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James Love

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In Defense Of WikiLeaks: Looking At Cables On Pharmaceutical Drugs And Trade Pressures

Posted: 09/04/11 03:43 PM ET

Like many others, I have spent the past several days combing through countless US Department of State cables. I am primarily looking at the cables that describe our government's efforts to drive up the price of medicine in developing countries. This is an act of state-sponsored violence that is rarely reported by the New York Times, the Guardian or other newspapers that had received early copies of the cables.

I am also looking at the news of and the reaction to WikiLeaks' failure to withhold access to cables that include the names of sources of intelligence, putting at risk the lives of the persons so named.

While I join those who are greatly saddened by this lapse in security, and aware of the consequences, I am also shocked at the bitter attacks on WikiLeaks, which seem unbalanced, under the circumstances. I think that Glenn Greenwald got things right in Salon, when he wrote yesterday that "a series of unintentional though negligent acts by multiple parties -- WikiLeaks, The Guardian's investigative reporter David Leigh, and Open Leaks' Daniel Domscheit-Berg" led to the release of all documents in unredacted form. Domscheit-Berg, who sought to share in the glory of the WikiLeaks operation, essentially stole a copy of the encrypted files from WikiLeaks, which led, unintentionally, to the circulation of the encrypted version of the unredacted cables. But this by itself would not have created the problem, except for the fact that David Leigh of the Guardian chose to publish the password to the file in a book, last year.

This is the passage from David Leigh's book:

Assange wrote down on a scrap of paper:

ACollectionOfHistorySince_1966_ToThe_PresentDay#. "That's the password," he said. "But you have to add one extra word when you type it in. You have to put in the Word "Diplomatic' before the word 'History." Can you remember that?"

Nigel Parry, in his excellent account of the disclosure, notes that David Leigh remains unrepentant about having published the "secret" password, claiming he did not realize that a password to the encrypted file would be permanent, rather than temporary. And, given the reporting in his own book, it seems obvious that Leigh did not know much about computers. But at that point, as Greenwald and others have noted, after a series of mistakes by lots of people, "virtually every government's intelligence agencies would have had access to these documents as a result of these events, but the rest of the world -- including journalists, whistle-blowers and activists identified in the documents -- did not." So, WikiLeaks finally released everything, and I think this was the right thing to do.

Is there blame to go around? Yes, plenty. The US Department of State allowed someone to leak its cables to WikiLeaks. WikiLeaks allowed someone to leak those same cables in encrypted form, and a reporter from the Guardian thought it would be good literature to publish the password to the encrypted files.

What else was happening during this period? US political figures were calling for Assange to be assassinated, or thrown in jail. Every major financial institution was blocking financial transitions to WikiLeaks. Domscheit-Berg and others were carrying out what increasingly looked like a personal vendetta to smear WikiLeaks. The Swedish government put out an Interpol red alert charging Assange with rape. And, probably lots of other things were going on to destabilize the WikiLeaks operation. This was, I am certain, more pressure than most of us have experienced.

In the end, what have the WikiLeaks cables given the public? For those who care about such things, we now have a much clearer and documented view of the actual policies carried out by the US government, and also by many other governments, whose actions were described in the cables.

The Arab Spring may be the most visible and important consequence of the WikiLeaks cables. WikiLeaks did not by itself cause this social movement, but WikiLeaks did a great deal to stimulate action and to lend creditably to critics of the regimes, and for this, WikiLeaks certainly deserves credit.

My own areas of expertise includes trade policy, as it relates to intellectual property rights. Here the cables provide an unprecedented wealth of information about the Bush and Obama Administration policies over roughly a nine year period, ending in February 2010.

Even before the most recent dump of documents, were were able to locate 240 cables detailing U.S. government efforts to expand controversial intellectual property rights in the evidence that new medicines are safe and effective -- an IPR rights that works interdependently from patents granted on inventions. This is a topic that is obscure to most non-experts, and completely unreported by the mainstream press, but is extremely important in the eyes of public health groups. To see what our government does, why it is important, and how aggressive is U.S. advocacy in shaping another country's laws, take a look at these cables on Jordan or Guatemala, for just a few data points.

The U.S. government also constantly pressured developing countries on drug pricing. Even when US government officials knew, and wrote, that high drug prices would undermine access, they conspired to undertake all sorts of pressure to get policies favorable to the drug companies. Read some of these cables and then ask yourself: what this would feel like if you were reading about a foreign government telling us what to do?

