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Letters: Fixing the drug gap

Jeremiah Norris, the author of a recent article published in your paper, works for the Hudson Institute, which is described in his bio as a think tank ("WHO: Long on agenda, but short on the facts," Nov. 4, page 8). This think tank is funded by pharmaceutical giants including Eli Lilly, Merck, Pfizer and the Pharmaceutical Research and Manufacturers of America, and its output regularly reflects the views of its corporate sponsors.

Norris' ill-conceived rant suggests it is health infrastructure, not drug prices, that matters in developing countries.

The reality, however, is that both factors are vital.

If AIDS drugs in developing countries still cost US$10,000 a year per person -- as they did at the beginning of the decade and before the introduction of effective generic drugs led to a 99 percent drop in prices -- mass treatment of people with AIDS in the developing world would be impossible.

Even with the massive infrastructure problems that beset developing countries, lowered prices for AIDS drugs has made it possible for more than 2 million people with AIDS to receive treatment -- and live rather than die.

Norris goes so far as to assert, against all evidence, that the system creates incentives for research and development into "neglected diseases," which predominantly affect people in developing countries. In this, his position is even more knee-jerk than the Hudson Institute's pharmaceutical industry funders. The brand-name industry is at least willing to concede the need for mechanisms to supplement patents.

Many public health advocates hope for something more far-reaching: that drug developers be generously compensated, but by mechanisms other than ultra-high drug prices.

Norris' fantastic claims notwithstanding, no one, least of all the WHO, says the agency should be placed in charge of global research and development.

But public health advocates do believe we can and must find ways to support R&D that do not result in the rationing of life-saving medicines in developing countries and the denial of life-saving treatment to people simply because they are poor.

Robert Weissman, WASHINGTON
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