Depending on what terrorists do next, the United States could be on the verge of a public health catastrophe.
The administration is moving--belatedly--to develop stocks of antibiotics to treat anthrax. The government also is looking to procure 300 million doses of smallpox vaccine to inoculate a new generation.
Bayer, the maker of the anthrax antibiotic Cipro, resisted government efforts to mandate patent licensing, which would enable other labs to manufacture an emergency supply. The generic version of Cipro is easily produced for a tiny fraction of the $350 for a month's dosage that Bayer charges. Producers in India sell that much generic ciprofloxacin for about $10. Another antibiotic, doxycycline, is just as effective as Cipro to treat anthrax. A month's treatment of doxycycline retails for about $20.
But until this crisis, Cipro was the only drug approved by the Food and Drug Administration explicitly to treat anthrax exposure caused by inhalation of spores.
Meanwhile, the trade association of brand-name drug makers, the Pharmaceutical Research and Manufacturers of America, or PhRMA, has convened a task force of chief executives from the industry to address the extra production needs. This sounds good, but PhRMA explicitly excludes makers of generic drugs.
There is a name for this behavior: war profiteering.
We should hardly be surprised. This is the same industry that mightily resisted supplying inexpensive AIDS drugs to Africa until it was shamed by world public opinion and outfoxed by makers of generic equivalents in India and Brazil. The Third World basically dared American and European drug makers to take them to court, and PhRMA blinked first.
What is good enough for a public health emergency also is sound policy for everyday emergencies. Millions of people are denied medicine they need because they have to choose between paying to fill expensive prescriptions and eating. We need federal controls on drug prices and more production of generic drugs financed by public funds.
The other part of this story has to do with public health. For 20 years, public health has been a stepchild of federal policy, while both parties have supported prodigious increases in the budget for the National Institutes of Health.
What magic does NIH possess? The drug industry loves it because the NIH finances the basic research on which the industry relies to make its customized products and exorbitant profits. Every time a particular disease comes into vogue as a public cause, the drug industry jumps on the bandwagon and gets another hike in NIH funding.
It makes sense for the public to fund basic research. But then taxpayers should not have to pay twice via high prices at the drugstore.
Neither is it sound policy to favor research that helps the drug industry while short-changing public health and epidemiological efforts that could safeguard more people at lower cost.
Let's rein in drug company profits and rebuild our public health system so that all Americans can get the drugs and vaccines that we need at the lowest possible cost.
Copyright 2001 Los Angeles Times