Killing Bill C-393 equals killing period. A visual aid for Canadian politicians.

donotkillbillc393.jpg For the interest of discussion, I've made the above visual aid for members of Canada's Senate, since this is the week that they have a chance to pass a Bill that "aims to make it easier for Canada to export affordable, life-saving, generic medicines to developing countries." I wrote about this Bill C-393 earlier, stating how the right choice (passing the bill and not killing the bill) is obvious. But then it occurred to me that if the decision was so obvious, then why is there so much "push back" from the pharmaceutical industry (as well as the Harper government). It turns out the reason appears to be about Bill C-393 representing a trend that "could potentially" lead to a loss of control over the status quo. This being the status quo that provides the pharmaceutical industry with an inordinate amount of lobbying power to set prices; a business model that values huge profits above innovation; and something that they are so focused on protecting that even the smallest of losses must be avoided no matter the consequences. Which is simply reprehensible - because with this Bill, the consequences are not just about patent control: it's about the livelihood of millions of people, where the decision to "kill" or "not kill" the Bill could literally be a matter of life or death. Please send an email to the Harper government by using this Avaaz link.


  1. Thank you so much, I hope everyone who reads is also driven to act. Lets protect children, all of them. All of us have great teachers who respect. All of us. Your teacher tells you what to do here.

  2. Drug pricing ought to be regulated. If there is a justification for making drugs so expensive that only the rich can afford them I can’t think what it might be. Cut out the management and put the head research scientists in charge of big pharma, if you ask me. The people in the lab develop something life-saving and the greedy dicks upstairs make their fortunes sentencing people to death. We shouldn’t allow this in a civilized society.

    1. signsofrain makes so much sense, it is hard to comprehend how badly organized our society is. We are sick, most of us know it, and our waking up is the first step to a cure.

  3. I like the idea, but I’m not going to lie, it’s a little confusing visually speaking, in that I’m not sure at first blush which examples are arguing with kill/don’t kill. It should labeled “What will happen if you kill this bill” or something like that. Other than that it’s a great idea but if it’s all confusing Canadian politicians are just gonna toss it out, if it makes it past their aides. Just sayin!

  4. Why is it bad that drug companies make a profit? A successful company makes a profit, that is the only reason for a business to exist, and is the only mark of its success.

    Same thing for advertising; if it takes twice as many advertising dollars as R&D dollars to turn a profit, that’s what needs to be done. Would you rather they equalize the two numbers and earn 25% (arbitrary number) of the profits they make now, ultimately cutting funding to R&D over the long haul?

    If you have a problem with this, start you own non-profit corporation that designs, manufactures, and distributes drugs at the lowest cost to the patient. Nobody is stopping you.

    I really can’t understand this mentality here that companies should all run at a loss for some kind of perceived societal good. It doesn’t make sense in any way. If you think everyone should have free oranges and the orange company is selling them, get some oranges and give them away if it bothers you that much. Don’t make the person selling them start giving them away.

    1. They ARE stopping you: that’s the whole point of the article: to make it legal to “start you own non-profit corporation that designs, manufactures, and distributes drugs at the lowest cost to the patient.” AT PRESENT IT IS ILLEGAL TO DO THAT.

    2. songofsixpence:

      Your reasoning makes oh-so-much sense in the moral vacuum of economic reasoning, but get your head out of your ass for a minute and think about our situation:

      • We are an intelligent species clinging to life on a giant rock hurtling through a freezing vacuum. The only place in the known universe we can survive is here.

      • All of us are one. Race, creed nationality… irrelevant, we’re all on the same rock. What happens to some of us in a very real way happens to all of us.

      • Capitalism devalues the future for a buck now, so we are in the process of destroying our one and only home as fast as we can, and the reason we aren’t stopping is because capitalism is so well entrenched, so much a part of our cultural programming, that giving it up in favour of a new system is not even on the table. Even suggest it and goons like you throw fits. Tell me what exactly is wrong with forcing big pharma to reduce their pricing combined with government subsidy of valuable medical research? It results in gain for so many people, and those who would suffer losses (mainly executives!) already have a much larger share of the pie than their labour earns them anyway! Fuck ’em! Let ’em drive Subarus instead of Ferraris..! If you think that this is just so-much liberal hogwash, I ask you to take a second look at the word ‘destroying’ and think about what it means in real terms. It means your kids kids won’t be successful entrepreneurs, they’ll be born deformed, breathe poisonous air, and have nowhere to live because half the world is flooded. That is what prioritizing profits over people is going to do. They’re going to wish for cheap drugs, believe you me.

      • We have the raw resources and technological means to deliver the essentials of life to everyone on the planet. Adequate food, clothing, shelter, and health care COULD be given to everyone were we all to work together, but aren’t mainly because profits matter more than the greater good.

      So you know, songofsixpence, there’s nothing WRONG with capitalism, except, you know, EVERYTHING.

