In China, Desperate Patients Smuggle Drugs or Make Their Own
nytimes.com
nytimes.com
I don't know the explaination is accurate or not.
China routinely violates tech IPs by Americans' own reporting; I'm surprised as to why they'd not do the same for drugs.
1.US IPs are violated in China. 2.Chinese government deliberately let Chinese companies violate US IPs.
They are not the same meaning. But media mislead Western audience to believe the second version by some tricky narrative and hide partial truth. The real situation is more complicated
On the night of December 3, 1984, a cyanide cloud drifted over the streets of Bhopal, India, set loose by a leak in a nearby chemical plant. When the deadly fog lifted untold numbers of the city's residents--perhaps as many as 30,000, by some accounts--lay dead, while half a million others were injured. Dominique Lapierre, a French journalist and longtime champion of India's poor, joins with Spanish writer Javier Moro to recount the terrors of that night, about which the whole truth may never be known. The deaths are but one part of the authors' long, sometimes elaborate tale, which relates how the industrial conglomerate Union Carbide had come to build its vast chemical complex at Bhopal, one meant to be a glory of technology and, ironically, to save thousands of lives brought low by insect-wrought starvation. There are few villains but many heroes in the authors' account, which explores the margins at which good intentions conflict with the profit motive, at which cost-cutting omissions yield horrifically unintended consequences. It all makes for a thoughtful and disturbing book.
Ranbaxy executives didn’t care, says Kathy Spreen, and made little effort to conceal it. In a conference call with a dozen company executives, one brushed aside her fears about the quality of the AIDS medicine Ranbaxy was supplying for Africa. “Who cares?” he said, according to Spreen. “It’s just blacks dying.”
[1]https://blogs.sciencemag.org/pipeline/archives/2013/05/17/a_...
Regarding France, I find odd (hypocrite?) that the French state is pushing against generics abroad, whereas locally the (state-run) social security system and health ministry are pushing for generics, because they are cheaper (and thus cheaper to refund).
It's just some shady semi-government-worker-semi-business-man who controls the important channel for extracting money, and usually they do not want poor people to live.
See for example: https://asia.nikkei.com/Business/Companies/China-s-Changshen...
Some companies produces fake vaccines and regulated the vaccine market to not allow imported vaccines.
Liu Shaoqi was a Chinese revolutionary, politician, and theorist. He was Chairman of the NPC ... Originally groomed as Mao's successor, Liu antagonized him in the early 1960s before the .... He was denied medicine for his diabetes, by then a long-term illness, and for pneumonia, which he developed after his arrest.
I have some friends who lived in Canada for a while. They said the Canadian medical system doesn't go all-out to treat people with cancer, which is probably just as well. Someone I knew (United States) just passed away from cancer. She spent 3 years getting treated, then died after a single day on hospice care. Medicare paid in full, I'm sure: that final operation was not a success, but the doctors were paid anyways.
Everyone dies eventually. American doctors are trained to try all the interventions they can possibly think of in a futile effort to prevent the inevitable. If my grandparents would have had to pay for their final months of interventions themselves, they certainly would have chosen to leave the funds in their estate. But since Medicare was paying they begrudgingly went along for the ride.
Healthcare is hard, Americans especially should get that.
As for approvals, I don't know why we have each country doing its own approvals, instead of international groups that individuals can choose whether they want to trust or not. Are Europeans sufficiently different than Chinese, Indians, Australians, Canadians, Germans or Americans to warrant independent safety approvals?
If they're using different metrics to process approvals, why? Shouldn't the same inputs result in the same outputs?
Take Auryxia which is literally ferric citrate. Its used by kidney patients to control phosphorus levels and boost iron. Why did it take so long to get tested and approved as a drug when the formula was "open source" for a long time? Well one company did the time and effort and suddenly it is considered a valuable drug. The value came from proving the safety and efficacy and someone has to be willing to fund it.
The long line of failed drugs are the real issue.
Sure, just the trial might cost that little if it’s an orphan disease, but it’s also ignoring all the other stuff that goes along with running a trial. Things like manufacturing, compliance, data analysis, etc.
When you look at the total cost of R&D for a drug, it’s typically 1/3 for discovery and 2/3 for development (clinical trials).
If your drug is used in any reasonable sized population, development is easily in the hundreds of millions of dollars.
You are correct about the failure rates though.
In reality, approvals are also about politics.
Why would an insurance company be interested in developing new drugs? Health insurance companies don't lose money if you die.
How do you propose that academic researchers fund their work, all the way through the approval point?
> The drug research is paid for by patients and insured as it stands now, but the FDA/pharma cartel monopolized drug development using patents and the hugely expensive approval process.
