TCS Daily


New Global Villain

By Roger Bate - March 27, 2003 12:00 AM

With the war in Iraq leading to global protests it is perhaps not surprising that Hollywood and the entertainment business has got into the act. Many actors and musicians are notoriously left-wing, and so joining the protests in New York, San Francisco and London was in character - especially since the President leading the campaign is a conservative, and one they feel did not win the election for President.

A more worrying phenomenon is the tendency of the news media and entertainment profession to attack non-political targets that bring so much benefit to America and the rest of the world. Furthermore, their recent attack on the drugs industry could even be counterproductive, since they complain about the very method by which they make their wealth - intellectual property.

The activists have even managed to scare some heavyweight pension fund investors into writing to the large pharma companies asking them 'to improve their image', because it is damaging share price. The investors, which include Legal and General and Schroder Investment Management, and control nearly a trillion dollars, have said pharma risks becoming the 'new tobacco' unless it cleans up its act.

But the point is that pharma's bad image is a mirage created by Hollywood and activists, and to respond as they demand would be counterproductive, and cut off the research pipeline.

Searching for Villains

It has been hard for thriller writers, especially of the Cold War genre, to come up with convincing villains of late. The more prescient scriptwriters saw the writing on the wall back in 1989 as that old stalwart Soviet communism lost its edge.

They swiftly found a new target: even before the Berlin Wall fell, the movie "Licence to Kill" set James Bond against the war-mongering tendencies of Latin American drug dealers. But drug dealers have not caught on as universal villains.

Harming the environment was fashionable for a while, with a slew of Steven Seagal movies about unscrupulous owners of a hazardous waste site and oil refinery. More recently, writers have targeted those who harm health, such as cigarette sellers in the movie "The Insider."

The latest manifestation of this genre is the multinational pharmaceutical company. Harrison Ford had to search out the evil drug company in the blockbuster "The Fugitive" and the famous Cold War writer John Le Carré went after the industry in his thriller, "The Constant Gardner." The plot revolves around a multinational pharmaceutical company conducting drug trials in Kenya.

Why Kenya? Well, the company knows that its drug is harmful and therefore needs pliable clinical trials data to ensure that it can sell the drug widely. Africa provides a trials location where lives are cheap and where the company's bribery, intimidation and murder are ignored by local politicians eager for the dollars the company brings.

Le Carré describes the book as a novel about "the individual conscience in conflict with corporate greed". As a novel it is superb, but Le Carré is obviously so enamoured of the plot that he believes his fiction to be real-life fact.

In an article last year in the British newspaper the Sunday Telegraph, Le Carré claimed that his book understated the true activities of drug company criminals. Multiply his "concerns by tens and you begin to understand the corrupting power of pharmaceutical companies when they operate in emerging countries and can delegate huge slush funds to local managers who know how to get a drug accepted by local officials and ministers", he said.

Fascinating stuff. But in his article he provides no substantiation for this assertion, or for his scaremongering statement that a drug prescribed in the west "only for extreme cancer pain is sold to Africans as a headache cure".

Given his claims - which, if true, would be unveiling indictable offences - the lack of supporting evidence is surprising. Le Carré repeats the claims of anticapitalist and "pharma-watch" pressure groups, apparently convinced by no more than the strength of their convictions. Worse, by using his literary licence to exaggerate their message, he does them a disservice and risks discrediting them.

Some of the alleged evidence of the big pharmaceutical companies' mendacity has been supplied by the Washington Post. The Post published a series of articles in 2001, one of which discussed the 1996 meningitis epidemic in Nigeria. Drug company Pfizer used the epidemic as an opportunity to test a new meningitis drug.

The Post publicised claims by pressure groups that the testing of the drug, Trovan, might have cost lives. But reading the report, one is not convinced whether the testing cost lives or saved them. Pfizer insisted that it furthered knowledge about Trovan, which was subsequently approved for use in the US.

Testing a drug during an epidemic in a poor country with less stringent trials regulations than in the home market appears opportunistic, and it probably was. But potentially fatal meningitis is still fortunately a rare disease in Europe and the US, and finding enough cases to perform tests with sufficient rigor to satisfy the approval requirements is a time-consuming and expensive business.

Testing during the Nigerian epidemic was therefore probably sensible. Perhaps Pfizer did not do everything well, maybe some children could have been saved had the doctors conducting the trial used different combinations of drugs, but in deadly epidemics, decisions are made that later may be shown to be mistakes. Yet even this is not established.

In April a British documentary will seek to 'expose' the dangers of the Trovan trial. And it is likely that PBS will run the documentary in America. It will further the debate about increasing the regulation of the drugs industry, and may lead to lowering of the protection of patents around the world.

Regardless of what the Post, Le Carré or other liberals may think, drug companies are not in the business of testing drugs they know do not work, or of avoiding testing regulations because they want to harm the poor. To make a profit they need their drugs to work. There is no doubt that they benefit from the swifter testing regimes abroad, but then so do we all.

The drug approval process in the developed world has become so slow, with bureaucrats scared to approve anything that might be the new thalidomide, that it kills thousands by denying them the benefits of new treatments.

The time taken to bring a new drug to market is the real scandal, and the one that Le Carré should write about. Alas, it would not be a stinging indictment of "the criminals of capitalism" that he seems so desperate to believe in now that the red peril is gone.

And if he dislikes the intellectual property system that drives the current drug (and entertainment) industries, perhaps he should stop taking royalties from his book and give his previous earnings and future royalties to poor Africans. After all, he is a multi-millionaire, and has surely made enough money by now.

Dr Roger Bate is a fellow of International Policy Network and a columnist for TCS.
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