    3. It’s not making a profit that’s wrong, it’s making it by extortion. Simples.

      @GreenJello How does providing affordable drugs to people who can’t afford your expensive ones take money from a drug company? This is creating a new market, not forcing them to cut prices in the existing one.

  5. What would be the viability of creating a not-for-profit, a by the people for the people pharmaceutical company? I know, from a previous BoingBoing article that the R&D is inflated, but I’m tired of the greed!

  6. Don’t worry, this won’t be ‘killed’ rather it will die on the vine because the opposition will find the government in contempt over a minister not funding a religious group and then not recalling who wrote the ‘not’ on a memo… People wonder why voter turn out is low, its because writing a ‘not’ on a memo becomes a ‘scandal’ while this bill never even makes the news cycle.

  7. Let me get this straight – now not providing cheap drugs to everyone in the world is morally equivalent to homicide?

    1. This isn’t curing AIDS or HIV. It’s significantly extending the lives of those infected. Doesn’t that mean you’re running a greater risk of increasing the spread of the disease by keeping these people alive and active?

      1. Using that logic, we should just cut down anyone who has a communicable disease, or hereditary health problems. Everyone who is stricken by one thing or another would have to be sentenced to death by lack of treatment using that logic, because they would either pass on the disease to another person or potentially to their children if they have any.

        1. In fairness, Lucifer didn’t explicitly espouse the idea of killing the infected. It was framed as a question, and as a question, I honestly don’t know the answer. Does increasing lifespan translate into a higher incidence rate, or just greater prevalence? Do treatments which decrease viral load also reduce communicability?

          It certainly seems like decreasing viral load will reduce contagion. So, I’m not sure if the question has an easy answer.

          That having been said, the question does sort of seem to imply that it would be optimal if people with aids would hurry up and die, especially if they could do so before they’re old enough to be sexually active. I’d consider this to be a fairly shitty way of approaching the epidemiological aspect of the problem.

        2. Your knee-jerk reaction begs for a simple strawman argument: Killing the sick v. helping them. However, my question is a more pragmatic one. It even stipulates humanitarian motives in both cases:

          1. give a non-curative medicine that extends the life of the host which increases the probability that the HIV virus will be passed on as a direct result of the life-extending medical intervention.

          2. withold life-extending medicine, resulting in higher immediate incidences of AIDS-related deaths.

          Now in cases 1 and 2, AIDS patients will die. (in fact, we will ALL die…) But the question is whether case 1 can somehow “help” the virus spread and stay thanks to keeping the hosts alive and active longer.

          By giving greater life to a population of infected individuals, is it possible that the spread of AIDS will cause more infections and deaths?
          It’s a simple factual inquiry with no bias in either direction.

      2. This isn’t curing AIDS or HIV. It’s significantly extending the lives of those infected.

        I’ve got news for you, dude. “Significantly extending life” is the best we can hope for from ANY medical procedure. We’re all destined to be worm food sooner or later.

        But unlike treating the elderly (which is where most medical spending goes), HIV medications routinely extend lives by decades rather than mere years or months. Measured by years-of-life per dollar you get much more bang for your buck with HIV meds than almost any treatment out there. With proper medical treatment it’s highly likely that most people infected with HIV today will live to the day we find a cure.

        1. “HIV medications routinely extend lives by decades rather than mere years or months. Measured by years-of-life per dollar you get much more bang for your buck with HIV meds than almost any treatment out there.”

          Right – that’s why I said these meds can “significantly” increase the life of those infected with HIV. However you don’t address my question about whether putting a widespread population of HIV/AIDS patients on these drugs might not cause *more HIV infection* within the general population.

          What I’m not refuting is the humanitarian aspect of giving more life to those suffering from a life-shortening disease.

          What I am asking is that these meds permit those infected to lead active lives for much longer than they otherwise would without the meds. Do you believe an unintended consequence of these patients living out free and unfettered lives might be to engage in such activities like unprotected sex, drug use, having children, that might increase infection rates?

          The meds you give only prolong life as well as the quality of that life but they do not in any way prevent or lower risk of infection to others do they?

          I didn’t say “kill the sick” – it’s perhaps a conclusion that appears to be implied in the question I am asking but it is not what I am after.
          If anything, the implied message I am picking up is that this road paved full of good intentions may cause greater death and unintended assistance to the transmission of HIV. So my question then is: If you knew that giving these meds to the poor in third world nations WILL lengthen life and quality of life to that significant population of infected people so that they can be active for years and that translated into greater incidences of transmission, does that not make you complicit in the deaths and infections of those who would otherwise not be infected if the meds were not available?

          1. I’ll acknowledge that higher infection rates through longer lifespans is a possible, if yet-to-be-demonstrated, consequence of anti-HIV medication. However, a child who grows up to be infected with HIV will still live longer than one who starves to death because his caretakers have died and his country is facing widespread famine as a result of a collapsed workforce. The suffering associated with the AIDS pandemic goes far beyond those who are actually infected.

