All posts by Harsh Chandra

Corporate Power and Access to Healthcare

Pyrimethamine, more commonly known as Daraprim, is a drug that is frequently prescribed for the treatment of protozoal infections and malaria around the world. It is also very often prescribed for HIV positive patients in combination with other drugs. Until recently, not many knew of this drug even though it features on the World Health Organization’s List of Essential Medicines. However, that changed overnight as a new pharmaceutical company acquired Daraprim and raised its price to a whopping $750 for a pill. This development also brought attention to the rising prices of other prescription drugs, uncovering a trend which is seeing the interests of patients being pitted against the profits made by pharmaceutical and insurance companies. We know from our readings of Smedley and Smedley and Kris Holloway’s account of her experiences in Mali, that race (beyond its relation to socio-economic status) and gender are major determinants of access to healthcare around the world, but socio-economic status which is influenced by both of the aforementioned factors still remains the primary determinant. If you live in a country like the UK, where the state bears most of the healthcare costs, the inflation of pharmaceutical prices may not affect you much; however, for most of the developing world, where 70% of the world’s population resides, the price of medicines can be a barrier to being able to avail treatment for a disease.

 

90% of the people living in developing countries have to buy their own medicine. Diseases like malaria and HIV for which Daraprim is prescribed are more prevalent in developing countries. But how is an ordinary citizen from sub-Saharan Africa, where the average annual income is less than $750, supposed to afford sustained treatment for a long term disease like HIV if a single pill costs $750? This problem is not limited to HIV and malaria either. A recent study found that treatment for pneumonia in Tanzania costs an ordinary worker a whole month’s wages.

 

Some countries like India are able to subsidize some medication but most developing countries don’t have the capacity to do that. The majority of medication in most of these nations has to be imported from overseas as only 7% of world’s pharmaceuticals are produced in the developing world. Multinational pharma corporations have entrenched themselves on the global health landscape. Given that their global presence has prevented the development of domestic pharmaceutical industries, their manipulation of prices is a major concern as a lot of people depend on them for their medicines and this gives these corporations immense power. Power that they can wield in a socially responsible manner or use to milk people for their money.

 

Multinational corporations extol the virtues of corporate responsibility. Nevertheless, their track records show that they tend to exploit people and resources (their motivation for going multinational), pollute the environment and disappear once they’ve gotten what they wanted. As we learnt from our readings about the tobacco industry, profit driven corporations stop at nothing to raise their profit margins, even if that means selling addictive and harmful products like cigarettes to children or promoting a culture of smoking. If tobacco companies which sell a health hazard are able to have their way, one can’t help but wonder what pharmaceutical companies on whom the world depends on can get away with.

 

At the end of the day, the pharmaceutical sector is a business. Like many other corporations, they may not be conscientious and may even be willing to deny the poverty stricken and the impoverished their pills and let them suffer to be able to rake in more profits. This makes me wonder, are these corporations any different from the colonizers of old who used political power to exploit others economically? After all, the East India Company, the so called original corporate raiders, started out as a trade mission and evolved into a power hungry, exploitative machinery. Capitalist tendencies of pharmaceutical companies as illustrated in the instance of Turing Pharmaceuticals and Daraprim are a warning sign. In fact, journalistic organizations like WikiLeaks have being tolling the alarm bells for a while. WikiLeaks’ latest exposé, that of the Healthcare Annex to the secret draft “Transparency” Chapter of the Trans-Pacific Partnership Agreement (TPP), outlines the construction and enforcement of a transnational legal system that will allow multinational pharmaceutical corporations to exploit the world’s basic human need for healthcare by strengthening their oligopoly. While the sources may be questionable, the concern being aired is quite real… For long, public health scholars have highlighted the need for more healthcare professionals like doctors and nurses in order to improve access to healthcare globally; however, if multinational pharma companies maintain their current trajectory, we may see the need for affordable medication added to that list.

WikiLeaks-TPP-Healthcare-Cartoon

 

Discussion questions –

How can states induce pharmaceutical companies to recognize their social responsibility and provide more equitable access to drugs? How might international organizations such as the World Health Organization play a role in this?

Over-priced medicines are certainly a big problem. However, underpriced medicines can be as well. In India for instance where the government subsidizes antibiotics, a combination of over prescription and self medication have led to alarming levels of antibiotic resistance. How can we allow people the access to medication and prevent them from misusing it? How can any pertinent regulations be enforced?

 

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Kelly, Stephanie. “Testing Drugs on the Developing World.” The Atlantic, February 27, 2013. http://www.theatlantic.com/health/archive/2013/02/testing-drugs-on-the-developing-world/273329/.

McGee, Suzanne. “Daraprim ‘Profiteering’ Controversy Lifts Lid on Soaring Cost of Prescription Drugs.” The Guardian, September 27, 2015, sec. US news. http://www.theguardian.com/us-news/us-money-blog/2015/sep/27/daraprim-profiteering-cost-prescription-drugs-martin-shkreli.

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Pollack, Andrew. “Drug Goes From $13.50 a Tablet to $750, Overnight.” The New York Times, September 20, 2015. http://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-raises-protests.html.

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