However legal entry into Britain is not easy and straightforward. When possible, obtaining a work permit, even for low-qualified positions, is challenging. Many migrants are aware of these difficulties and this is where “traffickers” (often family members of relatives, though organised trafficking can’t be ignored or denied) comes in as facilitators. They may act coercively or on the promise of a job in exchange of a sum of money. Once in-country, opportunities are limited because of employment and immigration laws. Sex work often remains the only prospect to make a living.

Perception of the situation of women in the sex industry differs according to different worldviews. For some support organisations, women are victims. For other, choosing to be a sex worker is an expression of free will and in many cases empowering, allowing women to support themselves and their family and sometimes escape difficult situation at home. It certainly isn’t neither/or but many academic research concludes that “women as victims” is a far too simplistic conception.

The legislator under the pressure of some support organisations and the public opinion, often manipulated by the media, has adopted an approach that penalises women’s clients whilst also criminalising the worker.

The police has admitted the limitations of the current legal framework but still carries on with interventions (from which they financially benefit) such as “Pentameter”, which led to few arrests of real traffickers and have limited, if any impact on migration and trafficking. Meanwhile, women are put in a situation where they have to admit being trafficked or sex-worker with the respective consequence of being sent back home or to jail.

The current legal approach to human trafficking and sexual exploitation of women ignores human agency and the complexity of women’s situation and is therefore inefficient. A proper framework for intervention would need systematic and systemic understanding of those that the law allegedly wants to protect.

2010 will be remembered as the year when the results of the CAPRISA trial that followed those of the Thai vaccine trial in 2009 reshaped the biomedical approach to HIV prevention. These are also the years in which HIV prevention has been both at a turning point and in turmoil with repeated assaults on populations at risk, notably in countries with high HIV prevalence and an economic crisis rewriting the funding agenda. Further trials of new prevention technologies (such as Pre-Exposure Prophylaxis) and a recognition that treatment can contribute to prevention, all happening against a background of economic recession are creating confusion and dilemmas amongst advocates, funders and beneficiaries as to what should be done next to successfully contain and quell the HIV epidemic.

The tenofovir-based microbicide tested in the CAPRISA trial is an obvious way forward but it is widely acknowledged that more trials are needed to confirm the study’s results and to ensure that the effect observed in this one trial can be confirmed in different settings and countries and to assess easier ways to use the product. If confirmed, this microbicide would be the first women-controlled HIV prevention tool.

But this is where promising clinical science has hit a snag. A number of trials have been in the planning pipeline for some time already, even before the results of the CAPRISA study were known. All have the potential to provide critical information about the product acceptability, use and effectiveness, information that is necessary to license the product. But less than 40% of the money needed (about USD 150 million) to conduct these trials has been committed or pledged by donors.

This is neither satisfactory nor acceptable. Insufficient funding could not only limit and slow down the development of the product, but it also leaves scientific decisions at the mercy of economics rather than hard scientific evidences. And haven’t we been told enough that scientific and clinical research should be evidences-based?

Whilst INGOs, donors, politicians, and philanthropists are being cajoled into supporting these much needed studies with money that is mostly ours, more than 7,000 new infections are occurring every day, a large majority of them in Sub-Saharan Africa, disproportionately affecting women whose urgent need for an HIV prevention tool they can control could be fulfilled with an efficient tenofovir-based microbicide.

In addition, the reticence towards identifying and committing funds to cover the necessary studies places scientists in a position where they have to support one study rather than another because funding is limited and investments need to be prioritised in times of global recession and a massive bank bailout. The message is clear: there is no money for HIV, only for bankers, as only they can help the economic recovery.

The irony is that a small investment in the tenofovir trials could make a huge and rapid economic difference. Many scientists, NGOs and activists (with some exceptions) have bought into the argument that there is not enough money to adequately address the HIV epidemic and are prepared to compromise on the science fearing that raising concerns or calling for more support may jeopardise the little money available.

As a scientist, activist, advocate, and an individual directly affected by the HIV epidemic, I can’t accept giving up or caving in to the general apathy, resignation and funder’s whim. The HIV epidemic can be dramatically curbed within a few years if we decide to give priority to prevention and match funding and policy accordingly. Letting ourselves be led by economic interests or twisting science’s arm will not buy us out of the epidemic.

Published on openDemocracy on 25 October 2010

The definition, relevance and even existence of globalisation (see Bayliss, 2008, pp. 10-11 for a summary or the sceptical view of globalisation) are the subjects of impassioned discussions. For the purpose of this essay we will consider a contemporary globalisation as defined by Manfred Steger as “the expansion and intensification of social relations and consciousness across world-time and world-space” (Steger, 2009, p. 15). This globalisation is sustained and driven by a set of processes involving economic, technological, political and cultural shifts and is characterised by the stretching and intensification of human activities and the increased speed at which these activities are conducted with the consequences that distant events in one place may have a massive impact elsewhere (Harriss, 2000, pp. 347-348).