          2. I don’t have links at hand, but I’m 90% certain that effective medication for HIV/AIDS lowers virus load to the point that probability of transmission is greatly reduced per contact, even in the absence of changes in sexual behavior. Remember that HIV takes quire a while to progress to AIDS, but medication, when the money’s there, starts before progression to AIDS. As I understand it, one of the benefits of treatment–one of the major benefits–is reduced transmission.

    2. Let me get this straight – now not providing cheap drugs to everyone in the world is morally equivalent to homicide?

      Making it a crime to buy and make the drugs at a profit, so that people outside the gun enforced market of exorbitant coercive price protection, can still buy the drug at cost, is what is happening.

      Thats right, it isn’t even what you fear, or what(probably) your god told you to do, heal the sick or go to hell, its just a way around the fear that a pharmaceutical company screams about when people who never live long enough or earn enough to ever pay them a cent of their royalty, can still live. Without cost to “you” (as you appear to be acting as if you might have to sell a rolex to save 400,000 children.

      1. Making it a crime to buy and make the drugs at a profit

        And, as I asked you elsewhere, what’s your proposal for driving drug discovery if you take the profit motive out? How do you propose to keep the drugs coming to treat the other orphan diseases, once you’ve made one freely available? Where does the money come from? Government? Charitable donations by huge publicity drives? Philanthropy? Other business ventures? These are serious questions, because you have to finance drug discovery *somehow*, and you can’t just do it once, because there are many, many diseases in the world with no current treatment.

  8. Horrible Graphic.

    The old people in the Senate are going to go “huh?” and throw it away.

    It is really too confusing and disjointed and I know about the topic.

    As for the person defending big pharama and their right to profits: I don’t think it is about profits, its about gouging and profiteering. Essentially charging to make a profit makes good sense, and mechanisms to enable that are also to a certain extent. However when your model is to corner a market and change whatever the market will bare, particularly when health care is provided by the state and the tax payer, well it is being abused. Pharma companies are well overstating their R&D expenses in order to justify charging 5000$ for fifty cents worth of drug.

    Anyway, as I said profit is fine up to a point, after that it starts getting criminal… literally. As for starting up a non-profit, nothing really stopping anyone except all the huge costs, and an inability to acquire capitol.

    However, if they (pharma) want to behave this way, the way I see it is if we are going to have national health care, we should then start a government run nationalized drug company that is non-profit, that is created using tax payers money, and they can create and provide drugs for our health care system. On top of that, just imagine how our place in the world would shine (other than pharma execs or investors) being able to also distribute drugs at much better prices.

    Yes, that’s right, I think the costs are so inflated, that governments could do a better job of it than private companies.

  9. Kill people now, or kill people later is the real decision. If you destroy the drug companies ability to make money, or produce new drugs, you kill the companies ability to make new drugs, at which point you’re killing people in the future.

  10. Profit alone is not usually a good enough reason to do anything. Lack of profit is always a good reason to do nothing. So, what do we do about all the shit that needs to be done but there is no profit in doing it?

    An explanation for the pocket full of rye crowd; it’s about priorities and profit should be lower down on the list. What is wrong with 25% of your current profits so long as they are still profit? When is too much ever too much? Is it ever?

    Ever increasing growth is unsustainable, check out the science, growth has it’s limits.

  11. Kill people now, or kill people later is the real decision. If you destroy the drug companies ability to make money, or produce new drugs, you kill the companies ability to make new drugs, at which point you’re killing people in the future.

    Except they’re not making money hand over fist in Africa – for the most part there isn’t enough money there to buy the drugs in the first place.

    Also, I do tend to prioritize actual deaths now over hypothetical deaths in the future.

    Let me get this straight – now not providing cheap drugs to everyone in the world is morally equivalent to homicide?

    At the scale we’re talking about, no one’s going to be calling it a homicide. Either you’re okay with people dying or you’re going to call it mass murder, through depraved indifference to human life.

    1. >Either you’re okay with people dying or you’re going to call it mass murder, through depraved indifference to human life.

      Or you’re going to be rational, and not say something is murder just because you disagree with it.

      I think people should donate way MORE to the World Food Programme and the Malaria Vaccine Initiative.

      Likely you’ve spent over $100 on entertainment in your life. either on videogames, DVDs, movie tickets, or restaurant food. That $100 could have saved at least 10 lives. While it was one pleasant evening for you, it was life and death for 10 others. In that moment you decided to benefit your own pleasure rather than save lives.

      However, it doesn’t mean I’m going to call people who don’t donate, murderers. They’re simply not.

      It’s so bafflingly double-speaky to be calling not helping people murder.

      Not only does it achieve no communication to the opposing side whatsoever, its just self righteous feel good grand standing.

      1. Anon my friend are you in a religion? do you have a faith? have you studied a philosophy? Is the height of your contemplation a wonder how you can close faster? Is ‘always be selling’ your mantra? Or is there another level to your thinking?

