The debate over good or bad intentions of “big pharma” has been ongoing for decades. As early as 1974 an article was published discussing the pharmaceutical industry, international expansion, and corporate power. The presence of multinational pharmaceutical corporations has increased since the 1970’s and does not appear to be slowing down anytime soon.
In 2017, a report from the International Federation of Pharmaceutical Manufacturers & Associations, they share that the “researched based pharmaceutical industry spends over US $149.8 billion on R&D each year.” They also add that in 2014, five of the eleven leading global research and development firms were pharmaceutical companies. Notably, both Pfizer and Novartis had a 2018 market value that is above that of Mastercard and Coca-Cola.
Considering these numbers, it is obvious that the pharmaceutical industry is quite powerful and a global force, whether for good or bad. Therefore, tasked to answer the following question, “Is the involvement of multinational pharmaceutical corporations a necessary condition for an effective global governance of health issues?”, I adopt a viewpoint often attributed to The Art of War: Keep your friends close, but your enemies closer.
Is the involvement of multinational pharmaceutical corporations a necessary condition for an effective global governance of health issues?
Of course, viewing the pharmaceutical industry as “the enemy” may be an exaggeration; nonetheless, it is a sentiment often felt by those who understand the burden of global health in low income settings, and subsequently wish the sector would do more to improve drug pricing, R&D for neglected tropical diseases, and new medications for tuberculosis and childhood HIV/AIDS. Yet we must remember, the explosion in global health initiatives over the past 15 years has depended on strategic alliances. The alliance might be between a national government and the WHO, GAVI, the Bill and Melinda Gates Foundation, or USAID, among many others.
It is prudent to view the multinational pharmaceutical company as one more of the vital actors. Regardless of the actors, these alliances are key, and should have a governance structure that is mutually understood by all partners. In this manner, those involved in global governance can negotiate to ensure that regulations and standards exist, and that people are protected as a result of these agreements.
One of the most effective ways to benefit from research and development and technologies of pharmaceutical companies is to partner with them
I believe that one of the most effective ways to benefit from research and development and technologies of pharmaceutical companies is to partner with them. In doing so, more joint funding possibilities might arise, and strengthened alliances could eventually lead the companies to consider new patent agreements. I recently read an interesting article titled, “Who’s in charge? Corporations as institutions of global governance”.
One assertion made quite an impression on me: "The decisions and actions of corporations have social consequences largely indistinguishable from those created by public regulators, but... corporate decision-making is largely insulated from public participation, engagement or scrutiny… If corporations are significant institutions in the transnational governance regime, then policymakers and activists will need to find ways to affect the decision-making of these corporate institutions.
It makes sense for the state to engage with pharmaceutical companies in global health governance because if they do not, companies may make unilateral decisions that are not subject to the eyes of government and responsible to the people. It is better to be proactive through partnerships, with the goal of making good bedfellows.
The Gray Area Between Altruism and Business