Do you think the process is expensive because of the pharma companies, or do you think the pharma companies are the way they are because the process is expensive?
> Now, pharmas are interested in profitable drugs which don't as much cure the diseases but rather allow mainenance of chronic conditions for years and years. Actual effective cures are not a priority.
This is a thing people say, but it's not really true. It'd be great if all you had to do to create more cures was snap your fingers and change the incentive structure. But the fact of the matter is that cures are harder to create. Incremental improvements are easier. So you get more of them. Pharma companies do in fact still cure things when they can, see the recent HepC cure.
Yeah, having dealt with Chinese vendors and mfgs for years that is a scary scenario. The whole culture of trust / fairness / honesty is very different from the west.
Dealt with our products being knocked off for years, wouldn’t want to buy cancer meds ever!
> consider the details of the Chinese infant formula scandal of 2008. Unscrupulous businessmen had discovered they could save money by greatly diluting their milk products, then adding a plastic chemical compound called melamine to raise the apparent protein content back to normal levels. Nearly 300,000 babies throughout China had suffered urinary problems, with many hundreds requiring lengthy hospitalization for kidney stones. Six died. A wave of popular outrage swept past the controlled media roadblocks and initial government excuses, and soon put enormous pressure on Chinese officials to take forceful action against the wrongdoers.
> China’s leaders may not be democratically elected, but they pay close attention to strong popular sentiment. Once pressed, they quickly launched a national police investigation which led to a series of arrests and uncovered evidence that this widespread system of food adulteration had been protected by bribe-taking government officials. Long prison sentences were freely handed out and a couple of the guiltiest culprits were eventually tried and executed for their role, measures that gradually assuaged popular anger. Indeed, the former head of the Chinese FDA had been executed for corruption in late 2007 under similar circumstances.
> In September 2004, Merck, one of America’s largest pharmaceutical companies, suddenly announced that it was voluntarily recalling Vioxx, its popular anti-pain medication widely used to treat arthritis-related ailments. This abrupt recall came just days after Merck discovered that a top medical journal was about to publish a massive study by an FDA investigator indicating that the drug in question greatly increased the risk of fatal heart attacks and strokes and had probably been responsible for at least 55,000 American deaths during the five years it had been on the market.
> Within weeks of the recall, journalists discovered that Merck had found strong evidence of the potentially fatal side-effects of this drug even before its initial 1999 introduction, but had ignored these worrisome indicators and avoided additional testing, while suppressing the concerns of its own scientists. Boosted by a television advertising budget averaging a hundred million dollars per year, Vioxx soon became one of Merck’s most lucrative products, generating over $2 billion in yearly revenue. Merck had also secretly ghostwritten dozens of the published research studies emphasizing the beneficial aspects of the drug and encouraging doctors to widely prescribe it, thus transforming science into marketing support. Twenty-five million Americans were eventually prescribed Vioxx as an aspirin-substitute thought to produce fewer complications.
> Although the Vioxx scandal certainly did generate several days of newspaper headlines and intermittently returned to the front pages as the resulting lawsuits gradually moved through our judicial system, the coverage still seemed scanty relative to the number of estimated fatalities, which matched America’s total losses in the Vietnam War. In fact, the media coverage often seemed considerably less than that later accorded to the Chinese infant food scandal, which had caused just a handful of deaths on the other side of the world.
Killing an old person 7 years before they would otherwise die is not as bad as killing an infant 78 years before it would otherwise die. But is it really less than 0.1% as bad?
I've met contractors who did extensive work for businessmen in the US, who then turned around and told the contractor, "You want to be paid? Sue me!"
The whole culture of trust / fairness / honesty is very different from the west.
Is it really that different? There are some people who are good and some people who end up being opportunistic in evil ways. The more I learn about differences across cultures, the more I conclude that the differences are always ones of degree, and the differences are made more visible due to the cultural contrasts. That said, is there more rule of law and enforcement around IP issues in the west than in China? I suspect that's also true.
Dealt with our products being knocked off for years, wouldn’t want to buy cancer meds ever!
There are also people in the west who aren't above faking treatments for cancer.
So true, here you go: https://www.dw.com/en/cancer-drug-scandal-german-pharmacist-...
The free press and independent justice system makes the difference.
Those can and do make a difference. No system is perfect, however. Chinese culture has an extensive heritage of moral philosophy. Despite that, it's still been shown that it's possible to overturn the social order there with massive consequences. The west certainly isn't above that sort of chaos. France and Germany, the largest economic powers of continental Europe, have that in their history. The US isn't entirely above this kind of chaos, either.
The press in the west also follows a propaganda model.
https://www.amazon.com/Manufacturing-Consent-Political-Econo...