        That $100 could have saved at least 10 lives. While it was one pleasant evening for you, it was life and death for 10 others. In that moment you decided to benefit your own pleasure rather than save lives.

        However, it doesn’t mean I’m going to call people who don’t donate, murderers. They’re simply not.

        Yes we have been sick for along time, and many people have died because of it, because we are sick. Its time to wake up, stop being in this dream.

        Yes the decisions we make have consequences. Yes people die because we are stupid, and we can change. In fact we are changing. We will do these things, make these much better decisions, have more people live better lives.

    1. Yes Jorpho: it was:

      Wait a minute. Isn’t CAMR supposed to take care of the IP problems?

      But it was “regulated” so in seven years, barely one request has been filled, for part of one population in one area. I think it was, correct me, for less than a thousand people, less than .2% effective. This law is more than a reaffirmation, it is a repair, to strip away the artificial blocks that prevented that law from actually doing anything.

  12. David

    I find it a very poor and confusing graphic.

    In an earlier post on C-393, you say:

    I’d prefer to rely on reason, and not on rhetoric.

    You then proceed to enumerate some emotive examples, mostly hypothetical, with one concrete example of sharp practice thrown in (which I happen to agree is pretty indefensible).

    I’m sorry, but that’s almost the very definition of rhetoric.

    This debate is complex, and you are delivering one side of it, stridently.

    Apotex, as an eager backer of the bill and (coincidentally) a manufacturer of generics (although I was amused to read about their ‘research division’ – A cure for intractable halitosis! Just what the developing world needs!), has a vested interest in seeing drug patents weakened. But I’m sure they aren’t in it for the profit.

    C-393, as well-intended as it may be, seems like the wrong approach to fixing the complexity.

    1. Daen: you’re right. In this case, the visual does have its fair share of rhetoric (and yeah, it’s very busy).

      But this is because the reasons that the pharmaceutical industry have been using to rebut Bill C-383 have been largely nonsensical (some of which is outlined in the post you linked to). In every case, whether the pharma rebuttal was about loss of R&D, or loss of revenue, or fear of black markets, or delaying the Bill because of infrastructure priorities, or saying that it will increase prices at home, or saying that generic companies are evil too, there is either evidence to suggest the contrary or logic that would illustrate that these counter arguments are essentially inconsequential when examining the specific role of this Bill.

      This is why it’s so infuriating to hear that there is any debate over what should be done with Bill C-393.

      In fact, it’s downright confusing as to why the pharmaceutical industry is pushing back so hard. Certainly confusing enough that it was a question I had to ask of several of my colleagues: ones who live in academic and industry circles that involve law, health policy, business, biotech, economics, medicine, and various life-science fields Some of these were advocates, some of these were simply thinkers, some fueled by passion, and others calculating in nature.

      Here, the cynics generally didn’t have nice things to say, but the ones who weren’t cynics were basically scratching their heads too. Bill C-393 has a very clear, specific and analysed to ad nauseum role that would be of tremendous help in parts of the world that need all the help they can get. It should be obvious.

      And so, the non-cynics assumed that it had something to do with fear. Fear that this Bill represents a small step towards a loss of control – control of the kind that they’re very comfortable with.

      Hence, the hypotheticals and the potentials. This graphic is the attempt to outline what were the “real” reasons for why the bill should not be passed, and of course, they are all hypothetical because this is how they view that loss of control.

      But how can you compare the hypothetical with the very real statistics of individuals living with AIDS? The push back might be confusing, but the choice to pass the Bill shouldn’t be.

  13. I’m not “sure” who made this “graphic,” but somebody needs to inform them that “quotation marks” are not used for “emphasis.”

    In all seriousness though, as a Canadian I’ve really appreciated Boing Boing’s coverage of this story. It’s given me a different perspective on it, and I haven’t heard that much about it on the CBC.

    “Thank you.”

  14. Everybody here know the story of Dr. Banting? He discovered insulin, and its purposes, but lawyers for big pharma tried to steal it from him, saying first that they had discovered it. not him, and a great expense probably, and actually won a court case, but could not actually “find” or make insulin after they won, so it was given back to Dr. Banting by the courts (jeeez sorry doctor), and he was then courted by Americans to “join” their firm, with the insulin of course, or their University, or sell the rights to the drug, or license it so it could be re-licensed to others (incentivized!) at nice profits.

    Dr. BVanting said no. Simply said no. The drug he said belonged to the human race, and it was allowed to made and sold at cost.

    That is why Dr. Banting (and Dr. Best) almost became the Greatest Canadians of all Time (CBC), crazy huh?

    Of course, he wasn’t the greatest Canadian ever, thats Tommy Douglas, he was the force, the drive the mind and heart behind the work that gave Canada Universal Single Payer Health Care. The right to healthcare, without regard to an ability to pay. Nice, really really nice.

    Which reminds me, almost time to kick the tories out of office.


