New at Reason

Tim Cavanaugh | January 5, 2005

Ronald Bailey shows what's really killing people in the developing world.

Comments

drf|1.5.05 @ 4:16PM|#

besides having the absolute best name of all time (well, ranking up there with hetereoskedasticity), Schistosomiasis, thanks for an interesting read!

a question about 1) uses of DDT, which i've read as being effective as a way to hinder mosquito proliferation - is that so? and 2) does the US have a position on family planning/ condom use as part of USAID packages? or has that been discontinued?

thanks,
drf

|1.5.05 @ 4:29PM|#

"A global R&D treaty, in which the profits of pharmaceutical companies are heavily taxed and their intellectual property rights undermined, would be almost certain to have the unintended consequence of effectively turning off the tap of innovation that is essential to dealing with the world's changing health problems."

Except that you spent the first half of the article proving, fairly effectively I'd like to say, that drug innovation is not "essential to dealing with" the most important health problems faced by poor countries.

Let's say a tax on PHRMAs pays for 100 million doses of quinine (a malaria treatment), but completely wipes out research on Schistosomiasis. According to the facts presented in this article, such a tradeoff would greatly benefit the health of people in poor tropical countries.

drf|1.5.05 @ 4:43PM|#

since schistosomiasis is a parasite in the northern nile, it's not tropical, grin. that was
for fun.

and from what i understand, joe, your observation that R&D is not necessary for alleviating much of the impovrished world's health and infrastructure problems is 100% correct.

your final paragraph could very well present the most efficient solution. yes, that could be the "best tradeoff".

still agriculture and textile tarifs on the third world probably do a good job in keeping those countries poor, and sweetheart government and UN deals probably keep existing power structures that are tilted against those most susceptible to disease...

|1.5.05 @ 5:05PM|#

joe,

Yes, that would solve some of the current problems of the third world, but the question is, what about the next health crisis? You won't be able to steal meds from Big Bad Pharma, 'cause they won't have developed any.

Think about it like this: it's like a third world version of the social security system.

|1.5.05 @ 5:29PM|#

Ron,
Thanks for a sensible article. While speaking common sense in the face of demagoguery often seems futile, it's still nice to see someone doing it.

|1.5.05 @ 6:16PM|#

From the article:

"Among other things MSF is calling for a potential "essential research obligation" mandate that would require companies to reinvest a percentage of pharmaceutical sales into R&D for neglected diseases, either directly or through public R&D programs. MSF also favors a global treaty on R&D for neglected diseases that could provide a framework for such mandates and help make drugs for neglected diseases global public goods. "

joe

According to the article the proponents of the "tax" aren't advocating spending it on existing drugs but on "R&D for neglected diseases". The pharmaceutical companies are expected to surrender their property rights to "make drugs for neglected diseases global public goods".

I'm not arguing the merits of this, simply pointing out your "Let's say a tax on PHRMAs pays for 100 million doses of quinine" is not quite on target. There are plenty of ways to raise money for 100 million doses of quinine, either publicly or privately.

Of course, one way to put a dent in malaria is to end the idiotic DDT ban. It's not a total solution but certainly part of a rational public health regimen.

drf

Aren't our and the EU's agriculture subsidies the big problem. And aren't textile tariffs pretty much a thing of the past?

|1.5.05 @ 6:19PM|#

While I don't necessarily disagree with its conclusion about the R&D treaty, Bailey's article makes barely any sense.

First he argues that:
"The health problems faced by the world's poorest populations are not caused by a lack of drugs"

And then points out that we shouldn't taint the purity of the profit motive because:

"...innovation is essential to dealing with the world's changing health problems."

You just spent half the article essentially arguing that it isn't. Then followed up by saying that squelching it would be harmful to the poor.

Double Yew Tea Eff?

|1.5.05 @ 6:40PM|#

drf: DDT is in fact effective at controlling mosquito populations, and it may be possible to use it in limited applications in such a way that the danger to birds is minimized. For example, spraying in and immediately around human dwellings at intervals spaced to let the residual effects work, rather than wholesale continuous saturation of the ecosystem with a toxic chemical. Some things I've read suggest that the problem with DDT was less with the insecticide itself than with the carrier chemical (might have even been a Ron Bailey article, can't remember definitely). I don't know how true that is. I do know of researchers working on other effective insecticides without the possibly-hazardous-to-birds side effects.

I don't agree that the ban on DDT is necessarily idiotic a la Issac's comment.

People dying of disease has a similar effect to that of smokers dying early. Smokers dying early don't get the full benefit of their Social Security and reduce the burden on Medicare/Medicaid. People in poor countries that die of disease won't die from starvation. Sounds cruel, but if you stop all the deaths from disease, you're going to have widespread starvation instead, because the human population exceeds the local carrying capacity.

Just in case you're not pissed at me yet, keep in mind the human species is not in much danger of extinction, particularly not from disease.

"The highest function of ecology is understanding consequences." (from Dune by Frank Herbert)

finally, you can't mention heteroscedasticity without mentioning homoscedasticity!

Larry A|1.5.05 @ 6:49PM|#

"First he argues that:
"The health problems faced by the world's poorest populations are not caused by a lack of drugs"

And then points out that we shouldn't taint the purity of the profit motive because:

"...innovation is essential to dealing with the world's changing health problems.""

Actually he says that current problems are not caused by lack of drugs because of innovation, mainly by profit-making companies. (See paragraph eight.)

