What will be Bush’s greatest positive legacy? I think PEPFAR is a likely candidate, despite its flaws. I can’t think of any other program initiated by Bush that has helped so many people.
The World Health Organization has announced that polio has been eradicated from Somalia. This was an incredibly difficult task, given Somalia’s endemic violence and instability. And it took a huge effort:
More than 10,000 Somali volunteers and health workers vaccinated more than 1.8 million children under the age of five by visiting every household in every settlement multiple times.
However, this has happened before. Polio was eradicated from Somalia back in 2002, only to be reintroduced from Nigeria. The fact that polio was reintroduced from a country on the other side of the continent calls attention to the interrelatedness of disease control efforts in different countries (diseases know no borders) and the tragedies that occur when vaccination efforts clash with local cultures or religions.
But despite its tenuous progress in terms of total eradication, the WHO’s $4 billion polio campaign has made great steps forward:
When WHO and partners began their anti-polio campaign in 1988, the worldwide case count was more than 350,000 annually. The disease’s incidence has since been slashed by more than 99 percent and remains endemic in four countries: Afghanistan, India, Nigeria and Pakistan. Polio cases were also detected last year in Angola, Cameroon, Chad, Congo, Myanmar, Nepal, Niger and Sudan.
So that’s the good (albeit cautiously so) news. The bad news for Somalia:
If you read that and asked “wait, Somalia has a government?” you’re not alone. But it does have a government of sorts:
By its own admission, the Transitional Federal Government of Somalia is on life support. When it took power here in the capital 15 months ago, backed by thousands of Ethiopian troops, it was widely hailed as the best chance in years to end Somalia’s ceaseless cycles of war and suffering.
But now its leaders say that unless they get more help — international peacekeepers, weapons, training and money to pay their soldiers, among other things — this transitional government will fall just like the 13 governments that came before it.
Less than a third of the promised African Union soldiers have arrived, the United Nations has shied away from sending peacekeepers and even the Ethiopians are taking a back seat, often leaving the government’s defense to teenage Somalis with clackety guns who are overwhelmed.
The right to intellectual property is fundamental to much Western innovation. If I write a book, I own that book and can sell it for what I like. If I invent a new type of automobile (or spaceship for that matter) I can profit from its sales. But should intellectual property rights be extended into all areas of creative endeavor?
I’ve been telling my friends for some time that much stronger government-provided incentives are necessary to bring the level of research on drugs for the poor to badly needed levels. Funding for HIV, malaria, and tuberculosis have improved in recent years, but their funding is still disproportionate to the scale of their impact. Other diseases that primarily affect the developing world don’t get as much attention from the Global Fund and the Gates Foundation, either.
I am always appreciative when someone well-known articulates something that I’ve been telling my friends all along, and Nobel Prize-winning economist Joseph Stiglitz (who I’ve written about before) has done just that (thanks Joe). His short piece in The New Scientist, “Award Prizes Not Patents,” offers a workable alternative to patents for drug research.
The absolute right to intellectual property has at times been overlooked in many of the fastest advancing fields of science. If Watson and Crick had been able to patent the structure of DNA because they first discovered it, they would have profited beyond imagination from the myriad technological advances that have stemmed from our knowledge of DNA.
But their ability to monopolize the use of that knowledge and ask whatever price they desired could also have stymied much additional research, and made its benefits unavailable to the poor.
Historically, scientists have published their research in journals and felt free to use the data and techniques originated by others (giving ample credit where it is due, of course) in the course of advancing our knowledge of the physical world. Some scientists and inventors have of course been quick to patent specific inventions which are easier to monopolize/protect.
But the patenting of a new drug by a pharmaceutical company makes as much sense to me as Watson and Crick patenting the shape of DNA. They were only able to discover the double helix because they stood on the shoulders of giants. And despite their lack of a patent, the rewards for research were still strong; professional respect, international fame, a place in history, career stability, and the not-insignificant monetary compensation of a Nobel Prize.
As Stiglitz writes, what is needed is a strongly funded program that provides large prizes for drug development based on the national and global need for new treatments. Breakthroughs in treatments for cancer, heart disease, diabetes, malaria, tuberculosis and AIDS would be rewarded prizes similar in proportion to their need, giving research companies more than enough incentive to pursue new drugs. Once developed, drugs could be distributed at cost.
Sound socialist to you? Well, some goods, like having drugs available to treat HIV and tuberculosis (where treatment also slows the spread of disease), are social goods that benefit entire communities, nations, and the world. Funding medical research based on the impact of disease is merely a recognition that the development of new drugs should be guided by the extent of someone’s suffering, not the depth of their wallet.
In addition, this particular alternative system would maintain the current level of competition among pharmaceutical companies (which is what makes the U.S. the world leader in drug development) while focusing research on drugs that would lead to the greatest public good, not the diseases for which rich people are willing to expend millions.
We are not isolated—disease has no respect for international boundaries—and the perverse incentives our current system gives pharmaceutical companies to research impotence and baldness have a very really cost on the poor of the world.