Molly Ivins July 15

AUSTIN, Texas — A story finally getting some attention is the hideous case of the U.S. trade representative trying to force African countries NOT to manufacture cheap generic substitutes for the drugs used to treat AIDS.

Our government's object is to protect the profits of multinational drug companies. Obviously, practically no one in Africa, where the disease is rampant, can afford the $15,000 a year that the drug companies now charge for the full AIDS "cocktail." And 85 percent of all AIDS sufferers live in Third World countries. In a sane world, we would be subsidizing the manufacture of generic substitutes for AIDS drugs.

The story is getting some attention from the narrow-focus American media because Veep Al Gore personally pressured South African officials to ban substitutes for Taxol, an important cancer drug, threatening that country with trade sanctions.

Gore is getting flak for his tiny role in this revolting story — ergo, the press has found a political flap and is on it like a duck on a Junebug. In the "there oughtta be a law" category, put me down for one that would oblige the media to report the campaign contributions involved in every political story.

The pharmaceutical industry has the largest profits of any legal industry: The industry also spends more to lobby the federal government than any other industry and last year gave $12 million in campaign contributions. I know, you're about to say, "Duh."

But listen to exactly how bad this is: Taxol was discovered, tested and manufactured by the National Cancer Institute (your money) and then turned over to Bristol-Meyers Squibb for marketing. According Ken Silverstein's excellent article in the July 19 Nation magazine, the company got the inside track by hiring an Institute official familiar with the Taxol program to write its application.

All the government asked was that it be given enough Taxol for clinical trials. The company then purchased 400 kilos of the drug from NCI's supplier, Hauser Chemical, for which it paid 25 cents per milligram. Silverstein reports that when the FDA approved Taxol in 1992, the company announced a wholesale price of $4.87 per milligram and today it makes more than $1 billion annually from the drug.

The Nation article is focused on the larger topic of the gross distortions that profit makes when the pharmaceutical industry decides which ailments to research and provide drugs for. Here's the drug industry concentrating on impotence (Viagra), baldness (Rogaine), toenail fungus (Lamisil), wrinkles (Botox) and drugs for pets — including one for "separation anxiety" for your dog — while millions of people around the world are dying for lack of drugs.

Where's the pro-life lobby when we need it?

The estimable group Doctors Without Borders is trying to bring attention to the need for access to drugs in Third World countries, and offers some positive ideas: tax breaks for smaller firms doing research on tropical diseases, creative use of international trade agreements and increased donations of drugs from the big companies.

In at least one case, the drug industry was the hero rather than the villain.

In the 1980s, a Pakistani researcher at Merck discovered that a drug used in veterinary medicine was also gave perfect protection against river blindness, which then afflicted millions in Africa.

Merck realized it couldn't make a profit marketing Ivermectin so, in an unprecedented move, it gave the drug to the World Health Organization. For years, WHO couldn't get governments, including ours, to fund a program: Only lately have the World Bank and private organizations given enough so that river blindness will probably be wiped out.

The United States is the only First World country that does not control drug prices. Silverstein reports that prices here are about twice as high as they are in Europe and nearly four times higher than in Japan.

The industry's old shuck and jive about how much it costs to develop a new drug has been discussed in earlier columns. The bulk of the cost in developing a new drug is in pre-clinical research and much of that is performed by universities or government-funded research facilities.

Even more obscene than the industry's profits is its habit of seeking exemptions to patent expiration dates on its most profitable drugs from members of Congress willing to try to slip an extension through as an amendment to some other bill — in direct exchange for handsome campaign contributions, of course. Can anyone explain to me the difference between that and bribery?

It is not too much to demand some public service from the industry, just as phone companies are required to subsidize service in rural areas.

Only 1 percent of new medicines brought to market by multinational drug companies between 1975 and 1997 were designed to treat the tropical diseases that kill millions in the Third World, according to Doctors Without Borders.

Why not require the drug companies to set aside some percentage of research for these major diseases, surely as much a plague to mankind as toenail fungus? That, or why shouldn't the government hang on to the patents of the drugs developed by its own research at the public expense and use the money for more research?

Molly Ivins is a columnist for the Fort Worth Star-Telegram. To find out more about Molly Ivins and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate web page at www.creators.com.

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