Monday, 26 January 2009

Medicine, Money, Malaria and You!

The production and supply of pharmaceutical products is an entirely commercial venture, or in other words, your medicine is supplied by those who have to put profit before social and environmental costs. In the words of the Director of Roche in Korea "We are not in business to save lives, but to make money. Saving lives is not our business."

I have discussed before the problem of pharmaceutical companies manipulating the medical profession in order to make money (see here), but in this post I will address the issue of the provision of health care, of who gets treatment and who doesn't, of who lives and who dies.

In an article in the Independent today it was stated that the weak value of the pound could lead to a shortage of drugs in the UK as imports become less profitable and exports more profitable (see article). Basically, you may not get the medicines you need on time because the money market dictated otherwise. This situation is, however, a very positive one compared to how it is in some other countries or how it could be here in the future.

I first became aware of this problem a few years back, about the time I was becoming interested in studying herbal medicine, when I went to a seminar on using natural medicines in the tropics. The seminar was run by an amazing charity call Anamed (www.anamed.net), whose basic aim is to educate people who may not have access to medicines, such as in parts of Africa, to be able to treat common conditions, such as malaria, effectively with herbs. It was when reading up on the information for this seminar that I found out about the problems concerning the provision of medical treatment and realised how they might apply to Western countries in the future.

In parts of Africa the reasons for the lack of medicines can be many, though mainly it comes down to money. Often drugs are simply not affordable. In some cases where a person can buy the drugs even simple medication may cost a month's wage. In other cases it is the problem of infrastructure that makes drugs inaccessible - health centers are too far away, roads are too poor, deliveries can't get through. So what is done? well, a lot do the only thing that can be done: die. They may die of a serious case of malaria, or they may just die of diarrhoea. So this is where Anamed comes in - teaching simple things like oral rehydration solution for diarrhoea, herbs for malaria (Artemisia annua) and other things.

The question of poverty in Africa is a topic for a different post, but I will look here at how it relates to a specific case, that of malaria. Artemesinin is (in combination with a few other medicines) the leading drug for the treatment of malaria and it is currently extracted from the plant Artemisia annua. It is grown in huge plantations in some African countries, is purchased by pharmaceutical companies at a very low price, it is shipped over to America or a European country, the artemesinin is extracted and then sold back to the African country at a price most people can't afford - so people die. Where the drug is purchased by those rich enough, the money goes back to the pharmaceutical company, meaning the African country gets poorer. The actual herb Artemisia annua can be drunk as a tea to treat malaria and is just as effective as the drug, though taking slightly longer to have its effect.

So anyway, drugs become scarce if a country becomes poor or the infrastructure breaks down, and pharmaceutical corporations follow where the money leads. Who is to say that our country will always stay rich and function smoothly? When you consider the far reaching effects of financial instability (which is likely to increase in the long term) and the looming problems of both the energy crisis and climate change it seems wishful to think that we are immune to these problems. Pharmaceutical companies are no more stable than other industries, such as the automotive industry, or the money grabbing industry. So as things can't or won't stay the same, and as millions are already dying due to the lack of health care, what needs to happen?

Take the money out of medicine

Pharmaceutical corporations should not be allowed to profit from what they do, health should not correlate with your pay packet, essential medicine should be freely available to all whether an individual has money or not. An option may be nationalising the pharmaceutical industry with the development and production of drugs being paid for by the government. This would be easily funded by the savings gained from the NHS not having to buy drugs from pharmaceutical companies and by the profits from the sale of non-essential over-the-counter drugs. Knowledge of how to manufacture the drugs could be freely shared between countries further increasing benefit. Or maybe there is some other scheme that would work, but however it is done it should not be a profit making business. If this was done it would also have the following benefits:
  • Doctors would have less bias information on the effectiveness of drugs.
  • Research showing harmful effects of drugs would not be hidden.
  • More holistic drugs could be researched (pharmaceutical companies don't want people too healthy, it is bad for business).
  • Drugs would be freely accessible to all.
  • Drug supply would be more stable.
  • Government money would provide more medicine instead of making a few rich.
  • Effective alternative treatments would not be suppressed.

