not exactly. one can't generalize important drugs have been developed but a lot of drugs that have been developed are neither new nor are they better. there are many more copycat drugs. even drugs that have already been devised, tested and approved and the corporation seeing the twentieth and about to run out doesn't want to lose its grip on its patent. they want to maximize profits. what do they do? take the molecule and treat it slightly. what i say slightly i mean slightly. they change an electron. ..

>> decision by the supreme court that found for the first time that a product of nature can be patented. that means a living thing can be patented. so now we can take a patent out on a gene, on a genetic e wednesday, on a biological important animal. on a plant. so the fact that something is living was no longer a legal bar to patenting it. now, living things had been patented sporadically, but there are often legal challenges. this eliminated the legal challenge. i don't know if any of you have followed it, but recently the supreme court sent back the case of the breast cancer gene patents. these patents could be affected because of this law passed in 1980. then there were other laws like the stephenson-wilder act which made it easier for universities

and corporations to partner. and john moore, a patent was taken out on a part of this patient's body even though the doctor never told him when he removed his spleen he was doing it for research. when his doctor took out his spleen and isolated the active ingredient, he took out a patent on it, he owned a patent on the product of john moore's body, a very pretendous -- pretend white house precedent. it disappears to the detriment of the interests of society. it's now the patent, not the patient, at the center of american medical research. what do i mean when i say that drugs are way too expensive? i suspect you already know without me telling you, but even i was completely stagger today see how expensive some of them

are. we're talking literally hundreds of thousands of dollars for a year's treatment. how did this happen? drug companies, interestingly, they don't deny their drugs are very expensive. they say that they are, but they explain they have to be expensive because they invest so much money bringing them to market. and, um, i think 2001 demassey released a report that was heartily endorsed by the pharmaceutical manufacturers claiming every new i pill that came to the market cost $800 to a million dollars to bring to market. two years ago it was a rise the $3 million. now it's $2 billion for every drug to come to the market. well, economists looked at this and said, no, i think the figure you want is closer to $20 million. that's not chump change, but

it's not $2 billion either. the tb alliance did their own analysis, they said, no, they're in the ballpark of 150-200 million, and public citizens found it was 110 million. so why the wide divergence? why do the pharmaceutical companies spend their claiming $2 billion, and these groups that are dedicated to providing low-cost medications claim it's so much cheaper? well, because the demassey report is deeply flawed. it's simply not accurate. first of all, when they looked at the cost of drugs, they only looked at atypically-expensive drugs. these are drugs that are brand new with no precedent. they're not copy cat drugs, not the tweak drugs i spoke of, they're a new molecular entity, a totally new drug. those are expensive. those are also quite rare. most drugs do not fall in that category. they also looked at a small

subcategory of those drugs. those few drugs for which the government invested no money in its development. that's also quite rare because usually the government will invest money in the researcher's work, in the university, and then when the researcher finds something that's worth developing medically, only then does the corporation step in as a partner and start controlling the additional research fielded for fda approval, etc. so a few drugs, relatively few drugs don't have that initial support, so they looked at that small segment. also, the demassey report did not correct the industry's dramatic tax benefits. the tax benefits are the largest of any industry in this country, and they're so high that for every dollar the industry spends, they only lose 66 cents. so these are really big benefits, and they did not figure into this report. also they charge an opportunity cost. this was an education to me. i'd never heard of opportunity costs before. opportunity costs were actually desided by john -- devised by

john stuart mills. that cost that you pay, that you surrender to pursue activities in one direction at the expense of another. the example i gave in the book is if i have $10, i decide i'm going to go to the movies with it. i buy a movie ticket. but if i had put it in my savings account, i would have earned interest. that lost interest is my opportunity cost. now, if i left it in the bank long enough, it would have doubled to $20, and that's exactly what demassey did in this report. they said, well, these drug companies spend all this money on research. now, they could buy stock in starbucks with that money, or they could devote that money to global hunger relief, and they would have benefits from it. but they're giving that up to devote their, um, you know, devote their funds to, you know, drug development. well, isn't that what they exist to do? i mean, if these drug companies

were to buy, expend all their resources on starbucks or on global hunger relief, they wouldn't be drug companies anymore, and that's why the opportunity cost does not apply. actually, um, what they receive as tax benefits and, actually, it's not an investment for them to do drug design, it's part of what they do. it is a cost of business. and the opportunity cost does not apply. this would cut the remaining figure in half. so we can see how easily you can fall from the two billion figure to something that's closer to 100 million. and that's why their claim is baseless. so what do these high drug prices mean? you all know what they mean. if we ourselves haven't suffered it, we know somebody or are close to somebody who can't buy their medications, who can't get care, who can't get health insurance or who has not had a test or treatment that they need. so there's no mystery there, we know this is really significant.

