The Hidden Sickness, Colltalers
As the marathon of grotesque headlines continues to pound and puncture our collective bubble, one moment being about the restart of carnage at Gaza, another about U.S. airstrikes on Islamic State of Iraq forces, it’s hard to wrap our heads around any particular issue.
Some seem to choose the Ebola virus outbreak, as garish and desperate that may be, either because it’s contained within Africa, and chances of spreading through Western societies are nearly nil, or out of a natural humanitarian concern, a muscle we can all develop and exercise.
Another look at what’s happening, though, even if hindered by that aforementioned limited ability of grasping events one at a time, may uncover deeper roots for what appears to be a world suddenly out of whack. And, surprise, surprise, they’ve been there all along.
Staying with the health disaster of having a virus running rampant through fertile grounds of insanitary, raw-sewage-at-the-doorstep, so familiar to Africa, Latin America, Middle East, Asia and, grasp, America, we come quickly to the realization that, first, this latest crisis is neither purely medical nor new, and even if this virus is ‘over there,’ there are other dragons to slay right outside our own door.
Let’s not consider, for the sake of this argument, the fact that viruses have been around before most species came to be, and will probably be here long after our own civilization will be gone the way of the saber-toothed cat and the dodo. In other words, they’re invincible.
Never mind that, for a moment, and focus instead on the fact that the spread of most viral diseases is directly related to unsanitary conditions, untreated human waste in the scale needed for urban settlements, and absolute lack of access to proper preventive drug therapies.
That’s where we run out of excuses, because for at least a century we’ve been aware of what takes for humans to live together in society, and the kind of massive infrastructure that warrants the continuation of the species, even if that is far from your own set of priorities these days.
In the textbook on the confluence of public health and urban development, we can’t help it but using Africa yet again, a continent that’s served to both noble flights of voluntarism and entrepreneurship, and also to downright gangsterism and greed. We simply need to start there.
Take South Africa, for instance, a country of 51 million, with a GDP close to $400 billion which is, by no stretch, not your average African economic stats. It’s plagued, however, by staggering gaps between the very rich and the most miserable, something that we’ve become ever more acquainted to, whether in São Paulo, Los Angeles, or Paris. But knowing all that can hardly prepare anyone for what’s happening now.
It’s long known that AIDS has been a catastrophic public health scourge, and that in Africa it it counts as victims much of the young adult, sexually active female population. Since such dire prospect is compounded by the fact that the other at-risk demographics, so-called sexual minorities, are publicly scorned and persecuted, what you get is your typical, sad, stereotypical portrait fed to the world by the media.
Now, though, there’s yet another stunning twist: a rising young population addicted to a homemade mixture of cheap heroine, rat poison, cleaning products and, please have a seat, HIV antiretroviral medication. You read it right, the same medicine developed to help beat AIDS from a dead sentence into a chronic disease, is being used for a highly-debilitating drug habit, in yet another health crisis.
Again, what’s new about all of that, is not the devilish creative ways humans, specially the predatory kind, will find to get its prey high, but the fact that in a country with such a hefty GDP, unemployment, illiteracy, and poverty still consistently afflict a quarter of its population.
Which means that even if the cure for AIDS or even for addiction, for that matter, would be found, say, tomorrow, conditions that fuel the health crisis created in their wake would remain in place and take the same deadly toll on countless lives, that could otherwise thrive.
In the case of Sierra Leone and Liberia, the bizarre twist is that people are actually being advised to flee hospitals, said to carry the virus ‘on their walls,’ and seek refuge in poorly maintained tents in the backyard, where they can be vulnerable to a whole host of other woes. Unreal.
Except that it isn’t. From the now identified 2-year old, Patient Zero for the current crisis, to the estimated 2,000 that have died in just a few months, the chain of events leading to contagion of ever wider populations necessarily goes through lack of sanitation and running water.
Even if the rate and speed of the contamination and death are indeed staggering, however, it’s statistically unsustainable, according to public health experts, and as with any other viral spread, it will subside by a combination of care and the own nature of virus outbreaks.
We’re not dismissing or making thrift of those who fell to this terrible disease, and what it does to a healthy human being. Or discounting the efforts to contain the Ebola being done in Africa and the U.S., where fears of an outbreak are not just exaggerated but also manipulated. For they now serve also the xenophobic and racist impulses of so many with unduly space voicing their nasty prejudices on mass media.