Not counting the latest disclosures, from May 2001 to February 2010, the Department of State published 23 cables per week mentioning pharmaceuticals. A typical but shocking example of this was the U.S. campaign to undermine legislation and reforms to make medicines more affordable in the Philippines. In one striking quote from a September 2009 cable setting out opposition to price controls, Kristie Kenney, then the United States Ambassador to the Philippines (currently Ambassador to Thailand), acknowledges there is a strong rationale for the Philippines to cut drug prices:

"Prescription medication prices in the Philippines are the second highest in Asia (next to Japan), in a country where about a third of the population subsists below the official poverty line. In this instance, some multinational companies failed to recognize that cheaper medicine for the masses is an emotional and political issue."

Then there is this May 14, 2007 cable from Ralph Boyce, then the Ambassador to Thailand, where he seems elated that Abbott Laboratories was withdrawing drug registrations for seven products, including among others, a version of a US government funded AIDS drugs that could be used without refrigeration -- a feature quite important for AIDS patients living in rural areas.

http://cablegatesearch.net/cable.php?id=07BANGKOK1524"

¶1. Abbott Labs, the recent target of a compulsory license on their patented antiretroviral Kaletra, confirmed to Embassy that the company had withdrawn applications for registration of seven new pharmaceutical products in Thailand, and had no plans to introduce new products until its intellectual property was properly respected. The seven drugs include Aluvia, a new heat-stable version of Kaletra. Although the two drugs are identical in effect, the new version is considered ideal for tropical environments such as Thailand. Other drug applications pulled include treatments for hypertension, kidney disease, auto-immune disease and congestive heart failure. The applications had been on file with the Thai FDA for up to ten months awaiting approval.

¶4. Comment: Abbott's actions will certainly be controversial. However, the action may strengthen the hand of Abbott and the rest of industry in future dealings with the RTG. Abbott's move puts the RTG on notice that there are visible consequences for its actions, rather than solely a vague weakening of the investment environment. Whether this focuses the minds of RTG officials at upcoming negotiations remains to be seen. End Comment. BOYCE

You don't have to be Noam Chomsky to find this truly appalling.

In a number of cases, the US government pressures developing countries to put pharmaceutical company lobbyists on key government committees dealing with drug regulation, IPR policy or drug pricing.

The disclosures go on and on. I am so angry at many of the cables that I can hardly explain how screwed up the U.S. policies are. Some of the disclosures have been blogged here.

http://www.keionline.org/wikileaks

After reading these cables, it is difficult to stomach the defenses of US secrecy. Forcing developing countries to raise the price of drugs has predictable and well known consequences -- it kills people, and increases suffering. Many people could care less -- including reporters and editors of newspapers. How much of this ends up in the Washington Post, the New York Times or the Guardian these days? But others who do care now have more access to information, and more credibility in their criticisms of government policy, because of the disclosures of the cables.

Many of the cables are in theory available under our Freedom of Information Act (FOIA). In practice, the Obama Administration has made it more difficult to obtain information about trade practices under FOIA, and in many respects is even more aggressive about secrecy in IPR negotiations than was the Bush Administration. For these reasons, the WikiLeaks disclosures are even more valuable. One hopes the substance of the cables become more widely known in the United States, and that U.S. citizens begin to question our government's close collaboration with big pharmaceutical companies in our dealings with low income countries.

 

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03:04 PM on 09/10/2011
After reading up on the subject a bit (including the affidavits from your own website) it’s become clear that the $3.5 million NIH research grant didn’t fund all the preclinical development of ritonivair; it was just a drop in the bucket. Prior to getting the federal grant money, researchers at Abbott Labs were already looking at the effect of protease inhibitors on HIV. Even though their work showed promise, when they tried to get the budget increase needed to take their pilot project further, the powers that be at Abbott turned them down because they didn’t feel there would be enough money in it.

The importance of the NIH research grant was that it gave the project the leverage needed to convince Abbott Laboratories to move forward on it. Think of it like a student who gets a $10k a year scholarship for college. It may not be enough to cover the cost of his education, but it might be enough to convince his parents to take out a home equity loan to cover the rest of his tuition costs. The NIH grant was a key factor in the development of ritonivair, but the role it played was still a small one.