but here it's quantified a bit. half of the people in this country fall into one of those categories. even people who are employed and have health insurance are not immune because employers have consistently been making employees' children more and more of the cost of their research -- i'm sorry, of their insurance and of their medications. so now we have the background, we see what happened, and we understand what this means to us in terms of drug cost. but interestingly, this law, this confluence of industry and research organizations doesn't only effect patients, it effects researchers as well. and this is the thing that i found deeply, deeply troubling, and i wonder why people are not more aware of this. chris parish is a researcher in australian national university, and he has devoted his entire career, 20 years, to a liver cancer drug, a very promising liver cancer drug. it was in stage iii trials, it was doing extremely well.

it was called pi88 at that point, and it looked really promising. he had acquired a corporate partner, and he was very happy about that because his corporate partner allowed him to finish work on the drug, have it tested, it funded his research. he didn't really care, he said, that when he partnered with this group through the university, they told him, look, you know, we have to license or sell the patent to this new health forma, this new company, so you no longer own the patent. he said, i don't care, i just want to devise a drug. and he did. at the end of the stage iii trials, right before it was about to obtain approval, they ended the trial and said we're not going to pursue this drug, we don't want it, we're not going to market it. why didn't they want it? it's a liver cancer drug. and although it's not a large problem in this country, liver cancer's the number three killer globally, and there are not many

drugs for it. but paul farmer said we're not interested anymore. why? because two other drug companies were devising cancer drugs that would compete with it in the marketplace. paul farmer said we don't want this drug unless it's going to be a blockbuster. it won't be a blockbuster because there's a competition of other drugs. therefore, we're going to pursue something else. it's not worth our time and money to see this through to the end. now, what's a blockbuster drug? a blockbuster drug is usually defined as a drug that takes in at least $1 billion in profits a year. we're talking about a $310 billion industry. so that's, actually, you know, that's the watershed. if you're not take anything a billion dollars a year, you're not worth our time. and the interests of the people like chris parish whose life work is now at a standstill, and the interest of the liver cancer patients around the globe don't factor into the corporate bottom line. so what other things have we

seen recently having to do with devising new and better drugs? are the drugs really better? that all depends on your point of view. the drug companies certainly think so. but looking at it globally, it seems quite clear that they're not better drugs because if you look at the diseases that kill people and the greatest numbers across the globe, these are diseases that the pharmaceutical companies are not at all interested in devising, and the answer is simple. because malaria effects people who are poor and can't afford the drugs and, therefore, they're not making the assessment. there's been one new malaria drug devised recently, but guess what kind of drug it is? it's not to treat malaria, it's for wealthy western travelers to help them avoid contracting malaria. so even when drugs are deviced for -- devised for people in the developing world, they're not for those people to use, they're devised to protect people like us, wealthy westerners,

relatively wealthy westerners. so if you look at sleeping sickness, i think that's a perfect example because there are only a handle of drugs -- handful of drugs, most of them are as bad as the disease. one of them is a come pound of arsenic and antifreeze, and you don't have to be a chemist to know that's bad news. [laughter] so if you're desperate in western africa, you take it because you're desperate. sleeping sickness will definitely kill you. the drug may kill you. and be, um, i think it's like one in four people actually die from the treatment. moreover, if you, if your disease can progresses to the point where you go into a coma, then this drug cannot bring you back from the brink. it can't help people who go into the final stage of the disease. so this is a tragedy, absolute tragedy. however, a drug was found that would not only treat people safely, but it would bring those unconscious patients back from the brink. this was wonderful.

the company -- and i'm not going to name right now because i don't want to spend my life in litigation, but the company decided to call it ornidal. and for a while in partnership with doctors and borders -- a very good thing -- the company actually partnered with doctors without borders in order to make sure that people in west africa had access to the drug. but they only did that for a few years because after a while it was quite clear that no one in that part of the world could afford the drug. they were losing money on it, you know, consistently. i think it's wonderful that they were willing to do this, they were willing to make sure people had the drug, but the problem, of course, is -- as is very, it's typical -- they only did it for five years, they only did it for a short period of time. it wasn't nearly enough to treat the real problem. they only were able to help a relative handful of people. so they withdrew it from the west african market. that -- now, the generic name is anor no teen.

the fact they withdrew it from the west african market does not mean you can't buy it. any one of us can get it. you need a prescription. we can get it, but there's no sleeping sickness in this country. so why would we need it? if it's being marketed for women who have facial hair, it's called reneka. the commercials come on tv sometimes. if you're embarrassed by your facial hair and you don't want to use a razor, it's a cream you put on your face, it's $50 a month with a prescription, it'll get rid of your facial hair. so wealthy women can buy this drug, but dying west africans cannot obtain it. and that's what's wrong with medicine today. that's what's wrong with this corporate partnership. i want to take a minute to say that these corporations, i criticize them heavily, i think they deserve it, but i also want to note that they are not in business to, um, promote health.

