Developing drugs for the developing world: An economic, legal, moral, and political dilemma

Developing World Bioethics

Volumn 1, Issue 1, 2001, Pages 11-32

  Resnik, David B ^a  

^a EAST CAROLINA UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

DRUG;

ANALYTICAL APPROACH; ARTICLE; BENEFICENCE; BUSINESS ETHICS; DEVELOPING COUNTRY; DRUG COST; DRUG INDUSTRY; ECONOMICS; ETHICS; HEALTH CARE AND PUBLIC HEALTH; HUMAN; INTERNATIONAL COOPERATION; LEGAL ASPECT; ORGANIZATION AND MANAGEMENT; PATENT; POLITICAL SYSTEM; SOCIAL BEHAVIOR; SOCIAL JUSTICE;

ANALYTICAL APPROACH; HEALTH CARE AND PUBLIC HEALTH;

BENEFICENCE; DEVELOPING COUNTRIES; DRUG COSTS; DRUG INDUSTRY; ETHICS, BUSINESS; HUMANS; INTERNATIONAL COOPERATION; OWNERSHIP; PATENTS; PHARMACEUTICAL PREPARATIONS; POLITICAL SYSTEMS; SOCIAL JUSTICE; SOCIAL RESPONSIBILITY;

EID: 0001782168     PISSN: 14718731     EISSN: None     Source Type: Journal    
DOI: 10.1111/1471-8847.00004     Document Type: Article

References (50)

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4. McNeil, D. Prices for Medicine are Exorbitant in Africa, Study Says. New York Times. 17 June 2000: A1.
5. Resnik, D. The Ethics of HIV Research in Developing Nations. Bioethics 1999; 12, 4: 287-306. The cost of AZT for the 076 protocol used to prevent perinatal transmission of HIV is $800, which far exceeds the per capita income of most developing nations. To develop a less expensive treatment, researchers tested a regimen that uses less than 10% of the AZT used in the 076 protocol. Many people objected to this study because it used placebo control groups even though the 076 protocol was recognized as effective in preventing the perinatal transmission of HIV.
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7. Angell, M. The Pharmaceutical Industry - To Whom is It Accountable?. New England Journal of Medicine 2000; 342: 1902-4.
8. Gerth, J. and Stolberg, S., 'Drug Firms Reap Profits on Tax-Backed Research. New York Times. 23 April 2000: A1, A20-21.
9. Gerth, J. and Stolberg, S., 'Drug Firms Reap Profits on Tax-Backed Research. New York Times. 2000: A1, A20-21. Ibid.
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13. McNeil, note 3.
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15. McNeil, D. Selling Cheap Generic Drugs, India's Copycats Irk Industry. New York Times. 2000: F1. Ibid.
16. McNeil, note 3.
17. Ibid.
18. Ibid.
19. Benatar, note 1.
20. Angell, note 6.
21. Reich, note 2.
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26. Ibid.
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28. Schüklenk, U. 1998. Access to Experimental Drugs in Terminal Illness. New York. Pharmaceutical Products Press.
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31. Brody, note 29; Spinello, note 30.
32. This issue of exploitation has come up many times in research involving the developing world. One of the criticisms of the HIV trials (mentioned in note 4) is that these studies would not make the new treatment reasonably available to the population. See Crouch, R. and Arras, J. AZT Trials and Tribulations. Hastings Center Report 1998; 28, 6: 26-34.
33. Some writers have argued that the Human Genome Diversity Project will not offer participant populations a reasonable benefit. See Resnik, D. The Human Genome Diversity Project: Ethical Problems and Solutions. Politics and the Life Sciences 1999; 18, 1:15-24. See also Benatar, note 1.
34. Murphy, note 24.
35. See Pojman, L. 1995. Ethics. Belmont, CA. Wadsworth. Although most people would agree that beneficence is an imperfect duty, I would also maintain that justice is an imperfect duty if we understand the duty as including a duty to follow specific material principles of justice, such as the obligation to distribute benefits and burdens equitably. First, it is impossible for a person to follow these principles perfectly. As any parent can testify, it is impossible to distribute benefits and burdens to different children in a perfectly equitable fashion, no matter how hard one tries. Second, these principles must be weighed against one another and against other values or commitments. For example, when faced with a scarce resource in health care, such as a shortage of influenza vaccinations, it is morally acceptable to emphasize utility while de-emphasizing equity. If there is a shortage of influenza vaccines, then public health officials are justified in offering these vaccines to the patients who need them the most.
36. For further discussion, see Beachamp, T. and Childress, J. 1996. Principles of Biomedical Ethics, 4th edition. New York. Oxford University Press.
37. Murphy, note 24.
38. DeGeorge, note 22.
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44. Pharmaceutical Research and Manufacturing Association (PHRMA). 2000. PHRMA Policy Paper: Strong Patent Protection is Essential. Washington, DC. PHRMA.
45. PHRMA Policy Paper: Strong Patent Protection is Essential. 2000. Ibid.
46. PTO. 2000. General Information Regarding Patents. Washington, DC. PTO.
47. Stolberg, G. and Gerth, J. Medicine Merchants: Holding Down the Competition. New York Times. 23 April 2000: A1.
48. Reich, note 2.
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50. Reich, note 2.