Showing posts with label pharmaceutical industry. Show all posts
Showing posts with label pharmaceutical industry. Show all posts

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.

Thursday, 8 January 2009

Doctor good, pharma bad?

I know a fair few medical doctors (including four of my own relatives) and without exception all are very good people and very skilled: they are kind and caring, wish the best for others having dedicated their lives to serving others and have undergone extensive and difficult training. How then did they end up with such jerks as pharmaceutical companies? It is like a beautiful, caring, intelligent woman ending up in a relationship with an ugly, twisted, malicious monster!

I'm sure there are nice people working in pharmaceutical companies - in my more sceptical moments I think they just wondered in by mistake and couldn't find the exit, but I'm sure they are there, fervently trying to design a new drug to save the lives of those around them. BUT THEN THERE IS THIS:

"We are not in business to save lives, but to make money. Saving lives is not our business." (Director of Roche in Korea when challenged about providing AIDS drugs to those who couldn't afford them) (article)

"Disease mongering" - Pharmaceutical companies undertaking marketing to convince healthy people they are sick and to make people think mild diseases are more serious (BMJ article)

Pharmaceutical companies trying to bribe governments into allowing their products to be used - even if the science says they are no good (Guardian article)

Pharmaceutical companies ghost writing research to make it look unbiased (journal article) or forcing researchers not to mention harmful effects of drugs (article).

Adverse drug reactions killing over 100,000 people a year in the US (Lancet article) with serious side effects of drug affecting many many more.

Basically, when doctors get a large amount of their information about drugs from drug reps; when training or research centers can be under the pay of pharmaceutical companies; when research and clinical trials contain, for many different reasons, bias; when all other alternatives are suppressed; when pharmaceutical products can involve hidden (or overt) harms: where does that leave medicine?

On the plus side however, I really believe that if pharmaceutical companies' money making motives were removed, the doctor's art and the amazing advances of biomedicine that have been made would loose their tarnish and medicine would really shine again.

As always, your comments are welcome.