The world’s major pharmaceutical corporations are collectively known as Big Pharma. Like other globalised corporate giants, Big Pharma has in recent years accrued massive power in shaping regulation of business to suit their own interests. They will be sniffing around Gleneagles in July, claiming to support efforts to tackle disease and HIV/AIDS in Africa, but the profit motive comes first. The political influence of Big Pharma has serious implications for populations in both rich and poor countries, for distinct reasons.

The world’s major pharmaceutical corporations are collectively known as Big Pharma.  Like other globalised corporate giants, Big Pharma has in recent years accrued massive power in shaping regulation of business to suit their own interests.  They will be sniffing around Gleneagles in July, claiming to support efforts to tackle disease and HIV/AIDS in Africa, but the profit motive comes first.  The political influence of Big Pharma has serious implications for populations in both rich and poor countries, for distinct reasons. 

Big Pharma's marketing strategies in rich countries are increasingly aggressive.  Here in the UK there are real costs to the NHS and to the health of patients.  There is the increasing drugs bill for a start.  New drugs present one of the biggest cost pressures on the NHS, whose drugs bill is rising by around 13 per cent each year.[1]   Additionally, drugs companies increasingly invent diseases requiring their products as a way of increasing profits.  This is so well established, it is known as 'disease mongering.'[2] 

On a global scale, Big Pharma has huge influence over the World Trade Organisation, which sets international trade rules.  The industry has directed the positions of the US, European and Japanese governments, forcing developing country governments to sign up to an agreement against their interests.  The Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS), established at the WTO ten years ago, has ensured that northern knowledge-based industries have strengthened their grip on the global control of knowledge and political power to protect their profits.[3]   The industry increasingly makes money not from the drugs they make but from the patents which allow them to charge exorbitant prices.  The motives are clear.  The combined value of the world’s top five drug companies is twice the combined GNP of all sub-Saharan Africa.  Pharmaceutical profits are among the highest of any commercial sector.  Yet, considering the G8 agenda this year, Blair's Commission for Africa report pays scant attention to TRIPS and its implications for Africa's health. 

Paradoxically, while most people lack adequate access to essential medicines, millions of others are subject to an over-consumption and over-prescription of medicines.  Some estimates suggest up to 5% of hospital admissions in the UK may be due to adverse drug reactions.[4] 

Big Pharma is finding new and creative ways of making us take their medicines.  At present, advertising prescription-only medicines directly within the European Union (EU) is illegal.  One alternative strategy is to make as many people as possible believe that they have a particular disorder and to imply that medicines are the best, if not only, solution.  To assist this process, companies initiate "disease awareness campaigns", benefiting from association with patients’ groups to have their promotional messages accepted as balanced information.  For the UK in 2005, the BBC lists details of six disease awareness months, eleven disease awareness days and forty-eight disease awareness weeks.[5]   Drug companies also pay PR firms to invent fake patient groups to raise 'awareness' of their diseases.[6] 

Selling cures for imaginary diseases is where the drug industry rakes in the cash.  This is illustrated well by modern pharma research.  Glaxo Smith Kline took the antidepressant Seroxat and had it approved to treat shyness, now reclassified as 'social anxiety disorder.'   Barry Brand, the product director, told the journal Advertising Age, ''Every marketer's dream is to find an unidentified or unknown market and develop it.  That's what we were able to do with social anxiety disorder.'[7] 

Another tactic of Big Pharma is the targeting of health staff as promoters of their products.  The ethical campaign group 'No Free Lunch' gave evidence to a UK Select Committee last year, on 'the troubling and inappropriate hospitality' offered by Big Pharma, including expensive lunches (£50 plus) and the use of exclusive hotels (including Gleneagles), describing it as common practice..[8]

As the NHS now permits nurses to prescribe in some cases, the pharmaceutical industry is preparing to take full advantage.  As one industry spokesperson put it: "The good news is that for those prepared to rethink their approach, the door is wide open to take competitive advantage."[9] 

NHS nurses have been invited on luxury trips to four and five star hotels by pharma firms which manufacture the drugs they are now allowed to prescribe.  Earlier this year, Astra Zeneca entertained nurses and doctors at a dinner at the four star groucho St Jude's in Glasgow.  Nurses were also invited by AZ to the five star Cameron House hotel on the banks of Loch Lomond in Scotland.  This trip was cancelled at short notice.  Des Spence, from No Free Lunch UK, had raised concerns about it with the Association of the British Pharma Industry.[10] 

At the level of the Scottish parliament, corporate lobbyists are also mooching around trying to buy influence and access government budgets, such as NHS funding.  The International Advisory Group of Scottish Enterprise, Scotland's main economic development agency, funded by the Scottish Executive, includes the chief executive of pharmaceutical giant AstraZeneca,[11]   Let's not forget the discovery a couple of years ago that New Labour's Margaret Jamieson MSP, had signed a ten year confidentiality agreement with drugs giant Pfizer after a number of meetings with the company, including one in New York.  At the time she was chair of the health committee of the Scottish parliament.[12]  At the level of the UK government, serious questions are now being asked about the cosy relationship between government and the industry.  The House of Commons Select Committee reported earlier this year on a clear conflict of interests:[13]

"The Department of Health has not only to promote the interests of the pharmaceutical industry but also the health of the public and the effectiveness of the NHS.  There is a dilemma here which cannot be readily glossed over. The Secretary of State for Health cannot serve two masters. The Department seems unable to prioritise the interests of patients and public health over the interests of the pharmaceutical industry.."

On the question of wider political influence, the industry's impact on international trading rules, through the WTO, is well documented.  The WTO in turn, is largely controlled by the G8 countries.  Since 1995, corporate leaders have been directly involved in G8 governance.[14]  The CEO of Shell oil, Mark Moody-Stuart, is likely to put in an appearance at Gleneagles this summer as co-chair of the Global Business Coalition on HIV/AIDS.   With HIV/AIDS central to the G8's Africa Agenda, the Coalition, which argues that above all confronting the epidemic makes good business sense, are likely to make their presence felt.  The Coalition had a lobbying presence at the G8 Summit in Genoa.  It includes pharmaceutical giants GlaxoSmithKline, Pfizer, Merck, Roche and Bayer.  UK drinks multinational Diageo is also a member of the Coalition.  (How cosy: Diageo and the drugs companies are members of the HIV/AIDS coalition, and Gleneagles, owned by Diageo, hosts the same drug companies' junkets for health staff).

Although Blair has promised to address poverty in Africa, and to address the devastating impact of disease and HIV/AIDS in the continent, the G8's decisions will be heavily influenced again by the interests of astonishingly rich Big Pharma.  There is no denying that some of the medicines produced by Big Pharma can alleviate suffering and save lives.  But corporate greed and rich governments' collusion ensure that our health and the health of Africans will continue to suffer unnecessarily.