I realize you’re probably done with this conversation, and I appreciate the time you’ve taken to respond to my comments- a first for me on HP. I do have a bit more to add, so I’ll probably write a little more before this fizzles out.
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James Love
07:03 PM on 09/10/2011
First off, I think the Thai government was right to issue the compulsory license on the Abbott AIDS drug, regardless of what was spent on R&D, or who paid what. But with regard to ritonavir, I think you under estimate the value of what the NIH did and over estimate what Abbott did. John Erickson, a friend of mine, was the scientist at Abbott that wanted to do this. Management did not want to work on AIDS. He could only move forward because the grant. $3.5 million, in the 1990s, for pre-clinical research, was not a small grant. This is the most risky phase of development. What do you think the odds of success where, at that point? On a risk adjusted basis, the NIH grant is more like a 350 million or more investment. Abbott claimed to have spent a lot of money, but never backed that up with any real evidence. For ritonavir, they had fewer than 1500 patients in very short trials, and a very speedy approval. The certainly spent much less than $10k per patient in direct costs for those trials. If you don't believe me, do some research on what HIV trials cost per patient in the 1990s.
07:56 PM on 09/11/2011
I'm sure you do think Thailand was right, but only time will tell. My guess is the incompetent government of Thailand will try to cut corners and fail to maintain bio-equivalence in its product. Any change to the active compound will result in widespread drug resistance, which will undoubtedly spread to the US through Thailand's sex tourism. The manufacturing of drugs is a very exacting science, requiring very specific temperatures, levels of humidity and pressure and a variety of other conditions, the slightest modification of which will have dire consequences. Apparently you have more faith than I do with state-of-the-art medicines in the hands of a governemnt agency with no experience producing ARVs.

The world shows contempt to the innovators of medicine- the companies that worked hard to develop these much needed pharmaceuticals. Meanwhile they kiss the feet of the pirates of the drug industry- wealthy thieves of intellectual property that reverse engineer patented drugs they then cheaply produce in countries with an abundance of poverty and a dearth of worker's rights laws, and then sell for pennies on the dollar. Companies like Cipla- that violates patent law and produces more AIDS meds sold worldwide than any other company - are likened to Mahatma Gandhi, even though the founder's son has made hundreds of millions in personal income by ripping off other's inventions and paying his employees little, so the world could have cheap meds.

I'll answer the rest in another reply later.
07:14 PM on 09/12/2011
The risk adjusted basis has no bearing on the fact that it cost a whole lot more than 3.5 million to develop a drug. I just saw on TV a case of anthrax poisoning where it was mentioned that the CDC had spent over $144m on an antigen, but the only problem was it had never been tested on anyone. Putting the pre-clinical estimate anywhere below
$100m is essentially a joke.

The NIH grant was roughly $700k a year over 5 years. I don't doubt that without it Abbott wasn't going to support Dr. Erickson's research. But that doesn't change the fact that it cost a lot more than that to develop. $700k a year was probably what Abbott was paying for the research on protease inhibitors before they got the grant.

I understand how frustrating it must be for John Erickson, whose project this was, who got the NIH funding, and who played a pivotal role in the development of Norvir, to have to watch Abbott play harball on this. I can appreciate what it must be like for the humanitarian in him to have to sit by and watch as people are dying in poverty stricken nations, while the company he had to convince to let him work on ARVs gets to play god with the fruit of his research. But I'm sure he'd tell you in private that Abbott put up a lot of out-of-pocket funding of his work on PIs.
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12:27 PM on 09/06/2011
Mr. Love apparently believes efforts by US government officials worldwide to protect the commercial and intellectual property rights of US healthcare companies constitute "state-sponsored violence"? That has to be one of the most irresponsible allegations I've ever seen tossed around on these blogs.
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HUFFPOST SUPER USER
Artanis71
Colbert Super PAC unleashed in 2012
11:33 AM on 09/06/2011
Come on HP, you feature a big article that Bachmann lost 2 people and this kind of story a small note on the side?
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Brett y
Frack the frackers!
01:38 AM on 09/06/2011
I am Ashamed!
07:30 PM on 09/05/2011
It's always so easy to villify the pharmaceutical companies, but Thailand had no right to compulsory licensing of Abbott Laboratories' antiretroviral meds. Lets keep in mind it's not the poor people of Thailand (who at 9.6% have a lower poverty rate than the US at 12%) footing the bill, but their government. Thailand ranks 13th in the world for reserves of foreign exchange and gold (placing them just under Germany and right above France) with about 43.7 billion dollars more in reserves than the United States. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2188rank.html?countryName=Thailand&countryCode=th®ionCode=eas&rank=13#th

