Last month, Oxfordshire County Council announced that they would be completely ceasing financial support for the Community HIV Prevention and Support service run by the Terrence Higgins Trust. The scheme provides essential advice and support for people living with HIV as well as disseminating vital information about prevention and ways to combat the stigma that surrounds the illness. In the month that OUSU hosted their HIV and AIDS Awareness Campaign ahead of World AIDS Day on 1st December, the cut couldn’t come at a more ill-fated time. Unfortunately, the erosion of support networks for those living at HIV is not an issue delimited to the UK. An even more worrying instance of this is currently unfolding in the US, and it is something that demands us to question what type of society we want to live in, and the extent to which aggressive economic strategy is allowed to operate in that society.
In his book What Money Can’t Buy, political philosopher Michael Sandel examines the way that ‘market values have impinged on almost every aspect of life’. From a parent who sold the naming right’s of her child to a corporation, to a woman who tattooed, for huge financial remuneration, a company’s logo on her forehead, transforming herself into a walking advertisement. Things we would have never considered “sell-able” 30 years ago, are now fair game for the right price. Far from viewing this trend with equanimity, however, Michael Sandel identifies in this encroachment of market values a growing tendency for morality to go out the window when it comes to economic reasoning.
Martin Shkreli – CEO of Turing Pharmaceuticals and former hedge fund manager – represents a troubling extrapolation of the socio-economics trends Michael Sandel highlights. In September, Shkreli bought US selling rights to the drug Daraprim and subsequently hiked the price from around $13 per pill to $750, an increase of over 5000%. Daraprim is used to treat toxoplasmosis, a disease caused by parasites found in things such as raw meat and contaminated water. According to the NHS website, “a third of people in the UK will be infected by toxoplasmosis at some point in their life, but most people won’t notice it.” This is because regularly functioning immune systems are strong enough to fight off the infection.
However, the effect of toxoplasmosis is much different in bodies where the immune system has been severely compromised, such as with patients suffering from cancer or HIV, where an infection often leads to serious illness or death. Due to the presence of the parasite that causes toxoplasmosis in such everyday objects as raw meat, Daraprim forms part of a regular course of drugs for HIV patients that provides health and life security. The 5000% price rise makes Daraprim an inaccessible drug for most of the people that desperately need it, putting the 1.2 million people living with HIV in the US at even greater risk.
Shkreli’s price gouging generated widespread condemnation in the United States and led to statements from organizations and figures as diverse as the Diseases Society of America, the HIV Medicine Association and Hilary Clinton. As a result of this public criticism, in late September, Shkreli announced that he would abandon the price increase. However, on the 25th November, Turing Pharmaceuticals went back on this statement, announcing that Daraprim would only be discounted for hospitals that ‘bulk-buy’ the drug, leaving the normal consumer price at the level of the 5000% increase.
In the days following the break of the story in September – and prior to his commitment to lower the price of Daraprim – Shkreli labelled the many social media users who condemned his actions as “morons”. Perhaps this is because from the vantage point of Shkreli’s economic reasoning – a reasoning worryingly lacking in humanity – there is a logic to the price hike. He insists that the profits generated from the higher price will be put straight back into research for a newer, more effective drug than Daraprim. But what about the people who suffer in the interim?
The instant medically vulnerable people suffer or die, the economic logic that supports Shkreli’s decision – and that of Oxfordshire County Council – from a moral perspective, collapses. Even more concerning though is that Shkreli masks the moral corruption of the price gouging behind a capitalist ideology that in most other circumstances, would be wholly legitimate. Indeed, in an interview with the CBS network in the United States, Shkreli claimed, “There’s no doubt I am a capitalist…but our (Turing Pharmaceuticals) first and primary stakeholders are our patients.” So is he driven by greed? Generosity? Or a conflation of the two? That life-saving drugs are often the archetypal example of price inelastic good points to the vapidity of Shkreli’s claim to ‘put his patients first’.
There is a clear and worrying imbalance between Shkreli’s perception of Daraprim’s potential as economic good for financial gain, as opposed to medical good for the benefit of living humans. An interview with the BBC demonstrates this well. In it, Shkreli smugly reasons, “If there was a company selling an Aston Martin for the price of a bicycle, and we buy that company and ask to charge Toyota prices, I don’t think that should be a crime.” Yes, if the market concerned did in fact involve vehicles and not human life. The reason we find illegal trades such as human trafficking morally reprehensible is because it treats human life as a commodity. By pricing a life-saving drug at untenable levels for the majority of people, Shkreli tends to the same level of moral degradation of human traffickers; because like them, he is bargaining with human life for financial gain. The only reason that these two activities do not psychologically equate is that the bargaining of life occurs latently; by-passed by the physical, “commodified” object of the pill.
At the heart of the issue is the genuine requirement of enormous amounts of money to develop more effective drugs. Yes, funds must absolutely be driven into these advancements, but that should not come at the expense of those suffering at present. That Shkreli ominously continues to claim that he and Turing Pharmaceuticals represent an “ally” to those at risk of or suffering from toxoplasmosis is abhorrent. As a society, we need to re-assess what we are willing sacrifice for the sake of economic gain. One thing is for certain though; people should not be priced out of a market that ensures their survival.
The petition to lobby Oxfordshire County Council against cuts to the Terrence Higgins trust can be found here
image credit: Chaos