Damn the Drug Companies, Full Speed Ahead!

It must be weird to live in a country that can, perhaps legitimately, complain about poor news service, and yet have as its mainstay the BBC. The Beeb sucks, perhaps, but watch this eleven-minute clip on the decision of the Thai government to manufacture cheap copies of drugs the government says its citizens need.

Lehrer wouldn’t allow such things to be said on his show. Olbermann would, if he had the eleven minutes to spend on one subject. But drug patents aren’t as sexy as, say, sex scandals with DC madams handing pounds of telephone records to ABC, so it doesn’t rate much time on the nightly news; and I suspect producers would draw a lot of heat from Big Pharma if they made such a forthright case against certain intellectual-property constraints in a Frontline or documentary context.

I’m All Right, Jack, Keep Your Hands Offa My Stash

The recent coup in Thailand continues to have interesting repercussions. Dr. Mongkol na Songkhla, the country’s new health minister, has decided to issue “compulsory licenses” for the manufacture of three drugs he thinks Thai citizens need.

Thailand’s growing world connections are making conditions like diabetes and heart disease more common, and the government health care system is overwhelmed. Bangkok’s main chest hospital spends nearly a fifth of its total budget on Plavix, a heart drug. So Thailand issued a compulsory license for Plavix.

Such licenses are allowed by the WTO under an agreement that gives governments the right to compel manufacture of cheap drugs in a health crisis. The thing is, the agreement grants the governments a lot of discretion.

The language of the agreement is vague. It recommends that governments consult the drug companies first, and requires them to pay a small royalty. But crucially, the government itself can decide what constitutes a health crisis.

The drug companies have always assumed that the Trips exception would only be used for a dire emergency, like HIV/Aids or avian flu.

Issuing a compulsory licence for a heart drug, they say, breaks the spirit of the agreement.

Abbott has now withdrawn all its future products from the Thai market – including a new heat-resistant form of Kaletra which is desperately needed by HIV patients.

This is the kind of action that makes Big Pharma more despicable than any other industry except for weapons manufacturers, whose money comes even more directly from death.

Explain to me, beloved capitalist, how capitalism solves such problems. Or at least how it justfies inaction resulting in deaths because the profit motive was removed.

Get the Right Kind of Sick

It’s interesting that the country and the companies had hammered together some working arrangements on Aids drugs. But when it came to heart problems, I mean, really, you gotta feel the drug companies on this one.

After all, R&D is so expensive (the companies say), and drug development takes a long time, and lots of it doesn’t prove to be usable or can’t get approved by the government. In other words, research and development in the area of drugs is a particularly risky business.

Which is true. That’s why we long ago socialized a lot of the cost. Paul Cawthorne from Medicins Sans Frontiers, who supports the Thai government’s decision, argues that much of the research into new drugs is done in government-funded universities, and that the drug companies spend more on advertising than on R&D.

He is calling for a radical shake-up in the pricing of a whole range of essential drugs, to make them affordable in every country – and he believes Thailand has set an example other governments should follow.

Opponents argue that governments cannot feel free to break the patents on any drugs they choose, just to fund cheap healthcare for their citizens.

That, they say, destroys the incentive to develop new drugs.

Violate the Principle of Profit just to provide cheap healthcare? Horrors! Death and disease? They’re not really an incentive to develop new drugs; there’s only one kind of incentive that matters, and it’s the kind that people mean when they say “incentivize”.

It’s interesting to note that neither the US government nor the World Health Organization has criticized Thailand’s action.

The Good of Society

Chomsky calls it public subsidy, private profit: universities do the research, corporations market and sell. And that’s my fundamental problem with capitalism as an organizing philosophy: it’s basically amoral, but its amoral judgements often lead to immoral actions, and for the basest of purposes.

Certainly the marketplace can be an efficient method of supplying certain kinds of needs. Everyone needs groceries, so distributing them is big business, hypercompetitive with very low profit margins. But this system works because it’s so heavily regulated. I’ll go into a store I don’t know and trust what I buy because I saw their health-inspection certificate on the wall. I expect that the food I’m buying has been inspected along its path to me, and that I’m not depending purely on companies with lawyers and insurance for the safety of my food, because government is enforcing certain standards.

In other areas, too, like energy and transportation, we act more effectively as a community rather than a pile of individuals. And, I would claim, in medicine we should as well. Call it socialized medicine if you will. What I want, and what I believe Americans should demand from their government as soon as we get ourselves extracted from Iraq, is universal health CARE. I don’t want a law that requires me to buy insurance and helps me pay for it. Insurance buys me nothing; health care is what I need, and what everyone will need at some point.

And by the same token I want drug technology to be controlled in ways that are designed to benefit society, to save lives rather than make profit. The concentration of wealth is not advancing humanity or making the world a better place. So how do we justify allowing it to happen?

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