"Health for Sale" asks: are the world's largest drug companies, paradoxically, major obstacles to making a healthier world?
The film focuses on Big Pharma, the ten largest pharmaceutical makers, who account for 500 billion dollars of world health spending a year and whose 205 billion dollars in pre-tax profits were more than the combined profits of the 490 other Fortune 500 companies. Officials from all sides debate the impact of drug companies' patenting, "intellectual property," pricing and new product development strategies on global public health. These policies, according to Nobel Prize winning economist and former World Bank Chief Economist, Joseph Stiglitz "are condemning billions of the world's poorest citizens to death."
The key to the power of Big Pharma over the world drug market is the TRIPS agreement (Trade Related Aspects of Intellectual Property Rights) negotiated by the World Trade Organization (WTO) between its 150 signatory nations. TRIPS requires member states to grant drug companies patents for the exclusive manufacture of new drugs for at least 20 years. This enables them to maximize profits through artificially high monopoly pricing, unaffordable to all but the most affluent nations. Drug companies often hold 240 patents on the same drug and, in a process called "ever-greening," obtain extended patents whenever they can invent a new use for a drug, however small its therapeutic value. A spokesman for the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) rationalizes charging as much as 100 times manufacturing costs as necessary to recoup the considerable costs of developing a new drug. Yet during the decade of the 1990s drug companies made a 25% profit on turnover (compared to only 3.3% by other consumer sectors), while spending only 12.5% on research but 36% on administration and marketing.
Patents prevent the manufacture of generic versions of these drugs at prices affordable to the Global South. Yet, as a World Health Organization (WHO) spokesman points out, under TRIPS, a signatory government can authorize "parallel imports" and "compulsory licensing" to obtain drugs at affordable prices during health emergencies. President Bush, a staunch ally of Big Pharma, threatened to use these provisions against Bayer during the Anthrax scare of 2001, but less powerful nations confront highly restrictive language and frequent legal challenges by the big pharmaceutical firms. The President of Cipla, an Indian generic drug manufacturer founded with Gandhi's blessings to free the subcontinent from British pharmaceuticals, describes drug patenting as "selective genocide" against the poor.
Health for Sale reveals that Big Pharma invests next to nothing to treat the diseases which afflict most of the world's population. 85% of all people die from five diseases, many specific to the poor countries of the Global South, but only 11% of health spending is on these plagues. A Latin American pediatrician points out that, during the last quarter of the 20th century, 1500 major new drugs were approved but only 13 of them were for tropical diseases and only 4 for malaria, one of the world's worst killers. The reason is clear: the money and, hence, market for drugs is in the Global North not the Global South. In fact, drugs with proven therapeutic value developed to treat European colonials in the tropics are no longer produced because they are not profitable.
A visit to an AIDS clinic in South Africa shows how drug companies' priorities are set for the lucrative markets in the developed world but neglect the needs of the poor. There are 29 million people living with AIDS in sub-Saharan Africa, most on less than $1 a day. While millions of dollars are invested to develop new "cocktails" to treat HIV+ patients in the Northern hemisphere, Big Pharma is investing nothing in appropriate, affordable drugs and diagnostic tools needed to treat patients in the global South. For example, drugs are not being developed for children with HIV because few children in Europe and America have the disease.
Big Pharma is hungry for even a larger share of the market in the Global North. Public spending on drugs is increasing there by 7% a year while gross domestic product by only 2%, contributing to the current crisis in health costs in developed countries. One reason is that Big Pharma not only treats diseases, it creates them in a process the industry calls "astro-turfing." They invest millions of dollars on junkets and research contracts to persuade doctors to recognize new diseases requiring still more medication. For example, by reducing the threshold level for high blood pressure from 140/90 to 120/80, a new condition, "pre high blood pressure", was invented. Pfizer's Lipitor, a cholesterol lowing medication, is the world's best selling drug, earning a profit of 10.4 billion dollars in 2004 alone. Hyperactivity in children has been reclassified as Attention Deficit Disorder so that, today, 15% of school children are on Ritalin. These expensive, often unnecessary, prescriptions squander billions of dollars which might better be spent on initiatives like universal health care.
In 2004, a British parliamentary report concluded that "The interests of public health are not in the health industry's interest." A spokeswoman for the international relief organization Medecins sans Frontieres says that governments must use their regulatory powers so that the public health sector can set the priorities for drug companies' pricing and product development. Otherwise, Big Pharma will continue to loot health services in the Global North and deprive billions in the Global South of critically needed treatments. World health is too precious to be treated as just another commodity. Health for Sale, through a close examination of one essential industry, calls into question whether global markets and corporations can be trusted to serve the interests of a majority of the earth's population.
"By visually anchoring the obscure set of real world legal and policy linkages to the health and well-being of the nations and cultures experiencing the realities of the operation of the international patent system, Health for Sale greatly facilitates comprehension of the issues." - Philip Bereano, University of Washington and co-founder, Washington Biotechnology Action Council "Health for Sale takes extremely complex issues involving intellectual property, access to medicines and the shaping of health research priorities and provides a morally disturbing and yet balanced view of the impact these issues are having on the lives of millions of vulnerable people around the globe." - Heinz Klug, Professor of Law, University of Wisconsin
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