Aware of the widespread hostility to its exploitation of disease to make ever fatter profits, GSK recently went to great lengths to put a nice face on its operations. Andrew Witty, its new chief executive, has announced announced a new strategy whereby the company “would help the poor”. Medical charities have pointed out, however, that lowering prices would undercut companies that produce generic drugs, thereby leaving the poorer countries still at the mercy of Big Pharma.
The swine flu pandemic is an example of not just how the pharmaceuticals cash in on disease but why profit-centred research and production actually makes it impossible to tackle diseases in a systematic way. This is demonstrated by two US scientists, Christopher Walsh and Michael Fischbach, writing in the Scientific American magazine.
They point to the challenges in discovering cures for the new “super bugs” which have arisen in recent years. Not only swine flu, but the lethal MRSA are bugs which have emerged from a combination of modern medical treatments and the evolutionary process of bacterium. Like MRSA, the “hospital bug” which caused 19,000 deaths in the US in 2007 alone, the H1N1 strain, which causes swine flu, does not respond to antibiotic treatment.
Walsh and Fischbach say that “modern medicine is losing the war against disease-causing bacteria that were once considered vanquished, and new approaches to discovering and creating antibiotics are needed to turn the tide.” They add:
Unfortunately, all the antibiotics sold today are blunt instruments; they not only kill the pathogens that cause infections, they also kill the helpful bacterial mutualists that inhabit our gut. In some cases this eradication of a patients gut micro flora clears the way for a different strain of bacteria, such as clostridium difficile, to multiply and cause a new, ‘secondary’ infection, that can sometimes be more dangerous than the first.A new strategy of developing “narrow spectrum” drugs that target the pathogen more accurately and leaving other bacteria intact is needed, they say. But the financial incentive for Big Pharma is missing because such drugs would have limited applications and require rapid diagnostics, they “might be economically unattractive to drug companies”.
Walsh and Fischbach explain that the urgent need to discover new antibiotic classes is a complex process requiring novel discovery strategies. There was a “golden age” of antibiotic discovery from the 1930s-1960s, but such discoveries ground to a halt. One reason, they claim, were the small profit margins in antibiotic research, “compared with so-called lifestyle drugs” as well as the challenge of finding brand new antibiotic classes.
The spread of pandemics like swine flu is seen by many as the result of the over-use of antibiotics in factory farming as well as in medical treatment in general. The blunt instrument approach, in which millions become unpaid and unconscious guinea pigs, yields bigger profits than the innovative strategy and precise targeting that is urgently needed.
The outbreak of swine flu has led to a race between the drug giants, GSK and rival Hoffmann-LaRoche, which is earning vast profits on its drug Tamiflu. During the bird flu epidemic of 2005, the US government purchased $2 billon worth of Tamiflu doses. Some 50 million doses of were prescribed for it before and during the bird flu epidemic. Dangerous side effects were noted amongst Japanese teenagers. The antiviral was developed by a company whose chairman was gung-ho Bush ally Donald Rumsfeld, by the way.