Big pharma has an interest in rich people being sick, by Gilles Fraser

The Guardian – What profit is there in a healthy population? If everyone were healthy, it would be the job of the pharmaceutical companies to persuade us that we were not well

The giant pharmaceutical company GlaxoSmithKline said yesterday that its work on a vaccine for Ebola will “come too late” to do anything about the current situation. Even now it is trying to compress trials that would normally take a decade into a year. The impression it gives is that it is working flat out, no holds barred. But hang on a moment. Ebola was discovered back in 1976. What has GlaxoSmithKline been doing since then? Answer: not much.

A small clue to why can be found by looking at the stock price of Tekmira Pharmaceuticals, the Canadian-based drugs firm that some investors seem to think is leading the pack on Ebola research. Tekmira shares rose a massive 180% from mid-July to October, with most of the share-price action coming when the virus jumped to Europe and the US.

Ebola has been killing people in central and western Africa for at least 38 years – but it’s only when the virus becomes a threat to the developed world that there is seen to be a profit in it. I know it sounds cynical to say it flat out like that – but it sounds cynical because it is. What business case is there for developing drugs to save the lives of poor Africans when they don’t have the money to pay for them? Especially when there is so much more profit to be had in – for instance – giving rich white men erections. As a study in last year’s Lancet showed, of the 336 new drugs developed in the first decade of this century, only four of them were for what are known in jargon as neglected tropical diseases – three for malaria and one for diarrhoea.

The point being this: the business model of market-driven big (or even medium-sized) pharma does not work well to address the challenges posed by a virus that ultimately has no respect for geography or bank balance. Some of the developed world’s early interest in Ebola was in whether it could be weaponised. It was said that the Russian biological weapons unit – Biopreparat – had turned Ebola into an aerosol spray.

All of which is red meat for conspiracy theorists (like those who tell you that the patent for the Ebola virus is owned by the US government, which is true). But my suspicion is not about shady government actions but about basic capitalist economics. Isn’t it interesting that there is money about to ask scientists to turn a virus into a weapon, but not the money about to ask scientists to find a vaccine? And by the time there’s a market for a vaccine, it’s too late.

What better example of what is commonly called market failure – that state of affairs in which market forces do not make for desirable outcomes. Here’s another example: remember Nelson Mandela having to take on the big pharmaceutical companies as thousands of dying South Africans were unable to afford Aids drugs. Apparently, the market-driven economics of health care do not have an answer to a virus that begins in a part of the world where there isn’t much money. And that is often where dangerous viruses begin. Which is precisely why market forces will not be able to save us.

Indeed, on the contrary, market-driven healthcare is incentivised to keep us sick. For what profit is there in a healthy population? If everyone were healthy, it would be the job of the pharmaceutical companies to persuade us that we were not well, that certain things about us needed fixing, putting right (even if they didn’t).

Its a bit like Friedrich Nietzsche’s criticism of the Christian priest: that the priest first has to poison us into imagining we are unwell – and thus in need of saving – before he can present himself as the cure, as salvation. There is no market for salvation in a sinless world. Of course, big pharma presents itself as evidence-based and scientific. Not at all like Nietzsche’s Christianity. But it’s not the science that calls the tune. It is the stock price. And the stock price goes up when rich people feel threatened.

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