what drives the world the fear mongering used by politicians who makes decisions come to the breakthrough it's already been made who can you trust no one. is imbue it with a global machinery to see where are we heading state controlled capitalism is called sessions when nobody dares to ask why we do our t. question more.

for tonight's conversations with great minds of honored to be joined by dr harriet washington dr washington is a medical ethicist who has written extensively about bioethics the history of medicine african-american health issues and the intersection of medicine ethics and culture actual washington spent seven years as an award winning newspaper editor to metropolitan new york dailies ultimately as health and science editor and has contributed to several dozen publications throughout her career winning several journalism awards for her investigative coverage of the health industry dr washington's two thousand and six book medical apartheid the dark history of medical experimentation on black americans from plone time to the present is the first social history of medical research with african-americans and one a national book circle critics circle award her latest book deadly monopolies is an exposé of the medical industrial complex is rush to own and exploit the raw

materials of human life itself including your body tissue and d.n.a. dr washington has been a research fellow in ethics at harvard medical school a fellow at the at the harvard school of public health a night fellow at stanford university a senior research scholar at the national center for bioethics at tuskegee university and a busy visiting scholar at the depaul university college of law i'm delighted to welcome from our studios in new york city dr harriet a washington dr washington welcome. thank you so much for having me here i do have to correct a very common misperception though i'm not a doctor oh ok well. welcome back you for being with us you build and frankly i think you're far more well informed than most doctors on these issues as you're reading this book is a mind boggling you build this case that human life is quickly becoming a wholly owned subsidiary of the metal medical industrial complex can you elaborate on that. yes and unfortunately it touches every sphere of medicine if

we begin with medical research we've seen a paradigm shift in their american medical research in the last thirty or forty years it's now corporations who dictate which products will be tested which products will be developed which will go on to the market and which will be ignored and that's to flounder it's corporations who dictate to university researchers how research will be conducted whether or not they're going to be presented with the research protocol that does not allow people to have informed consent for example that's a corporation's decision and it's corporations that are pricing medications out of the reach of people in developing world and people in the undeveloped or world or simply dying people in the united states in wealthy european countries can't afford their medications and go bankrupt trying to pay for them whereas people in nigeria and india and brazil simply die it's oh it's a horrible situation i was talking with senator bernie sanders today and he said the. years worth of aids drugs in the united states are twenty five thousand

dollars the identical drugs in. brazil or or india for example are are several hundred dollars that that's the that reflects the actual cost that this medical industrial complex is mind bogglingly profitable is that consistent with what you found. what i thought of is that the costs of medication do not reflect the cost of research and development if they do they reflect the price of innovation what they reflect is what people are able and willing to pay to stay alive people in that state are able and willing to pay hundreds of thousands of dollars for an anti-cancer drug people in canada because government has a very good job of negotiating will pay considerably less and people in developing countries. will pay less money but we have to consider it relative to their income when you have people who earn one or two dollars a month a drug that cost several thousand dollars a year is priced out of their reach now in your book you suggest that nineteen

eighty was the pivotal year when the medical industry industrial complex really you know went off the rails in terms of pretty much everything. with regard to the patent office. if i have this right. that's correct yes you want it can you can you explain to us what happened in one nine hundred eighty and and how that june of the and also the supreme court ruling that living things could be patented what the impact of that was. that's correct one thousand nine hundred eighty was a watershed year we saw a confluence of several laws that had great import for medical research and for the dissemination of medical products such as medications what happened first of all was that living things products of nature had long been patented very sporadically only occasionally very few and when it was patented there were often legal challenges sometimes the patent didn't hold sometimes it did but in one thousand

nine hundred eighty the supreme court decided in a ruling called for six party that they were going to allow living things to be patented that the fact that something was a lie was no longer a bar to a patent so you could patent someone cells someone's tissues a cell line a medically important animal such as harvey's on come out. which is guaranteed to develop cancer and of course invaluable for cancer research so this law was very important and specially in partnership with several other laws the most important of which is called the badal act this for the first time the generalized the selling and licensing of patents developed in universities researchers would discover medically important molecules or medically important processes and in the past they had not been able to transfer these patents to industry the feeling was that in congress was that the american people to our tax dollars had paid for the development of these bent medically important advances and it was

