Medicine as a Luxury: The West Treats Vital Pharmaceuticals as Just Another Commodity. If Poor Countries Can't Afford Filet, Why Should They Get Cheap Drugs?

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IT'S GENERALLY RECOGNIZED THAT PEOPLE HAVE THE right to eat. When famine breaks out, relief agencies rush food to the hungry. Politics and war may get in the way (indeed, they are often the causes of the famine). Sometimes relief efforts are too small or come too late. But the advanced industrial world usually acts as if it has a moral obligation to respond to a hunger crisis.

In recent years, humanitarians have been taking a similar approach to global public health. Shouldn't we be rushing medicine to people who need it, no matter where they live and no matter how much money they have in their pockets?

Today, microbial plagues are devastating the developing world far more than hunger is. Yet there is no rush to provide assistance. On the contrary, governments and activists have had to force drug companies to help people who are dying simply because they cannot afford the medicine that might save them.

The AIDS pandemic, which has killed 22 million people worldwide and has infected an estimated 36 million (including 26 million in Africa), is only the most notorious of these manageable global killers. According to Doctors without Borders--a group that won the Nobel Prize last year for its tireless efforts to secure medicine for the world's diseased masses--research and development would go a long way toward fighting tuberculosis, malaria, and leishmaniasis (black fever) as well.

Tuberculosis, largely eliminated in the industrialized world since the 1950s, today infects eight million people a year, 77 percent of whom do not have access to medicine. The result is two million deaths a year, many of which could be avoided with antibiotics that cost less than $100 per course of treatment. Pathogenic resistance to those drugs is growing, however, and few new medicines will kill the most virulent strains of this age-old scourge.

Malaria infects more than 300 million people worldwide every year and kills an estimated one million to two million. Chloroquine, the standard treatment since the 1940s, is increasingly ineffective because of resistance; no new drugs for malaria are in the pipeline.

Leishmaniasis, an immune-system disease that is transmitted by sand flies, has infected more than 12 million people in 88 developing countries. Leishmaniasis-related conditions, including diarrhea and pneumonia, kill more than 500,000 people a year. The standard course of treatment--a derivative of the heavy metal antimony--costs $150 and has nasty side effects. As with malaria, no new drugs have been developed to combat this disease since the 1930s.

THE ESCALATING CAMPAIGN TO FORCE THE GLOBAL pharmaceutical industry to provide affordable medicines to fight these plagues took another step forward this November in Doha, Qatar, where the World Trade Organization met to launch the next round of trade negotiations. A coalition of more than 80 developing nations and nongovernmental organizations (NGOs) pushed the WTO to reaffirm language that already exists in its charter. Every nation has the right to void patent laws and grant licenses to generic manufacturers of essential medicines in order to meet public-health emergencies, the resolution read. U.S. Trade Representative Robert Zoellick, whose office usually acts on the industry's behalf when faced with intellectual-property issues, opposed the language until the last moment. The Clinton administration, with similar priorities, threatened trade sanctions against South Africa after it passed an essential-medicines licensing law in 1997. The Bush administration did the same until April of this year, when 39 multinational drug companies finally dropped their suit against the law.

In the weeks leading up to Doha, the United States and Switzerland did everything they could to water down the resolution that supports compulsory licensing to meet public-health emergencies. They backed down only when it appeared that the issue might doom the Doha talks. …