The outbreak of the deadly Ebola virus in west Africa that has killed over 10,000 people so far has only become an issue of concern since reports of individuals from the West have become infected with the disease. Even then the response by the international community has been far from optimum with UN officials reporting that a $1 billion appeal to fight Ebola has only been 25% funded. Stephen Hall, a CEO of a pharmaceutical company explains why, “Traditional investors have not been enthusiastic about funding the development of a vaccine that, until now, has been a third-world problem,” He adds, “Even now that Ebola has entered other countries, the traditional investor has still not shown much interest. They are just driven too much by economic considerations.” The neglect of research due the lack of financial incentives into the Ebola virus for almost 40 years is indicative of the priorities of the pharmaceutical industry, placing profits before ethics.
Ebola is a rare and deadly virus. It takes its name from the Ebola River in the Congo, where the first known case appeared in 1976. “This disease is one of the most infectious diseases known to man and has an extremely high mortality rate in comparison to other more commonly considered diseases,” says Dr. Graham Fry of the Tropical Medical Bureau in Dublin. Until now there is no US FDA (Federal and Drug Administration) approved vaccine or medicine (e.g. antiviral drug) available for Ebola. This is not due to the newness of the Ebola virus since it has been around for four decades, rather due to a lack of funding. Michael Katze, a professor of microbiology at the University of Washington said “We’ve been studying Ebola for almost a decade and we’ve always been interested in Ebola. It’s like the rockstar of viruses,” Katze says “The big pharma companies are not in the business of charity, so unless they have the money, they aren’t going to bother with a vaccine that isn’t important in this country,” and that “The inadequacy of international response had nothing to do with research. ”
An insight into the drug industry will allow us to understand why a vaccination for the Ebola virus has yet to be discovered. Pharmaceutical companies must adhere to strict regulatory frameworks namely the FDA which filters out failed drugs from entering the market after preclinical and clinical trials. As a result, pharmaceutical companies claim that their expenses must be covered from compounds that successfully become drugs since only 3 out of 20 approved drugs bring in sufficient revenue to cover their developmental costs and only 1 out of 3 approved drugs generates enough money to cover the development costs of previous failures. This means, in the current context, that for a drug company to survive it needs to discover a blockbuster (billion-dollar drug) every few years.
The process for ‘orphan’ diseases like Ebola fall into the less marketable products as it currently infects only people in poor countries unable to pay for expensive drug treatment. Furthermore such treatment would last for a short period of time, weeks not years, which means there is more chance of a net loss so there has been no financial motive for research into the Ebola virus. According to IBIS World Healthcare analyst Sarah Turk, “Once individuals take Ebola drugs, they will no longer make repeat purchases of Ebola medications, thus demonstrating the limited revenue potential for Ebola drugs.” Pharmaceutical companies are therefore unwilling to invest the considerable resources needed to develop a drug to cure Ebola.
This business model is well known and has sparked controversy over the decades with other cases such as HIV in which hundreds of thousands of Africans were denied treatment simply because governments couldn’t afford drug treatment. Indeed there is a current crisis in the development of new antibiotics which are needed to combat current antibiotic resistant bacteria. Andrzej Rys, director of health systems and products for the European Commission stated, “The [European] Commission is acutely aware that the many years of success of antibacterials are now threatened by the emergence and spread of microbes resistant to these key medicines. Antimicrobial resistance is clearly one of the greatest challenges to global health… At the same time there is a decline in investments by the pharmaceutical industry into development of new effective antibacterials. The result is that the pipeline for new antibacterials is almost empty.” Klaus Dembowsky, chief medical officer of Polythor explained that the lack of new antibiotics was the lack of revenue such medicines generate, “The reason why many companies dropped out from the anti-infectives [field] was because of the [lack of] return on investment”
But nothing can be done to change this dependency on drugs from private companies under Capitalism since it contradicts the inherit pillars of free-market economics, government granted monopolies and the price being the cornerstone of the economy. Dr Margaret Chan, director of the World Health Organisation also attributed culpability to the biopharma industry “Ebola emerged nearly 40 years ago. Why are clinicians still empty-handed, with no vaccines and no cure?” she asked. “Because Ebola has been, historically, geographically confined to poor African nations.” She continued “The R&D incentive is virtually non-existent. A profit-driven industry does not invest in products for markets that cannot pay.”
Capitalism is not designed to make decisions based on ethics, but strictly based on increasing economic yield as Dr John Ashton, President of the UK faculty of Public Health correctly identified “We must also tackle the scandal of the unwillingness of the pharmaceutical industry to invest in research to produce treatments and vaccines, something they refuse to do because the numbers involved are, in their terms, so small and don’t justify the investment. This is the moral bankruptcy of Capitalism acting in the absence of an ethical and social framework.”