Abbott Laboratories, like pretty much all of "big pharma" gives away hundreds of millions of dollars worth of product each year. Last year they gave $450 million worth of medication through their patient assistance programs http://www.abbott.com/citizenship/priorities/access/pap.htm
as well as $89 million worth of product through the Partership for Quality Medical Donations http://www.abbott.com/citizenship/programs/community.htm

Please note, I do not work for Abbott Labs, nor do any of my friends or family members. I found this information on the internet as anyone else could have done. I do think the drug companies are unfairly maligned, and there's no reason why the government of Thailand can't pay a fair price for the innovation of the drug companies, especially since they put a large portion of their profits into further innovation.
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08:41 PM on 09/05/2011
Agree completely. Like any big industry, pharma has plenty of faults that deserve attention and scrutiny. However, Mr. Love is merely trying to justify his organization's support for systematic weakening of the global protection of intellectual property rights, especially in the area of pharmaceuticals and medical innovations. Mr. Love seems to think the "Boyce comment" is some kind of smoking gun. I simply see a US ambassador sticking up for a US company and international law in the face of stupid threats from a greedy, short-sighted military junta. Well done, Mr. Boyce.
Genders
Love, Tolerance, Enlightenment
12:16 AM on 09/06/2011
Maybe you are being fooled by Abbot labs pr folks.

http://www.bioportfolio.com/news/article/759790/Patient-Assistance-Scam-Aids-Drug-Company-charity-Programs-Fail-Patients-Yet-Provide.html

Your first point about foreign currency and gold, makes no sense. It's not a direct measure of their ability to pay. Thailand has about the same income per capita as mexico, they are poor. Same for GDP per capita. So now I kind of think you do work for Abbot, because that was a deceptive argument.
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08:42 AM on 09/06/2011
Now you are the one who appears to be deliberately deceptive. Your link has nothing to do with Abbott or Thailand.
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Whistlejackett
Hey stop doing that
07:16 PM on 09/05/2011
Great article, and thank you. Firstly I would like to say that I hate, I hate the US government, Democratic or otherwise. I live in Canada, and we now have found out that the US has pressured us to adopt American Internet Copyright Laws. We are slowly losing our rights as a sovereign nation, but our present Conservative Government seems to want to follow US guidelines. The Wiki Cables are very helpful to us, and I hope that they will continue.

Marc Zukerberg has said that Facebook is striving for 100% openness. That may be appealing to government, but then, should those governments not be open to the public? 100% is a cloudy number in this case. God bless the people of the United States, and down with the US Government.
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Brett y
Frack the frackers!
01:42 AM on 09/06/2011
By definition, to hate our government is to hate us.
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Whistlejackett
Hey stop doing that
02:03 AM on 09/06/2011
No, your government does not represent you, it represents the rich.
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07:04 PM on 09/05/2011
Mr. Love claims that the former US Ambassador to Thailand, Ralph Boyce, "seems elated" in the following comment. I am having trouble detecting anything close to "elation" in this comment, which in turn appears to be one of the linchpins of his whole above article. Can anyone else please point out the "elation" I'm missing? Thank you:

"Comment: Abbott's actions will certainly be controversial. However, the action may strengthen the hand of Abbott and the rest of industry in future dealings with the RTG. Abbott's move puts the RTG on notice that there are visible consequences for its actions, rather than solely a vague weakening of the investment environment. Whether this focuses the minds of RTG officials at upcoming negotiations remains to be seen. End Comment. BOYCE"
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HUFFPOST COMMUNITY MODERATOR
ConfuciusSay-
Aglets: their purpose is sinister.
07:35 PM on 09/05/2011
Seems rather dispassionate and analytical to me...
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James Love
12:39 AM on 09/06/2011
For more context, take a look at the 34 cables sent from the Thailand Embassy from Feb 25, 2005 to January 26, 2010. (http://keionline.org/node/1245) I would not describe Boyce as having been neutral or dispassionate as regards the pressure put on Thailand during his tenure. To this day, the U.S. is putting daily pressure on Thailand and other developing countries on the drug patents/ drug pricing issues.
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phoenixdoglover
My dog loves my progressive treats agenda
04:46 AM on 09/06/2011
I just read two of the cables that seem to be most relevant to the drug licensing discussions, and I don't see big presure being put on the Thai government. In fact, the Thais look like pretty hard-nosed negotiators able to take care of their own interests.
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HUFFPOST SUPER USER
calibellemom06
Silence so loud it hurts my soul
05:44 PM on 09/05/2011
An article well written!
And this article is a huge reminder as to why ignorance is bliss! OK--Only at certain times.....
To know this stuff with more assurance that it is legit information, angers me-- even more so than I already was.
It adds to the distrust of government entities and only serves to reaffirm my personal beliefs as to why our country is in such a state of disrepair--pull of broken promises and empty dreams.
Every election is the same in that one candidate bashes another--they all make promises that they never keep and they are all involved one a scandal of some sorts with in their terms.
When people are appointed positions of power--greed thrives and they are blinded by back room motives.
What both sides are doing is irresponsible, neglectful, dangerous, and illegal. What both sides are doing contributes to the problems at hand.
I for one hate tattle tails----especially the ones that do it over a power fight.
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tracerhaha1
It's time to end the war on (some) drugs.
04:58 PM on 09/05/2011
More evidence that the government works solely for the benefit of corporations.
Genders
Love, Tolerance, Enlightenment
05:32 PM on 09/05/2011
That our sold out GOP and DLC gov does.