But the real crisis, the one that won’t go away and runs deep underneath public demonstrations of despair and intolerance, is likely to remain in place for as long as the kind of politics that many African leaders favor, with little regard to human dignity and right to be free.
If it all sounds like just words, and they are, we haven’t talked about the drugmakers’ role yet, our final twist for today, as surprising parallels can be traced between the most forsaken realms of poverty in the underdeveloped world and the planet’s richest economy, the U.S.
Such link is possible because there are only some two dozen pharmaceutical companies controlling the production and, more relevant, development of all new drugs. Thus, interest in producing another headache medicine is likely more important for them than to venture in the risky task of creating one for a complicated disease, whose potential consumers may not even be able to afford buying it.
That, in a nutshell, is the essence of the business of profiting out of human illnesses: first and foremost, it’s a business, so they’ll produce more of what’s already selling, and less of what may ultimately not sell at all. Humanitarian and/or medical considerations are relegated to a lower level of priorities. No wonder, the revolutionary drug cocktail that controls AIDS was initially developed with government funds.
The parallel is that, while AIDS organizations successfully forced some labs to cut prices of certain vital medicines or work with local governments, to provide them to those in need, drug prices are still expensive and have to be constantly kept from getting even pricier.
Again, to keep the conversation going, we’re not talking about efforts to deliver and administer the drugs, itself a whole new can of worms, as difficulties of access and the strict regularity required to follow a prescription regime can derail even a well planned treatment.
A New York Times story last week showed how Sovaldi explains charging $1,000 a pill of its new Hepatitis C drug, said to cure 95% of patients in a fraction of the time taken by previous, more demanding treatments: soaring demand for it and expected short time for its use.
With estimated 3,2 million Americans infected, one wonders what kind of treacherous rationale is the one that spins the need and efficacy of a new drug, not to eradicate the illness for which was created, but to justify prohibitive prices and maximize profits before enough people are cured and no longer need it. The story, by the way, takes a one-sided approach to the matter, and skims over patient activists’ arguments.
In that particular, the situation in the U.S. is worse than even comparable economies, such as in Europe. A good example is the medication for Asthma, which afflicts about 40 million Americans, and costs them several times more than to European patients.
That’s because, unlike the U.K., France, and many other countries, the current U.S. health system limits the government’s bargaining power to lower drug and therapy prices, except within Medicare. Although Obamacare’s been an improvement, big insurance corporations and drug laboratories still have the upper hand when it comes to setting up prices, and determining what gets to the market and how much it will cost.
And don’t let us get started with the cancer drug industry, which feeds off the general public’s empathy but doesn’t seem to have made much inroads when it comes to real cure in the past 40 years. Patients still go through the traditional, and gruesome, routine of harsh drugs, chemo and radiation therapy, a world of side effects, and a relatively low rate of remission for most cancers, that has been around since the 1970s.
For similar reasons that we now must fight the tendency of averting our eyes to the resuming hostilities in Gaza, fatigued by so much death and apparent unwillingness by the parties involved to seek a permanent solution, we can’t think that once the U.S. warplanes obliterate the advancing ISIS armies in Iraq, or the latest Ebola outbreak is controlled, we’re safely on our way home, to enjoy our deserving seasonal pleasures.
We need to resist and keep paying attention, because neither peace will be achieve by the roars of explosive charges, nor a single drug therapy will lead the world successfully out of the grips of a lethal virus. Long after the Middle East fires cool off, and way before a new virus rears its infinitesimal head inside a human body, the system that breeds both things will remain intact and ready to host new tragedies.
New rules and restrictions, on a global, governmental scale, will have to be imposed on the multimillion dollar business of producing drugs. Big labs can’t possibly heed only to the siren call of money-counting machines, and thrive unbound by ravages of disease, which give them reason to be, if we’re to survive as an entire civilization, not just a wealthy group of individuals who can afford being sick.
It may be time to reset our collective moral compass and force a conversation about what means for a corporation and its shareholders to do business involving human health. For it’s a right of every individual that’s being neglected with disturbing consistency and impunity. Now let us all go back to that unfortunate other business of death and destruction in the Middle East. Despite of all, we wish you a great week. WC