But if a new disease developes next year, and all the R&D departments are tied up in bureaucratic morasses of politically inspired goals, there will then be precious little of the innovation responsible for solving existing problems.

|1.5.05 @ 7:51PM|#

I think some of you have forgotten that health threats aren't constant. There will never be a point in human history where we can say "that's it, we've developed all the drugs we'll ever need". Bacteria and viruses rapidly evolve and spawn new strains. New diseases crop up all the time. The single biggest health threat to the developing world -- HIV -- was basically nonexistant as a human health threat fifty years ago.

Sure, you can fuck drug makers out of their property rights and reap a short-term gain from it. But the long-term result is that you kill the incentive to research new drugs, which means that you leave humanity as a whole vulnerable to the inevitable new diseases. AIDS medication research is already suffering from this -- pharma companies know that an effective and easy-to-take AIDS treatment is likely to be immediately confiscated by the governments of the world in the name of "the people". So the incentive to develop such a treatment is minimal.

Kevin Carson|1.5.05 @ 10:39PM|#

"....their intellectual property rights are undermined...."

Oh--you mean they actually have to compete in a free market?

|1.5.05 @ 11:46PM|#

Oh--you mean they actually have to compete in a free market?

A free market requires property rights.

|1.6.05 @ 3:50AM|#

I understand that Larry. But while he makes a good case against R&D regulation, the article makes an even better indirect case for stronger global social welfare to poorer countries because, as mentioned, lack of innovative drugs isn't the problem.

So any measure that might undermine the profit motive yet be useful in ways that R&D control isn't would be a good idea.

And, I'll be honest, the entire tone of the article bothered me. As if the only way to improve the medical misery of third world nations is to do everything in our power to improve the lot of pharma companies. So that the scraps from their table may one day taste sweeter and all subsaharan Africa can rejoice at the cheap off patent penis pills they'd have been able to take if they weren't already in the terminal stages of AIDS.

|1.6.05 @ 7:01AM|#

Dan, how can the market be "free" if I have to pay for stuff?

drf|1.6.05 @ 11:04AM|#

because, RC, the "rich" will pay for it. you're entitled. just come up with some sort of sob story, and you've got endless "free money"! remember "fairness" (snort)

thanks Bio.

i'll remember same-variances next time. however, the "dicky fuller" test is one of my favorites.

|1.6.05 @ 11:48AM|#

finally, you can't mention heteroscedasticity without mentioning homoscedasticity!

Someone should set that to music.

Larry A|1.6.05 @ 8:13PM|#

"I understand that Larry. But while he makes a good case against R&D regulation, the article makes an even better indirect case for stronger global social welfare to poorer countries because, as mentioned, lack of innovative drugs isn't the problem."

"Stronger global social welfare" is code for bigger government programs. But as we see in paragraph thirteen:
"The abject poverty in which billions are mired is chiefly sustained by bad government economic policies. By adopting better economic policies, governments in poor countries would go a long way toward improving the health of their citizens. In addition, governments often impose high tariffs and taxes on medicines. For example, taxes account for 55 percent of the retail cost of medicines in India, 34 percent in Nigeria, 33 percent in Pakistan, 28 percent in China, and 24 percent in Mexico. And finally, in nearly all of the poorest countries, public expenditures on the military vastly outstrip those on health care."

If big government is (as usual) the problem, bigger government is not the solution.

"So any measure that might undermine the profit motive yet be useful in ways that R&D control isn't would be a good idea."

Again from paragraph eight:
"Furthermore, many treatments already exist for many of these diseases. Schistosomiasis is treated with praziquantel for 30 cents a dose; onchocerciasis can be controlled with ivermectin (which is being provided free of charge by its manufacturer Merck & Co. for as many people as needed, for as long as needed). Lymphatic filariasis is treated successfully with a combination of ivermectin and albendazole (which are being donated free by Merck and SmithKline Beecham). Note that these treatments were not developed by WHO or MSF researchers, but by profit-making private companies."

So companies are already making major donations, an effort funded by the profits you want to undermine.

Just what motive do you want to substitute to encourage companies to do R&D. Let's say, for instance, that you have a degree in biochemistry. You're offered a choice of ways to spend your job time. You can drive a garbage truck at $15 per hour, money you need to provide food and shelter for you and your family, or you can volunteer to develop drugs while they go hungry. (Without profits, drug companies have no funds to pay researchers.) What incentive would tilt you toward the second choice?

"And, I'll be honest, the entire tone of the article bothered me. As if the only way to improve the medical misery of third world nations is to do everything in our power to improve the lot of pharma companies."

As I read the article, pharma companies were doing just fine, thank you. The answer to the problem is to get rid of the government interference hamstringing their efforts.

Big government is the theory that since individuals are incompetent at managing their individual lives we should make some of the incompetent people bureaucrats, and put them in charge of managing everybody's lives.

Kevin Carson|1.6.05 @ 8:46PM|#

Dan,

A market requires property rights in finite goods that can't be possessed by a large number of people at the same time. Intellectual property [sic] is a property in the right to *do something* like combine certain natural elements or ones and zeros in a particular configuration.

|1.6.05 @ 9:52PM|#

A market requires property rights in finite goods that can't be possessed by a large number of people at the same time.

A market requires property rights for anything which has value to human beings. The fact that you wish theft of intellectual property was legal in no way changes the simple fact that, from both an economic and a human-rights standpoint, we're all far better off because it isn't.

I am amused, however, at some of the implications of your property-rights ideas. For example, I could delete the only copy of the novel you'd spent four years writing and -- since nothing you owned was harmed -- you'd have no basis for claiming damages from me.

Or, for that matter, I could (had I the technological capacity) read your thoughts -- which, being neither finite nor of limited reproducibility, aren't owned by you or anyone else -- and share them with whomever I wished.

Etc, etc. Eh, bored now.