Vote for the Locke liberal US founder types, the CPC Progressive caucus, Kucinch folks in the primaries:
http://cpc.grijalva.house.gov/
Not the Obama Clinton Rahm Blue dog new dem DLC corporatist anti-populist folks:
http://en.wikipedia.org/wiki/Democratic_Leadership_Council

Then vote straight Dems in the general, because the GOP/Tea are much worse.
foresure
Brash and Harsh
04:51 PM on 09/05/2011
Breaking News:

I have emailed Mr. Love, the author, encouraging him to read:

"Presciption Drug Importation and Internet Sales: A Legal Overview" By Jody Feder, Legislative Attorney, American Law Division.

He REPLIED that he intends to.

Now, YOU should read it.

If anyone asks, I will provide a short excerpt of the relevant portion of PubL. No. 108-173, the The Medicare Act.
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kendraro
deadhead echelon peacenik mom to Marley the awesom
04:45 PM on 09/05/2011
I'm not sure how you are going to get Americans to care about this when we don't even seem to care about how our government is more concerned with pharma profits than with our own health and well being. As far as I am concerned profit and healthcare do not mix well and until we get this through our thick skulls we are just plain wrong.
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02:31 PM on 09/05/2011
The author of this piece should do some research before writing, for example the Abbott situation in Thailand. In 2007, the Thai government was forcing Abbott into a compulsory license to local companies for Kaletra, despite the fact that Kaletra was still under patent AND the Thai price of the drug was about 5% that in the US. Not 50%, not even 10%, 5%. Abbott did not cause the HIV epidemic in Thailand, but policies of the Thia government certainly contributed to it.
03:16 PM on 09/05/2011
I hope Love replies to your comment. However, your assertion that Love did no research before writing makes me skeptical of everything you say. BTW, what are your sources? Please provide references I can check out (like Love provided in his article).
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04:00 PM on 09/05/2011
My sources are almost any objective news story from the 2007 timeframe. Here is a good summary, note the Kaletra price cut in Thailand led to an annual cost of around $1,300, which was
foresure
Brash and Harsh
04:44 PM on 09/05/2011
siberiandreams:

1. Documentation please. A reference to an English language Thai paper would do.

Or a Reputable publication.

2. I have seen a documentary that the Thai government has a very active policy of distributing condoms free of charge.
01:18 PM on 09/05/2011
You are preaching the ill effects of using weed to the stoned. People are immune to US drug companies muscling developing countries and forcing them to empty their coffers to fund big pharma's profits.

Trouble is, the US environment isn't in that much better shape.
01:12 PM on 09/05/2011
what's going on with Bradley Manning? no trial yet, hey....
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Ellamenta
Oh no! My microbio has gone viral!
12:37 PM on 09/05/2011
In a better world, this article would be given much more prominence on HP than to be only one of many blog postings. Of course, in a better world, U.S. foreign policy would not quite be "what's good for General Motors [or Glaxo-Smith-Kline] is good for the U.S.A."
Regarding the policies of the Obama administration, though, Mr. Love, what alternative can you propose?
How can we the people work to change such a deeply ingrained priority in U.S. policy, both foreign and domestic? Even the minor adjustments Obama makes are greeted with public denunciations of his "anti-business" mentality.