In this current moment, when we think of pharmaceuticals and healthcare, we probably think of vaccines and COVID19. Hopefully, today I will be able to provide some food for thought on a slightly different topic within this area.

During my work experience in a variety of medical environments, – A&E, theatres and GP surgeries, I noticed a clear and intriguing trend. Many patients’ issues had root causes in lifestyle diseases, such as heart disease, COPD, type 2 diabetes, hypertension and stroke.

The first question that came to mind, after establishing that my observations were in fact ‘lifestyle’ diseases, was, what had happened to the notion of prevention is better than cure? Upon further thought, many questions came to mind – would the NHS be under so much pressure if lifestyle diseases were to prevented before causing complications? Is this an issue on a global scale? How much control do we have as individuals over the way we eat, sleep and exercise? Who is responsible for what we put in our body? And why, despite arguable being at the peat of our existence as a species, are we sinking lower and lower into the clutches of self-inflicted illnesses?

After much reading and thought, I became aware of a conspiracy surrounding the pharmaceutical industry, also known as ‘Big Pharma’.

Firstly, what’s the big deal with the pharmaceutical industry?
In the most basic sense, this conspiracy entails that the Big Pharma industry creates, inflates, worsens or markets diseases to boost their profits, working against public goods. We, as consumers, are manipulated into becoming chronically unwell. Therefore, we end up paying for heaps of medication which then leads to huge ongoing profits for the firms. Supposedly, organisations as such are in cahoots with other crucial bodies such as food conglomerates and national governments, in order to impact the way in which we live our lives, from several different aspects.

Secondly, the origins of Big Pharma. Before modern-day medications, from the beginning of time, man has reverted to plants for medicine – like aspirin found in willow bark, and morphine derived from poppy seeds. The industry, as we know it, was only really established in the second half of the 19th century.

The scientific revolution in the 17th century allowed for the now-widespread rationalism and experimentation to flourish. In the 18th century, the industrial revolution happened, transforming the production of goods. The combining of both concepts, for the benefit of human health, didn’t occur until later. Merck in Germany was arguably the earliest company to do so. Pharma giant, GlaxoSmithKline’s origins can be traced all the way back to 1715, however it has undergone numerous merges, notably with Beechams, who created the world’s first factory dedicated exclusively to medication, in 1859. Pfizer was America’s first large pharma firm, beginning as a fine chemicals business, founded in 1849, by two German immigrants. It expanded rapidly during the civil war, with demand for antiseptics and painkillers at an all time high. During this war, a young cavalry commander named Eli Lilly was on the receiving end of Pfizer’s medications. He went on to begin another pharma giant, Eli Lilly and Co, which was the first to focus on R&D.

Benevolent and progressive work in science, for the good of humankind… what are these companies up to currently?
One example is Astra Zeneca, a British-Swedish multinational pharma company, who aspire to utilize genomics and precision medicine in order to deliver the most effective treatments to their patients. What is precision medicine? Very simply put – customized healthcare. For individuals, tailored medication is provided as opposed to a ‘one-sizefits-all’ drug. The benefits of such a system are endless:

  • Pre-empting progression of the disease
  • Customizing disease-prevention strategies
  • Prescribing drugs that are more effective
  • Avoiding drugs with predictable side effects
  • Reducing time, cost, and failure rate of clinical trials
  • Eliminating trial-and-error inefficiencies that undermine patient care

They also intend to harness the power of genomics, to achieve this goal. Genomics is an area in molecular biology, which focuses on the structure, function, evolution, and mapping of genomes. Astra Zeneca’s Medimmune Genomics initiative is set to analyze 2 million genomes by 2026. Using information on such a micro scale will be revolutionary in the drug industry and will undoubtedly change its trajectories in the future.

GlaxoSmithKline is another pharma giant which has been carrying out entirely benevolent work in Africa concerning malaria. Malaria is a disease carried by mosquitos, particularly the female which carries the plasmodium parasite. There are 5 different plasmodium parasites which are known to affect humans in different areas of the world. If infected, symptoms such as fever, shivering, and vomiting arise, and anemia, seizure, and coma if left untreated. Children under 5 carry the largest burden of disease.

A vaccine has proved almost impossible to formulate, due to the parasite being able to adapt to the human host and escape its immune mechanisms. There is only one existing attempt, with a very low efficacy. GSK is fighting malaria on different levels – in the lab, and on the ground. They are supporting vulnerable healthcare systems as well as assisting from a vaccine perspective, which allows for full coverage of the issue in a very vulnerable area of the world.
Big Pharma. This body wants a sick population. Their profit margins depend on a sick world. Preventative care is never promoted as highly as pharmaceutical care. Is this an ethical choice?

Mahnoor Raja
Mahnoor Raja

Member of NLCS Dubai
Deputy chair of NLCS Dubai Medical society

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