The Medicine Chest ‘Villain’: Roger Bate WT Op-Ed

These are serious allegations of potentially indictable offenses, yet there is no evidence of criminal activity, or even of malpractice. Mr. Le Carre is a great author, but in losing the line between fact and fiction he may find himself in trouble — and not from any murderous tendencies of the drugs industry, but from their libel lawyers.

No doubt, Mr. Le Carre has been engaging in controversial “factual” writing to drum up controversy and hence sales for his new novel, “The Constant Gardener,” which I am regrettably promoting further. Mr. Le Carre describes the book as a novel about “the individual conscience in conflict with corporate greed.” And you guessed it, the plot revolves around the illegal activities of a fictional drug company in Africa. But he has made public allegations in articles published by the Spectator and The Sunday Telegraph of criminal offenses in the real world. By not naming companies, he has probably saved himself from libel, but he has certainly gone beyond the accepted bounds of generating publicity for his novel.

Mr. Le Carre claims that his fictional account actually understates the true activities of the drug company criminals. Multiply my “concerns by tens and you begin to understand the corrupting power of pharmaceutical companies when they operate in emerging countries and can delegate huge slush funds to local ‘managers’ who know how to get a drug accepted by local officials and ministers,” he says. According to Mr. Le Carre, companies only make drug donations to the poor for tax breaks and because the drugs are past their sell-by date; medical journals and senior scientists have been corrupted because of drug company support; companies abuse patent protection to arbitrarily overprice drugs for developing countries; and scientific findings, which are inconvenient to drug companies “have been suppressed or rewritten, and those responsible for them hounded off their campuses with their professional and personal reputations trashed by the machinations of public relations agencies in the pay of the pharmas.”

All fascinating stuff. But in his article he provides no substantiation for these assertions, or for his rather scaremongering statement that a drug prescribed in the west “only for extreme cancer pain” . . . “is sold to Africans as a headache cure.” Given the strength of his claims, which amount to indictable offenses, the lack of supporting evidence is surprising. Mr. LeCarre repeats the claims of anti-capitalist and pharma-watch pressure groups, apparently convinced by no more than the strength of their convictions. But worse, by using his literary license to exaggerate their message, he does them a disservice and risks discrediting them altogether.

Some of the alleged evidence of big pharma’s mendacity has been supplied elsewhere by a selection of writers for The Washington Post. The Post recently published a series of articles, one of which discusses the 1996 meningitis epidemic in Nigeria. The drug company, Pfizer, used the epidemic as an opportunity to test a new meningitis drug. The Post publicized claims by pressure groups that the testing of the drug, Trovan, might have cost lives. But reading the report, one is not convinced whether the testing cost lives or saved them — Pfizer insisted it furthered knowledge about the drug, Trovan, which was subsequently approved for use in America. Testing a drug during an epidemic in a poor country with less stringent trials regulations than in the home market appears opportunistic, and it probably was. But potentially fatal meningitis is still fortunately a rare disease in Europe and America, and finding enough cases to perform tests with sufficient rigor to satisfy the approval requirements is a time-consuming and expensive business. Testing during the Nigerian epidemic was therefore probably sensible, even though the main market for the drug will probably be in the west. Perhaps Pfizer didn’t do everything well, maybe some children could have been saved had the doctors conducting the trial used different combinations of drugs, but in deadly situations like epidemics, decisions are made that later may be shown to be mistakes. Yet even this regrettable situation is not established.

Regardless of what The Washington Post, John Le Carre or other liberals may think, drug companies are not in the business of testing drugs they know don’t work, or of avoiding testing regulations because they want to harm the poor. To make a profit they obviously need their drugs to work and there is no doubt that they benefit from the swifter testing regimes abroad, but then so do we all. The drug approval process in the developed world has become so slow, with bureaucrats scared to approve anything that might be the new thalidomide, that it kills thousands annually by denying them the benefits of new treatments. The time taken to bring a new drug to market is the real scandal, and the one Mr. Le Carre should write about. Alas, it wouldn’t be a stinging indictment of “the criminals of capitalism” that he seems so desperate to believe in now that the red peril is gone. Of all his complaints, Mr. Le Carre is most likely to successfully garner media support for his anti-patent campaign. There appears to be widespread media belief that anti-AIDS drug cocktails made by “generic” companies, that ripoff Western drug company patents, should be encouraged. This is because they cost so much less, are hence more affordable to the world’s poor, than the drugs made by the patent holder, who are recouping the cost of drug development. Perhaps Mr. Le Carre will lead by example and give us all a Christmas present next year — go on John, give-up the copyright on your latest book (surely you will have made enough profits after one year), so we can all read it off the web for free.

Dr. Roger Bate is a fellow at the Competitive Enterprise Institute. His latest book is When Politics Kills: Malaria and the DDT Story.

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