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The Real Cost of Development
A Treatment Issues Editorial

July/August 2001

The pharmaceutical industry just doesn't get it. Here we are on the cusp of a revolution in medicine, with genomic insights likely to yield a generation of medicinal products safer and more effective than any before; with burgeoning markets, record profits and a consumer culture increasingly comfortable with drugs as a part of everyday life -- and humanity is facing an epoch of disease beyond historical precedents. HIV, tuberculosis, malaria: these problems and more are crying for medical, industrial and economic innovations -- but the corporate directors behind the pharmaceutical industry can't get past their greedy obsession to own, control and milk the life out of every cash cow they can corral.

Before the African AIDS crisis finally erupted onto international TV screens last year, the world's corporate brain was busily wiring up a global legal system to assure, among other things, universally enforceable patent protections for corporate intellectual property. Big Pharma was especially anxious to finally nail down the right to market their drugs on a universal, and to every extent possible, perpetual basis. The crucial issue for them was extending patent protections to countries that had traditionally allowed generic drug makers to run free. And despite the violent scene at the Seattle meeting of the World Trade Organization in 1999, the future looked rosy. Then AIDS got in the way. Activists from countries overrun by the HIV plague started demanding that the new trade rules be nullified because they kept lifesaving HIV drugs from reaching their dying friends and families. It was an easy-to-understand issue, and the media and the public paid attention, ultimately pressuring the industry to drop an ugly lawsuit against South Africa.

But Big Pharma cooked its own goose. In the propaganda war over reasonable and unreasonable profits, industry mouthpieces invariably pander to ignorance. They spin teary tales of the onerous effort Pharma expends to bring just one new health-giving drug to the poor children and grandmothers who stoically await succor. (A spokeswoman for PhRMA actually recently implored consumers to "Pray the companies will always be successful.") But it only takes one story on the nightly news about seniors bussing north to seek affordable medicine in Canada, for these silly PR efforts to lose all credibility.

The truth is, if a cure, or a vaccine, or even a drug that doesn't give you nightmares or gas ever comes along, it will undoubtedly come from the for-profit sector. The drug companies make drugs. They're quite good at it and they have a lot of money to spend on developing new drugs -- money that comes from selling the drugs they've already developed. It's depressingly naive to think otherwise. But because of the industry's obdurate greed and inept PR, it's now commonly held lore that the drug industry is simply a usurper and exploiter of other people's research, driven to drain unconscionable monopoly profits from desperate and gullible people. That last bit, of course, is largely true. And that's the problem.

For an industry that celebrates innovation, the pharmaceuticals have been remarkably slow-witted about rethinking their devotion to trade rules that suffocate humane commerce in the goods and ideas they claim to own. Ownership at all costs -- when the cost is measured in millions of lives -- is not defensible or acceptable. The fall of communism didn't give the winners a license to act like 19th Century robber barons again. We need open discussion about reasonable and unreasonable profits -- not propaganda. We need creative economic proposals, like Jean Lanjouw's idea to stimulate tiered zones of patent protection. We need political leaders who defend the aspirations of people around the world to lead healthy and productive lives; who proclaim the right of people, through government, to protect themselves from economic and cultural abuse. And we need to hold out for a "new world order" that's able to reward innovators without punishing the rest of us.

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