This week [June 2011] a plan was announced by GlaxoSmithKline (GSK), Merck, Johnson & Johnson and Sanofi-Aventis to cut drug prices through an international vaccine alliance. A week later, Bill Gates and Pime Minister David Cameron got in on the act supporting Gavi.
Gavi is a partnership for funding mass vaccination programmes in developing countries. Glaxo CEO Andrew Witty told the BBC about the plan:
If you’re in Kenya or a slum in Malawi or somewhere like that there is no capacity for those people to contribute to [profits to invest in future drugs], so they have to be helped out by the contribution from the middle and the richer (countries).
He struck a balance between the philanthropic benefits of the scheme, and the business model of Big Pharma to generate funds for future investment by maintaining high prices on their proprietary drugs.
Enter Bill Gates and David Cameron
A week later, Bill Gates and Prime Minister David cameron pledged their support to GAVI
The medical plight
The medical plight of many countries is illustrated by the case of Dr Freddie Coker, a pediatrician in Sierra Leone’s capital Freetown. Dr Cocker tells of his fight against diseases which result in child mortality rates of 50% which could be saved by drugs if made available.
“I’m very excited. As a doctor, I usually spend sleepless nights trying to see how much I can contribute to reducing the infant mortality rate among under-fives in my country. I’m quite happy.”About 40% of cases we see are due to diarrhoea diseases. The mortality rate can be as high as 50%.”The earlier a child is commenced on treatment, the better the outcome.”
The next step in a long campaign
Students studying leadership will be familiar with the case of Glaxo Smith Kline’s Jean Pierre Garnier (Dilemmas of Leadership, Chapter nine). The case outlines the dilemmas of morality versus profits.
Some call him a humanitarian. He has been awarded the Legion d’Honneur by the French government. He has indisputably taken GSK several rungs higher on the ladder of altruism than any other drug company. But at the end of the day, he says, he runs a for-profit company. And if people are still dying of AIDS in Africa, it is because their governments are ineffective, or do not care. It is not to do with the greed or indifference of the pharmaceutical companies. His vision is clear. He is willing to supply not just antiretrovirals but other medicines poor countries need for epidemics, such as malaria, at cost, he says. Combivir, [a dual combination AIDS drug], sells at $1.70 a day. For a Malawian woman .., it might as well be the price of a flight on Concorde. His answer is twofold: order from GSK in bulk, perhaps for the whole of sub-Saharan Africa, and the price will drop. Secondly, persuade the rich countries to support the Global Fund so that poor countries will have the money to buy GSK’s drugs.
A moral dilemma
Drug companies face a dilemma between two morally right options. The first is to do everything possible to ameliorate suffering through their medical products. The second is to secure enough revenues to invest in the drugs of the future. Big Pharma receives criticisms for its financial model and its marketing methods for influencing the medical professionals. Is this story a case of moral leadership from within their ranks? Or is it pragmatism, and at least partially a result of protests and stakeholder pressures? And in any case, should the ends be welcomed, regardless of the motives?
To go more deeply
News Medical provided a summary of editorial opinion pieces on this story.