By Chris Floyd
    t r u t h o u t | UK Correspondent

    Tuesday 16 January 2007

    I. The Biochemistry of Hope

    More war in Iraq. A new front in Somalia. Ships, troops and planes lurking on the borders of Iran. Every day seems to deepen the shadow over the dark valley of our times. Driven by a reckless regime in Washington and the increasingly strident reaction it provokes, and by growing financial and social inequities stranding billions of people in poverty and despair, the geopolitical scene appears locked in a cycle of conflict and chaos that nothing can break.

    But a quiet announcement at London's Hammersmith Hospital at the turning of the new year heralded a breakthrough that has the potential to be one of the most transformative developments ever seen in global affairs: a positive change on a par with - or even surpassing - the world-altering malignancies of war, greed and strife. But this boon could be strangled in its cradle by the vast corporate interests threatened by its radical new approach to both health care and business.

    The approach is called "ethical pharmaceuticals," and it was unveiled on January 2 by Sunil Shaunak, professor of infectious diseases at Imperial College, and Steve Brocchini of the London School of Pharmacy, the Guardian reports. Their team of scientists in India and the UK, financed by the prestigious Wellcome with technical assistance from the UK government, have developed a method of making small but significant changes to the molecular structure of existing drugs, thereby transforming them into new products, circumventing the long-term patents used by the corporate giants of Big Pharma to keep prices - and profits - high. This will give the world's poorest and most vulnerable people access to life-saving medicines - now priced out of reach - for mere pennies.

    But the breakthrough is not merely biochemical. Shaunak's team is proposing a new model for the pharmaceutical business. The patent of the transformed drug they have developed is held by non-profit Imperial University. And because their methods are hundreds of millions dollars cheaper than the mammoth development costs of the big pharmaceutical companies - whose spending on marketing and advertising often dwarfs their funding of scientific research - Shaunak and his colleagues can market their vital medicines for infectious diseases at near-giveaway levels, yet still stay in business. How so? By forgoing the profit motive as the ultimate value of their work.

    "People in academic medicine have a choice," Shaunak told an Imperial College journal. "They can use their ideas and creativity to make large sums of money for small numbers of people, or they can look outwards to the global community and make affordable treatments for common diseases."

    The first drug developed by the team is a new version of interferon, the main treatment for Hepatitis C, a debilitating disease that afflicts 200 million people worldwide. Yet only 30 million can afford the medicine. That leaves the rest to face the chronic liver disease and premature death that the illness inflicts. The cost of Hepatitis C treatment in the UK is approximately $13,000 per patient per year, New Scientist reports. Nor can a cheaper version of the existing interferon be made, because Big Pharma players Hoffman-La Roche and Schering Plough hold patents not only on the drug but also on the standard way of adding the special molecules needed to enhance its performance.

    So Shaunak and Brocchini invented a new way attaching the molecules - from the inside, not the outside - that went around the patent restrictions and produced a medicine that "appears to be as effective as the existing product," according to Nature, the leading scientific journal. Their novel methods could also be adapted to extend the effectiveness of "drugs for other conditions such as HIV," at a fraction of current costs, Shaunak told New Scientist. Big Pharma says it costs an average of $800 million to create a new drug; but without the need to produce ever-expanding profits for shareholders or use glitzy ad campaigns to push their pills - or lay out the vast political patronage that Big Pharma dispenses each year to keep its favored politicians sweet - Shaunak says his team can now develop essential medicines for only a few million dollars each.

    In fact, while their Hepatitis C medicine undergoes government-funded clinical trials in India, Shaunak and Brocchini have been asked by Médecins Sans Frontières to work on treatments for another ailment: Leishmaniasis, a parasitical disease also known as black fever. It "occurs in the poorer parts of the world: India, around the Mediterranean, South America, Sudan," Shaunak told Spero News. "Again, there is a treatment that cures the disease but in places like Bihar, India, the cost of the drug is 80 percent of a person's annual income. What we are going to do is make a version of the drug which will be stable in hot climates and which will cost about 10 percent of the price of the existing medicine."

    The potential benefits and geopolitical implications of this approach are almost limitless. Imagine a world where the most downtrodden can be rescued from the ravages of chronic disease that now beset them, generation after generation. A world where they don't droop and languish, where their energies are not consumed and exhausted in the struggle for survival. A world where their children are born to healthy mothers, with all the proven advantages for future development, both physically and mentally, that such a birth provides. Imagine a world where the preventable deaths and epidemics that break down societal bonds, devastate communities, cripple local economies, destroy families and make any kind of political action almost impossible are a thing of the past. Whole new polities, new movements, new philosophies, new centers of power would be created as the majority of humanity - the untold multitudes who simply "don't matter" now, who live and die on the ragged margins, in the mega-slums and shattered villages, the industrial wastelands and war-scarred regions - are finally liberated from the tyranny of chronic disease. Imagine the kind of politics that could emerge from millions of long-forgotten people suddenly given more strength, more longevity, more time and energy to seek political change and redress of grievances rather than merely fighting to stay alive.

    It would be the political, social and cultural equivalent of the discovery of the "New World," which transformed global affairs forever. Only this time, the "natives" would be healed and empowered by the encounter, not decimated and marginalized by disease and dispossession.

