Campaigning investigative TV journalism is not often seen on our small screen these days. Dying for Drugs did very well what good TV documentary can do - tell a simple story and communicate the huge implications, as no amount of tables and statistics could do. It brought home the human impact of the big drugs companies' search for profits.
Dying for Drugs told four stories, each more terrible than the last.
The first story was about the drugs firm Pfizer, and their unethical drugs experimentation in the Third World.
A bacterial meningitis outbreak in Kano, Northern Nigeria, gave Pfizer the chance to treat 200 children with an unlicensed drug, an antibiotic called Trovan. The testing of drugs is regulated by the 1947 Nuremberg Code, formulated in response to the Nazis' experimental "medicine" in the concentration camps. The code requires that people taking part in experiments should give their informed consent. Pfizer claimed that the parents were illiterate, so consent had to be given orally. However the documentary makers tracked down the father of the first child treated. He could not only read and write, he could do it in three languages including English. His son has been left with an inflamed knee joint that may have been caused by the drug.
Other children were less 'lucky'. One girl was treated with the drug but did not respond. It is basic medical practice to change the treatment if this happens. However the Pfizer doctors persevered with the drug that they were testing. Three days later the girl was dead.
Pfizer cannot claim ignorance. Their own head of child medicine produced a memo outlining the reasons why the trial should not go ahead. These included that oral antibiotics should not be administered to potentially malnourished children and that the drug had not been tested against the Kano strain of meningitis. Pfizer's response? The head of child medicine was given the sack.
The Kano parents are now seeking compensation. Pfizer wants the case heard in Nigeria. Nigeria has one of the most corrupt legal systems in the world.
The second story centred on Dr Nancy Olivieri of Toronto University, one of the world's leading authorities on the blood condition thalassemia. She led a study into a new drug for the condition, called L1, developed by another multinational drug company, Apotex. At first the trial appeared to be going well, but soon it appeared that the drug might cause liver damage. Dr Olivieri proposed withdrawing those patients under risk from the test and warning the others of the potential side effects. Apotex's response was to terminate the trial with a view to bringing the drug to market. Olivieri's contract gagged her from saying anything, even to her patients. She refused to do this, and ended up being sacked (although later reinstated) by the university after pressure from Apotex (who were funding a new building at the university).
This world expert who should be doing research to benefit humankind has now spent six years fighting a money-grabbing multinational. Apotex have recently succeeded in getting L1 licensed in the EU.
The third story looked at a group of patients in South Korea suffering from myeloid leukaemia. They got together after discovering another multinational drugs company, Novartis, had developed a then unlicenced drug, Glivec, to treat their disease. They volunteered for a trial. As a result the medicine was licensed in quick time. But then came the rub. The treatment would no longer be free. The cost of the drug would be $19 per capsule - a yearly cost of $55,000.
Only Novartis can make Glivec, so they can charge what they like. Under existing world trade rules it is possible for a country to declare an "economic licence" in order to allow a generic version of the drugs to be produced in that country. The cost of Glivec if manufactured in South Korea could be around 80 US cents per capsule. When the US government heard of what was happening they wrote to the South Korean government, threatening dire consequences if they allowed an economic licence for Glivec. That was the US playing world policeman because Novartis is a Swiss firm. When the South Korean Health Minister continued to pursue the issue, he was sacked.
The leukaemia sufferers battle on. These often frail people braved the formidable Korean riot police in an attempt to occupy Novartis' offices. Novartis has not budged. One sufferer explained how, having sold his house, he could no longer afford the drug and how he could not tell his wife and child that he was no longer taking the drug. He would tell them that Glivec had just stopped working for him.
The last story was about Jairo, a twelve year old AIDS sufferer in Honduras. Living with his grandparents since his mother died of an AIDS-related illness, he was an emaciated skeleton. This stage of the disease is increasingly uncommon in Europe because of the use of retroviral drugs. He could not eat because of a thrush infection in his throat. Thrush is easily treated with a Pfizer drug, Flucanozole. Jairo would need one a day until the infection cleared up, but Pfizer sell the drug for $27 a capsule in Honduras and Jairo's grandparents earn $90 a month. In neighbouring Guatemala, where a generic version is produced under an economic licence, it costs 30c a capsule.
The documentary makers offered to pay for whatever medicine would help him. The film ended with the child being taken to hospital in the family's pick-up. But the convoy stopped. The child had died.
Pointlessly, unnecessarily died, because of drug company profiteering.
The film didn't make any positive statement about answers to the obscenity of the drug companies. However, the filmmakers implied two things. First, that developing countries should be allowed to manufacture and sell generic unlicensed version of the drugs, as in India where drugs can't be patented. The WTO is attempting to outlaw India's system by the end of next year, and moves towards the production of anti-AIDS drugs in the developing world have been blocked by the US. Second, it called for academic freedom for those researching drugs in universities in joint ventures with drug companies.
Vital as these demands are, the crazy centre of the problem remains. The making of drugs that cure people should be the most humane thing in the world - but their production by private companies for private profit turns this into its opposite, the inhumane production of cures only for those who can afford to pay for them. Many people may be ill, but capitalism is obscenely sick.
Link: Dying for Drugs
Reviewer: Matt Cooper