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| December | 06 |
| 2003 |
A lot of people got to feel good about themselves this week. World AIDS Day on Monday gave all sorts the opportunity to show just how much they care about the 42 million HIV positive men, women and children across the planet.
For most, that amounted to little more than wearing their red ribbon. For many of the most committed campaigners, however, it meant chanting a familiar refrain: the evil of the pharmaceutical industry. They charge so much for their drugs, so the story goes, that poor Africans don’t have a hope of treatment. And, to make matters worse, they refuse to allow generic (cheaper copied) versions of the drugs to be distributed. All they are interested in is making a profit over the bodies of the dying.
It’s a seductive argument. But it is dangerous nonsense. The real problem is not the pharmaceutical companies, without which none of the drugs would even exist, but the activists themselves, who are the ones really responsible for prolonging the misery of AIDS sufferers.
The only means by which AIDS will be cured is profit. Without profit, there will be no research, and without research there will be no drugs. It is that simple, and it is the activists who are campaigning, in effect, for an end to research.
The activists’ success has been entirely perverse. Today, around 30 per cent fewer companies are doing research into AIDS than were five years ago, and there is about a one third decline in the number of new products in the pipeline – and this in the context of a steady increase in overall research spending over the same period.
The money involved is mind blowing. In 2001 alone, the pharmaceutical industry spent $30.5 billion on research, and the average drug costs $802 million to research. But the consequence of the anti capitalist activism is that drugs companies now face an uncertain environment for their property rights and potential profit. Why, they ask, should they invest more resources, if the return is non-existent or marginal? And with every less dollar committed to research, the chances of a breakthrough diminish. That is the grotesque responsibility of many of the AIDS activists, who with their every campaign condemn more to die of AIDS.
But the real motivation of many of the activists is not helping AIDS victims, but destroying capitalism. Organisations such as the AIDS Coalition to Unleash Power (ACT UP), the Treatment Action Campaign (TAC) and the Consumer Project on Technology (CPTech) campaign on AIDS, but their agenda is much broader: they are classic anti-capitalist groupings. There are, of course, few more towering examples of capitalism’s success than the giant pharma companies. So the call comes out from the activists for their patented drugs to be released to generics manufacturers who will charge a fraction of the price.
Yet again, though, the consequences of this are dire. If the pharma companies cannot recoup their investment, they will not invest. The generic manufacturers are simply leaches – hugely profitable ones - on that investment. They fork out almost nothing in costs, and reap huge returns on someone else’s intellectual property. And have a guess from where many of the activists get their funding. Spot on: the generics manufacturers. It’s a fabulously poisonous cocktail of supposed angels who behave like devils.
Since 1998, the evil pharma companies – the ones who don’t care about Africa - have given the continent some $2 billion in products and cash. More, that is, than many African states’ entire health care budget (but a lot less than their arms budgets).
Work by Prof Amir Attaran of Harvard shows that most of this issue is a red herring, anyway. As he reports: “...essential medicines are rarely patented in developing countries”. 98.7% of the time, there are no patents on any of the World Health Organisation's list of 325 essential drugs. In other words, the fulminating over pharma companies’ patents concerns 1.3 per cent of the real issue.
That real issue is, as the Director-General of the WHO, Dr. Jong-Wook Lee, has said, when discussing the WHO's goal of providing antiretroviral drugs to three million HIV-positive people in developing countries by 2005, rather different:
“It is not just the issue of money, because clearly if all the money and all the drugs were available today, I doubt whether we could implement it right now because of the weak infrastructures, such as the shortage of nurses and doctors. It is more than just a funding issue”.
But you don’t get win emotional arguments for the anti-capitalist cause by talking about infrstatructure. You do it by blaming evil pharma companies. And prolonging the misery of AIDS sufferers in the process.
MessageSpace
Hear, hear.
But this is the early-21st Century and the normal, good sense of the advanced world has given way, to guilt-ridden angst about the 'evils of capitalism'. It is a diverson from the discredited faith of Socialism / Communism and far more pernicious.
If these people, and their allies in the eco-fascist and anti-globalisation movements (but then, they're all interchangeable) are not defeated then the world will slip back intoa mediaeval slum.
The debate over the future of drug companies is a beautiful illustration of the stupidity and ignorance of chatterers on both the Left and Right. At the same time as my having to listen to people around me echo the fuzzy wibbling of the anti-globalization clowns about the "fair" distribution of AIDS therapies, I also read loony libertarians congratulating themselves on not being shocked by Natalie Solent's silly piece comparing drug companies to slaves.
