And like big corporations in every sector, of course, the pharmaceutical companies have a relative view of market freedoms — they want the government to protect them from competition, even when that competition is themselves. An organization called the Pharmaceutical Research and Manufacturers of America has mounted a fierce campaign of lobbying against an amendment to an agriculture spending bill currently before the Senate that would allow Americans to import prescription drugs from Mexico and Canada. Relaxing restrictions would lead to the import of killer counterfeit drugs, the PhRMA warns in a full-page ad in Wednesday's Washington Post. Not only that, "the importation of prescription drugs also means spoiled, adulterated, impotent or subpotent medicines making their way into American medicine cabinets." But critics believe they're simply covering up for price-gouging, and have adapted the amendment to allow for greater FDA screening. And in a sharp back-at-ya, Senators James Jeffords (R-Vt.) and Byron Dorgan (D-N.D.) have added language to the amendment that would allow American pharmacists and wholesalers to import medicines previously exported by U.S. drug companies — in other words, to permit American consumers to buy the drugs at the lower prices the U.S. corporations often charge in foreign markets. Not surprising, then, that the industry is mounting a full-court press, and doing its best to rebut these arguments on its web site.
But there was also good news for the industry from the White House Wednesday, in the form of a program to offer $1 billion in loans to AIDS-stricken African countries to facilitate the import of drugs and medical infrastructure from the U.S. While the New York Times gushed that the program "greatly increases the money available to combat the disease in a region that has become its epicenter," the Wall Street Journal was less sentimental, characterizing the scheme as "a campaign to help American businesses sell about $1 billion in AIDS drugs, medical equipment and health services." The Journal also had the good sense to ask how $1 billion in commercial-rate loans was going to help a continent that, while it requires at least $3 billion a year to combat the disease, already spends some $15 billion a year simply servicing its existing debts.
Drug companies have already floated the possibility of profitably selling their AIDS therapies in Africa at discounts of up to 90 percent — inadvertently telegraphing the size of the profit margin in the prices they charge in the U.S. — but even then, a year of cocktail treatments would still cost about four times the per capita income of the worst-hit countries. Asking Africa to increase its debt burden to finance the purchases may quite simply be untenable — indeed, the U.S. Export-Import bank, which is financing the program, has had to go into negotiations with the IMF because a number of the would-be recipient countries are already at their debt ceiling. The Clinton White House is fond of win-win scenarios, in which there's a happy confluence between corporations making a profit and doing the right thing. But the brutal reality is there's no good-for-business solution to the AIDS crisis in Africa. Some 10 million Africans will die of AIDS in the next five years alone if it's left to the market to determine their fate, because there's simply no profit to be made in saving them. And that reality will force some tough choices not on the pharmaceutical industry, but on government.