Year on year pharmaceutical companies’ rake in huge profits. From 2003 to 2012, the world’s largest 11 drug companies (Big Pharma) made a net profit of $711.4 billion. In 2012 alone, Big Pharma earned nearly $85 billion in net profits. According to IMS health, a worldwide leader in health care research, the global market for pharmaceuticals is expected to top $1 trillion in sales by 2014. You would expect therefore that the number of life-saving drugs would have increased due to an increase in R&D, however, this is not the case. Only a handful of important drugs have been brought to market in recent years and they were mostly funded by taxpayer funded research at academic institutions, small biotechnology companies or the NIH (National Institute of Health). The majority of new drugs are variations of older drugs known as “Me-Too” drugs that are simply marketed as revolutionary. Pharmaceutical companies are amongst the top Direct-to-Consumer (DTC) advertising spenders in the world, in 2013 Big Pharma spent $3.6 billion on DTC expenditure.
Like all industries in Capitalism, the free market economy has allowed pharmaceutical industry to exercise power, political might and social influence over a country’s governments, health care networks, doctors and hospitals as well as define the narrative of treatments i.e what is needed and what is not needed such as the Ebola Virus. Moreover, Big Pharma spent almost $2.7 billion on lobbying expenses from 1998-2013, more than any other industry and 42% higher than the insurance industry, the second highest paying. In the United States the industry contributes heavily to the Food and Drug Administration which is responsible for regulating the drugs and devices made by the same companies.
This culpability of Ebola rests not only with the pharmaceutical industry, but the Western governments who only paid attention to the outbreak once people in the West were infected even though the disease has been spreading since December 2013 between parts of West Africa including Guinea, Liberia and Sierra Leone. It was only in the last four weeks that Obama ramped up his response creating fear of a global pandemic and distrustfully assigned 3,000 US military personnel to the strategic location of Africa to supply medical and logistic support. The UK has now followed suit sending in hundreds of troops including aircrafts and warships to the ebola infected region of West Africa.
The victims and future victims of the Ebola virus are not just victims of the disease, but victims of the voracity of Capitalism. A system that predicates humanitarian aid on political gains and profits. This is why a disease that has been known about for over 40 years, in which treatment could have been developed for, has been largely ignored.
Islam in stark contrast does not predicate help on monetary returns. Rather the Khilafah is obligated by the Shariah to help those requiring treatment. The Khilafah took care of the necessities of its citizens and ensured that nobody (muslim or non muslim alike) was without food, shelter, healthcare and education for these matters were communal obligations (fardhul kifayah). Sadaqa (charity) was well entrenched in the Islamic society such that even the Islamic State would provide humanitarian assistance to those who did not live under the authority of Islam. This was aply demonstrated when Sultan Abdul Majid sent ships laden with food to Ireland who were suffering from a severe famine at the time in 1847.
The Khilafah also provided the fertile environment for development in science and technology with a motivation rooted in looking after the affairs of the people rather than the capital incentive. In Medicine, the Persian scientist known as Ibn Sina or Avicenna, wrote the famous book “The Canon of Medicine”, which was a standard textbook taught in various universities around the world until the 18th Century, in which he introduced: the contagious nature of infectious disease; the use of quarantine to curb the spread of infection; neuropsychiatric conditions such as epilepsy, stroke and dementia; the symptoms and complications of diabetes and the use of clinical trials in experimental medicine. The progress made in Medicine, was due to the Muslims following the commands of Allah as laid out in the Quran and Sunnah in looking after the affairs of people as well as the famous Hadith the Prophet PBUH said: “There is no disease that Allah has created, except that He also has created its treatment.” (Sahih Al-Bukhari). The existence of a cure for every disease and looking after the affairs of the citizens of the state encouraged the Muslims to make progress in medical research.
Similarly today the future Khilafah state can help create an environment where research and development can flourish. For instance rather than allowing a free market where companies are only incentivised into researching drugs that would establish a profitable return, the Islamic state can provide a research fund that would be competed for by private companies. In this way the Khilafah can direct the type of investment needed. The funds can be taken from the baital mal (state treasury) and in acute situations an emergency tax can be levelled upon the people in order to provide the sufficient funds for research and manufacture of vital drug treatment. This would be a far more efficient process than the current system of private companies deciding on what to develop based on their own financial benefit and then patenting drugs at many times the price of the cost of manufacture. Ultimately the R&D costs are still passed onto the taxpayers whose taxes will be used by governments to pay for the drug treatment priced by private corporations. For example in the UK the hormone antagonist treatment for prostrate cancer called casodex 150mg is priced at £240 for 28 tablets whereas its generic version is only £9.73 for the same amount. The £230.27 difference is meant to represent the R&D costs which are overinflated to provide a healthy profit for the pharmaceutical company. Clearly then providing a research fund, not only provides an efficient way to research and develop vital medicines, it would allow the cross fertilisation of technology as other companies wouldn’t be restricted by the regressive patent system. Thus Islam under the Khilafah state would provide a clear alternative to the current failing system under capitalism.
Crises such as Ebola outbreak demonstrate the shortfall of the capitalist system and it’s free market economics and the desperate need of an alternative that puts human life above the bottom line.