Salon recently ran a story on Amy Kapczynski, a Yale Law School student who was instrumental in pushing Yale into committing itself to less expensive access to AIDS drugs for Africans. Kapczynski and Doctors Without Borders started the ball rolling, but I think the key moment was a New York Times interview given by Prof. William Prusoff, the author of the work that resulted in Yale having a patent on on AIDS drug d4T. (Prusoff and Yale have, of course, profited immensely from the current patent on d4T, but Prusoff’s support for making generic versions available in the Third World was certainly candid. As far as I’m concerned, it was morally right. It was also, I assume, immensely embarassing to Yale.) What made the story noteworth, though, was some amazingly wrongheaded comments by a policy analyst. The National Center for Policy Analysis bills itself as "a non-partisan public policy research institute to develop and promote private alternatives to government regulation and control, solving problems by relying on the strengths of the competitive, entrepreneurial private sector," which is all well and good; as I’ve said previously on this site, I own stock in Johnson & Johnson, and I’d be thrilled to see J&J make quazillions of dollars from discovering an AIDS vaccine.
But how can Robert Goldberg look at himself in the miror after saying things like this?
What’s happening on these campuses is a tragedy. Students like Amy Kapczynski at Yale aren’t really thinking about AIDS — it’s capitalism that they see as the real virus. AIDS is a glamorous disease to worry about.
Now, South Africa is a unique case; the rate of HIV infection is approaching one in four, the president has some weird notions about HIV, and the public health infrastructure may well be underdeveloped. But even if Kapczynski were a bomb-throwing radical bent on destroying Western capitalism — which I don’t for a minute think that she is — and even if making AIDS cocktails cheaper via Indian generic drugs isn’t the most cost-effective solution — which seems at least plausible — where does Goldberg get off saying that the tragedy is Kapczynski’s work? The tragedy is the tens of millions of Africans who are going to die of AIDS in the coming decades.
There’s something disturbing (and, yes, racist) about Goldberg’s claim that South Africa isn’t capable of dealing with AIDS drugs. ("Half of the drugs would be stolen, a quarter unused or improperly used.") Brazil has done a marvelous job bulking up its public health infrastructure to deal with making generic AIDS drugs manufactured by Cipla and local companies available to its population and making sure that they are used properly. (No link; head to your local library and look through some back issues of the Wall Street Journal if you’re interested.)
Goldberg goes on:
This populism is simply a U.S. domestic political effort to suck profits out of the pharmaceutical companies by reducing worldwide price through eliminating intellectual property protection. In the short term, it sucks profits; in the long term it will result in a reduction in research funding as we saw with tuberculosis and malaria drugs when the original patents expired.
I suppose that since the other health care policy bugaboo the NCPA is concerned about is the Canadian single-payer health insurance system, this piece of misinformation shouldn’t be surprising. But given that, according to a Federation of American Societies for Experimental Biology paper, "of the 21 drugs with the greatest therapeutic effect introduced between 1965 and 1992…only five (24%) were not based on a key enabling discovery made in the public sector," it seems at least an oversimplification to say that by mildly curtailing pharmaceutical company income all research will grind to a halt. How much money does a Bristol Meyers or a Pfizer make in Africa to begin with? The bulk of pharmaceutical company income comes in the West, particularly in America, where drug prices are higher. Pfizer earns 68% of its revenue in the U.S. and Japan. (For what it’s worth, they then spend 15% of that revenue on research.)
It’d be a shame if Johnson & Johnson lost a penny or two in per-share earnings. All other things being equal, I’d rather that they had the money, because presumably that income will translate to a higher valuation on the company as a whole and more money in my pocket. But unlike Mr. Goldberg, I know the difference between "a shame" and "a tragedy."