Giving generics away won't work, but even that famously anti-free-market rag *The Economist* acknowledges that there is a profound crisis in our current profit-based model of drug development. Why not listen to real biomedical scientists for some genuinely radical approaches to both problems?
Health is one area where the market fails. My favourite example is blood donations. Britain's voluntary system had a far smaller problem with HIV contaminating blood banks than either (on the Right) the US---where people (including hard-up drug addicts) were paid for their blood---or (on the Left) France---where a public-sector elite inadvertently condemned fellow citizens to death by their sluggishness in mandating the testing of supplies. (Some have argued that the delay was to allow a French HIV test to be patented first.) Back in the UK, when my local blood service started selling on derived products to the private sector I stopped giving blood.
The most successful and important drug of all time, penicillin, wasn't even patented in the developed country where it was developed, in an academic research institute. Despite the chronic recklessness of those using and prescribing it in the years since, penicillin still saves lives today. 60 years on, people still haven't learned the lesson its history should have taught us.
Every time this subject comes up I feel like I'm sitting in a cave with a bunch of hairy savages. On the Left of me they're hitting the ground with a stick and wailing: "The Market is evil! The Market is evil!"; on the Right they're waving a skeletal limb and cooing: "See the wisdom of The Invisible Hand!". I'm in the middle in a lab coat, scratching my shiny pate and asking "Why don't we see what really works, eh?"
Well, truly & righteously said
Of course, "Pootergeek," the vast majority of US blood is obtained by free donations, just like in the UK. And the contamination largely came from voluntarily donated blood. There are surely other factors that contributed.
It's as silly as blaming the UK's system for BSE, independent of any evidence or reason.
John
This hand-waving criticism of my point about blood contamination is incidental to the main argument over future models for drug development, but I'll deal with it anyway. Your hopeful wording---"There are surely other factors that contributed"---carries a grim irony for people who know what they are talking about.
Many of the early victims of HIV in developed countries were haemophiliacs. Their bodies' tendency to bleed uncontrollably was treated with collected and aggregated blood clotting factors. In the early nineties, in my first paid research job, I was employed by a UK Medical Research Council (MRC) project. The team I was a (lowly) member of followed changes in the immune systems of HIV positive individuals over the course of their disease development. At that time, the vast majority of the patients we studied were haemophiliacs. Anti-Haemophilic Factor (AHF) concentrates used to treat haemophiliacs were obtained from blood. To quote the US Institute of Medicine 1995 report, HIV and the Blood Supply: An Analysis of Crisis Decisionmaking:
"[writing of other pre-HIV blood-borne infections:] Blood from volunteer donors was known to be safer than blood from paid commercial donors (Allen et al. 1959; Eckert 1986)... ...In November 1975, the FDA required that all blood units collected be labeled as from either a paid or volunteer donor (US Comptroller General 1975). At this time (and currently), paid donors were the principal source of plasma for fractionation into blood products such as AHF concentrates"
[my emphases].
Let me simplify:
1. The population most at risk of HIV infection from the blood supply was that group receiving the largest quantities of blood products.
2. The biggest recipients of blood products were haemophiliacs.
3. In the US, the "principal source" of the blood products that those haemophiliacs received was the paid blood donor group.
4. That donor population was---for economic reasons and others---at higher risk of HIV infection than the voluntary donor population.
As for your latter implication that I "blame the US system for [HIV]": that's what's really "silly". Read my original post again. I could have been clearer about what I meant when I talked about "problem[s] with HIV contaminating blood banks", but I didn't think casual readers would be particularly interested in the clinical details of haemophilia and, as I have just admitted, this was a side issue. If you want any more "evidence" or "reason", John, just email me and I'll be happy to oblige.
Incidentally, although I have been working for the MRC again over the past couple of years, the views I have expressed here are mine and not theirs.
"PooterGeek"
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Regards
In my view the debate over the future of drug companies is a beautiful illustration we have given how many debates same as above but they are not affective till date, in short Health is one area where the market fails.
Healths care foundation are spreading all over the world.But its really pathetic to see unawarness of peoples about their healths.Let the peoples rein havoc a bit.
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I think we need to reflect on the world’s response to an unprecedented tragedy, that is of coursed HIV/Aids are robbing communities and nations of their greatest asset to their people.
I think we need to reflect on the world’s response to an unprecedented tragedy, that is of coursed HIV/Aids are robbing communities and nations of their greatest asset to their people.
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I think we need to be planning to control, monitor and regularize health care process.
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