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Doctors Without Patents
William Rogel • Is Yale a drug-free zone? • May 2001

The recent dispute over the AIDS drug patents seemed scripted in Hollywood—Goliaths Bistol Meyers Squibb and Yale teamed up against the suffering poor of AIDS-stricken Africa. Here at Yale, there has been a mass of pressure from students demanding that the University step in and ensure that the fruit of its research be sold at very low cost or given to the poor in foreign countries, such as South Africa.  And for that effort, they should be commended.  The University and drug companies need to be reminded of the good inherent in such humanitarian acts.  However, it must be remembered that such actions go beyond the negative duties most of us are so comfortable with.  Instead, they are acts of charity in the usual American sense.  That is, far from being the sort of thing that anyone would be expected to do in this situation, these are the extraordinary and openhanded actions one would expect of a charitable institution and a business.

Critics of the much maligned drug companies, therefore, should keep two things in mind.  First, the drug companies have no more of a burden to give the drug to the poor than each individual has to buy the drug and then send it to Africa.  Second, without the drug companies (and the free market) the drug would not exist in the first place.  

To claim that the drug companies are evil for not giving the drugs to the poor is essentially to say that such a level of charity is the bare minimum, that it is the expected action for anyone in such a position.  This view is both incorrect and terribly harmful.  It is true that we might expect a person to give food to a man starving on his doorstep.  We would not expect, however, that as long as someone in the world is starving, no man should eat at above subsistence levels.  Not only is it impractical, it is also at odds with any sense of virtue.  First, it does not allow a father or mother to treat a child as more important than other people.  There is no personal love or duty, just a general love of humanity and there must be some room for both.  

Second, in this understanding, there really could not be a positive understanding of good.  Human virtue is reduced to not doing wrong, and standards are set inordinately high.  It is important to set a high goal, but it is also important that that the goal include actions that are affirmatively good and not just neutral.  Therefore, it is true that drug companies should be charitable inasmuch as individuals are expected to do the same.  This poses a possible solution.  Once the companies will not go any farther, individuals still may purchase the drug at full price and give it to those AIDS patients who cannot afford it themselves.  Governments could probably do the same, though that would be much more complex.

Few could deny that the free market has been the major spur for continued medical research.  As long as there are diseases, there will be a demand for the products of drug labs, and as long as diseases are serious, there will be people willing to pay large sums of money.  Therefore, there is quite a potential for profit in medical research.  This potential continually draws investors to the companies and pushes those companies to search for the next miracle drug. The free market has produced the pharmaceutical industry of today; the result may not be perfect but it is by far the most profitable and the most beneficial medical system in the history of the world.  And these two things are not coincidental; as shown above, they go hand in hand.  Obviously, it would be harmful for government regulations to interfere such that companies cannot earn the same profits.  We need only look to Europe to see the failure of medical research in nations with socialized medicine. Even though France spends the same percentage of sales on R&D as the U.S., only three percent of the 152 leading drugs between 1974 and 1999 were developed there, while 45% were developed in the United States. It is the evil, profit-seeking drug companies that have saved millions of lives worldwide.

The Rawlsian left that that opposes the drug companies would do well to consider that these manufacturers provide very good examples of Rawlsian principles in action (cf. A Theory of Justice).  Generally, Rawls holds that all inequality should be engineered to work to the benefit of the least advantaged.  The drug companies, by remaining competitive in the free market, are able to use profits for more research into more and better drugs, which in the end does benefit the least advantaged—the sick..  

Aside from the trouble with government intervention and the philosophical problems with declaring it a moral imperative to give drugs to the poor, there remains the question of exerting pressure on companies to do more.  This is beneficial to an extent, as it will motivate companies to give as part of their economic interests.  However, this pressure can be harmful.  Drug companies, as noted above, are driven by the prospect of a “miracle drug.”  It is this thought and this profit that allows the whole industry to exist.  If the public begins to expect that such “miracle drugs” will be given to those in need, while needy individuals may benefit in the short term, the possibility of discovering such a drug becomes much less enticing.  This has two results.  First, it will push research to less essential areas—cosmetic medicines and remedies for common ailments.  Such a move will prevent research into new miracle drugs and will create an industry incapable of continuing to develop versions of the same drug that combat the resistant strains.  Second, because the single greatest profit opportunity has disappeared, the whole industry will be crippled.  Therefore, even a well-intentioned public pressure is harmful to the very people they strive to help.

Activists condemn the fact that pharmaceutical companies prefer to manufacture Propecia, Viagra, and Accutane rather than malaria and AIDS drugs.  But the activists’ own suggestions would only increase the problems they (rightly) decry.  They should turn their attention to more market- and research-friendly solutions, like buying the drugs and distributing them at subsidized prices.  This solutions has its own problems, but it avoids the worst intended consequences of AIDS activists’ current recommendations. 

William Rogel is a sophomore in Berkeley College.

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