The price of life
• Medicine becoming more and more expensive world-wide
 • 15% of the global population consumes 90% of pharmaceuticals

Sergio Alejandro Gómez Gallo

NOBODY in their right mind would dare to estimate the price of a life. However, pharmaceutical giants which control the world medications market have spent many years trying to do so and have reached an obvious conclusion: it is extremely high.

Thus they are making people pay, including those who cannot afford to do so.

"In recent decades there has been an exponential growth in the cost of medical treatment, which is becoming unpayable," affirmed Dr. Agustín Lage Dávila, director of the Cuban Molecular Engineering Center (CIM), during the 1st Strategic Studies Conference which took place recently in Havana.

There is a relationship between access to medicine and national income. "Fifteen percent of the world population consumes 90% of all medications," according to studies by the World Health Organization (WHO), cited by the Cuban specialist.

According to Lage, on many occasions, there is an attempt to justify the prices of new medicines in terms of the high cost of research. However, he noted, a large part of the expenses of major pharmaceuticals are destined elsewhere, such as marketing and advertising, which absorb more than 25% of their income.

Price policies are also linked to those of patents, a phenomenon which is not as old as one would think.

During the 1980’s, in the midst of the neoliberal whirlwind of the Ronald Reagan administration, the first precedent was set for authorizing U.S. universities and institutions financed with public funds to sell their patents to private companies.

This trend of channeling public funds for science into private profit became universal at the beginning of the 90’s after the establishment of the World Trade Organization, which also supervises the fulfillment of the sacred right of patents, but not that of health, which is inscribed in the Universal Declaration of Human Rights.

At the same time, universal regulations were imposed for the entry of medications with no respect for socioeconomic characteristics. According to this logic, Haiti must have the same requisites for importing antibiotics as Switzerland.

In terms of scientific insufficiencies affecting countries in development, Lage mentioned that, with 80% of the world population and 30% of world scientists, these only produce 4% of patents.

Lage stated that the pharmaceutical industry is a clear example of the failure of market mechanisms, given that resourses do not reach where they are needed.

WHO insists on noting the 90/10 reality. Less than 10% of resources for new medications are dedicated to confronting diseases which cause 90% of deaths in the world.

The market, Lage said, functions well in terms of directing the private sector to scientific investigation and interventions in health, but only for those who can pay.

He gave the example of antibiotics, which prevent millions of deaths per year but are losing their effectiveness in the face of more resistant bacteria. Investigation in this field is not attractive to pharmaceutical companies in comparison with research into non-contagious illnesses in older adults such as hypertension and diabetes – growing fast in the First World. Those suffering from these disorders must take medications for decades, which is big business.

The CIM director spoke about the Cuban strategy, initiated in the 1980’s, of creating a scientific complex for the development and marketing of medications and biotechnology products in a closed cycle, which currently groups together more than 7,000 scientists in 20 institutions.

These enterprises were created with the complete cycle concept: research, development, production, marketing and re-financing, which reduces costs.

However, Lage insisted on the need for a regional focus, given the dimension of the problems in accessing medicine.

One of the difficulties which Latin America has historically confronted, he noted, is the disconnection of research from production and the lack of communication between institutions in the region, which relate more with their counterparts in developed countries than among themselves.

He expressed the need for a network of scientific and industrial institutions designed to introduce their products into the health system, which is the final objective.

Lage also said that the myth that private research is more productive than public research must be broken. In high income countries, financing does not come from industry, but from the public budget in the majority of cases, subsequently converted into private profit.