no matter what their stirring ads say, no matter what those heart-wrenching commercials say, they're not in business to maintain and restore health. they're in business to make a profit. so i do criticize them, but i have more criticism for the government because the government is supposed to protect our health, and the government is involved here. it's our tax dollars that fund the initial research on these molecules that get transferred to corporations. we have an investment here. as marsha angeles points out, we end up paying for our drugs twice. we pay for the initial development through our tax dollars, and when it goes on the market, we pay their inflated prices. so the government should step in. in other countries governments have stepped in and said to companies, your drugs are too expensive, or you have a drug that you're refusing to distribute. if you are not going to distribute this drug at a price that our people can afford, we're going to take that pat patent from you and give it to somebody else. that could be done in this country. and what's interesting is the government has done it in this

country for radio receivers, for certain television testimonies, but not -- technologies, but not for medications that we need. so there is a shared responsibility here. the government has a responsibility to do this, and why don't they do it? in my opinion, this is not being done because of a very cozy relationship between these companies and legislators. the lobbying is completely out of control. pharmaceutical companies have the highest number of lobbyists, and they pay them the most. and a lot of these lobbyists are former legislators, so there they are cutting deals with their former colleagues to make sure that drug prices don't go down. to make sure that we are locked into paying high prices and to make sure that they are permitted to sell their trivial medications and ignore critical health problems without any interference from the government. oh, of course, i always have to say a word about, um, the fact that there are so few medications for these killers, but for erectile dysfunction

we've had 14 drugs since 1996, and it doesn't kill anybody -- although, what, almost 600 men have died from taking them? [laughter] so it says something very sad about where our priorities seem to lie or where pharmaceutical companies' priorities seem to lie. so what effect has corporate, um, control of research had in the developing world? the image on the left is familiar to anybody, these are children who had folk mill ya as a result of taking no lid hide. it was distributed in europe, and it was distributed pretty widely. it was given to pregnant women as a sedative, and, um, and to treat their sleeping problems. but when the children -- after a while even though it had been improved in europe, children were born that had these devastating birth defects. everybody knew it, there were articles everywhere, pictures

everywhere. even as a kid you couldn't avoid them, and they always said we can never allow this to happen again, no lid hides will never again -- now, why weren't american people affected? because of the fda. it's the fda's shining hour. francis kelsey, a pharmacologist and physician at the fda looked at the tests and said the tests weren't done correctly, i am not convinced the drug is safe. the drug maker said we are going to sue the fda, if you don't approve this drug, we're going to sue you. everybody else is selling it, why won't you? and the fda held firm and said, no, we're not going to gamble with the lives of americans. and, of course, americans were saved from this tragedy. but what's happened today? the babe on the right is a picture of one whose mother was

given the lid hide. it's not being be tested in the west. this is a horrible, ethical misstep. it's not only that these people are being asked to assume all the risks and be none of the benefits of the testing, because the testing is for conditions like multiple myeloma and leprosy, and what they have said to me is, well, harriet, leprosy is rampant in places like brazil and nigeria, so we're doing them a favor. no, we're not. because this drug to treat these conditions will never make its way to these people. they can't afford it, and more to the point, pharmaceutical companies do not devise drugs for people in developing worlds. for quite -- for a long time researchers told me that there was an unspoken tenet that you didn't test drugs for uses in the tropics or developing worlds because people there couldn't afford it, and the company

didn't even want to explain why they weren't using the drug there. but the data will also tell you, um, economist michael kramer wrote that of the 12,333 drugs tested by pharmaceutical companies within a 25-year span, guess how many were developed for the people of the developing world, for people who live in the tropics? four. so these people are not a priority for pharmaceutical companies. but they are a priority for testing of these drugs. so the testing is done by european and american researchers in these countries, and there are lots of social justice violations. um, for example, no lid hide when it is prescribed to people in the west for a condition like leprosy, of course, very rare in the west or multiple myeloma, they are warned that you have, if you're a woman, you have got

to take two forms of contraception. you can't become pregnant on this drug. they're also labeled with the picture of a deformed baby. but, unfortunately, i don't think that labeling is the most clear thing. um, if you don't already know, you may wonder what it is you're looking at. there's a picture of a baby on this cap, so what does that mean? but, so these people are being warned. however, there's a -- it's quite certain that in some trials people in the developing world are not warned. for example, the packaging material in west africa until 1978 described no lid hide as completely harmless, without side effects. and many of these people are illiterate, they would not be able to read written warnings and a brazilian study revealed 67 children had been born to women with the disease, and they were distinctly traced to women who had been given the drug, no question about it. there's also a question about whether no lid hide might be

