‹ Distributive Justice in the Abstract and Concrete •
Hello!
I’m soliciting feedback on a draft paper on a new way of getting pharmaceutical and biotech companies to extend access on essential drugs and technologies to the poor. I’m also keen to solicit references to other new (or working) papers on pharmaceutical justice.
Here is the abstract:
Fair Trade Bio
Most of the world’s health problems afflict poor countries and their poorest inhabitants. One reason for this is that the poor cannot access many of the existing drugs and technologies they need. Another reason is that little of the research and development done on new drugs and technologies benefits the poor. In light of these facts, several authors argue that there is reason to restructure the incentives pharmaceutical and biotechnology companies to encourage them to target their technologies to the poor. This paper defends a package of Fair Trade and Investment strategies that may have this effect. The idea is to rate pharmaceutical and biotechnology companies based on how their policies impact poor peoples’ access to essential drugs and technologies. The best companies, in a given year, will then be Fair Trade certified and be allowed to use a Fair Trade label on their products. Highly rated companies then have an incentive to use the label to garner a larger share of the market as those engaged in trade and investment often prefer to purchase Fair Trade goods and invest in Fair Trade companies. If even a small percentage of consumers or doctors would prefer Fair Trade products, the incentive to use this label could be substantial. And, socially responsible investment companies could include in their portfolio Fair Trade certified companies. Finally, having a Fair Trade certification system for pharmaceutical and biotechnology companies would open the door to all kinds of fruitful social activism including boycotts of poorly rated companies, lobbying of insurance companies to include Fair Trade products in their formularies, and so forth. Because, for instance, pharmaceutical and biotechnology companies rely, to a large extent, on university research and development, universities might make it a condition of the sale of their licenses that any companies holding their technologies must abide by Fair Trade standards. Of course, the Fair Trade proposal this paper defends will not solve all of the poor’s health problems, but it might have a significant impact.
A draft (to be updated shortly) is here: http://www.hss.cmu.edu/philosophy/hassoun/papers.php
Thanks! -Nicole
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3 comments
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1 - Saturday, 20 June 2009 at 8:58 pm
Kevin Vallier
Hi Nicole. I’m worried that the major problem with getting drugs to the poor is cost. And a rating system will not clearly reduce it.
So in that spirit: Have you considered addressing the patent issues on most of these drugs? Many policy-makers and economists agree that the patents on pharmaceuticals last too long, far beyond what pharma companies need in order to pay for the research and development costs. One easy way to reduce costs is to limit these patents.
Another way of reducing costs is to reduce the regulations on drug testing. The FDA adds enormous expense to the drug development process, for instance. The UN might have a voluntary regulatory board that could test drugs and deem them safe for ‘emergency care’ to the poorest across the globe. Then governments and NGOs would have the ability to buy and distribute the drugs internationally (that is, if national regulatory bodies would allow it).
2 - Tuesday, 23 June 2009 at 4:45 am
Jason Brennan
I’m suspicious about whether Fair Trade labeling does any serious net good, rather than just having the same economic effects as cartels. I suspect the main benefit of it is that it allows rich first worlders to feel good about themselves without having to give money to charity.
Early on, you write, ““Malaria, pneumonia, diarrhoea, and tuberculosis, which together account for 21 percent of the GBD, receive 0.31 percent of all public and private funds devoted to health research”
It strikes me that these are the kinds of diseases you prevent by better sanitation, better food, and with some chemicals to repel mosquitos. Prima facie, they don’t seem like the kinds of diseases we need new drugs for. As you say, “War, natural disasters, dirty water, and inadequate food provide the biggest obstacles to health in developing countries. Prevention and poverty alleviation could do much more for the poor than pills.” That sounds about right to me.
3 - Tuesday, 30 June 2009 at 9:11 pm
Nicole Hassoun
Hi Kevin and J,
Thanks for your thoughts and sorry for the delay (I’m at the UN (WIDER) in Finland if that is an excuse?)…
In any case, Kevin, there are a few proposals regarding patents. Pogge has (co-authored) an online book on the topic. The problem is coming up with the funds to create an alternate patent system or getting the companies to agree to the limits. I wish him the best of luck and would be happy to help out in any way I can. The nice thing about the Fair Trade Bio idea is that it is not a competitor to these other reforms. And, it is practically free.
There is a lot of work on research ethics and whether or not it is acceptable to have lower safety standards in poor countries. I won’t go into it, but I think it would be better to help the poor secure safe drugs.
Although Fair Trade Bio would not be a panacea, the rents companies could get from those who care enough to pay a bit more for Fair Trade drugs (or who would buy those over alternatives) might help with some of the costs. There might also be a shift in research priorities - away from pimple medication etc. and towards essential drugs if the licensing schema was implemented.
J, I think an AIDS, tuberculosis, or malaria vaccine could do wonders. I’ve seen some CBAs out there that suggest at least some of these things are a great idea. So, while helping companies create these vaccines might not be the most important thing we could do for the poor, it does seem worthwhile.
As far as the cartel bit, I think you’ll have to explain.
Cheers, -Nicole