    It’s dishonest to include Viagra’s advertising budget with vaccines and HIV cocktails. Not that the latter don’t get some promotion, but that’s not what’s filling the air with TV commercials.

    And these “trivial” drugs help keep the companies afloat, so you can’t argue that they should spend 100% of their research on humanitarian purposes.


    I can’t find the link, but this is untrue on the face of it. Most “derivative” medicines are already in the development/testing/approval pipeline before the first of their kind is released. Given how long this process is, drugs released within a year (or even more) of each other had to be in the pipeline at the same time.

    Research news and manufacturing techniques tend to get spread around, enabling concurrent drug development among several different parties. I mean, think of how many famous inventors were almost beaten by their (now) lesser known rivals.

    Not that true derivatives are bad anyway; due to things like allergies, immunity buildup, different side effects, etc. I’m sure someone who needs antidepressants doesn’t mind the options available, for example.

    Now, as for the purpose of the bill, perhaps someone can (or has?) run a study about this: How much donated/discounted HIV drugs end up on the black market? Do they make their way back to markets that drug companies sell to?

    If it happens now, then there’s good reason to believe it’d continue to happen on a larger scale if supply was increased.

    That’s all kind of a footnote to the main point of the linked article:

    you would like to live in a civil society where the government can step in and forcibly change the patent

    A system where patents are sometimes protected isn’t really a patent system at all. It’d skew the risk/reward ratio and kill private research in the uncertain areas. To believe otherwise is naive.

    A more appropriate solution would be for the government to negotiate bulk purchases — perhaps even with deferred payment in times of emergency. Or tax incentives for selling certain drugs closer to cost. Anything beats the long-term cost of undermining the patent system.

    (Not that the system doesn’t need some reform to cut down on the number of bullshit patents, but that’s another topic altogether.)


      I can’t find the link, but this is untrue on the face of it. Most “derivative” medicines are already in the development/testing/approval pipeline before the first of their kind is released.

      You’d best find that link, then, because I can find plenty that say you’re wrong. Well, at least not completely right. When drug companies are not finding ways to “repackage” old medicines when their patent runs out (and they may have a few simple tricks to begin with for any new drug that makes it, like its mirror image isomer), they rely substantially on research from universities to come up with new drugs. They do their own research, of course, but it doesn’t seem like there’s a lot of money in being the innovator for something new when so much more can be made on what’s been given to you.

      Stanford Medicine

      Mother Jones


  16. Dr. Banting said no. Simply said no. [Insulin] he said belonged to the human race, and it was allowed to made and sold at cost.

    A lovely story.

    And not entirely true.

    He licensed insulin to a company run by Hagedorn and Krogh in Denmark, the co-founders of what is today Novo Nordisk. There was also some controversy surrounding Banting and Macleod’s award of the Nobel Prize while Best and Paulescu were left out (Banting and Macleod shared the prize money with the other two).

  17. We adopted our daughter from Ethiopia a little over a year ago. She has HIV. Yes, we knew. The medications…are miraculous. You would never know. In fact, if she were tested today, it’s likely the test would come back negative.

    The thought of what she might have faced without the medicine and medical care we have been able to provide for her…well, I don’t like to think about it. I also don’t like to think about the countless other children just like her that we aren’t helping.


    I think this idea (weakening medication patents) is pretty bad. We can villify the pharmas all we want, but they’re the only one’s that have come up with medications that are effective. If it was possible to do it without them, or without the profit motive, why hasn’t it been done?

    As much as I believe in playing by the rules we’ve all agreed upon, I might still be tempted. But what happens in the future, when current medications cease to be effective? Who, having the resources, is going to risk millions of dollars of research on HIV/AIDS treatments when it can assumed that the spoils will be taken from them — if by chance they succeed?

    If you really want to make this situation better, it’s going to take a little more self-sacrifice than finding yourself in a booth on voting day. Donate money to any one of a number of great charities working against HIV in third-world countries. And if you really think it can be done without big pharma, without the profit motive, put your money where your mouth is: form or fund some non-profit organization to develop HIV medications to be distributed at minimal or no cost.

  18. I have to say that this and the previous post on this bill are not particularly convincing, because you’re asking us to just take for granted that your analysis of the consequences of passing or not passing this bill are “obvious” and thus the counterarguments are not even worth examining.

    Give us some actual information to work with here, not just rhetoric. How does this new bill “fix” the old bill? What was wrong with the old bill? What are the counter-arguments, and how can we understand their validity or lack thereof?

    I live in California, and every election season we get a bunch of propositions to vote on, and the proponents’ and opponents’ advertising is full of wildly opposing claims as to the consequences of passing the propositions or not. Sometimes one side is lying, or greatly exaggerating things. Other times both sides have valid points to make, and we have to make a reasoned judgment as to whose claims have greater weight.

