The dark side of the pharmaceutical industry

On Wednesday February 19th, Manchester Youth Stop AIDS society hosted the 10th annual Speaker Tour. Manchester Youth Stop AIDS is part of a national network of groups and societies who are passionate about campaigning to bring about an end to AIDS. There is currently no cure for HIV, however, with the currently available treatment, the continuous spread of HIV could be prevented. This is why one of the three targets Youth Stop AIDS wishes to achieve by 2030 is zero new infections. The other two goals are zero AIDS-related deaths and zero stigma and discrimination.

The Speaker Tour visited 17 different locations over a three week period, eventually finishing in the Houses of Parliament. George and Brian were the two HIV-positive speakers that spoke in Manchester. Brian, who was born HIV-positive in Uganda, spoke about the shame he felt when his teacher asked him—in front of his entire school class—about the pills his teacher had found. Those pills were Brian’s HIV medication, and after that day he felt ashamed and excluded from the rest of his class. George, from England, told us about the drastic side effects he had experienced when he first started taking his medication and about his feelings towards his status—both now and when he was initially diagnosed. Both George and Brian told us about their desires to turn their HIV statuses into something positive. They believe that, through speaking out about their own personal experiences with the virus, they will inspire more people to do the same—but not just those living with HIV.

There is a myriad of problems surrounding HIV and AIDS. The stigma that has historically been associated with the virus still remains today, meaning that many people are incorrectly fearful of HIV-positive people based on how they believe the virus is transmitted; the consequences of a diagnosis; and the types of people that can catch it. By speaking out about HIV, we are helping to reduce this stigma so that a HIV diagnosis does not come attached with other non-health-related problems.

Over 36 million people are currently living with HIV, however only 15 million of them have access to the treatment that they desperately require. This treatment reduces the chance of transmission by 97 per cent, meaning that it could essentially be used as a prevention method. Not only that, the life expectancy of a patient on treatment can be the same as someone without HIV. It seems completely counter-intuitive that, given its efficacy, this treatment is only accessed by few. The reason for this inequality is based on the current system of biomedical research and development.

Currently, more money is invested into research for treatment for Male Pattern Baldness than HIV and AIDS, this is due to the enormous discrepancy in the amount of revenue that can be generated from the subsequent drugs developed. This situation does not apply to HIV alone. The first Ebola outbreaks occurred in 1976. However, there was limited research into the means by which Ebola could be treated, due to the epidemiology of the virus. Consequently, the most recent Ebola epidemic killed five times as many people as all the previous Ebola epidemics combined. Is it even worth speculating about the number of lives that could have been saved if pharmaceutical companies had been interested in developing treatment for Ebola back in 1976?

The stringent patents applied to the drugs in question also mean that treatment for HIV, and other diseases, can be extortionately expensive due to certain drug companies having a monopoly over the prices of the drugs. As a result, even if the appropriate drugs did exist, the possibility of being able to afford them is completely out of the question for many people. This is especially the case in Sub-Saharan Africa where 70 per cent of the world’s HIV-positive population live.

Until “pharma bro” Martin Shkreli hiked up the price of Daraprim from $20 to $750 per tablet, the flaws of the pharmaceutical industry have rarely been exposed in mainstream media. Daraprim is used to treat toxoplasmosis, a condition sometimes developed by AIDS patients that can be fatal if untreated. Shkreli justified his 5500 per cent price increase by comparing the medication to cars, stating that “if there was a company that was selling an Aston Martin at the price of a bicycle, and we buy that company and we ask to charge Toyota prices, I don’t think that that should be a crime.” His actions have been deeply criticised by people with varying levels of knowledge in the biomedical industry. He was subsequently considered to be the personification of the dark side of the pharmaceutical industry and was nicknamed the “pharma bro”.

An article published previously in this paper, written by Jessica Chow-Lau, defended Shkreli and his actions. In this situation, however, it is essential that the overall picture is taken into consideration, rather than simply the actions of individuals. It is completely absurd that the man who pays $2 million for a one-of-a-kind album by Wu-Tang Clan also has the control over the price of life-saving medicines. Such people like himself should not be able to prevent access of essential medicines to those who require them.

If healthcare was truly considered to be a basic human right, large companies and individuals would not be able to profit from the lives of others, as is currently the case. The entire system is focused around the ultimate profit made from the drug developed, however there appears to be some discrepancy between the real cost of drug development and that stated by pharmaceutical companies. This is exemplified by the Indian drug company, Cipla, who have offered anti-retroviral medicines (to treat HIV) at under $350 per year, per patient.

Given the complexity of the system of biomedical research and development, there is no simple solution to how the price of drugs should be determined. Despite this, a shift is urgently required so that health is prioritised over profit with respect to the reasons for drug development. Medecins Sans Frontieres (MSF) have been a driving force in ensuring that this switch occurs by pioneering new approaches to the ways in which affordable, essential medicines should be developed. As a result, the World Health Organisation (WHO) are holding a meeting later this month to push for reforms to the research and development systems to take place. Currently, the UK government are yet to confirm their attendance at this meeting. Youth Stop AIDS however, would like to change this. Their petition to convince the UK government to attend the meeting is rapidly acquiring signatures—indicating that people really do believe that global health should be prioritised over profits. As a result of the Youth Stop AIDS Speaker Tour, it is hoped that an increasing amount of people are aware of the issues associated with the pharmaceutical industry and are inspired to push for the essential changes that must take place in order to save millions of lives.

To find out more about the work of Youth Stop AIDS, and to sign the petition, head over to www.youthstopaids.org.