in states where they are cheaper. The pharmaceutical companies abandoned their lawsuit on April 19, 2001, after a wave of bad publicity, including condemnation by the European Parliament and a petition signed by 300,000 people in 130 states denouncing the lawsuit. Later in the month, Merck announced that it would sell two ARVs (Crixivan and Sustiva) in the developing world at a 90 percent discount. The price of Crixivan was subsequently reduced from $6,016 per patient per year to $600, and Sustiva's price was reduced from $4,730 per patient per year to $500. In addition, GlaxoSmithKline granted a voluntary license to a South African generics manufacturer to share the rights to three of its ARVs (AZT, 3TC, and Com-bivir) without charge. Despite this progress, continuing success of HIV/ AIDS prevention and treatment programs remains uncertain. In April 2007, United Nations Program on HIV/AIDS estimated that spending would need to increase from $8 billion to $20 billion to make access to ARVs universal. Considering that less than $14 billion was invested in HIV/AIDS programs in 2008, a funding shortfall appears inevitable, especially given economic recession and deepening budget crisis confronting many states. Another financial barrier to universal treatment is that infected individuals who begin taking ARVs must remain on them for the rest of their lives. This places enormous pressures on governments and international organizations to ensure consistent funding for access to ARVs for a period of time that will most likely span several decades. This also places pressure on pharma- ceutical manufacturers who may be confronted by the specter of ARV-immune strains of HIV due to incom- plete or discontinued treatment. In June 2008, the WHO reported that it had reached its goal set forth in 2002 to guarantee ARV access to three million people infected with HIV in the developing world. More than 2.2 million of these people are located in sub- Saharan Africa. However, only one in ten of the 2.1 million infected children under the age of 15 are receiving ARVs and for every two people who start drug treatment, another five people are infected worldwide. In November 2009, the International AIDS Vaccine Initiative concluded that the HIV pandemic would remain out of control by its 50th anniversary in 2031 unless funding was increased to $35 billion per year. The initiative predicted that the developed world and rapidly developing states such as Brazil, China, India, Mexico, and Russia would be able to finance efforts to combat their domestic epidemics. However, the vast majority of states in the developing world would remain heavily dependent on the developed world, international organizations, private donors, and pharmaceutical compa- nies to assist in combating the pandemic in the foreseeable future. ANSWER THE FOLLOWING QUESTIONS 1. Applying teleological frameworks for ethical thinking, what is your analysis of the pharmaceutical industry's behavior prior to and after 2001? 2. Based on teleological frameworks, what is the appro- priate course of action for the industry to take in the future with respect to the ongoing HIV/AIDS crisis? 3. Applying deontological frameworks for ethical think- ing, what is your analysis of the pharmaceutical industry's behavior prior to and after 2001? 4. Based on deontological frameworks, what is the appropri- ate course of action for the industry to take in the future with respect to the ongoing HIV/AIDS crisis