Globalisation is palpably at work in many sectors of human activity and is typically multidimensional (Harriss, 2000, pp. 353-359; Bayliss, 2008, p. 21; Steger, 2009). We will consider four chief dimensions of globalisation.

The first is economic: with the triumph of capitalism over socialism and the self-regulated market as a development compass, globalisation inaugurates the emergence of a global economy and the internationalisation of trade and finance characterised by industrialisation, transnational exchanges, and delocalisation of production but market integration.

However, economic choices result in part from political decision; this is the second dimension of globalisation often characterised by the demise of the nation-state and the birth of global politics and policies and global governance.

Politics is inseparable from the cultural and social context in which it happens and which constitute the third dimension of globalisation characterised both by a homogenisation of cultures through migrations, communication and exchange networks but also the emergence of strong regional an ethnic identities with various outcomes.

Crucially, human activities do not happen in a vacuum but within the confines of the planet Earth and therefore another dimension of globalisation is environmental. There, the globalisation processes, which both depends and impacts on the way natural resources are managed and exploited, has significant repercussions on sustainable development and by extension sustainable globalisation.

An Asian bride is getting wed in Angkhor Wat, Cambodia. Rich and poor side by side, globalisation creates a new North/South divide. Photo (C) peripheries.

With this in mind, different views of globalisation echoing different views of development (developed in Thomas, 2000) have led to different accounts of globalisation and its sustainability (McGrew, 2000; Bayliss, 2008, pp. 6-8). Whereas the Neo-liberals see globalisation mainly from an economic standpoint as a new epoch marked by the triumph of capitalism, a single market economy where capital flows freely and a global competition benefiting all, the Radicals see the continuation of Western imperialism, the perpetuation of a divide between “core and periphery” in place of “North/South divide” and capital replacing military power. To the Neo-liberal belief in a closer integration of markets, a borderless economy that spreads affluence through a trickledown effect and the fading away of the distinction between North and South, the Radicals oppose the impossibility to carry on with a growing divide between rich and poor, growing social exclusion and alienation, and the abandon of developing economies; global dependence is opposed to global interdependence. Likewise, the Neo-liberals hold that economic changes leads to a progressive democratisation of political life, a new division of labour and a positive homogenisation of cultures along the “American Way of Life” welcomed by social theorist like Francis Fukuyama, who equates the Americanisation of the world with the expansion of democracy (Steger, 2009, p. 75).

However, the Radicals have a point when objecting that this cosmopolitan outlook, driven by a technological revolution marked by the development of communication means that reduce distances between places and people (from air travel to the Internet), remains out of reach for most of the developing world. Far from unifying the world, the subordination of social relations to economic relations identified by Karl Polanyi as a key element of the Great Transformation (quoted in Harriss, 2000, p. 327), has led to social exclusion and the development of nationalism and politics of identity often triggering ethnic conflicts. As Manuel Castells puts it “Along with the technological revolution. The transformation of capitalism, and the demise of statism, we have experienced in the last quarter of the century the widespread surge of powerful expressions of collective identity that challenges globalization and cosmopolitanism on behalf of cultural singularity and people’s control over their lives and environment” (quoted in Allen & Eade, 2000, p. 503).

The role and power of the state in a globalised world are perceived differently. Whereas Neo-liberals foresee the demise of the state and the emergence of market-lead global policies, the Radicals foresee the demise of the welfare state and its safety nets under the attack of all-powerful Trans-National Corporations (TNC). From livelihoods to conflict, it is ultimately the environment that suffers of benefits from globalisation. Here too views diverge between Neo-liberals and Radicals. Whilst the former see the environment as a commodity that can be valued and managed along classical economic principles, the latter denounce the environmental damages caused by the over exploitation and mismanagement of natural resources, the pollution and the social and cultural disruption caused by industrialisation and the market economy (Woodhouse, 2000, p. 159).

Whilst Neo-liberals and Radicals have clearly opposite views on the possibility to achieve a sustainable globalisation, a third “Transformationalist” analysis rejects both accounts and offers a different narrative and outcome for globalisation (McGrew, 2000, pp. 348-352). The Transformationalists see globalisation as a historically unique event (McGrew, 2000, p. 351). They recognise the problem identified by both Neo-liberals and Radicals but portray globalisation as a complex and dynamic phenomenon leading to a different role for the state and to the birth of a transnational civic consciousness.

