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Even Pharma's Good Deeds Are Criticized

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The pharmaceutical industry is far from perfect and previous posts have discussed some of these problems. However, this industry plays a major role in the discovery and development of new medicines. Furthermore, in annual surveys of the most generous companies in America, pharma companies routinely dominate the list.

Yet, even this generosity gets challenged, as shown in a recent article in The Guardian entitled “Drug Donations Are Great, But Should Big Pharma Be Setting The Agenda?”  The concern raised in this essay is that, by giving out free medicines in Africa, pharmaceutical companies are essentially shaping the public health agenda in developing countries. The major example cited revolves around an HPV vaccination program for cervical cancer in Rwanda, which was made possible  by Merck which agreed to donate its vaccine for three years. The concern of health care providers in Africa was twofold.  First, they believe that Merck is simply priming the market in Rwanda for future vaccine use, although Merck has promised to provide discounted prices for vaccines after the three year period. Second, critics feel that such a concentrated focus on HPV (95% of 11 year old girls ) was misplaced as cervical cancer lags way behind other vaccine preventable diseases in the developing world.

This is a fair concern. However, the multiple drug donation programs that pharma has instituted is not a case of foisting  medicines on patients in need. A company can only donate drugs that it produces. For example, when Merck, in partnership with the WHO, UNICEF, and the World Bank, set out to eradicate river blindness in Africa , it was able to do so because it had a valued anti-infective product, ivermectin, available for use. The WHO has estimated that 40,000 cases of river blindness are prevented annually as a result of this program.

Industry critics would prefer that companies work in conjunction with the developing world to bring forward medicines that would be more cost-effective in meeting their needs. Rather than having Pharma “push” medicines that they already have in their portfolios into the developing world, countries would prefer it if Pharma would work on diseases that predominate in these regions.

Well, that’s not a bad suggestion. In fact, it would surprise a lot of people to know the broad extent that Pharma is already doing this. By simply checking the website of the International Federation of Pharmaceutical Manufacturers & Associations, one can find a stunning array of investments and initiatives dedicated to finding cures for diseases that plague the developing world, diseases that largely don’t exist in the western world. For example, AstraZeneca , GlaxoSmithKline (GSK), Merck and Novartis all have R&D centers established solely for work on cures for neglected diseases. Pharma companies are devoting resources to find treatments for malaria, trypanosomiasis (sleeping sickness), Dengue fever, and Chagas Disease that plague the developing world. If Pharma’s efforts are successful, they will come up with new medicines that will benefit millions of people - medicines that will have a negligible effect on the bottom line for these companies.

Pharma isn’t working in a vacuum . Many of these efforts are being done in conjunction with the Gates Foundation, UNICEF and the WHO.  In addition, Pharma’s efforts go beyond providing drugs and money. GSK has run the African Malaria Partnership for over a decade to implement behavioral change programs to aid in the prevention of malaria in vulnerable communities. GSK is not alone in these efforts. Other companies like Novartis and AstraZeneca have programs designed to help train health workers, educate patients and then measure health outcomes to determine which methods are working best.

I have no doubts that industry critics will dismiss these efforts as attempts by pharmaceutical companies to generate good publicity. But these efforts go beyond PR – they reflect the social responsibilities of the hundreds of thousands of people who work in this industry. These efforts benefit some of the neediest people in the world. Unfortunately, this altruism is too often overlooked.

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