Global Health

To fight pandemics, donors must help poor countries buy generic drugs.

AIDS, tuberculosis, and malaria are international scourges. Some 42 million people are living with AIDS, 2 billion suffer from tuberculosis, and each year 400 million contract malaria. And these diseases are destroying not just people, but national economies as well. (For more on the politics of malaria, see “Dying to Be Politically Correct,” page 46 of the Journal, Issue 3.)

Developing nations are particularly hard hit, as increasingly, members of their workforces fall ill and die. In Uganda, for example, coffee production (a primary cash crop) has dropped 50% over the past five years, pushing an already teetering economy further toward collapse.

Poor health, diminished family structures, and declining global domestic output are a recipe for disaster, but there are fresh signs that politicians, scientists, philanthropists, and industry want to commit significant forces to the battle. To much acclaim, the White House earmarked $15 billion for AIDS, tuberculosis, and malaria prevention and treatment in Africa. Philanthropists, led by Bill Gates, have increased their charity. Scientists, long working in fiefdoms rather than in collaboration, are now calling for a globally coördinated effort to develop AIDS medicines. Solid efforts, all.

But the most significant recent development for the treatment of diseases in developing nations came late this summer when the World Trade Organization voted to allow the importation of generic copies of essential patented drugs into poor countries. Humanitarian organizations like Oxfam argue that the WTO deal doesn’t go far enough and may just introduce an elaborate bureaucracy that will still inhibit access to necessary drugs. Even generic drugs might continue to be too expensive in the poorest of poor countries.

In a perfect world, all players would donate their efforts so that countries like Uganda could join the community of developed nations in receiving adequate health care. But social conditions that plague some developing regions like continuing corruption, civil war, foreign debt, poverty, poor public health care systems, and disease misinformation will all limit the effectiveness of even the most successful effort to make needed drugs available in developing countries.

And, for the most part, ailments like cancer and heart disease that afflict the citizens of large, wealthy countries will continue to get the majority of the drug industry’s attention and resources for research and development. This is simply because these treatments provide optimal returns on investment. Unfortunately for poor nations, pharmaceutical companies do not have a special social responsibility to risk their time and capital developing medicines only to give away their products.

Where politicians and philanthropists can help is not only to provide funding for prevention and research, but also to combine forces to buy medicines needed in poor nations. Along with generics, new money from wealthy countries funneled through an internationally respected group like the World Health Organization could be the missing link.

Leaders

» Paying for vital drugs for poor countries.

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