Big Pharma: Exposing The Global Healthcare Agenda, by Jacky Law
This is the second book  in a series I picked up from the library to do some critical comparative reading on the issue of the legitimacy of drug companies. There are a lot of subject matters in which the two books overlap: nutritionists, alternative medicine, the corrupt and unethical behavior of big pharmaceutical companies, the problems with scientific studies and popular understandings of the placebo effect, SSRIs, Vioxx, the priorities of medical research, the troubled relationship between doctors and drug companies, and the contrast between Europe and the United States. This similarity of subject matter despite very different approaches suggests that there is a fairly well-established and well-worn set of paths by which people of a broadly similar and broadly pro-scientific worldview travel when seeking to make an argument about the evils of the pharmaceutical industry. One suspects that there is a lot of low-hanging fruit that is noted by writer after writer.
This particular book is divided into three parts. After a preface that looks at the start of the AIDS crisis, the book examines three essential problems with the contemporary pharmaceutical industry. The first section looks at the issue of convenience, how drugs suit our times because they offer an easy answer that does not require more fundamental change to the way we live, and therefore is more appealing than the difficult sorts of interventions that are required to effect deeper improvements. The second section looks at what happens when the good are silent, or are silenced, because of the way that large pharmaceutical companies influence the political and educational institutions of the world’s countries to better suit their own interests. The third section of the book then looks at the costs of our infatuation with pills, including the way in which that cost is unfairly distributed around the world and where access to high quality care varies widely even within countries.
One of the qualities that makes this book particularly damning is the fact that it is written by an insider to the pharmaceutical industry and that it is written in such a dry and understated fashion that its points are all the more searing. I have a few anecdotal stories myself that mirror what the author has to say about the importance of two-minute meetings with well-paid drug company salespeople. In 2006, when I had my first gout attack and was trying to figure out what was wrong, during the time I waited for doctors to see me, I would regularly see attractive twenty-something young women with cloth bags come in to drop off drug samples and pitch to the doctors. Of course, when I was getting a checkup for one condition, those same doctors would give me psychological questionaires and then try to pawn off medicines that claimed to deal with conditions like anxiety and depression. This is apparently not an isolated sort of experience, and the author is meticulous in his approach at citing specifics over and over again.
That is not to say that this book is perfect. Although the book wisely gets that the essential element of improving health is the trust between patients and medical practitioners, and although the book examines the collapse of trust in doctors and drug companies and governments with distressing frequency, ultimately the author is left to peddle discredited left-wing solutions which are shown as problematic by the author’s own argument against the pharmaceutical industry. The author, for example, bemoans the influence of money in scientific research but also seeks for better treatments and cures for infectious diseases, all of which would require some investment of monetary resources. Likewise, the author shows a great deal of hostility to free enterprise and a great deal of faith in government, but the book as a whole repeatedly shows how socialist government agencies have been co-opted by crony capitalism and are insulated from the voice or meaningful involvement of commonfolk, and shows how governments have forfeited the trust of the people, which makes public alternatives to private enterprise as problematic as the businesses which are all too easy to condemn. Even worse, the desire of ordinary people for convenient solutions that do not involve lifestyle changes as well as a lack of knowledge of and interest in science, suggests that we cannot trust ourselves with health concerns either. And if we cannot trust ourselves and everyone else is just as corrupt (if not more so) than we are, how are we ever supposed to live better lives if getting better requires faith and trust? This is a vexing problem, and one the book cannot solve because its political worldview is at odds with the moral and religious implications of the evidence the book describes so intensely and passionately and intellectually.