    What helps is reading the text of the law, reading the objective legislative analyst’s writeup, reading editorials from trusted news sources, etc. My sister routinely gathers a group of friends to drink alcohol and review the propositions the week before the elections. The point is not consensus, but education.

    These posts on C-393 are basically the equivalent of the paid-for mailers that arrive in droves promising dire consequences of voting NO on a proposition. It’s always interesting to see what the different sides are saying a bill will or won’t do, but all the talk of consequences without explaining how the bill will lead to those consequences (and a corresponding analysis of why the other side’s arguments are flawed) sheds more heat than light.

  19. As a person living with HIV (yes, we’re even here on Boing Boing) I would like to point out that those of us on our meds do not become a separate race of death spreading, sex crazed, zombie like individuals out to destroy humanity, in fact, many of us develop an aversion to sex and intimacy in general as a result of the trauma of infection – many of us suffer from Post Traumatic Stress Disorder in fact. Papers have been written. When we do date, we tend to cautiously seek out those of our own kind out of the very real fear of rejection. Impotence is often a side effect.

    With infection comes education, and an introspective confrontation of our mortality that those of you who are still healthy and uninfected have yet to experience.

    Smokers who cheat death through expensive radiation and chemo drugs do not linger in school grounds pushing cigarettes on children.

    Amputees once given access to artificial limbs do not run amok with knives, hoping to deprive others of their arms and legs.

    Diabetics given access to insulin do not open candy factories out of spite.

    Those examples sound ridiculous don’t they?

    A reduced viral load significantly decreases the chances of transmission. It also allows HIV positive women to give birth to healthy children. That’s why certain AIDS drugs come with pregnancy warnings and are not ideal for those who are pregnant.

    So there you go.

    And now, it’s time for me to take my once a day Atripla pill. I have a life to lead, and at $1400.00 a month, I’m going to make the most of it.

    1. As a person living with HIV (yes, we’re even here on Boing Boing) I would like to point out that those of us on our meds do not become a separate race of death spreading, sex crazed, zombie like individuals out to destroy humanity

      That’d certainly be an interesting twist on the zombie apocalypse genre. (Not a good one, mind you.)

      It’d ruin zombies harder than Twilight ruined vampires.

    2. I completely empathize with your post – and in fact, I wish the meds you require did not have to cost you that much.

      The points you make about your sense of being a responsible person managing life with HIV and the way it destroys your desire for sexual contact is probably the way many in the western world deal and cope with this situation. However, having been privy to the reports of people who returned home after spent some time in places like sub-Saharan Africa where culture and information is so different from what we know, I wonder if one can expect a similar way of “living with HIV”.

      We’re talking about a place where belief systems exist whereby *many* think that sexual contact with virgins, even infant babies, can somehow cleanse one’s self of AIDS. It’s a region where AIDS is widespread to begin with because condom use is low compared to rates of promiscuity, prostitution, sex with underage girls, and even significant rates of rape.

      My point is not to say we should *not* give the drugs to help those stricken with the disease. I just want to take a sober look at the possible consequences of doing so because as I’ve said before, these noble and humanitarian motives may result in some unintended results.
      When you end up with an HIV+ population that is given the means to lead longer and active lives, what are the risks that this enables them to continue engaging in high transmission prone activity?

      By anticipating some of these consequences, one could structure secondary policies that follow the distribution of the meds that prevent unwanted fallout. Increased education, greater access to condoms, etc…

      You may be extremely conscientious about *not* spreading HIV to anyone, but my question is: would a population in West Africa given this newfound lease on life do the same?

      Unlike giving out polio vaccines, these meds do not cure the disease. They significantly extend life and quality of life. In other words, could this well-meaning policy enable the virus to exist longer and present greater opportunities for it to spread into the uninfected population?

      1. So, we should just stop treating all infectious diseases? Or just the ones that affect queers and colored folk?

        1. I kept my discussion free of the kind of garbage you’re injecting into this. I’m disappointed that a moderator would take on the troll’s way of participating in that discussion.

          The initial campaign makes use of manipulative rhetoric waving “dying children” to guilt one into supporting the policy of making the meds widely available. What it doesn’t take into account is the possibility that “dying children” is exactly what this policy may be causing more of.

          1. Your post is questioning if providing drugs will make things worse because of how ignorant West Africans are. When Antinous asks about not treating diseases of colored folk, he’s not injecting garbage, he’s simply pointing out what you actually said.

          2. In a study by Physicians for Human Rights, 25 percent of women and 40 percent of men reported having multiple partners. Despite these numbers, 46 percent said they don’t use condoms during sex.

            Now consider adding 10, 15 years of active and asymptomatic life to those millions infected.

            Then, apply the impact of 10-15 years on absolute HIV transmissions given the first set of statistics.

            Is it so fantastical to see an underlying problem here?

          3. No. It is fantastical to see any solution that involves restricting drugs, which is a form of collective punishment, letting HIV kill them all and God sort out the ones who were responsible for spreading it. If you were proposing solutions like education that didn’t involve letting death take its course, there’d be more of a positive response.