secreted in the see men which mean -- semen which means men would have to be careful. in the developing world women are told to take two forms of contraceptives. in many countries contraceptives are beyond their reach. some of these women live in countries where they are illegal or the religious leaders forwade their -- forbade their use. this is where the research is being carried out, and one might wonder why, you know? i think the west would be a more logical place because here at least women can protect themselves. but why is the research carried out in the developing world? as you can see, the developing world is not the market for these companies. the problem is -- well, not the problem is, a decision has been a financial one. new england journal of medicine article showed that

pharmaceutical companies conduct one in every three trials in the developing world, and that was more than a year ago. it may be more now. one in three trials. why? because they can conduct cheaper trials, faster trials -- very important for fda approval -- and be these trials are higher quality in the developing world. they can get better quality, they can get more experienced, more practiced researchers to work for less money. so although a lot of our discourse about providing drugs to the developing world has been, well, we can't afford to do this, these people are so poor, that's why they can't afford health care, they're so poor, they can't afford drugs, and we can't afford to be the world's beneficiary and give them free drugs. companies certainly make that claim. we wish we could give free drugs to these people, but we can't afford it. but i say we have a debt here. these countries are actually saving us a lot of money by allowing us to conduct cheap trials there, cheap, fast trials. and so we're in their debt.

morally, we have an obligation to provide them minimally with free drugs to offset the excess risks they're taking on it. and as i mentioned n some cases we should not be conducting trials there because people can't protect themselves. so if you look at the disease burden around the world, it's a very consistent pattern. very, very high when it comes to infectious diseases, and yet all these medications that are needed are missing. a lot of the, you know, a lot of focus is on hiv, as it should be, but there are other things that are much easier and cheaper to administer and give. for example, vaccines in the developing world. vaccines are very easy and cheap because you don't have to make a diagnosis, you don't have to, um, provide a lot of time or monitoring. a one-shot deal. everybody, every child, um, gets a vaccine, it's very easy to administer, and it's not very expense bive -- expensive, um,

necessarily because, um, bill gates' foundation has partnered with a drug company among others to provide very cheap vaccines in the developing world. you have to keep in mind it's not a matter of just importing western vaccines and medications. the special challenges in the developing world include the fact that health practitioners are scarce. you don't want it to be injectable, something everyone can take. refrigeration is not always an option, so these things have to be kept in mind, and even so they were able to take a $70 vaccine and distribute it for 50 cents in alaska rah and the developing world. and it's really important to me that pharmaceutical companies were part of that partnership. in my opinion, this is where the future lies for them. because as i talk about how this new model, this current model does not work for patients, and it doesn't work for researchers really because researchers run the risk, as chris parish did, of having the plug pulled on them, it doesn't work for pharmaceutical companies either. think about what it means to

them to have a dried-up pipeline of new drugs. fifteen new drugs a year, 26 new drugs a year, that's not enough for them to make a profit. they are seeing their patents expire. blockbuster drugs have come off patent in the last few years, and drug companies are suffering. they've fallen from the number one spot to the number three spot, so this system is not working terribly well for them either. i think that they should become aware of the fact that the developing world presents a huge, untapped market for them. instead of thinking in terms of charging you serious prices and bankrupting people and charging hundreds of thousands of dollars a year for a drug, they should think about the fact that providing relatively cheap drugs to many, many people in the developing world can prove, ultimately, lucrative if they come up with a good model. and there are people like the health impact fund out of yale, there are economists who are

actively working on these kind of models pharmaceutical companies might consider adopting. and as an ethicist, i'm deeply concerned about the effect of these corporations on research ethics. research ethics have been deformed by corporate control. even the ethicists who are supposed to be the guard minneapolis, the watchers, the people who critique everything, even they are engaging in what i consider troubling activities, joining the boards of pharmaceutical companies. and i see this as a distinct, um, problem. you know, if someone is doing things that are resulting in the deaths of people, resulting in people not being able to afford their drugs, resulting in people going bankrupt trying to pay for their drugs, i am not going to be on the corporate board, i am not going to advise them. yet ethicists do advise them, and the troubling thing to me is many of these people don't think

they're doing anything wrong. you know, there's, unfortunately, a mentality among many ethicists that we know in our hearts that our motives are pure, we're doing god's work, we can't be corrupted. yes, i have this check from pfizer in my back pocket, but it's not going to change the way i act as a champion for the underserved. well, it might. it might easily. and so being able to cite the opinions of ethicists in defense of some of their practices, i think, is a very developing, new trend. another, another disturbing new trend is the fact that corporates have discovered that recruiting people for clinical trials takes a lot of time because you have to explain the trial, you have to pay their commission, informed consent, in a nutshell. and informed consent has been a basic tenet of american medical research since the mid 1940s after the nuremberg trials when the principal tenet was