Justice systems in the west have been known to cooperate with the authorities in miscarriages of justice, particularly in wartime or when subject to near-wartime hysteria.
When it comes down to it, there is always a struggle between good and evil in all times and places. The really tricky part of it is this: The worst evils disguise themselves as movements of good and justice. People and movements should be judged by their actions. Ask: Who is committing violence against whom? Who abets or tacitly accepts bad actions? Who is willing to call out their own side and their own tribe when they do wrong?
The left/right political spectrum ceases to have meaning when you look at it that way. The Authoritarian/Anti-authoritarian spectrum and the tribalist/universalist spectrums hold much more value.
Some are incredibly kind and fair.
Some are incredibly immoral, who can be viewed as demon incarnations. See example like this: https://www.zhihu.com/question/53610601 (manufacture human monster slave to use as worker as fake beggar)
Some are incredibly immoral, who can be viewed as demon incarnations.
You can find comparable extremes in all places.
The example I cite here is well-knwon, and yet it exists still today.
Can you imagine western countries allow this to happen regularly?
Just to point out the status-quo.
Exactly. When you have a culture that more often accepts scams as necessary to succeed and another culture that shuns them, you will probably see disparities in the percentages of people in those cultures who are willing to scam. Ostracism is a powerful deterrent.
"A spokesman said the scale of the problem proved it was 'clearly not an isolated accident, [but] a large-scale intentional activity to deceive consumers for simple, basic, short-term profits.'"
This is a nation of almost 1.4 billion people.
There are more unarmed civilians (including children) murdered by US police every year than all deaths from the Chinese milk scandal combined.
Would that make it reasonable to state that "All US citizens have proved they have no conscience"?
In any case, the Chinese milk scandal pales in comparison to what Nestle did: https://www.businessinsider.com/nestles-infant-formula-scand...
Do you no longer buy Nestle?
- Nestle made a baby formula
- They marketed it heavily to poor people in the third world.
- Poor people in the third world proceed to dilute the formula with more than the recommended amount of water to save money (and the article does not say that this was at Nestle's prompting), and as a result didn't feed their babies enough.
Maybe less than ideal and somewhat scummy? Sure, most advertising is like that really. Worse than literally selling poisonous baby formula? I don't see it.
But perhaps I misunderstand the accusation.
Mothers bought it and used it so their own breast milk dried up. Then when they couldn't afford enough of it as the baby grew and needed more, they were forced to ration the formula.
Millions died.
We are comparing a non defective product that couldn’t be used effectively by a certain populations to outright fraud.
https://www.odwyerpr.com/story/public/5379/2015-09-18/gm-pay...
As an analogy, take sugary snacks. Say a snack has lots of sugar but the company claims it is sugar free anyways. In another case, a snack is truthful about its sugar content but the consumer lacks the education (or willpower) to care. Aren’t these completely different problems?
Sugar has probably killed more than millions, which has definitely been driven by corporate profits and gaming the system (substituting sugar for fat). But again, Coke Cola and Mars (and yes, Nestle) haven't been consider a scandal yet.
https://www.huffpost.com/entry/sugar-harvard-scandal-nutriti...
And they both clearly involve outright deception. The difference is probably just not as many babies dying. At least not yet, cokes aren't advertised as being healthier than breastfeeding for babies.
From the parent comment: "Chinese vendors and mfgs"
To call out an entire people as cruel and heartless is just so wrong!
It's worthwhile to bring attention to that and it's good that you're doing so, but try to put it in a format that uses examples and sound reasoning. That way people might be more inclined to listen to it, as opposed to a fairly emotional argument that is also vaguely hostile to boot.
In support of my view, I quoted the World Health Organization stating that these people knew what they were doing, and it was done intentionally on a large scale.
In your view, is the World Health Organization fond of writing "racist white supremcist[sic] drivel"?
How is it "racist" or "white supremacist" to express horror at injury and death of Chinese babies? If I were either of those slurs, I would be celebrating this scandal, not expressing horror at it.
Extra points if you get the lab to quantify purity instead of just finding presence.
Lots of pharma APIs are manufactured in China or India.
this whole thing even sounds like dallas buyers club.
It’s also interesting how saying Chinese people are so different is widely accepted on HN. Can you imagine if the same comment was made about Jewish people?
I do hear others say the Chinese are the Jews of the East.
And “having dealt with Jewish vendors and mfgs for years that is a scary scenario. The whole culture of trust / fairness / honesty is very different from the west.”
Sure, if the Jews were most of the population of the US and Europe instead of being about 2%.
The Hakka are the Jews of the East. (Or, in India, the Parsis are.)
https://mashable.com/2017/08/06/fish-antibiotics-america-hea...