Pharmacologist’s apparatus. (Not shown: army of lobbyists bristling with cash.)
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As it stands, the entire drug industry is awash in incentives and far too much concerned with profits and too little with actually helping people; it should, as the cliche has it, “lead, follow or get out of the way.” A more rational solution is to deny new patents, vacate existing ones and create real competition among many smaller players with access to the full range of compounds currently on the market; companies that develop products of real merit will still have plenty of room to make money, although at nothing like the current, obscene rate.
Meanwhile, FDA approval has already been eased far too much: Companies are marketing new products without adequate testing, leaving patients to suffer for their negligence with unanticipated side-effects. As a result, for example, children diagnosed with depression and related mental illnesses are getting anti-depressants that aren’t appropriate to their developing physiology and leave them worse off than before, sometimes to the extent that they commit suicide. And making it still easier to get antibiotics approved will only accelerate the appearance of antibiotic-resistant “superbugs” which, as this article mentions, already threaten us with untreatable pandemics.
Also, however, much of this research should be unceremoniously taken out of industry’s venal and incompetent hands — sticky with the blood of the patients who live or die at their mercy and festooned with ill-gained currency — and taken over by universities. Grants to institutions of higher learning, resolutely overseen so that no one can turn them to private gain, will yield a far higher societal benefit than any number of special favors to private profiteers. And leaving drug companies to compete under the conditions of true free enterprise can only make them more efficient, even as it restores a measure of real choice to consumers.
In conjunction with this not-for-profit research, more attention should be given to alternative means of prevention and treatment. The reflexive, find-a-condition-and-develop-a-drug paradigm has long ago proved defective. More holistic approaches emphasizing proper diet, exercise, avoidance of excessive consumption of alcohol, caffeine and other drugs are far less expensive and relieve people of the need to become “patients” in the first place. And when disease does strike — as we can dare to hope will be less frequent and severe than it is in today’s stressed, fast food-fueled and sedentary population — the more sparingly used medications are likely to be more effective in proportion.
Finally, and most important, we must begin to take account of people’s environments at home and work. In vain we struggle to preserve or restore health to people who must spend their time surrounded by poisons. The greatest danger to public health today is air pollution, immediately followed by water and noise pollution, and we are essentially oblivious to the dangers they create.
Common sense is reinforced by countless studies: Bad air, bad water and the stress of constant noise kill. But most Americans would be shocked by the results of a simple experiment: Go out one calm night with flashlight in hand, and see what appears in its beam; still more appalling is to perform the same experiment indoors and see how clean the air really is in that imagined sanctum of peace and safety that is our homes.
Of course, all of this suffers one fatal defect: It’s not likely to increase profits. And until we replace our leaders with people who put public health ahead of money, nothing will change save for the greater gain of industry.