Tuesday, November 01, 2005

Free riding is not free

Movie critics seem to be in raptures over "The Constant Gardener" an adaptation of the John le Carré novel. Though the subject reminds me of the amusing Karl Kraus quip:
Medicine: "Your money and your life!"
("Die Medizin: Geld her und Leben!"; first published in Sprüche und Widersprüche, 1924), it is a pity that the movie perpetuates myths about the pharmaceutical industry. As the Times noted recently:
Andrew Sullivan, the journalist and gay activist who co-authored The Pharmaceutical Industry, uses the American experience to explain why there will always be a conflict between innovation and accessibility. “Look at pharmaceutical R&D over the past 15 years or so. Most years, it grew at a phenomenal rate of around 12 per cent to 15 per cent, leading to the pharmaceutical miracle we are now experiencing. There are two exceptions, 1993 and 1994, when Hillary Clinton attempted her government takeover and R&D collapsed to around 6 per cent growth. Investors aren’t dumb. They knew what that meant. And they pulled out.”
Indeed, although to admit it would offend the liberals who will lap up The Constant Gardener, pharmaceutical giants have often acted heroically in Africa — only to find their efforts sabotaged by local governments. Novartis recently proposed to sell Coartem, its anti-malarial drug, at cost through the World Health Organisation. There was no take-up: for several African leaders, the malaria debilitating thousands of poorer citizens was simply not a priority. Two years ago several fanatical Islamic preachers in Kano, northern Nigeria, warned their followers to boycott the polio vaccine that was to be distributed, free, to all children: it was, the imams insisted, part of a Western plot against Muslims. Everyone knows of South Africa’s reluctance to acknowledge publicly its Aids epidemic — and the resulting fatal delay in striking a deal with the manufacturers of available treatments.
Do read the whole thing. Clearly criticism and censure in the face of wrongdoing, and no one is claiming there never is any, is appropriate. What is baffling is that seemingly adult individuals seem to find it too hard to understand that there is such a thing as cause and effect, and that in this case the policies they advocate will have deleterious effects on the development of medicine.
Not to mention the fact that it is the Americans' willingness to pay market (higher) prices for medicine that ensures medical research is as advanced as it is: most of the rest of the world is a duplicitous free rider (because of price controls) in the benefits of innovation brought by this system. At the very least the developed countries should share the burden of innovation equally!

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