a very strong feeling that corporations should not have their hands on them admiral hours said he protested saying this should not fall into the hands of corporations because it will spawn ungovernable monopolies and so did russell long and others very powerful senators however it passed and now for the first time universities can sell the products of the research to corporations compliance of these two laws suddenly led to this huge blossoming of research in private industry and private industry very quickly gain upper hand gain control over this research that's why we find ourselves in the morass we are today because no longer researchers with a passion for healing but corporations the passion for profits who are dictating medical research and its products and the prices that we pay but the conservatives out there are the advocates of the so-called free market or whatever say but by putting a profit motive in there your you your phrase was there was

a blossoming of research or your increase in the incentive to do the research is what came out of this that we got more and better research and new and more innovative products or did it do to turn an unexpected direction or i'm assuming unexpected assuming the best of intentions on the part of the legislators who passed them on. well i can't speak to their intentions i wasn't there and i don't know them but i do know there have been many many unintended consequences and i do know that although it's true these new laws these new this new paradigm was sold to the american people on the promise of new and better medications and more medically important process of these great this great boom let's look at what's actually happened we did see. bridled profit making but that's not the same thing as an unbridled production of the medications we need looking the medications we need what we have seen is actually a dramatic fall off it wasn't too long ago perhaps fifteen years ago where we saw

hundreds of drugs being developed every year every corporation was developing fifty sixty drugs a year what do we see now an average of eighteen for company innovation is falling off there are fewer drugs being developed not more drugs and what are these drugs we don't have new drugs for the global killers like malaria sleeping sickness we haven't these things that kill most people on the globe are not being adequately addressed but we do have fourteen new drugs for rectal dysfunction all developed since one thousand nine hundred six and we do have corporations still making a huge profits perhaps of fallen off but they're still two hundred ten dollars million dollars a year i'm sorry three ten billion dollars a year according to the i.m.s. so it's been very profitable for corporations and profitable for universities you know who share in those profits but not so advantageous for the american people and we have not seen the promised you know boom in drugs so would you suggest we go back to saying you can't patent life forms or the ability of pablum is very limited

or that if they were developed with federal funds or at the university level you know that was funded by universities or federal funds that they are patent free. i mean is that the scientists have suggested well it could be. the way i. i look at it is the problem originated in the law this law was the beginning of this corporate takeover and we could address this problem by revoking that law so i don't think that would be a bad idea however that's not the only possibility there are already pockets of researchers i'm happy to report who have adopted new models that were whose intention was not to maximize profits companies will make profits but they won't make the profit save been seen over the past forty years the idea is to maximize health and so there are various models some out of yale some out of the gates foundation in which the goal is to maximize health for example bill gates has

worked with other charities to subsidize pharmaceutical companies say we guarantee you a certain amount of profit if you develop a badly needed drug a drug against sleeping sickness a drug against malaria so on and these actually have had some limited success already and then we also have other models such as health impact fund some professors at yale said let's look at inducing pharmaceutical companies develop drugs and reward them not based on profit from the patent but we warrant them based on the health impact so if your drug will treat or cure a disease that affects a huge number of people you're going to get a per capita payment the more people your drug will help the larger the payment or that's a very good model you could more easily do anyways i was addressing this system right now of course a single payer system would be a godsend for this problem and is that why. i'm curious in actually many of the

pharmaceutical companies are based in europe and in countries that have single payer health care systems do their indigenous pharmaceutical companies assuming that they have them and that they're not just all transnationals. tend to engage in more of this productive research as opposed to tweaking prozac to come up with a new patentable version of it. they do although i learned that there's a caution here an admonition because they're beginning to follow the american model but they do but they also have something up very important they also have a much more restrained attitude toward patents and it's important to know you mentioned that there are headquartered in europe but a lot of these corporations are not actually headquartered in europe their headquarters are actually spread out globally and. it actually is hard to determine sometimes you know where the heart is where the main. the main body of the corporation is for tax purposes some of them will dictate that they are centered in one place but sometimes if you look at their financials that might not be reflected in that sense it's very interesting forty thousand genes and d.n.a.