The growth in interconnection is leading developing countries to compete with Western economies, to a redistribution of power and a shift in the configuration of global relations at all levels. Power inequality and access to resources still exist but they no longer mirror the North/South divide. National development is now connected to the world order and domestic and international matters can no longer be dealt with in isolation. In short, it is the end of the old Westphalian order (Bayliss, 2008, p. 23) and the birth of integrated economic and social policies. Hence, international cooperation is becoming necessary to achieve a sustainable management of the environment. Cooperation and global governance are the keywords that will make sustainable globalisation a realisable goal.

These three views of globalisation, its benefits and shortcomings have led to four responses (McGrew, 2000, p. 360; Bayliss, 2008, pp. 6-7). The first is to promote further the market economy with the belief that modernisation and industrialisation is leading to economic growth, democratisation and a better life, the so-called “virtuous cycle” of liberal democratic democratisation and “good governance” (Potter, 2000, pp. 374-381).

The second is to regulate the globalisation process to provide developing states with fairer trade conditions. Incidentally, developing states have shown that they can “use the system” to ensure fairer representation and fairer rights (See for example the use of the TRIPS agreement by Thailand).

The third is to built on the 1960’s ideas of “Tiersmondism” with the aim of developing sustainable regional models of globalisation that will enhance the power of local organisations within the global economy (McGrew, 2000, p. 361) as did Malaysia with its multimedia super corridor. The last is to resist globalisation. Ironically building on the development of a trans-national civil society made possible by technological developments, and the idea of Justice Globalism (Steger, 2009), social movements are promoting a range of alternative models of development based on a “globalisation from below” (McGrew, 2000, p. 362). More radical organisations such as Al-Qaida have opted for a more drastic approach based on the use of global terror.

“The process of globalisation has been a long one and there is no reason to suppose that it is over yet” writes Michael Nicholson (2002). Its sustainability, in the broad sense of being conducive to social justice, human security and environmental protection, hinges on how we perceive and respond to it. What globalisation has achieved so far is an area where not only collecting accurate data is difficult but where facts and figures can be interpreted one way or another to support one side of the argument. If the income ratio between the richest and the poorest countries has arisen from 44 to 1 in 1973 to 74 to 1 twenty-five years later (Steger, 2009), at the same time, millions have been taken out of poverty (Zakaria, 2009).

Obesity in Asia, a disease of the developped world is turning into an epidemic worldwide.

China, a recipient of food aid until 2005, is now a major donor. The number of international wars has decreased and thought their nature has changed (Bayliss, 2008, pp. 212-224) since 1992 the number of refugees has declined whilst the number of internally displaced people has stabilised (IDMC, 2009, p. 15). The environment and in particular the effect of globalisation on climate change remains a major issue. However, world governments and in particular the US, the world’s largest polluter, have realised that this was a global problem in need of a global solution. China, which continuous growth is driving an increase in the number of cars has demonstrated its commitment to greener option as showed by Al Gore in “An Inconvenient Truth” (Guggenheim, 2006).

This is where it is useful to recall Polanyi’s observation of society’s reaction against the ravage of the satanic mill: “Society protected itself against the perils inherent in a self regulating market system” (quoted in Harriss, 2000 p. 328), and to trust that mankind would again react to protect itself. Assessing globalisation is a battlefield where Hirschman’s defence of industrialisation and Kitching’s “conventional wisdom” (Chataway & Allen, 2000) collide with Korten’s “global threefold human crisis of deepening poverty, social disintegration and environmental destruction” (Korten, 2001, p. 28). A third way, close to the Transformationalist approach explains globalisation’s failures as the result of tensions between global problems and national politics that cannot produce global solutions. “We have globalized the economies of nations. Trade, travel and tourism are bringing people together. Technology has created worldwide supply chains, companies and customers. But our politics remains resolutely national” (Zakaria, 2009).

All along, it is important to remember that globalisation is not only about structures but is also about agencies. TNC certainly operate behind globalisation, but at the forefront there are men and women with needs and aspirations, strengths and weaknesses, morals and ethics. Too often human agency as a driving force behind globalisation is taken out of the global equation. Nobody is immune to globalisation and its effects and it is important to remember that “Globalisation is the product of our collective action, and it is in our collective interest to generate the will and capacity to fashion it into a creative force. [...] The impact of the ideas and actions of individuals and countries can and do have unimaginable consequences for the rest of the world. [...] It is therefore vital that we strive to live equitably. [...] Humanity must evolve a new set of ethics, a new approach to sharing rather than profiting” as Lyonpo Jigme Thinley, former Bhutan’s foreign minister wrote.

It is our personal ethics that will decide if a sustainable globalisation is a realisable goal.

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