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Wednesday, May 09, 2007

Pharmaceutical Giants vs the Poor

I saw a story in the news today about a deal brokered to help poor countries get the AIDS drugs they need but can't afford ... Bill Clinton Announces AIDS Drug Deals.

The questionable ethics of pharmaceutical companies has been an issue for a long time and pops up not only in the news but also in fiction, in such works as John le Carré's novel, The Constant Gardener, and tv shows like The West Wing (In This White House), where the drug companies are accused of being more motivated to cure white men of erectile dysfunction than balck men of AIDS.

There was a very interesting and disturbing story on this subject published in the March 29, 2006 issue of The New York Times - The scandal of 'poor people's diseases'. Here's the beginning of the story ...

It's hard to imagine how a Rwandan woman with AIDS might be considered lucky, but in a way, she is. Effective drugs exist to treat her disease, and their price has dropped by more than 98 percent in the last six years. Research speeds ahead on treatments and vaccines. Although much more needs to be done, the world takes AIDS seriously: rich countries provide money, drug companies have lowered their prices and accepted generic competition, and poor countries like Rwanda are scrambling to provide free treatment to all who need it. None of this is true for people who suffer from malaria, tuberculosis, or a host of other diseases that citizens of rich countries haven't even heard of—like kala azar, sleeping sickness and Chagas disease. Even children with AIDS are out of luck compared to their parents.

All these diseases have been abandoned in some important way. For some, no good treatments exist and there is little attempt to invent them. For others, effective drugs exist, but aren't being made. Or those drugs are so expensive that poor people and poor countries have no hope of buying them. Most of these diseases are easily preventable and completely curable. Saving the lives of their sufferers is much cheaper and easier than treating AIDS. Yet millions of people die of them. Why the difference?

As fatal illnesses go, AIDS is the best one for a poor person to catch because rich people get it, too. The other diseases might as well hang out a sign: "Poor People Only." They offer researchers no profitable market. They have little political constituency. There is no well-connected group of sufferers who stage protests and lobby pharmaceutical companies and Congress to develop better medicines or make existing ones more available. The response to disease is political: the illnesses of invisible people usually stay invisible .....


Brazil, where the Pope is now visiting, was one of the first poor countries to have guarneteed all patients with AIDS free treatment ... coincidently, there was another story in the news just a while ago about Brazil - Brazil bypasses patent on Merck AIDS drug ...

President Luiz Inacio Lula da Silva on Friday authorized Brazil to break the patent on an AIDS drug made by Merck & Co. Inc. and import a generic version from India instead. It was the first time Brazil bypassed a patent to acquire cheaper drugs for its AIDS prevention program, a step recently taken by Thailand .....

Brazil's government provides free universal access to AIDS drugs and distributes condoms and syringes free as part of a prevention program the United Nations has lauded. The program helped Brazil slow infection rates and avoid what experts predicted would become an AIDS epidemic. Infection rates among adults have stabilized at about 0.6 percent -- similar to the United States ......


I hope the program President Clinton is sponsoring will help with the tension between protecting intellectual property and saving lives, but at the end of the day, saving lives seems vastly more important.


5 Comments:

Blogger Jeff said...

Boy, this is so true. My friend Joseph could tell you a lot of dirty things he'd seen and heard about the pharmaceutical industry, in which he worked as an executive for quite some time... The marketing of blood products not sufficiently tested and treated for possible HIV-contamination, because it was too expensive to do, and not doing it allowed a company to grab market share from competitors who did test for it... The distribution of bad batches of drugs that were produced off-spec in dribs and drabs worldwide in order to minimize the risk of getting caught, and as a cynical ploy to avoid the accusation that they were targeting poorer countries with bad batches, etc...

The ED industry, and all the ridiculous amounts of money spent on it! Once I went to visit my pill-pushing GP about a positive test that had come up for me for coronary diesease (turned out to false, luckily), and he kept me waiting and waiting and waiting while I could hear him in the next room talking on and on to some geezer and his poor put-upon wife about viagra. Viagra... Sheesh. Why don't you just try doing some Kegel exercises, all of you lazybones?

3:37 PM  
Blogger crystal said...

Jeff knows about Kegel exercises! :-)

When I worked for a while at the hospital for the anesthesiologists, drug company reps would come in all the time to get them to use certain drugs. They'd bring food, objects, even offer trips to persuade them to use one drug over another.

They also do injustice to indigenous people where they find new drugs (like from plants). I remember reading about the Madagascar periwinnkle once - it's a flower that local shamans used to treat patients. They told the drug company guys about it, who took it and made millions from it as an anti-cancer drug, but the local people never saw a dime from it.

4:41 PM  
Blogger Jeff said...

That was another aspect Joe told me about. All the blatant "backsheesh" (bribery) associated with the business.

7:19 PM  
Blogger Deacon Denny said...

I was over in Africa last summer. The first part of the trip I had the opportunity to visit Tanzania and Kenya as part of a group with Catholic Relief Services, and we visited a number of program sites that were combatting AIDS.

There are a lot of good programs out there, and we spent time with AIDS victims and their families. But two things really hit me: 1) for all the good work being done, it's only a small drop in the bucket -- the AIDS epidemic is completely out of control in places like Africa, and it appears that the disease will just run its course; and 2) for all the good that is done with those wonder drugs (and they really are amazing; they really work wonders), the patient has to take those drugs for the rest of his/her life. In other words, if the US cuts AIDS funding, or even if it keeps funding right where it is now (with inflation that makes for a cut), then those patients will just die. Sobering.

12:25 PM  
Blogger crystal said...

Hi Denny,

That one story about Brazil said ...

Brazil's government provides free universal access to AIDS drugs and distributes condoms and syringes free as part of a prevention program the United Nations has lauded. The program helped Brazil slow infection rates and avoid what experts predicted would become an AIDS epidemic. Infection rates among adults have stabilized at about 0.6 percent -- similar to the United States ...

I wonder why if it can be stabilized in Brazil, it can't other places? I wonder also how it's going in India. I remember a story on 60 years ago that India was the country with the fastest rising rate of AIDs ... but I think Bill Gates spent some money there (on education only, not on treatment) and maybe that made a difference? It's all pretty awful.

2:09 PM  

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