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What happens when we run out of medicines? Medical authorities around the world are pondering this question as they struggle with shortages of a range of essential medicines amid a global drug supply crisis.
Separately, England’s former chief medical officer Sally Davies, warns us of the growing threat posed by drug-resistant superbugs. The antimicrobial resistance crisis could make the COVID-19 pandemic “look minor”, Davies claims, if not met with urgent action, including the development of new antibiotics.
At first glance, these two crises seem to have little in common other than the serious threat they pose to human life. But they are, in fact, born out of a single problem: Big Pharma’s prioritisation of profit, which disincentivises it from both keeping essential medicines accessible and developing new medicines we desperately need.
Take a look at the many issues with the insulin supply. People living with diabetes are currently facing long and anxious waits for essential insulin products in many countries. One of the world’s largest insulin suppliers, Novo Nordisk, recently announced plans to stop production of a widely used long-acting insulin injection by the end of the year, seemingly opting to bolster its profit-raking weight loss drugs over its off-patent and price-controlled insulin products. Meanwhile, several essential formulations of insulin produced by leading drugmaker Eli Lilly have been out of stock for weeks due to what the company described as “brief delay in manufacturing.” Together, Eli Lilly and Novo Nordisk control some 75 percent of the global insulin market. The uncertainty currently faced by diabetes patients the world over is testament to the danger of leaving our medicine supply in the hands of profit-driven medicine monopolies.
The growing threat from antimicrobial resistance is also a direct consequence of Big Pharma’s focus on profit – the only difference is that at the root of this crisis are choices made regarding research and development, rather than manufacturing.
“Superbugs” – bacteria, viruses, parasites or fungi that have developed resistance to usual treatments – have long been a concern for the medical community. Experts agree that the development of new antibiotics will be crucial to tackling the problem. Yet, shockingly, not a single new class of antibiotic has been invented since the 1980s. And this is a choice made by Big Pharma.
Pharmaceutical companies have long turned their noses up at producing new antibiotics because they do not believe such an endeavour would be sufficiently profitable. Rather than potentially lifesaving antibiotics, they are focusing their research and development efforts on so-called “Me too” drugs, which are developed through minor modifications to existing drugs and rarely represent a meaningful therapeutic advance, but promise continued profitability.
With vital drugs in short supply and drug-resistant pathogens a growing danger, it may seem perverse that pharmaceutical companies are placing their bottom line above the health of everyday people. But at the end of the day, these companies are beholden to their shareholders, not global health. Our current model of medicine production which puts shareholder returns above all else means patients are beholden to these dynamics.
So what is the answer? It may be tempting to look for ways to make the medicines we need profitable to Big Pharma companies. Perhaps we can pay them a bit more for essential medicines or give them extra funding for antibiotics research? This may seem like an easy, if expensive, solution to a massive problem. This approach, however, has already been tried many times over – and it always led to prices rising higher and higher without any meaningful increase in accessibility. Rather than focusing on upping production, companies moved to hold medicines ransom to try and get more money.
In any case, humanity cannot pay its way out of these crises, because not every country has the means to feed corporate greed. What happens to patients in countries that cannot afford the ever-increasing price tag? The horrific “vaccine apartheid” we witnessed at the height of the COVID-19 pandemic is perhaps the best demonstration of how such a strategy plays out on a global stage.
So, if the solution isn’t paying pharmaceutical companies more, what is it?
Ultimately, we need to end Big Pharma’s control over our lives and future. We need to completely dismantle the financialised drug-production system that is leaving diabetes patients without access to insulin and exposing us all to the dangers of “superbugs”.
This may seem like a lofty goal, but across the world, governments are making promising moves in the right direction.
The World Health Organization is supporting Global South countries to share vaccine manufacturing know-how and patents among each other via its mRNA Technology Transfer Programme. Developed in response to Big Pharma’s shocking withholding of essential knowledge from Global South scientists during the COVID-19 pandemic, the programme enables these countries to scale up their domestic production capacities and prepare for future crises. Where the incentives provided by the monopoly patent system have led to high prices, vulnerable supply chains and lagging innovation, this project is instead built on the idea of sharing and collaboration. Some 15 countries have already signed up.
Even in the US, the government is making moves to limit Big Pharma’s control over the development and manufacturing of the medicines we need. The Biden administration has come up with a roadmap that would allow the federal government to grant licenses to third parties for products developed using federal funds if the company holding the original patent does not make them available to the public on reasonable terms.
Here in the UK, Great Ormond Street Hospital (GOSH) recently developed a gene therapy treatment for the rare but extremely dangerous “bubble baby” syndrome. It is hoping to license the treatment itself on a nonprofit basis – without any Big Pharma involvement.
Models like the one GOSH aims to pioneer will take investment, but as we know, the state is already spending significant resources on drug development and even more on meeting the cost of Big Pharma’s extortionate mark-ups – and nonprofit models tend to make medicines at a fraction of the rate Big Pharma companies do.
We won’t be able to replace the existing medicine production model overnight and we’ll likely continue to rely on Big Pharma to bring medicines to market for some time yet. But as we face crippling drug shortages, and a looming threat from superbugs, we must start to think more boldly. The Big Pharma model isn’t working and is actively endangering the health of ordinary people around the world. It’s time to invest in alternatives.
The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.
