You sit face-to-face with a notorious public figure. “Hear me out,” he says.
Several hundred Harvard College students made their decision when Martin Shkreli made his appearance on campus two weeks ago and asked them the exact same thing. The former drug executive, who notoriously raised the price of a life-saving drug from $13.50 per pill to $750, was invited by the Harvard Financial Analysts Club (HFAC) to speak to undergraduate students about investments and healthcare. Inevitably, his appearance sparked controversy--some students planned a peaceful protest, others pulled a fire alarm to trigger evacuation, and some attendees walked out after calling him a “sexual predator” and “racist.” Many also stayed.
Although important topics, today’s blog post will not discuss the integrity of the HFAC’s decision or form an opinion about the student reactions. Rather, we would like to take this opportunity to step outside of our predominantly liberal space to explore opposing opinions, gain knowledge, and think critically to develop a well-informed opinion.
While the majority of us want to immediately denounce Shkreli’s drug hike decision, there’s always two sides to a coin and it’s important that we explore his point of view and justification in raising the price. Throughout his many interviews with journalists, Shkreli pointed out a few ‘justifications’, one of them being raising the price of Daraprim for research and development purposes. He hopes to improve the current formulation of the drug and to develop new therapeutics since no significant advances into the disease have been made for a decade. But according to many physicians and professors, there is no need for new advancements, as the toxoplasmosis targeting drug works perfectly well (Fortune). So I guess it comes down to how much of that 5000% increase is actually going into R&D?
To shed some more light into the mind of Martin Shkreli, his ‘whole life has been one theme, of self sacrifice for his investors. He did [the price hike] for his shareholders’ benefit because that’s his job’. He continues saying that by charging $750 a pill to big companies like Walmart, it makes him feel like a hero since the money earned would go towards research for dying kids (The Guardian). So what if Shkreli is actually a robin hood in disguise? Taking from the rich and giving to the poor. Maybe we’ve had him wrong this entire time, maybe the media painted a nasty picture of him without hearing him out? To Shkreli, he certainly feels that’s the case.
During a casual lunch with a journalist, Shkreli expressed his concerns about the media and politicians that attacked him. He feels he became a target not because of what he did but because he was so easy to parody - essentially, he feels ‘misunderstood’ since other companies have jacked up drug prices with no consequences. Why should he get the blame when many other price hikes go unnoticed? How can you hate a person who says “I care more about drug science than anyone you can point at. I love this business and I love science and I hold my yardstick to that. I know I’m helping patients. That’s all I need to know” (Forbes).
To conclude, Turing pharmaceuticals’ actions should be no surprise at all, since one would be a fool to forget that pharmaceutical companies are profit-driven institutions. The issue is not the increased profits per se, but rather the use of these profits. While Shkreli claims that the increased profits from the price hike in Daraprim will support research and development of drugs, documents reveal that they are in reality being spent on lavish company celebrations and six-figure Turing executive salaries (the New Yorker).
What should be a surprise to us is what this reveals about the pharmaceutical industry. After Turing acquired rights to produce and sell Daraprim, it essentially became a monopoly for the drug in America. The reason for this was that there were insufficient policies and regulations in place to expedite the transition to generic drug production and promote competition. This serves as a critical warning of the fallacies in the regulation of the pharmaceutical industry, and by extension, emphasizes the importance of adopting more socially responsible patent and licensing policies to prevent the greedy hands of profit-minded executives from stripping helpless patients of essential medicines. If a roof leaks water after a heavy storm, who is to blame—the storm or the mason who constructed the roof? Shkreli is simply a scapegoat towards which the public is directing its anger. In reality, we should channel our concerns towards more critically evaluating the failure of the pharmaceutical industry.
Written by: Nancy Wu, Nabeel Mansuri, Kevin Fan
Nancy, Nabeel, and Kevin are currently in their third year of undergraduate studies at Western University and serve as Directors of the Access Committee
Back in 2012, the federal government in Canada passed a bill that would cut refugee healthcare funding by a quarter, saving around $20 million annually. On January 27, 2017, president Donald Trump issued an executive order that would ban the immigration of refugees and citizens in seven predominantly Muslim countries. Yet in a world that is becoming increasingly more divided—pushing away vs. reaching out to refugees with open arms—one particular action may have just tipped the scales in favour of humanitarian and social justice.
Recently, the Canadian federal government announced that it would restore refugee healthcare benefits to pre-2012 levels. Although the effects of better healthcare have yet to be seen on a macro level, the following passage is a testimony to the efficiency of the healthcare system, and if anything, offers a glimpse of hope.
The anecdote that follows is from a third-year medical student:
I have the privilege of working at a community health centre affiliated with McMaster University which is one of the centres dealing with refugee health. The family doctor I work with primarily deals with Syrian refugees, due to the fact that he speaks Arabic. When the government first accepts refugees they screen them for TB. When they arrive in Canada, they get put into a group home (the one in Hamilton is called Wesley Urban Ministries). Ideally, within two days of arriving in Canada, we visit the refugees at their group home and interview them. When I walk in, I immediately notice the stark contrast between this and the normal hospital setting. There’s a seven-year-old girl who’s missing a leg from a bomb explosion, and another man with fungal skin infections everywhere. We give them a head-to-toe assessment: taking their height, weight, blood pressure; accessing their history on previous immunizations and medications; auscultating their heart and lungs; and screening them for diseases such as lice and fungal skin lesions. After our visit, Wesley Urban Ministries arranges the family to see a dentist and an optometrist. Considering the amount of refuges that have cavities, I’m really impressed by this aspect of their healthcare. When we get the patients’ blood work back, we perform a comprehensive screening (hepatitis, MMR, varicella, etc.). The refugees come back to get all the immunizations they need, and usually a flu shot as well. We prescribe further medication, and perform a more thorough medical history is necessary. Part of the purpose of the second visit is to see how the refugees are coping with life in Canada, and how they are getting by at Wesley Urban Ministries. A big part of all of it is ensuring that they are healthy both physically and mentally. When you think about how little people that aren’t refugees actually receive this level of care, I’m surprised about how good the system really is, it’s actually quite good.