voluntary consent of the subject was essential. but that's not true anymore. beginning in 1990 and continue anything 1996, there have been a series of changes that have allowed researchers to conduct research on people who do not give their concept. if -- consent. if you are unconscious and can a trauma victim, you can be enrolled in the research. people like that have been enrolled in research without your consent. they don't have to ask your consent before the research, they don't have to tell you about it afterwards, they don't have to obtain your family's concept. and this law's easy to look up, federal code of regulations 21, there it is in black and white, a very, very chilling development in american law that has really remained under our radar for too long. i wrote a few articles about it because i am deeply concerned about this. and the largest study that, um, used this law ended in 2007. it recruited 720 people around

this country, and the artificial blood it was testing turned out to be harmful. it turned out more people who received it suffered heart attacks and deaths than people who got the standard of care. you would think this would lead to a moratorium on this research without concept, but instead -- consent, but instead a few in study was approved whose goal is to enroll 23,000 people. we went from 720 people, 23,000 people in 31 centers --11 centers across this country and canada can, and they're testing a wide variety of emergency agents on people who suffered traumas. trauma's anything from a gunshot wound to a car crash to a heart attack. so 21,000 people, and yet when i spoke to ethicists and said i'm really disturbed about this, don't you find this disturbing, what i heard most often was, yes, but you have to understand it's very rarely used. this is not something that effects most people. it's really rarely used.

well, i don't think 21,000 people is area, and i don't think that's an ethical defense. if i kill somebody, i can't go to court and say, but i very rarely kill people. [laughter] you know, wrong is wrong. and yet this is being done and defended. informed concept is going the way of the dodo, and one really troubling aspect of this, if you look at these consent schemes, a lot of them use the word "consent," but when you read their descriptions, they're united by their failure to provide consent, their failure to allow a person to say yes or no to medical research, a very, very troubling trend in american research, and my concern is if we don't stop it now, it's going to continue to escalate before most people are aware of it. i want to wind up soon because i do want to leave time for questions, but again, i really want to summarize by saying in my opinion pharmaceutical companies have been responsible for a lot of pain and suffering,

a lot of unnecessary heart ache, and they have a chance to redeem themselves though. if they take the opportunity to embrace new schemes of research that will benefit people in the developing world, that will benefit more people in this country, if they change their focus from maximizing patent profits to maximizing distribution of their medications at a lower profit, they might ultimately make more money. and if they don't see things that way, it's the responsibility of the government to do so. the government should exercise its power to force these companies to do what's right if they choose not to do the right thing. and that's, essentially, what i have to say to you. thank you so much for listening to me. [applause] so i was told if anyone has questions, and i certainly hope a loot of you do -- a lot of you do, give time for the mic to get over to you so that we can be sure to record them properly.

>> i think motivation is a big factor, and once motivation switched from the incentive for research and collegial competition to profit, what happened was profit went down. but it's hard to take us out of that mentality. what, other than saying because people would get angry at the government, i mean, the incentive to get out more medicines is going to increase your profit. we're finding the same thing in the american economy now, today. corporations want to make more money, but they can only do it if they recognize that we're a team working together. if there's no middle class for products, they're not going to make more money. so is there any kind of program or understanding or push other than little groups like this to try and bring this awareness

about? >> i think it's really important for people, especially little groups like this, to try the make their legislators aware of the fact that they're concerned about some of these developments because -- and that's actually worked in california where xavier becerra actually drafted the law, and dave wheldon joined with him, and it was a law against gene patenting. so i think -- but that's only part of what has to happen. this problem, this issue actually began in the law, in my opinion. it's got to be ended in the law. and the big hurdle is congress because right now we have legislators who have not been paid by -- well, these legislators have been elected by us, and yet their behavior is squarely in line with the interests of pharmaceutical companies and against our medical interests. so we have to get rid of these lobbyists, we have to outlaw them. they have no place in health care design. they have no place in decisions about medical care.

and yet they're exerting a huge influence. get rid of the lobbyists and make your legislator know that you are concerned about this. i always tell people, you know, i always urge people to take action where they are. whatever group you're involved with, that's the group that you should try to, um, sell your outrage about this and have them approach your lawmaker together and, of course, if they won't, you do it on your own. but i think in the law is where it's going to end because companies are not going to do the right thick of their own -- thing of their own volition. they do it occasionally and sporadically, but not in the consistent way that we need. up to you, okay. >> the fda came up with a statement that says that only drugs can cure illness, and i was reading a book by kevin trudy, and it went into the statement that you made about

the ungodly link between lobbying and the congress and the, um, and the pharmaceutical companies. >> uh-huh. >> but what do you think about the idea of, um, revitalizing the option of natural, um, supplements in this country? because that's, um, revising herbal options and that sort of thing to, um, to help with curing illness? >> that's a very interesting question. i'm not aware of the fda report that you're alluding to, but the question about, um, alternative, complementary medications, very interesting because in patents class earlier today we were discussing this very issue. my take on it is alternative and complimentary remedies are only alternative until they are shown to work, and then they're absorbed by medicine.

