Monetary incentives for medical justice

W e’re living in an age where medicine is politics. Most of us walk around as pharmaceutical bodies, saturated with all sorts of unnecessary (or seemingly necessary) medications. We’re even bombarded with medical advertisements as we sit on the toilet staring at the door in a bathroom stall. 
These billion-dollar ad campaigns are waged by Big Pharma, a group of the world’s biggest pharmaceutical companies that bring in billions of dollars each year and exert a great deal of control in the government and the field of medicine.

While there are many reasons to hate Big Pharma, we’ve largely accepted the fact that it infiltrates our everyday lives. What is undeniably unacceptable about pharmaceutical companies, however, is their role in keeping the world’s poor sick. The gap of health inequalities between rich and poor has actually widened since the beginning of globalization.

This problem of medical injustice and how to prevent it from worsening was the subject of Thomas Pogge’s lecture at McGill last Wednesday, a part of the Osler Lecture series. A large proportion of the diseases and infections that the poor are dying from are preventable.

The poor remain sick, Pogge explained, primarily because the high cost of pharmaceuticals makes them inaccessible. Well, the solution seems clear – we should make life-saving drugs more affordable, right? Unfortunately, losing money to help the poor is not part of the game plan for team Big Pharma. They’re in it for the big bucks.

Pogge, a professor at Yale and the leader of the Incentives for Global Health non-profit organization, has proposed a more pragmatic solution to the health inequality problem. It’s called the Health Impact Fund, and it aims to make medicine accessible for all people and get Big Pharma to assist in the process.

Pogge proposes that we need to stop accusing the drug companies, and “accuse you and me.” He gave this analogy to clarify his claim: There’s a dog in a room and a person has hung a steak in one corner of the room, which he tells the dog he cannot eat; there’s not a chance that the dog will stay put and not eat the steak, but it’s not the dog’s fault for eating it. Rather, the person who hung the meat in the corner is to blame.

To translate this into the Health Impact Fund’s raison d’être: pharmaceutical companies need monetary incentives in order to make their drugs accessible to the poor.

Pogge’s project intends to give pharmaceutical innovators an alternative to immediately launching their drugs onto the market. They can voluntarily register their drugs with the Health Impact Fund, who will reward them monetarily for their contribution based on the impact on health that the drugs have. To receive the money – up to $6 billion, depending on the degree of impact – the pharmaceutical innovators must make one promise: To sell their drug worldwide to anyone that needs it at the lowest possible price and without market mark-ups. Then, after a 10-year reward period, the drug must go generic. The $6 billion allocated to innovators will come from the governments of all the countries who chose to participate. This money will only be a small portion of the governments’ incomes and will manifest a whole lot of benefits for the country.

Firstly, taxpayers will have access to medicine at very low prices. They’ll also receive the benefits of the money that the country saves when it gets put into health insurance and national health care systems. And the most pioneering aspect of the project is that it gives pharmaceutical innovators strong incentives, because the greater the drug’s impact, the more money they’ll make. While the project is coming into fruition, it seems to provide a number of answers and fewer loopholes.

The lecture concluded with the entire hall of students, professors, and researchers, many of whom were clad in evening formal dress, bursting into applause. As one of the few attendees who never got the dress code memo, I saw the irony – these people had spent so much on their clothes to attend a lecture about injustices done to the poor. But they were there helping the Health Impact Fund make its mark. And if they’re trying to stop medical discrimination, I think I’ll leave the evening gowns alone for now.