- Patents and Progress
An academic paper, like a good story, has a beginning, a middle, and an end. But they don’t have to be in that order. Instead of laying out reasonable assumptions, followed by a careful argument that arrives at a plausible finish, I will start with an implausible conclusion, then try to justify it. This order might diminish the theatrical effect, since there is no build up to a dramatic finale, but it gains in clarity of purpose. My conclusion is this: We should eliminate all patents and other forms of intellectual property (IP) rights in medical research. All research should be publicly funded, all testing and analyses done by public agencies, and all research results publicly owned.
Most countries in the developed world have some form of socialized medicine and their publics would not dream of abandoning it. I will try to make the case for extending socialized health care to include the socialization of medical research. There have been numerous critics of the current situation in medical research and a number of different proposals for dealing with the problems. I will briefly discuss some of these alternative views.
The antibiotic situation today is not as good as it was around 1950. The problem is entirely due to drug resistance, which is the inevitable result of Darwinian evolution. Gonorrhea, for instance, is now treatable by only one antibiotic; soon there will be none. Is the market model for medicine making the antibiotic situation worse? Let us imagine that market-driven medicine is working as well as its free-enterprise champions might dream. The market model, according to its proponents, encourages innovation in research, it encourages bringing new products to market as quickly as possible, and it [End Page 505] encourages the maximum use of those products. In almost any field of human endeavor this, arguably, would be a good thing. Not so when it comes to antibiotics. Innovation is a good thing, but not the maximization of sales or the widespread use of antibiotics, including the non-therapeutic use in animal feed. All of this is part and parcel of the normal market model. Indeed, it’s obvious. The medical problem is almost equally obvious: each of these features, which are virtues in any free-enterprise environment, contributes to the overuse of the product and hence to increased resistance of the organisms that are the target of the product. This is very much to our disadvantage.
There is a consensus—which includes drug companies themselves—that this is a market failure. We must certainly continue to do research on antibiotics, and new ones are very welcome. However, we must sell less, use less, and only reluctantly introduce new antibiotics as they are needed. They should not be used non-therapeutically in animal feed at all. We will soon face the situation of having no antibiotic treatments for gonorrhea and, more generally, things will get worse. Currently in the USA alone, about 23,000 people die each year from drug-resistant infections. According to Dame Sally Davies, the Chief Medical Officer for England, “Antibiotic-resistant Diseases Pose ‘Apocalyptic’ Threat” (2013). It should be quite obvious to all that free enterprise cannot solve this medical problem. All of its impulses are in the wrong direction.
Who should step in? Having tipped my hand in the opening paragraph, I don’t have to answer explicitly. Readers are, however, encouraged to think of alternatives and to weigh them against my proposal to eliminate IP rights and publically fund medical research. When discussing a mix of scientific method and social policy, no answer is going to appear clearly and definitively right. But a fairly objective ranking of the proposed alternatives is possible.
3. Deciding the Issue
Most of my suggestions concerning antibiotics are not novel. Not only have the problems been repeatedly described by specialists, the topic has even made it into the editorial pages. In response to a recent US FDA (Food and Drug Administration) request for voluntary reduction of antibiotics in animal food, The New York Times declared: “A move to end the use of antibiotics to promote growth, while a strong...