so it's actually artificial. i, actually -- to me, not probably to most people -- i actually view it not between alternative and complimentary and conventional, i look at what works and what doesn't work. to me, that's a key distownship. and to know what works, one has to test it rigorously. there's some sentiment that i don't agree with that alternative and complimentary medications don't have to go through western-style testing in order to be thought of as efficacious, i don't agree with that, and interestingly, neither does germany. they have a long history of testing medications. they test western medications. and it's been very useful. they have a really good body of evidence now for some things that work and some things that don't work. and that's what we need to do, we need to do that rigorous testing. the way that alternative remedies are too often promulgated is not evidence, it's simply anecdotes. people will say i've used this for 20 years, and it's worked

well, and they trot out patient a who sings its praises. that's not ed, you know? -- evidence, you know? it may not be accurate. everyone deserves to have medication that we have done our utmost to make sure are effective and safe, and that's the only way we're going to get them no matter what kind of medication it is. next? >> i have a think lid hide question. if they're testing it in third world countries for diseases that primarily effect the third world like leprosy, the examples that you mentioned, where's the economic incentive for them there in even doing testing? >> wow, that's a good question. and the question is -- to me, what i ask is, is this actually the reason why it's being tested? is this actually the application they have in mind? because the figure i gave you about the four medications out of 12,900 odd, that would indicate that it's not being

used for application, but that's a useful thing to say when someone like me asks why are you doing this dangerous research in brazil and nigeria, but not connecticut? so i wonder if that's the real motivation. >> [inaudible] prescription drugs of users on television, i was wondering what you think about the ethics behind that. the second question i had was once a drug becomes extremely profitable, what's the impetus to have it become obsolete? if a disease were to be cured, would we not know about it because the drug is so profitable -- >> the direct to consumer ads is what you're talking about, where pharmaceutical companies bypass a physician and go right to you,

the television viewer, and they sing the praises of their drug, and then they do list the side effects and problems way too quickly for mortal man to read or hear. and then what happens? you go to your doctor and demand that drug. that's the way it works. it's an end run around the doctor. no country except the u.s. and new zealand allows this. other countries do not allow this because they understand that in bypassing the physician these companies are not informing you correctly about the drug. they also know they're capitalizing on laypersons' lack of information to sell it to them, and they also understand that this exerts, um, obscure but very, you know, subtle but very strong pressure on physicians. physicians will prescribe these drugs. partly because they're human, and i understand that if you don't get a drug from them, you're going to get the drug from someone else. so it's an enormous amount of pressure on them, and that's why

other countries don't permit it, and we should not permit it either in my opinion. and your question about do drug companies -- are they really interested in curing disease? if a disease could be quelled, would that not dry up their revenue stream? and that's a perennial question, and quite frankly, i don't know the answer, but i do know that for whatever reason to be honest with you, i don't think that's a question we really need to answer because i don't think we're in much danger of these companies devising new drugs that are actually going to cure disease for a much more direct financial reason, and that is these company bees are much more interested -- companies are much more interested in a quick return n a big return on their dollar, and that often doesn't mean finding cures which is very rigorous and lengthy. that means finding things like tests, um, devising a test for a particular drug, a genetic ailment. you devise a test for the genetic element, you take a patent out on that, now nobody

else can use your test. when a test for hepatitis c was developed, the price of hepatitis c in london, in great britain skyrocketed six times as high. why? because they had been using a cheaper test by another company, and the company's lawyers wrote them and said cease and desist, we own the patent, you have to use our test, and that's what they did. so i think the emphasis on cheaper revenues to patent exploration, devising tests, devising drugs for lifestyle disorders, you know, gastric distress. the dtc ads never tell you if you have daily gassic distress, stop living on pizza and hamburgers. they don't say that. they say, take our pill. and they capitalize on people's insecurities, you know, toenail fungus, erectile dysfunction. they've got half the men in america convinced that their normal, occasional failure to

function adds up to a disease which is very profitable for them. so i think because of that focus i'm not even sure we have to go to the point where we say is it worth their while to find a cure because it's not worth their while to find a treatment for certain ailments, it's worth their while to find cheaper, easier ways to patent exploitation. >> thank you. so we're on a university campus, and technology transfer has been very good to universities, and universities are always striverring to make it better by -- striving to make it better by transferring these patents to corporate entities. should we all be disbanding our technology transfer activities? >> define better. >> but can we go back? i think what i'm asking is can