  20. It’s interesting how whenever there is debate over a polarizing issue such as this, many (not all) of the debaters seem to assume that anyone who disagrees with their position is either malicious or incorrigibly stupid so that the end result frequently descends into vitriol, name calling and assuming the worst about the contrarians’ motives.

    Mind you there are generally some participants on either side who keep their strong emotions from clouding their arguments, and I have noticed they are more common here than on much of the blogosphere, but I still wonder why such a strident cross-section of our species seems to be overflowing with bile and incessant rage. Surely being angry all the time cannot be healthy for anyone. Emotions are wonderful motivators, but very poor analytical tools.

    Just a thought. I intend no offense and am not claiming any high moral ground; I’ve lost my own temper more times than I’m proud of.


  21. A few fun facts (if I may imply such a claim to the truth):

    • C-393 does not propose to remove the profit incentive in drug development – individual patents already expire after 20 years. This is one way in which society has chosen to balance discoverer “rights” (and discovery incentives) against other interests of society (consumer “rights”, facilitating further innovation, and so on). C-393 would not abolish patents on medicines. Rather it makes a very specific, limited exemption to their enforcement. This is considered (by proponents) necessary to provide balance in the greater interest of society – for humanitarian reasons as well as reasons of promoting mutually beneficial global economic development. Society has no obligation, nor interest in extending or enforcing patents without limit.

    • C-393 would not constitute stealing from patent holding drug companies: Apotex et al. would pay royalties to patent holders. Not such a bad deal, if patent holders are not currently selling in the intended markets.

    • there is no evidence that parallel reimportation (cross border “black market” for differentially-priced drugs) causes significant harm. Even in situations where this practice is legal (for example, in the EU) patent holding drug companies are still thriving. Given the weak empirical support for this concern, and the certainty of increased death and suffering should we delay in enacting this (I can’t emphasize this enough so forgive the all caps but) PERFECTLY LEGAL legislation, it is immoral to let C-393 die.

    • crucially, re the legality of C-393: compulsory licensing (what C-393 allows) is an internationally agreed-upon* corrective to the harms done by expanding the geographical scope of Western norms in patent law. [*Agreed upon and repeatedly clarified by the architects of this expanded patent regime – search “Doha Declaration” for more on this]

    So, as worthy as is the larger debate over whether (or to what degree) capitalism should drive drug development, it ought to be clear that there is no ambiguity over which choice (pass C-393 or not) is the moral one. We must not permit the predictable, enormous, and grave harms done by the present system to large numbers of largely powerless people to persist. Certainly not on the grounds of highly uncertain harm to relatively small numbers of largely powerful people.

    Please write & call your senators today, for time is short and the stakes are very high, and let’s carry on the debate on other points once C-393 becomes law.

    1. Thank you, mike, for at least attempting to explain what C-393 is *about* rather than jumping straight into querulous and emotive rhetoric about how not passing it makes no sense.

      David, you have done an appalling job of explaining the bill itself. Mike, in one comment, has elucidated its impact better than the many hundreds of words (and one poor graphic) that you have so far expended.

      I tried trawling through your link farm to find the actual text of C-393 and gave up.

      Also, here is an RSS feed of C-393 related speeches and votes in the House.

      The bill is short enough that you ought to be able to explain the impact of each of its sections in less space than you have currently expended on pleading for us to lobby the government: perhaps we can then make our own minds up, once we understand the bill itself, no?

        1. Try reading what mike actually wrote:

          [C-393] makes a very specific, limited exemption to [patent] enforcement.

          [what C-393 allows] is an internationally agreed-upon corrective to the harms done by expanding the geographical scope of Western norms in patent law.

          Clear as a whistle.

  22. I’m disappointed that a moderator would take on the troll’s way of participating in that discussion.

    You’re suggesting that it might be advisable to withdraw treatment that can prolong the lives of millions of people by decades. Possibly long enough that there’s an actual cure. You’re talking about killing millions of people. And I’m a troll?

    You’re missing some pieces.

    1. That is standard risk assessment and it’s the sort of scrutiny that any health policy would undergo regardless of where it happens and who it affects. The simple question was: Could this policy cause greater harm by enabling infection? It’s not about the race. You’re the one reaching for the easy race card to avoid considering that this “fantasy” is not only possible but will probably happen at some yet unknown amount. My concern is that this amount will be considerable and significant. If absolute numbers of infections rise rather than fall because of this, that would be a tragic step backward in the fight against AIDS.

      On the surface, we all want to do what’s right. That’s what the top execs Nestle corporations might have even believed in the 70s when it went down the most disastrous third world baby-killing event. Anyone who would oppose feeding children back then would probably have been thought cruel and callous too. But it turns out in retrospect that not permitting the distribution of Nestle infant formula would have resulted in fewer deaths.

