Monday, January 10, 2005

The poor man's diseases

Via AdamSmithee, an article in Reason by Ronald Bailey praising for-profit pharmaceutical companies for their efforts in combating infectious diseases, even those of the poor. He tries to deflect criticism that less than 10% of global health R&D is spent on 90% of the world's diseases, and argues that, actually, most diseases affecting the poor already have effective treatments and it is poverty per se, and hence inability to afford medicine, that causes disease, rather than the selfishness of Big Pharma.

First, a point about river blindness (onchocerciasis): Bailey points out that the drug for river blindness was developed by Merck and is now being given away for free. He neglects to mention that the drug was actually originally developed to treat parasitic infections in horses, because treating horses owned by rich people is more profitable than treating poor people. This isn't exactly a bad thing - in fact, it shows how even the profit motive can produce serendipitous results. But it's not exactly a guaranteed way of discovering future medicines to treat diseases of the poor. And Merck isn't donating the medicine merely out of good will, but rather because the poor people who need couldn't afford to pay anything anyway. Most of the costs of drugs go into R&D, not actual drug production - since Merck already had this drug lying around that was originally designed for horses, they figured they might as well give it away and gain the good publicity. Again, not a bad thing - but also not a reliable way to generate more drugs. Certainly not reliable in the way that the profit motive will generate drugs for rich people's diseases. (Viagra, anyone?)

Meanwhile, the attack on the 10/90 claim is a strawman. It's certainly true that HIV, TB, malaria, and diarrheal diseases are generally the biggest killers of the poor (so in terms of sheer lethality, the "90%" of diseases receiving only 10% of global R&D aren't that bad). But the 10/90 claim is just a rallying cry, shorthand for the inequity of global health system. Taking the real killers: Leishmaniasis, malaria, trypanosomiasis and tuberculosis account for 5% of global disease burden (in terms of Disability-Adjusted Life Years, or DALYs) and certainly more of the disease burden in poor countires; yet they receive only 0.5% of global health R&D. Bailey himself admits that leishmaniasis and trypanosomiasis (sleeping sickness) still lack effective treatments.

Furthermore, Bailey overstates the extent to which the big killers have "effective methods of treatment and prevention." Let's leave aside the ridiculous implication that there's no need for drugs if a disease is easily prevented (imagine telling a heart attack patient, "no need for bypass surgery! you could have prevented this with a healthier diet"). Though malaria and tuberculosis have effective treatments that just need enough resources and public health infrastructure to be put into practice (a pretty big hurdle in many places!), the microbes will always be evolving resistance. Multidrug-resistant tuberculosis is already a problem, and it's only a matter of time before malaria becomes resistant to the last "ultimate" treatment, arteminisin combination therapy. Meanwhile, HIV is completely incurable, and antiretroviral drugs are expensive because of the profit motive. Some companies have started selling antiretrovirals more cheaply in poor countries, which is great; but we should have more of that. Plus, because it mutates so rapidly, HIV exists in multiple strains all around the world. The West is mostly affected by HIV-1 strain B, but the Third World has myriads of other strains - A, C, D, and CRF02 in Africa; B, C, and CRF01 in Asia. And these may not necessarily be as susceptible to treatments or vaccines being developed in the West as strain B.

In the end, Bailey is partly right in saying that the ultimate cause of all this unnecessary suffering is poverty. But diseases also cause poverty, and we can't overcome the vicious circle without a serious attempt to address the Third World's diseases. The Gates Foundation and the Global Fund to Fight AIDS, TB and Malaria are welcome funders in that fight. And we need not heavily tax drug company profits or destroy their patent rights (another strawman); we can, for example, guarantee that Fund X will buy a certain amount of drug Y if a company develops it, and thus provide an incentive to research and treat the diseases of poverty.

9 Comments:

Anonymous Anonymous said...