Increase the use of natural medicines
  • They can be produced where ever in the world you are.
  • They are cheap.
  • They have been shown to be effective (Artemisia annua can effectively treat malaria, with treatment only lasting a couple more days than treatment with Artemisinin).
  • People could easily treat themselves for minor complaints, therefore reducing the pressure on the NHS.
  • They have limited side-effects and are generally more safe.
  • They can help the local economy when produced and used locally.
  • They are much more environmentally sustainable.
  • Focusing on a more holistic approach to health would mean less people getting ill in the first place.
As always your comments are welcome.

2 comments:

  1. Hi Mark, check this - from pyjamasinbananas.blogspot.com/
    ...James Wong, a 27-year-old ethnobotanist, wants to change our minds [about herbs]
    ..."Aspirin, for example, is made from the same chemicals that were first isolated from willow, which has been used for thousands of years as a painkiller.
    ...Wong, ...is quick to point out that the herbs and plants he recommends all have a long history of use and no record of toxicity."

    "So, presumably aspirin, which is derived from plants after all, has 'no record of toxicity'? This doesn't bode well."

    Anonymous said...

    "So, presumably aspirin, which is derived from plants after all, has 'no record of toxicity'? This doesn't bode well."

    This is where your presumption is wrong. Willow and meadowsweet both contain the natural compound that is converted into what is in aspirin. This is where the problem lies - altering the molecular structure into something synthetic ensures it does not perform naturally. Like altering a jigsaw piece and finding that it doesn't work properly in the jigsaw puzzle anymore. Plus, don't forget all the other constiuents that are left out of the synthetic aspirin, like the demulcents in meadowsweet that means it can be used for stomach ulcers with aspirin can create!
    16 June 2009 23:52:00 BST
    pj said...

    'Natural' does not mean 'good' or 'safe' - that is where you are wrong. Altering something 'natural' into something 'synthetic' can make it safer.

    Nature is filled with highly toxic compounds and only the woefully naive think that because something is found in nature it is likely to be either beneficial or safe.
    17 June 2009 09:13:00 BST
    Neil said...

    I've not stated that just because something is 'natural' that is it safe, this again is your presumption. Please give examples where converting something that is natural into something synthetic can make it safer. I assure you that largely this is not the case in regards to pharmaceuticals.

    The synthetic world is filled with highly toxic compounds and only the woefully naive think that because something is synthetic it is likely to be either beneficial or safe. :-)
    17 June 2009 11:28:00 BST
    pj said...

    "I've not stated that just because something is 'natural' that is it safe"

    Since you said, in response to my pointing out that a therapeutic dose of aspirin from willow bark is highly likely to be as toxic as synthetic aspirin:

    "This is where the problem lies - altering the molecular structure into something synthetic ensures it does not perform naturally."

    I can only assume that you either believe that 'natural' aspirin is not toxic and making it 'synthetically' makes it toxic - in which case you are both wrong, and a fool, or you having nothing relevant to say at all.

    And that is all I have to say on the matter, this is an old thread and you have little of any interest to add.
    17 June 2009 12:26:00 BST


    "I can only assume that you either believe that 'natural' aspirin is not toxic and making it 'synthetically' makes it toxic - in which case you are both wrong, and a fool, or you having nothing relevant to say at all."

    1. I did not say that _all_ natural compounds are save, if I did, please state where.

    2. How many people have died this year from taking willow bark or meadowsweet vs how many people die every year from aspirin? The death rate from pharmaceuticals is phenomimal in comparision to herbal medicine. Are you going to refute this?

    3. Compare negative effects for aspirin in the BNF to any negative effects in the German government's Commision E monographs or, Prof Kerry Bone books (a research research and industrial chemist, who graduated with first class honours from Melbourne University and won the Masson Memorial Prize as Australia’s top chemistry student).

    4. "I can only assume that you either believe that 'natural' aspirin is not toxic and making it 'synthetically' makes it toxic - in which case you are both wrong" Can you back this assertion up?

    ReplyDelete
  2. Thanks for this Neil. I couldn't find the original article, and if, as I assume, it was written by the person who was talking to you, nothing would be gained by doing so: he has an idea in his head and will happily stick to those ideas without questioning his assumtions or the evidence - very poor science indeed! Sceptical, but only in a particular direction - the day he becomes sceptical about his scepticism will be a good day! Or maybe I am generalising from other 'skeptics' I have read articles from.

    Well that is the impression I got. On second reading however I think there may have been some misunderstanding between the two of you. He was comparing the safety of isolated 'aspirin' with synthetic aspirin, whereas you were comparing the whole herb the isolate/chemical?

    ReplyDelete

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