Despite all this, there is still a lot of work to be done. As of now, only government-assisted, privately sponsored, or approved refugees are given access to proper healthcare. For those who can’t readily access the treatments that may potentially save their life, Canada may as well be one of the worst places to immigrate to. In fact, Canada pays the second highest drug prices in the world, only after the US. Amlodipine, a drug used to treat coronary artery disease, is priced at $130 in Canada, but only $10 in New Zealand. So it’s quite embarrassing that I’ve seen articles titled, “The Canadian Remedy: How to save hundreds on prescription drugs” written by ABC affiliated-WZZM where they advocate travelling across the border to “save hundreds, even thousands” on prescription drugs. Canada needs more systems and companies like New Zealand’s PHARMAC, which dramatically lowers the price of drugs to make them more affordable and accessible.
And although there is still a lot of work to be done in a world where so much of society is divided, and where Muslims have never felt more unwelcome, the recent appeal has given the refugees the sole most important thing in this battle for social justice: hope.
Written by: Jason Liu
Jason is currently in his first year of undergraduate studies at Western University and serves as one of UAEM Western's Empowerment and Events representatives.
The World Health Organization (WHO) defines “health” as the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. However, it is imperative to note that access to quality care and essential medicines is a strong determinant of how healthy individuals are. Explanations of lifestyle are dominant in Western views, but social factors are better predictors of health and are more effective, especially at the group or population level of analysis. The social determinants as a whole, can have varying effects on the health of vulnerable population groups such as those in remote and rural settings.
Populations in developing countries do not have the same access to health care and treatments that we take for granted. The World Health Organization estimates that up to 3 million children die each year in Africa from diseases, of which a significant amount can be prevented. These children suffer from vaccine-preventable diseases including measles, polio, meningitis, tuberculosis and pneumonia. This can be directly attributed to the lack of rural health service delivery in remote places across the continent. There is no infrastructure in place to address these limitations because there has not been investment to do so. There are safe and effective treatments to cure or prevent all of these ailments, but a combination of societal and geographical factors makes it hard to do so.
Additionally, the current research and development system has hindered the delivery of essential medicines to these populations. Societies are suffering from treatable illnesses because they simply cannot afford the price of expensive Western medication. The for-profit pharmaceutical industry has made it increasingly difficult to provide inexpensive care because of the high cost of essential medicines. The World Health Organization has a list of essential medicines that should be available to adults and children all over the world in sufficient amounts and at any time. However, this is not the current reality. Individuals in low socioeconomic settings in developing countries cannot access the lifesaving treatment that they need.
Above all, access to health care is an issue that affects different subsets of populations all over the world. Not only do we see this problem in developing countries, it can be found even in Northern Ontario and the aboriginal populations. To address this issue, the price of people’s lives need to be valued more than the price of pharmaceutical drugs. This is the essence of what UAEM is trying to achieve. It should be mandatory for individuals all over the world to be given the same level of access to essential medicines so that they can treat curable diseases. For further reading, check out the link below and get in contact with any UAEM member to find out what you can do to get involved.
Written by: Gagan Dhaliwal and Yallenni Imanvaluthy
Gagan and Yallenni are currently in their third year of undergraduate studies at Western University and serve as one of UAEM Western's Global Research and Development Leaders and Campaign Core Leaders respectively.
In this battle to make sustainable healthcare more accessible, it is great to hear yet another group of passionate people who advocate equal rights. Novartis International AG, a Swiss-based pharmaceutical company is pitching for exclusive patents rights on the drug Glivec in India. While the drug shows potential for cancer treatment, exclusive patent rights for a private organization undoubtedly translates into millions of people being deprived of this provision.
Being a member of the World Trade Organization, India imposes a strict patent law to avoid second-party transaction monopolies on medicines. While Glivec is sold for $40.46 by Novartis, the generic drug can be sold for $3.28. On average, 1300 people die on cancer every day in India, and thus access to medicine is a necessity.
In a situation like this, it is important to voice the ideology of affordable medicine for all and prevent the system from breaking under the influence of powerful private organizations. Such a step was taken when in an open letter to Novartis, the representatives of Doctors without Borders plead Novartis to “focus on innovation and not take actions that reduce access to essential medicines.” With the actions of spreading awareness and learning about the implications that supply of generic drugs have on lives of people, especially within the developing world will go a longer way to making medicines affordable for all.
With court proceedings running for over a decade, the Indian Court System ruled against evergreening the sale of Glivec for Novartis in 2013. The decision was widely accepted by global organizations including the World Health Organization and Doctors Without Borders who highlighted the benefits of the ruling for millions of people in poverty.
As students from Canada, a country with universal healthcare system, we can understand the importance of having access to medication. Being a member of the access committee in UAEM Western Club and through this blog, I want to highlight this one global issue and see how we as Western students can work to carry the philosophy forward.
To learn more about similar global issues, you can visit the following sites: http://www.msf.ca/en/article/stop-threatening-access-affordable-medicines-millions
http://www.msf.ca/en/access-medicines http://www.forbes.com/sites/judystone/2016/11/13/new-pharma-rankings-on-glob al-access-to-medicine/#3e1050402123
Written by: Janhavi Patel
Janhavi is currently in her second year of undergraduate studies at Western University and serves as one of UAEM Western's Report Card Leaders.