18 October 2005

TB muddies the water

Since the patent for ciprofloxacin (a.k.a. Cipro) expires soon, Bayer is going to test the successor drug moxifloxacin against tuberculosis. If the clinical trials work, it'll be the first new TB drug in 40 years; something which should be high on the priority list of the human race, as 1.5-2 million die of TB each year (at one point, 1/4 of all preventable adult deaths in developing countries were from TB).

This potential new treatment is great news, but it's hard not to notice the fucked-up incentives that dictate availability of these drugs:

Beside the small profits made serving poor countries, there are other risks to registering a drug for TB. For example, the cheaper pills may be shipped back to rich countries for "gray market" sale. In nations with broken-down health systems, the drug may be sold openly and overused, leading to drug-resistant germs that make their way to rich countries and render the company's best-seller useless. And when millions use a drug for months, rare side effects can emerge, forcing its withdrawal, much like unexpected reports of heart attacks forced Merck to pull Vioxx, its best-selling painkiller, from the market.

"Companies are much more likely to offer drugs that have no commercial value, or to piggyback a drug from the veterinary sector and give it a human application," said Dr. Mary Moran, an expert on drugs for neglected diseases at the London School of Economics. "Big companies say 'TB muddies the water.' If it works, governments may try to restrict it for TB use. And if you get a side effect, you've just trashed your best commercial antibiotic."

The problem with drug-resistant diseases isn't even that eventually White people will get them, it's that their spread will undermine the value of crucial intellectual property.

Hopefully a future civilization will some day look back on the broader picture the way we look back at, say, child sacrifice. But at least this development is positive!

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