Aids Drug Decision Opens New Technology And Equity Debate
By Walter Truett Anderson, March 23, 2001

In a rare bit of good news, a major drug manufacturer has agreed, after considerable pressure, to offer its AIDS medication to African countries at a price they can afford. But it is important to see this not as the solution to a problem but as an a sort of opening into a new world of problems. PNS associate editor Walter Truett Anderson is author of the forthcoming book "All Connected Now: Life in the First Global Civilization."

A major drug manufacturer, Bristol-Myers Squibb, recently decided to drastically cut in the price of its AIDS drug Zerit in sub-Saharan Africa.

This marks the end of a long, angry debate opposing the interests of huge multinational drug corporations to the needs of developing countries suffering one of the most terrible epidemics in history.

But the decision also marks the beginning of a new debate -- one that is likely to intensify in the years ahead -- about how to deal with the enormous inequities that will open up again and again in the globalizing world, sharply dividing those who enjoy the benefits of galloping scientific/technological progress from those who don't.

The controversy in southern Africa became enormously complex -- involving numerous governments and non governmental organizations, issues of patent law, and disputes about the cause of AIDS, among other things.

However the actions involved were fairly simple: the companies tried to protect their patents, which effectively gave them monopolies and allowed them to market the drugs at a price far above the ability of most disease victims to pay.

They were finally shamed into backing down by a storm of adverse publicity. No amount of legal or public-relations expertise could overcome the adverse reaction to the spectacle of wealthy companies withholding treatment from poor and dying people.

This specific controversy is not really closed, because the same companies will continue to walk a tightrope in many places between their desire to protect their intellectual property rights and the conviction of many people (including many scientists and business executives) that the owners of drug patents have moral obligations that transcend -- or at the very least equal -- their obligation to shareholders.

And beyond that, like a mountain rising behind the foothills, looms the prospect of a constant series of convulsions about other medicines, hundreds of new products likely to emerge from biotechnology and genomics in the decades ahead.

Some of these -- gene therapies, vaccines, etc. -- will raise the now familiar questions about who is entitled to treatment. But non- medical uses of biotechnology will also be involved in such controversies, including future applications in agriculture and a whole range of other applications in fields, like energy production, most people haven't even heard about.

Other technologies are also involved. There's already much talk about the cyber-gap -- the inequitable distribution of information and communications resources -- and other gaps are on the way. We are looking at a major transition in the conditions of human life, of which the AIDS drug that caused such a huge international flap is only a small isolated example.

MIT economist Lester Thurow describes this transition as a "third industrial revolution" (the steam engine being the first and electrification the second). "It is...based upon technical breakthroughs in computers, telecommunications, microelectronics, robots, new materials, and biotechnology."

Thurow goes on, "Together these six technologies and what flows from them are changing not just business but warfare, culture, government, and religion....The interactions between the six are just beginning."

He got that right.

Hard-nosed realists may say there's nothing new about inequality -- the poor are always with us, as the Bible pointed out. But other things are new: among them are the third industrial revolution, the proliferation of activist organizations eager to sniff out wrongdoing, the global mass media that rub our noses in faraway miseries.

Together, these elements are creating a new global political context -- and a new set of global problems for which the familiar nostrums of right and left are not adequate.

The right's complacent assurance that benefits will accrue to all in due time if we just let businesses do their thing is not comforting to somebody who is dying because of lack of access to the best medical care.

The strategies of the left -- demonizing globalization and biotechnology, arguing for junking patent protection -- aren't particularly productive either.

Neither trickle-down complacency or Seattle-style rage binges have much to contribute to the enormous task which now faces the world -- to keep the third industrial revolution humming along, and at the same time insure that some of its benefits reach the neediest -- not sometime, but soon.

So far the challenge is stated mainly in terms of debate. Debates can be useful, but we must consider all this also in terms of dialogue and constructive innovation among the many players -- governments, business, activists, foundations, the media -- in the new global ballgame.