      You’re the one with the head in the sand believing that as long as our intentions are good, we could never do harm. Believe me, if you’re really concerned about the lives of millions, you’d seriously consider this issue on its merit rather than just naively jump at some perceived opportunity to make a “Hitler” insult.

  23. Is it so fantastical to see an underlying problem here?

    The problem is that you’re proposing the death penalty for consensual sexual activity. We could just shoot everyone who develops an infectious disease, but we don’t because we’ve rejected public policies based on sociopathy.

    1. Obviously, I won’t waste any more time with you. It’s too bad you’re not willing to expand the discussion realistically with ways to minimize any potential problems this could engender but rather simply reduce the issues down to a boring internet troll fight where those who don’t see it exactly your way is Hitler.

    1. I don’t understand how you managed to get a camera into my confidential office during a sensitive meeting. Is this part of some kind of Wikileaks scheme?

  24. I may later regret weighing in on this flame war. It takes two to tango but threes a crowd. However, while I emphatically disagree with Lucifer’s prediction that restricting access to treatment will reduce the net number of deaths, I do not believe that e has once proposed murder. E has asked if expanding access to medications will result in greater loss of life from the disease. Enlightened people should not be hostile to the asking of questions; they should answer them. Hostility to a question because of perceived motivations (whether they are correct or incorrect) on the part of the questioner is exactly the kind of ad hominem response that religions and other tradition-bound dogmas (including fascist governments) have used to resist questions for millennia. If you think the answer to a question is obvious, self-evident and righteous, then address the question, not the assumed motives of the person asking it. Reason will prevail.

    On the flip side, the moderator has not engaged in trolling. Trolling implies cynically pushing others’ buttons. The moderator was genuinely outraged at what e believed Lucifer’s question implied. If I had thought that implication was necessarily accurate, I too would have been disgusted.

    Finally, to Lucifer. It is true that more carriers have more intercourse without condoms will increase the incidence of infection. Therefore, the rational action is to encourage the use of condoms. If people still won’t do so, no one can control the sex life of others. When people have consensual sex, they take a risk, and if they are unwilling to reduce that risk by wearing a condom or insisting their partner wear a condom, that is their prerogative. Others could not stop them even if they wanted and had the right to, which they do not. This is not an easily communicable disease. As for nonconsensual sex, HIV infection by rape should be a capital crime since it is, quite frankly, murder. IIRC, in South Africa it already is. If enforcement is lackadaisical, that is a problem that needs to be rectified by the government. I consider the alternative solution, active extermination of the infected population to be reprehensible and I would gladly watch anyone involved in such an initiative hang. Simply denying treatment would not eliminate the epidemic, it would only increase the pain and suffering of those who are infected and those who become infected, and that too is reprehensible.


  25. If the question posed were “should we, at great expense to ourselves, give away the CURE for AIDS?” (if that cure existed)? My answer would be completely in the affirmative. It would be our duty to do so.

    This however is not the current situation.

    The goal needs to be to reduce and eliminate this deadly disease.

    Policies that further this goal are absolutely desirable on every level.

    THIS proposed policy not only fails to fulfill that goal but it has a potential downside – one that had not been brought up, and when I did, it was as if *I* proposed to build gas chambers and death squads… which I wouldn’t suggest in the least.

    Simply, I suggested that if we’re not reducing the communicability of the disease yet increasing the active lifespan in those infected, we’re going to inevitably increase infection rates in the general population! That means we’ve done something to increase the death rate due to AIDS. That’s something we ought to take responsibility for. Relieving the suffering of those currently infected by giving them free meds does not free us from the consequence of affecting the lives of others who will suffer in the future *because* of this policy.

  26. HIV meds significantly reduce the communicability of the disease, in my case my viral load went from 220,000 copies down to undetectable levels (less than 49 copies) within two months. Levels in semen take longer to drop, but eventually reach parity.

    So Lucifer, the communicability of the disease is GREATLY reduced. End of debate. Educate yourself. It is science fact.

    Speak to any medical professional, and you’ll hear the same thing: HIV is now considered to be a chronic illness, NOT a deadly disease. I was surprised at how blasé every health care professional I encountered was about my predicament. HIV is now the diabetes of the new millenia.

    You’re argument is based on fears that are about a decade old.

    HIV is only a deadly epidemic in countries that don’t have access to drugs.

    Will the general population of HIV positive people increase? You may very well be right. Will the suffering and death? No.

    Not if they have easy access to the drugs and the stigma for seeking treatment is eliminated.


    Anyway, all of this is moot as gene therapies are in the pipelines.

    The cure is on it’s way in about 15- 20 years. I can wait, and yes, I’ll still be here.

    Unless I get hit by a truck of course. :)

    1. That’s great to hear. It is amazing how the treatments have progressed but I think the next generation of more targetted (and less toxic) antiretrovirals will be the first step, long before gene therapies, to reduce the cocktail of pills you probably have to currently take, many of which are no doubt to mitigate some of the side effects of the current antiretrovirals.

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