we go back to the time when researchers actually had to make a choice between academia and business, and they couldn't actually do both? could we will go back there? >> we could, and i think it would be a good thing. whether we will, i don't know. because it's true, universities make a good deal of money. it's true. very successful universities. but unfortunately, you know, that bonanza does not filter down to people, you know? the people who don't need money, but need effective treatments that they can afford. so we could repeal bay-dole which i propose in my book, but i'm pretty sanguine about the chances of that happening. i realize it may not happen at all, but it would be a good step. i think sometimes we're so afraid of not being progressive, you know, of not going forward. there's this, um, nigerian proverb, and the concept says it

is not wrong to go back for that which you have forgotten. in this case, we have forgotten something. in our zeal to make money, we have forgotten to put patients at the center. and so i think it would be a very good idea to, basically, affect a divorce between corporations and universities. now, that may not happen, probably not going to happen, so what should we do? i think we should do what i suggested. i think that the government should exert very serious pressure on pharmaceutical companies. i think they should first exert pressure -- i'm sorry, first, get rid of the lobbyists, okay? like in shakespeare, first, get rid of the lawyers, first, let's get rid of the lobbyists. then government should exert very strong pressure on these companies to partner with groups like doctors without borders which they have done occasionally and successfully, to do it wholesale. to adopt new marketing models like the health impact fund which says that instead of charging a lot of money for a

drug, you're going to be paid for your drug based on how many lives you save, based on how many people you help. that's a beautiful model because not only does it guarantee a windfall in curing an important disease, but in that model every life is the same. saving the lives of ten americans is the same as ten africans. so that's a wonderful model. the government should put serious pressure on these companies to adopt these models, and the fay balk, the government should -- if they balk, the government should force them. that's what i think should happen. >> how corrupting, if at all, do you think the massive amount of advertising dollars have on the news industry? >> ah, the news industry. not medical journals, but news industry? >> well, yes. because if you looked at the nightly news, for example, i mean, two-thirds of it are drug

advertisements. and what would happen to that? be and do you think that has an impact on coverage? >> yeah. i'm not in a position to say for sure. i will say i would be surprised if it doesn't have an impact, but i certainly -- in terms of the mass media, i would not single out drug advertisements though because it's, um, money in all its forms that can be a corrupting influence if you're not very careful. and i think -- and, of course, you know, the news media are plural, so it varies from publication to publication, you know? you have some publishers who have a strong sense of what abouting to -- wanting to keep journals independent, and then you have publishers who are, um, i don't know, what do they call that guy in l.a. who took over the serial killer because he was, like, heir to a cereal fortune? and people were claiming it had some effect on the news coverage there. so it varies.

but, definitely, advertising is a way of exerting pressure, and in my career i've actually seen it done. i've seen a case where we ran stories or did not run stories as a result of advertising pressure brought to bear. so i can't speak with any authority about exactly how often it happens, but i'm sure that it does happen. >> what has been the most tangible, um, hopeful result of your book from a drug company, from lawyers, from the government? >> they love it. [laughter] most hopeful? i wouldn't say that, you know, the most hopeful reaction has come from the drug companies at all. i think they've, actually, been very smart. they have not reacted much to it which is, you know, the smart thing to do. they want to draw as little attention as possible to it, so, you know, they've essentially ignored it which is fine with me.

um, the most hopeful aspect of what i've discovered is certainly seeing that these partnerships between drug companies and groups like the ones i've mentioned, doctors without borders, the gates foundation, they're ephemeral. they never last very long, but they are beginning to bear fruit. we have seen examples of them actually doing what they set out to do, and i really dream of a world in which these companies will work hand in hand with these groups who are devoted to the health of people and that we hit some kind of healthy medium. i'm not against them making a profit, i'm just against them making such a huge profit on the backs of other people. that other people suffer and die. um, that's what i'm against. so there is a happy medium there, whether we're going to achieve it, i don't know, but that is the most hopeful thing. i think it's possible, so i'm hoping things will work out that way. >> so you mentioned, um, earlier the fact that you can make

effective vaccines for 50 cents a dote, and i don't know whether you were thinking of the meningitis vaccine initiative -- >> that was one of them. >> okay. because there it was a transfer of intellectual property from the u.s. government to an offshore drug maker. >> uh-huh. >> a true partnership. >> right. >> and funded by more than $100 million of gates' foundation money, and it made a 50-cent vaccine that works. >> yeah. >> costs $80-$100 a dose in a pediatrician's office in the united states. so that brings to me mind the idea of offshore drug manufacturing. we know that india is an enormous drug manufacturer now. do you think these international drug makers are part of the solution, part of the problem, or what -- where do they fit? >> well, unfortunately, they're not doing very well right now, and part of it has to do with the world trade organization agreement which has laws dealing

with intellectual property that they have imposed on developing worlds. india was able to duplicate important drugs very cheaply and distribute to the rest of the developing world, but it can't do that legally anymore because india's laws, um, govern patents on manufacturing processes. not on composition. so they could duplicate a drug legally, you know? and distribute it. what was, what they had to change was the way it was manufactured. but trips has forced india to adhere to the patent system of the west where the composition of the drug is what is protected. so india can no longer duplicate those drugs as cheaply as it used to, and this, i think, is an enormous problem. imposing our patent strictures, i don't think a lot of this is even our intellectual property because a lot of it was raided from the third world to begin with.