sequences are now being patted or have been patented and people don't even know that there tissues are being taken during surgery and then people are making profits off this how is this happening oh yes. well it's happening with a profound lack of transparency for one thing and it's happening because it generates a lot of money for corporations if you look at just the gene patents for example and what we find is it's not that there are forty thousand genes that we don't have it's actually that there are forty thousand patents some of them are in parts of genes or gene sequences not you know entire genes but all of these gene patents allow the corporation to control the gene if you look at hepatitis you know a better example b. if you look at the breast cancer genes brought to one improper to marry corp owns nine patents on them and it has been able to control not only the cost of the test that that women may need to dictate their breast cancer risk it also controls

research they've actually there been researches who have been stop working on the gene because they got a letter from the lawyer saying we own this gene we hold the patent on this gene rather and you can't work on it unless you pay our license unless we give you permission so it stymies research it stymies. doesn't always abet them drug makers would have you believe. harriet what we're talking with harriet a washington i'd like to get to your book medical apartheid in if that's all right with you we'll be back in just a moment great with more conversations with great minds with harriet washington harry a washington just about. what drives the world the fear mongering used by politicians who makes decisions to breakthrough had to be made who can you trust no one who is human view with a global missionary see where we had

a state controlled capitalism is called sasha when nobody dares to ask we do our tea question more. i'll go back to conversations with great minds that i'm speaking with medical ethicist and author of deadly monopolies harriet washington harriet the in your book medical apartheid you document how people of color particularly

african-americans have been subjected to everything from medical experimentation and the section to the denial of medical services from the days of slavery today can you give us a brief summary of that or. probably not it's five hundred pages we have very have ensley we have thirty minutes or. ok. i will make a good faith i have what's interesting is that when you when you speak of medical research with african-americans the knee jerk reaction is to this is actually something i've noticed in my medical historians as well as laypeople but i have fifteen chapters in this book and they all talk about a different spirit in which african-americans have been historically abused under the name of medical research so it's banned everything from cradle to grave children are particularly vulnerable victims of research they always have been. i talk in children's chapter about how in the eighteenth century in the one thousand

nine hundred three rather dr james marion sims one to study a disease called technique and he did it by taking black children only black children from their mother during the slave era and take shoemakers tool to open up their skulls and move the bones around so the research was very crude and very abusive and then you progressed to a little bit later still during slave men we find hospital set up only to treat slaves and black people and what's interesting is that those hospitals that accepted both black people and white people would charge much less or the black people free this wasn't sure altruism or generosity they did that because they used the blacks in their hospitals as teaching material to illustrate diseases and to illustrate procedures including amputations that were done not to treat disease but to show medical students how to do an amputation so then you progress through reproductive surgery with women all the important reproductive surgery advances in

this country were performed initially with black women and the answer is quite simple why do they always black women because black women were enslaved and they could say no a white woman could refuse a black woman could not so everything from history. ectomy to be removed of the ovaries to appear of something called. a very painful surgery all these things are perfect in black women and men certainly were not exempt men were also used as experimental subjects doctor seem to be removed half the job one of a slave who didn't want his job only moved but dr sam's had. ten medical students tie him to a chair and he did the surgery forcibly so and then as we progressed beyond in slave when we find it was african-american bodies disproportionately for teaching in clinical materials you have to remember that during the victorian era. there's a very strong sentiment against using the human body for the section medical students needed bodies to the sect but nobody wanted to be that body in fact the

only legitimate source of those bodies was a sentence of death in the section if you're an especially heinous criminal you had to be really really bad you couldn't be a garden variety murder you had to be like you know a serial killer or something you could be sentenced to death in the section which meant that after you were executed your body would then be used for anything with all the sections but quite quickly as the need for bodies arose we found that black bodies were being used preferentially there are even laws put on the books stipulating that the bodies of black people and not white people could be dug up and used for an anatomical the section and as you go further there's no spirit in which african-americans skate being unwilling and abused experimental subjects experiment radiation experiments experiments in prison. infectious disease and what's really chilling about a lot of these is that we tend to think of this sort of thing as happening in the

you know in the past hundreds of years ago and much of it did but there is much that's fairly contemporary and some of the research that troubled me the most has been conducted you know within the last couple decades it was in one thousand nine hundred five that researchers used only black and hispanic boys in los angeles to test a missile spec scene and it was a vaccine that had proved so dangerous that the w.h.o. had already banned its use in other countries and it was in one thousand nine hundred four that south carolina was accused by the civil rights office of despair of taking black women only black women and when they were when they presented themselves for prenatal care while pregnant giving them drug tests and if they proved positive they did two things they would involve the women in a research study without the women's knowledge or consent and they also reported them to the. these were some of the women were in prison and some had to give birth in chains and these are only black women is what i read

