Drug companies- helping or harming the health of the Third World? This month we review a controversial study of the issue- and a round up of books on the Bomb.
Editor: Anuradha Vittachi
The quick fix
The Health of Nations: a North-South Investigation
by by Mike Muller
Faber pbk £3.95
Illustration: Clive Offley
In August 1979 a woman living in Mozambique took a pain-killing drug. It was sold by a well-known transnational company, manufactured according to the latest hygienic methods and contained what the label described. The effects, however, were frightening. A painful infection erupted all over her face and spread to other parts of the body. Abscesses formed in her lungs. Her life was in danger and was saved only by emergency action when she was flown to a hospital in South Africa It was later discovered that the drug had been shown liable to cause such side-effects 58 years before.
In The Health of Nations, Mike Muller asks whether the positive contributions made by transnational drug companies are not ‘outweighed by, and incidental to, the damage they do and the bad health they promote: in economic terms, whether the resources they have captured would not generate more benefit to their consumers if applied in other ways'.
In the early 1970s there was only a handful of relevant studies of these companies; now there is a deluge. Issues like drug safety, efficacy, research, market power and drug use are discussed in the first half of Muller’s book. All are legitimate targets for critics of the large companies.
More pertinent, however, is questioning the nature of health itself. Now the fashionable catch-phrases are ‘Health by the People’ and ‘Health for all by the Year 2000’. The emphasis is changing from curative to preventative medicine and, thus, away from pharmaceuticals.
Not surprisingly, the drug companies are eager to find a role for themselves in this new environment or, better still, to control any change. The second half of the book discusses the position in the 1980s: the concerted attack by UN agencies on bad health — and the corporate response. Muller’s information is up to date and his references as diverse as the Dar es Salaam Daily News, and documents produced by the transnationals for internal use.
Muller is an excellent person to tackle this subject He writes very readably and is no stranger to health controversies: in the early 1970s he wrote the influential War on Want book, The Baby Killer Scandal, and followed it with Tomorrow’s Epidemic, an examination of tobacco marketing in the Third World.
Today he works as an engineer in Beira, Mozambique. He has seen at first hand the effects of drug usage in the Third World and has the ability to set the particular against an international background. The woman described in the first paragraph called on him for emergency help and the book is full of such incidents observed in several countries.
And the other end of the chain has not been ignored. Muller has interviewed the decision makers of the big companies in their headquarters and presents a fascinating account of the strategies they now adopt to meet their critics.
If there is a failing in this book, it is in the oversimplification of the political economy. Mention is made of the vested interests of medical doctors but in countries such as India, frequently praised for its capacity to produce pharmaceuticals, there are other issues. Local production is-promoted not so much for medical considerations as for the economic targets of import substitution and the elusive benefits of industrialisation. Recent studies of India suggest that such schizophrenic planning is, at best, irrelevant to the health of the general population.
Although Muller is able to describe some positive recent developments, the mood of the book is pessimistic. ‘The multinational companies have a positive contribution to make to Third World health care: of this there can be no doubt,’ he say-s. The problem is that they are not making that contribution. ‘After all,’ says a spokesman for the pharmaceutical transnationals, ‘you can’t expect us to support policies which run counter to our own interests.’
Andrew Stoker has worked as a chemical engineer in a major
pharmaceutical company and is currently with the University
of Edinburgh, U.K.
The Politics of Uranium is an inadequate title for this book by Norman Moss (Andre Deutsch, £4.95). It does, to be sure, deal with the politics of nuclear power and nuclear weapons, and with the economics and trade that are linked with the politics. But it deals with so much else besides: the structure of matter; radioactivity; the invention of the fission and fusion processes; chain reactions and the manufacture of plutonium; efforts at control; where and how uranium is mined; the nuclear non-proliferation treaty; how the various types of nuclear reactor work; the disposal of nuclear waste; the dangers of radiation.
All these and more are dealt with in close packed, factual prose. The readers are left to pass their own judgement and to supply their own indignation.
But The Politics of Uranium stops short of discussing the possible use of The Bomb (it’s strange how everyone knows what is meant by ‘The Bomb’ and ‘The Pill’, as distinct from any other bombs or pills). For that, one needs to choose among the plethora of books and pamphlets that have appeared over the last couple of years, some with an international appeal, others primarily directed towards a readership in a particular country.
Among the best of the former is Nigel Calder’s Nuclear Nightmares; an Investigation into Possible Wars (Penguin £1.50, 53.95)— not a book to cheer one up. Calder says, ‘The risk of a holocaust is growing with every year that passes and whether we shall avoid it between now and 1990 is at least questionable.’
Of the many directed primarily towards British readers (slingstones of David against the Goliath of the official line and its supporters), my own preferences are How to Make up Your Mind about the Bomb by Robert Neild (Andre Deutsch, £2.95) and Nuclear Weapons: the Way Ahead by Ronald Gaskell (Menard Press, £1.20).
These serve to ‘educate our anger’, to take the Rev. Sloan Coffin’s phrase when addressing the World Council of Churches conference at Amsterdam last year. But first must come the anger that is to be educated. To that end I’ve recently reread John Hersey’ s Hiroshima* (Penguin Classics £1.10)— over thirty years old but nothing published since can match it.
(*For a fuller review of ‘Hiroshima’, see NI 113 classic)