Neglected tropical diseases (NTDs) represent a significant disease burden, feeding a vicious cycle of permanent disability and poverty . Better treatments and treatment access could break this cycle, but the significant financing requirements for development are a barrier, despite the public-health imperative. Traditional incentives for development and supply of new and/or innovative drugs, diagnostics, and vaccines—such as return on investment—do not apply, leaving philanthropy and government financing as the dominant mechanisms supporting new products for NTDs. The evidence of this “market failure” is damning: just 2% of the total research and development (R&D) spent is on diseases affecting 33% of the global population . Time trends show no significant improvement, with a mere 1% of all new chemical entities approved between 1975 and 1999 and between 2000 and 2011 [being for tropical diseases (NTDs and malaria) and tuberculosis. More diverse and sustainable mechanisms are required.
But once again, a handful of activists and public health professionals saw that many of the principal impediments to global access to HIV medications were human-made, even more so than had been the case during the era of drug development before 1996. They discovered that the prices charged by pharmaceutical companies bore almost no relation to the actual cost of production or even to the recouping of research and development expenses, but were based purely on a desire for maximum profits. And they realized to their disgust that the pharmaceutical companies could easily have allowed generic versions of their medications to be produced at a tiny fraction of the prices they charged, almost instantly alleviating the world's most devastating health crisis. Instead the pharmaceutical giants filed lawsuits under international trade agreements to protect their patents and convinced global institutions and powerful governments, especially the United States, to threaten developing countries with crippling economic sanctions. Yet most perversely of all, allowing generic drug development would scarcely have cost the pharmaceutical companies a cent; so few drugs were being sold in the developing World profits being Instead, the position of the pharmaceutical companies was based on a fear of"blowback"—the concern that revealing the true cost of production and lowering the costs of drugs in one part of the world would expose the exorbitantly inflated prices they charged in the developed world. Consigning millions of people to excruciating deaths and driving entire nations into shattering poverty was of less concern than protecting the profit margins that made pharmaceutical manufacturing one of the planet's most lucrative industries. Of course, the developed world has long shown an enormous capacity to overlook, ignore, or explain away the suffering of the developing world. Malnutrition remains widespread, for instance, and easily treatable conditions such as tuberculosis, malaria, and enteric diseases cause countless deaths each year. But in the case of HIV infection, there was one crucial difference—there were a core of committed activists in the developed world who were engaged and mobilized around the issue of AIDS in ways that they were not around other diseases. These activists, primarily in the United States and Western Europe, could draw upon more than a decade of their own experience in combating AIDS in their own countries while also linking up with activists from developing countries who had
while also linking up with activists from developing countries who had begun working in parallel. And so was born the second great AIDS treat- ment activist movement, this one focused principally on promoting access to drugs in the developing world but involving a dense global network of activist organizations in both the global North and South. Drugs into Bodies: Global AIDS Treatment Activism takes as its task the analysis of the rise, and remarkable success, of this second great AIDS treatment activist movement. The scope of the book is very much defined, then, by the key terms "activism" and "treatment." By activism, we refer to "contentious politics"—the process by which less empowered groups con- tend with powerful interests via such tactics as protests, demonstrations, direct actions, and other confrontational tactics. We recognize, and at times discuss, the many other types of activities that have also had a major impact on the promotion of access to AIDS treatments, including policymaking work, academic studies, interest group lobbying, the arts, and philanthropy. But our principal focus remains on "activism" in the form of contentious politics, in part because it uniquely intersects with all of these areas and because it has in many ways been the engine driving the response
But once again, a handful of activists and public health professionals saw that many of the principal impediments to global access to HIV medications were human-made, even more so than had been the case during the era of drug development before 1996. They discovered that the prices charged by pharmaceutical companies bore almost no relation to the actual cost of production or even to the recouping of research and development expenses, but were based purely on a desire for maximum profits. And they realized to their disgust that the pharmaceutical companies could easily have allowed generic versions of their medications to be produced at a tiny fraction of the prices they charged, almost instantly alleviating the world's most devastating health crisis. Instead the pharmaceutical giants filed lawsuits under international trade agreements to protect their patents and convinced global institutions and powerful governments, especially the United States, to threaten developing countries with crippling economic sanctions. Yet most perversely of all, allowing generic drug development would scarcely have cost the pharmaceutical companies a cent; so few drugs were being sold in the developing World profits being Instead, the position of the pharmaceutical companies was based on a fear of"blowback"—the concern that revealing the true cost of production and lowering the costs of drugs in one part of the world would expose the exorbitantly inflated prices they charged in the developed world. Consigning millions of people to excruciating deaths and driving entire nations into shattering poverty was of less concern than protecting the profit margins that made pharmaceutical manufacturing one of the planet's most lucrative industries. Of course, the developed world has long shown an enormous capacity to overlook, ignore, or explain away the suffering of the developing world. Malnutrition remains widespread, for instance, and easily treatable conditions such as tuberculosis, malaria, and enteric diseases cause countless deaths each year. But in the case of HIV infection, there was one crucial difference—there were a core of committed activists in the developed world who were engaged and mobilized around the issue of AIDS in ways that they were not around other diseases. These activists, primarily in the United States and Western Europe, could draw upon more than a decade of their own experience in combating AIDS in their own countries while also linking up with activists from developing countries who had
while also linking up with activists from developing countries who had begun working in parallel. And so was born the second great AIDS treat- ment activist movement, this one focused principally on promoting access to drugs in the developing world but involving a dense global network of activist organizations in both the global North and South. Drugs into Bodies: Global AIDS Treatment Activism takes as its task the analysis of the rise, and remarkable success, of this second great AIDS treatment activist movement. The scope of the book is very much defined, then, by the key terms "activism" and "treatment." By activism, we refer to "contentious politics"—the process by which less empowered groups con- tend with powerful interests via such tactics as protests, demonstrations, direct actions, and other confrontational tactics. We recognize, and at times discuss, the many other types of activities that have also had a major impact on the promotion of access to AIDS treatments, including policymaking work, academic studies, interest group lobbying, the arts, and philanthropy. But our principal focus remains on "activism" in the form of contentious politics, in part because it uniquely intersects with all of these areas and because it has in many ways been the engine driving the response
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