a lot of accounts but finally i found one i love you know primary sources i found and indicated that there was a white woman used i found that was really interesting i looked into it and there was a note by the nurse in her chart that she lived with her boyfriend who was a negro who seemed to be a very strong racial animus and again this was one nine hundred ninety four and so i what's interesting is as i researched this i found that the more recent events took on a really interesting coloration because. no pun intended because not only were african-americans being abused but i begin to see evidence of a wider abuse. a really good example is the case of partly artificial blood which i detail in medical and deadly monopolies but what's interesting is that i found that even though anybody in this country who happen to live in an area where the artificial blood substitute poly he was being tested could have been forced into the research study without his or her knowledge but when you looked when i looked

at the data generated by the company itself the corporation that you know paid for the study i found that most of the subjects were african-american hispanic so i began to recognize this can fluent of the horrible things that have been done african-american in the past seemed to be branching out and now all americans seem to be at risk for a lot of this nonconsensual research and this is a pattern that emerged periodically as i looked at deadly monopolies i kept finding evidence of research studies that could compass all americans and they did so everybody was at risk but when you look at the data you find that african-americans are disproportionately represented so it's a very interesting and ugly combination of racism and greed so here we are in two thousand and eleven and you know numerically poor whites outnumber poor blacks although proportionally if they don't is that kind of apartheid still happening is that are i mean is this largely an issue of race and not an issue of

quietness when when it's things like that is a very good question. that's a very good question as i did medical apartheid that really wasn't an issue because during most of the time that i discussed there there wasn't any class issue when it came to african-americans whether you were a doctor janitor or you were forced to live in the same neighborhood and go to the same schools so you had the same you know environmental experience but i began questions i looked at deadly monopolies but what i found was really really interesting and that is that it has more to do with geography. you would think that class would be paramount and in terms of the effects class is important but it's only important for people in the narrow swathe at the very top of the very bottom if you're very rich then astronomical drug prices may not be a problem for you if you're very rich you can afford both care and you don't have to worry about your surgeon slipping you

a consent form that means that during the surgery you can take tissues from your body and then give them over to a private corporation but for most of us almost everybody else. these are all important issues and one thing that's really interesting with the most troubling types of research is that there geographical for example presumed consent is something i discuss in deadly monopolies and presumed consent simply means that there are laws in this country in fact in most states if you live in certain units of how these the medical examiner in the corner i have the right once you die to take tissues from your body sometimes organs from your body to plea tissues and without your knowledge without asking your family and do with them as they wish what they usually wish to do is sell them now if you look at the law it's against the law to sell to shoes and these brokers would quickly correct me and tell me i'm wrong to say that sold but i call it selling because. it's illegal to sell tissues

is to shoot are taken from people's body and then they are transferred to a series of brokers to the hospital or institution where they're going to be used for research over they're going to be used for transplantation at each step the brokers paid a hefty fee so legally and illegally set may not be selling but most of us would consider that a sale sure but this happens this is dictated by geography it's a crazy quilt and geography live in certain cities and geography seemed it's sounds to me like that's code is the wrong word but. that there's a close association with race there i mean if you're talking about the poor south that's a very different thing than poor apple watcher for example or or a matter that's true then well you know what's it what's interesting is that it used to be and i think it no longer is. but but but by geography i mean something a little bit differently i don't mean geographies confluence with economics i mean

simple geography because as i was saying it's a crazy quilt of risk if you live in one city this can happen to you if you live in the nether city fifty miles away it cannot and that's just random that's not associated with the racial content or composition of the city but we're actually that's that's interesting that's an interesting question because it's not random what i found is that in many cases and of course i can't speak to every case but in most of the cases i've looked into it's actually a hangover from the practice of building hospitals and medical centers in heavily black areas for history is rife with examples of this for research right so if you're in fact i found in old newspapers debates going on among people i mean were they wanted to build a medical center in philadelphia and richmond was a rival city the people in richmond or say you should build the hospital here in richmond be a plenty of black people in philadelphia use a white people to do the labor of the city and that is not going to be enough black people in philadelphia to sustain

a good hospital so they were very you know unselfconsciously and over and above board about it so what happened is hospitals and medical centers were located in black areas for that purpose have experimental subjects and as time went on many things sort of maintain this sound etc news in this in this way as it was or exactly exactly even today if you look at most i'm sorry go ahead we're almost out of time we have about thirty seconds here kerry washington. so if you if you could be brab of your thought i'm sorry. but my thought is that we have allowed corporations to dictate too much of my. care it's time to take it back it's time for us to pass laws that will restore medical care to the hands of people who put the patient not the patent at the center of the healthcare universe so very very well so you're the breath of your research and your writing is extraordinary and i am so glad you were able to share it with us tonight washington period a washington thank you for being with us tonight thank you very much enjoyed it

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