    We're not speaking here of "miracle cures" for all ailments, but simply of access to the kind of basic health care that is considered normal in the developed world. Of course, millions in these more privileged countries also suffer needless debilitation from the firewall of profit and price that surrounds so many medical advances. And here too, "ethical pharmaceuticals" could also have a large political effect. Once the drugs pass medical trials in India and elsewhere, they can be sold in many nations in the developed world. Britain's National Health Service, for example, would be able to use the Shaunak-Brocchini treatment for Hepatitis C, saving tens of millions of dollars for the public health service every year: money that could then be used for treating other diseases, for preventive care, for improving facilities - a virtuous circle rippling outward through society.

    II. Pushbacks and Politics

    Of course, the American people would doubtless be "protected" from such radical virtue by its benevolent government, which even now shields them from the menace of "unsafe" low-cost prescription drugs from Canada. (For as we all know, al Qaeda has thoroughly infiltrated Canada's commie-style health care system and is hoping to flood the Homeland with polonium-laced heart pills and exploding suppositories from Montreal and Saskatoon.) A strong bipartisan consensus in Washington has long fought off the importation of dubious nostrums from devilish foreigners. And although this tender concern for the wellbeing of the American people has never quite extended to actually providing them with guaranteed health care, it has - no doubt coincidentally - done wonders for the coffers of the major pharmaceutical companies, who have reciprocated by showering their largesse on these dedicated public officials.

    The power of this relationship has just been demonstrated once again on Capitol Hill, as the Washington Post noted on Friday. The newly-empowered Democratic majority in Congress has scaled back its once-bold plans to overhaul George W. Bush's disastrous Medicare drug program, which bollixed the medical care of millions of Americans but has proven to be a bonanza for Big Pharma. (As well it should, seeing how pharmaceutical lobbyists wrote most of the bill.) Now, instead of their original plan to create a federal prescription-drug program that would genuinely benefit the majority of the populace, the Democrats are offering an anemic measure that would require the government to use its buying power to negotiate lower drug prices for Medicare patients. Even this would be an improvement over the current boondoggle, but it is of course foredoomed to failure: Bush has already promised to veto it, and the Democrats are unlikely to muster enough votes to override his rejection.

    That's because, as the Post reports, "drug firms and their trade groups have been transforming their Washington operations by hiring top Democratic lobbyists to gain access to new committee chairmen, bolstering Democratic political donations and spending millions on public relations campaigns to overcome an image, indicated in recent surveys, that the industry puts profits ahead of patients." (More money that could have been spent on developing cheaper cures for, say, Hepatitis C or Leishmaniasis.)

    In fact, Big Pharma has laid out more loot for American politicians "than any other industry between 1998 and 2005 - more than $900 million," the Post reports. For that amount of money, the Shaunak-Brocchini method could have produced some 90 new low-cost treatments for deadly infectious diseases around the world.

    With this kind of political muscle behind it, Big Pharma will be well-placed to launch its inevitable push-back against ethical pharmaceuticals. They are already limbering up the legal artillery for possible patent infringement suits against the Shaunak team - although the latter, through Imperial College, has also procured some big legal guns to protect the process, including top lawyers who have worked for Big Pharma itself, the Guardian reports. With press releases and pro-industry articles from friendly journalists in conservative UK papers, the corporations are also mounting a PR campaign against the new drug development method, and defending their huge profit margins as essential for continuing the industry's service to humanity.

    And it's true that the drugs developed by major pharmaceutical firms have been of tremendous service to humanity over the years. Of course, most of the time these benefits have gone to that portion of humanity that can afford to pay for them, but not always. In the case of some high-profile diseases, like AIDS, the industry has - often belatedly, sometimes reluctantly and sometimes with genuine altruism - provided some treatments at low cost, or even no cost.

    The irony is that Shaunak - who with his colleagues is now in the cross-hairs of Big Pharma - cheerfully acknowledges the industry's good works, and doesn't see his own researches as a threat. As he noted to Spero News, his team is focused on providing medicines for people who are getting no treatment at all. The drug companies are not making any money from these sufferers; therefore they won't lose money if someone else provides help for them. "These patients are simply getting no treatment because the medicines are so expensive," he said. "As somebody working within a university, I have a mission statement [to] try to make drugs available for patients who currently have no treatment at all. So in many ways our approach is complementary and not competitive to the big pharmaceutical approaches."

    Complementary in many ways, yes, but not in all; for there's no doubt that as ethical pharmaceuticals seep from the desolate areas of the earth where Big Pharma can mine no medical gold into the developed nations, it will erode the industry's towering profit margins. The drug companies will have to learn to live within somewhat more modest means - perhaps shaving a bit from the multimillion-dollar compensation packages of its executives - or else shell out even more around the world for the kind of political protection it now buys in Washington. Either way, even here, in this very modest beginning, the new political and financial power of the world's forgotten multitudes will begin to make itself felt.

    Of course it may well be that the development of ethical pharmaceuticals, like most human endeavors, will not achieve its full potential. It may well be that powerful forces will combine to kill or cripple it. But for now at least, it stands as a reminder that in the course of human events, the ultimate ends are always unknown. Cycles, systems, patterns of behavior and immense structures of power that seem so fixed and immutable today will be swept away tomorrow, in ways that we cannot begin to fathom. In dark days that seem locked in a glide-path to disaster, these glimmers of possibility can perhaps offer some measure of hope.