Everyone will suffer pain at some point in their lives. Grim as this may sound, some pain is necessary - it is a signal of our brain that something is wrong in our body, what we need in order to protect our health and well-being. Pain relief medications will stop your pain.
Celebrex medicine is a non-steroidal anti-inflammatory (NSAID) drugs, which relieves pain and inflammation (swelling). It is used to treat pain, swelling and stiffness due to arthritis. This drug works by blocking the enzyme in your body that makes prostaglandins. Reducing prostaglandin helps to reduce pain and swelling.
Fioricet pain relief drug is a sedative and pain reliever. It is used to relieve pain from mild to moderate and tension headaches.Tell your doctor your medical history, in particular: severe liver disease, alcohol or drug dependence, emotional / mental conditions, diseases of the heart (arrhythmia, recent MI), stomach / intestine ulcers, any allergies.
Imitrex pain relief drug is used for treatment of migraine and headache with or without aura (for example, flashing lights, wavy lines, dark spots). It is also used to treat headaches cluster. Imitrex is a serotonin 5-HT agonist 1receptor ( “triptans”). It works by restricting the blood vessels in the brain, which helps to alleviate migraine headaches and cluster.
Maxalt pain relief drug is used for treatment of acute migraine headache with or without aura (flashing lights, wavy lines, dark spots) for adults. It should not be used to prevent migraine or cluster headache. Maxalt is a selective agonist of the serotonin receptor. It works narrowing of dilated blood vessels in the brain, relieving migraine headaches.
Ponstel pain relief medication is used for treatment of menstrual pain. It can be used for the short-term (not more than 7 days), the treatment of pain from mild to moderate. It may also be used for other conditions as determined by your doctor.
Tramadol pain relief drug is used to relieve severe pain. It can also be used to treat pain caused by surgery and chronic conditions such as cancer or joint pain. Tramadol drug is sometimes prescribed for other uses; Offices You can address your doctor or pharmacist for more information.
Tylenol medication is used to treat minor aches and pains due to headaches, muscle aches, backache, arthritis, the common cold, flu, sore teeth, menstrual cramps, and vaccinations, and to temporarily reduce fever.
Ultracet drug is combination medicines containing opioid analgesics (pedo - KOT-ik an al-zicks JEE), such as tramadol (TRA unemployed machine) and acetaminophen (one seat to a MIN-OH-fen), used to relieve pain. An opioid analgesics and acetaminophen used together can provide better pain relief than either drug used alone. In some cases, you can obtain relief with low doses of each drug.

3/30/2008 07:36:00 PM  
Blogger hannah said...

I never go to my doctor anymore asking for pain killers prescription and then be turned down at the end, all I do is order online from www.medsheaven.com hassle free and low cost, they have three pain killers listed on their website which are ultram tramadol celebrex that you buy, and the best part is no prescription required!!!

3/12/2010 07:56:00 PM  
Anonymous Anonymous said...

Thank you for the great blog! By the way, if you are looking for cheap certified online ED pharmacy this information could be important for you:
Millions of men take benefits from Viagra. Read more about Viagra online. Viagra works effectively in amiable, moderate or undecorated Erectile Dysfunction.
Viagra improves erections for most men no matter how long they have had erectile dysfunction. Viagra online pharmacy. Brand and generic medications are available!
Generic Viagra is a need based pill. It should be taken only when you plan to indulge in sexual activity. Taken Viagra approximately 30 minutes before your plan sexual activity it will work on stimulation for around 4 hours. Order Generic pharmacy online from a certified generic drug pharmacy. Lowest prices on both generic and brand medications. Big discounts, fast and free worldwide shipping!

8/18/2010 09:03:00 PM  
Anonymous Anonymous said...

di sosor bebek

10/24/2010 09:00:00 PM  
Anonymous Penis Enlargement Pills said...

The author has written an excellent article. You have made your point and there is not much to argue about. It is like the following universal truth that you can not argue with: No truth is universal, everything has its exception. Thanks for the info

10/24/2010 09:00:00 PM  
Blogger FeNaaa said...

The latter, Web 2.0, is not defined as a static architecture. Web 2.0 can be generally characterized as a common set of architecture and design patterns, which can be implemented in multiple contexts. bu sitede en saglam pornolar izlenir.The list of common patterns includes the Mashup, Collaboration-Participation, Software as a Service (SaaS), Semantic Tagging (folksonomy), and Rich User Experience (also known as Rich Internet Application) patterns among others. These are augmented with themes for software architects such as trusting your users and harnessing collective intelligence. Most Web 2.0 architecture patterns rely on Service Oriented Architecture in order to function

11/03/2010 01:50:00 PM  
Anonymous Invertir en oro said...

I think it's important that we all know a little about this subject so interesting, I think it's part of human culture tell us about such things.
Invertir en petroleo

4/14/2011 04:44:00 PM  
Anonymous tadalis 20 said...


Nice Post Love Reading Its

kamagra 100mg

generic vaigra 100mg

3/20/2014 05:25:00 AM  
Blogger aliya seen said...

The disease are going strong so we must have anatomy and physiology homework for the betterment of our health.

9/09/2015 11:35:00 AM  

Post a Comment

Links to this post:

Create a Link

<< Home