Mbeki vs. the AIDS Establishment... (10)
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81% favour that patents on AIDS drugs fall into public domain. These
are the current e-mail + web results of the poll open at:
http://www.egroups.com/polls/prevges
The reply of Noam Chomsky reproduced below may help to partly under-
standing this strong support for lifting patents on AIDS drugs. For
those interested to follow more closely the debate on patents of AIDS
drugs, I recommend the Pharm-policy list.
http://lists.essential.org/mailman/listinfo/pharm-policy
Christian Labadie
mailto:CLabadie@t-online.de
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Noam Chomsky's reply re. patents
Chomsky ZNet Sustainer Forum Reply About Aids and Pharmaceuticals, etc.
By Noam Chomsky
[The ZNet Sustainer Forum system includes about 40 forums, many hosted
by Z related writers, including Chomsky, Zinn, Albert, Cagan Bernard,
Peters, Shalom, etc. This is one reply to a query from Chomsky (he gen-
erally does ten to fifteen a week)... ]
There's a good commentary on this by Danny Schechter, which maybe
you've seen. If not, I'd suggest having a look.
As I read the reports, the issue was not about what leads to HIV, but
whether HIV is the cause of AIDS. Mbeki aroused a tempest by inviting
for consultation the tiny group of scientists who question this (you
can't find anything in the sciences that isn't questioned, and that is-
n't uncertain; that's the nature of empirical inquiry); and also by
questioning the possibility for South Africa to provide the drugs that
mitigate the effects. On the first, I think he withdrew his initial
skepticism, sensibly I think. He has no basis for making a judgment
about this technical matter. On the latter, he's right, as things now
stand; a real scandal. I think there would also be general agreement
among specialists that he is right in pointing out that hunger is a
much worse killer than AIDS, and that hunger and other consequences of
poverty contribute materially to AIDS and every other malady.
There's little disagreement among public health specialists, to my
knowledge, over the thesis that public health measures (clean water,
sewage disposal, adequate nutrition, etc.) have done far more to im-
prove health than medical science over the last few centuries; until
very recently, overwhelmingly more. Whether it's TB (also a horrendous
epidemic), malaria, AIDS, anything else, poverty is a huge factor. Pov-
erty is a huge factor also in contracting HIV in the first place: e.g.,
in the socioeconomic conditions that are a substantial factor in the
radical deprivation of rights for women, which is an enormous part of
the problem. And that's not the only example.
I saw the NYRB article, but read it as leaving the matter with strong
suspicions, not a firm conclusion.
We can debate how much the South African government can do and should
have done. But as almost always is the case, there is a far more impor-
tant question: what can we do and what have we done? There are two ba-
sic issues: poverty and drug availability. Poverty has multiple ef-
fects, as noted (only sampled). Drug availability includes the question
of what is produced in the first place. There's a famous "90-10 rule"
in the public health field: 90% of R&D goes for 10% of the population.
So there is no malaria vaccine, not because it is intrinsically hard,
but because the rich and privileged don't suffer much from it. That
generalizes.
We should therefore be asking ourselves what we have done about these
two crucial issues. Answer, very little. Foreign aid is always tiny,
and mostly hypocritical (a form of export promotion, to mention only
one aspect). With the end of the Cold War, there was little motivation
to pay even marginal attention to the needs of the overwhelming mass of
the world's population, and what little substantive aid there was de-
clined sharply in most countries, most dramatically in the richest
country in the world, which is simply off the spectrum. The US provides
virtually nothing. A fraction of the military budget would suffice to
overcome a very large part of the severe suffering throughout the
world. What are we doing about that? As for drugs, the system works
pretty much the way the rest of the economy does. A very large part of
the cost and risk is transferred to the public; half is probably a con-
servative figure, if we take into account the work in fundamental biol-
ogy on which applied R&D rests. The profits are then entirely privat-
ized. The pharmaceutical corporations, which are among the most profit-
able, claim that they need the profits for R&D; therefore they insist
upon protection, under the extremely rigorous patent regime imposed on
the world under the World Trade Organization rules, a regime that the
currently rich countries never accepted during their own period of de-
velopment, and that not only sharply inflates prices and profits but
also is designed to retard development, innovation, and growth. The few
attempts to analyze the problem closely (there's an excellent study by
economist Dean Baker, not sure whether it's been published) indicate
that if the public assumed the total cost and drugs were then sold at
market prices, there would be an enormous welfare benefit, dwarfing the
total benefits predicted by optimistic forecasts about the WTO.
This is only for starters. These problems are here, not in South Af-
rica. One can understand why the doctrinal institutions demand that we
focus attention on the failures or crimes of others, refusing categori-
cally to look into the mirror. But we all know that we should do ex-
actly the opposite.
Noam Chomsky
http://www.zmag.org/chomaidsforum.htm
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