so for that reason i think it's the law, as it is, is going to make it very difficult for these offshore companies to work unless they're working in concert with the american pharmaceutical companies who up to now have been part of the problem. so the trips laws need to be eased, if not revoked. they need to be eased so developing countries can find their own way of providing drugs to their people since we have decided not to do that. and they should not be forced to respect our patents when we are not forced to respect their patents. the way it's set up now, it's not reciprocal. if they can be ignored by our researchers, then they should be able to ignore our patents with impunity. that's only justice. >> you know, just as a -- you've said a lot of unpleasant things about large pharmaceutical companies, and i'm not

questioning what you said. but you've said to me privately that there have been moments of generosity, moments where we've seen drug companies behave in good ways. would you mention one or two of those where you think they've not been -- >> well, i have been discussing them. i've been talking about the partnerships they made, for example, with the gates foundation and with the health in impact fund and with other groups that are, you know, dedicated to the health of people in the developing world. and as you mentioned, you know, the low-cost vaccine, i've mentioned all those things, and i think those things are very important. the problem is it hasn't been sustained partnership, but that's what i want to see happen. if there are sustained partnerships, we're actually going to be able to solve some of these problems, and they'll be able to make a profit and stay in business. so that's what i would line to see, and -- like to see, and i suspect that's what they would like to see as well. i hope at least. anybody else? thank you so much. [applause]

>> you're watching booktv on c-span2, 48 hours of nonfiction authors and books every weekend. >> richard brookhiser, when we talk about the founding fathers, what's the era we're talkingrs about? what are the events we're talking about? >> we're talking about theue american revolution and the writing of the constitution. and those are the two key events, and everybody who playea a major role in those events cae claim to be a founding father. now, obviously, the older ones had careers before the american revolution, the younger ones had careers that went on quite a few years after the signing of the constitution. years after the signing of the constitution. >> host: who were the older ones and younger ones. >> guest: benjamin franklin, the oldest, born in 1706. he knows cotton mather and the

died in 1790. he signs both the declaration of independence and the constitution. the last to die was james madison. he is born in 1751, and then he do is in 1836. 85 years old. so, he has seen the fight over missouri being admitted to the union. he sees nullification crisis but he is the last one. aaron byrd. but that's the other side. the dark side. >> host: in 2006, you wrote wow what would the founders do," wwfd, and in that book you write: the founders invite our questions now because they invited discussion when they lived. they were dry in public

speeches and in journalism. >> guest: that's right. they set up a republic and they're very proud of doing that, and this is unique -- virtually unique in the world. there were -- holland had been kind of a republic but that was going down the tubes so this was a unique form of government, and compared to all the competitors, month no, okays and whatnot, it's open. it's based on popular rule and, yes, of course, the franchise was restricted but still there is a franchise. so, voters, the electorate, has to be appealed to, has to be brought long and instructed, and they do this constantly. a lot of them are journalists. they write for the newspapers. some of them are professional journalists, alexander hamilton founds a newspaper that is still

going on, the new york post. he founded it. was the first publisher. benjamin franklin was a great publisher, sam adam was a publisher. it's hard to think of founders who didn't write journalism. george washington didn't. but that is very rare. even someone like james madison who didn't like or was great at it, he screwed himself up and wrote 29 federalist papers which were op-ed pieces in newspapers. so these guys, these men, know that they have to put themselves out there for the american public, which is their con constitute tune si. >> host: no it alls. >> guest: well, know it alls. they were well educated. it's a little country. the colleges we have -- he have

a handful of colleges. they're tiny. harvard or kings college, which becomes columbia, or yale or princeton, they have a few dozen students. unlike the thousands that they have today. but most of these men were college graduates. those who weren't made sure they read all their lives. they felt they had to be up on both the news of the day and the political theory of the day. they all knew their -- if you listen to their debates you would have thought that moscue the celebrate. and the knew their english history, their recent english history and they're ancient

history. the history of the classical world. the history of rome and greece. the didn't always admire what they read. in hamilton and the federalist papers he says the history of the little greek city states is disgusting because they all -- they go through cycles of tyranny and chaos and whatnot and that's what he hopes america can avoid. but that's a negative example. so you have to know the negative examples as well. >> host: you say -- tell me if i'm paraphrasing this wong -- our founding fathers were less well-traveled, perhaps even less sophisticated, than high school seniors today or veterans from iraq and afghanistan. >> guest: well, sure. it's harder to get around the world. and a crossing of the atlantic ocean takes 20 davis -- days if you're lucky. it can take 80 days of you fal