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From The Boston Globe


Injecting Conscience

BYLINE: Steven Levingston

DATELINE: September 7, 1999, Tuesday, City Edition


The Boston Globe Steven Levingston can be reached at

Microsoft mogul Bill Gates recently pledged to spend $750 million over the next five years to buy vaccines for millions of children in poor countries. In a single breath, he ignited the hopes of despairing parents in underdeveloped nations who can only watch helplessly as their sons and daughters die of diseases that barely touch children lucky enough to be born in rich countries.

Consider this from the Economist: "Of children who die before their fifth birthday, 98 percent are in the developing world. Of the millions who die prematurely of tuberculosis, malaria, measles, tetanus, and whooping cough, all but a few thousand live in the poor world."

Gates' generosity is aimed at creating a market for vaccines to entice the behemoth pharmaceutical companies to deliver products to those who desperately need them. If the drug makers could be convinced that a market does - or will - exist, then perhaps they might be willing to develop remedies for diseases common to poor nations instead of focusing their research almost exclusively on rich-world afflictions. The World Health Organization says that $56 billion is spent each year on health research, with less than 10 percent going to diseases that afflict 90 percent of the world's population.

One scourge in particular, malaria, continues to plague the poor nations of the world because those who produce vaccines see no possibility of a profit.

It seems there is no other motive for a drug company. Don't bother mentioning the words "social conscience" to a pharmaceutical bigwig. He'll look at you with a glare that's the visual equivalent of a lethal injection.

Not long ago, I was doing my usual volunteering on Sunday morning at the Soup Kitchen for Corporate Executives Who Were Stupid Enough to Speak From the Heart, when I bumped into an old acquaintance. He had, by diligence and degrees, climbed the ladder at a well-known pharmaceutical giant. I couldn't imagine how he had fallen on such hard times. As I ladled breakfast gruel into his tin bowl, I could see he needed to talk. So I sat down with him.

"I had a crazy idea," he began, "so I wrote a memo to my boss. I told him, 'Let's do it! Let's do something for the common good of man! Did you know that 200 million people suffer from schistosomiasis, a parasitic disease of the intestines or bladder - and hardly any of them are in the United States or Europe? Another 120 million suffer from lymphatic filariasis, another parasitic ailment that causes painful, disfiguring swelling. And what of malaria, river blindness, AIDS? Darn, I said, we're a drug company. We can do something about this.' "

"Heck, it makes good business sense," I pointed out. "I reminded him that countries plagued by bad health can't develop economically. After all, companies need healthy workers to turn healthy profits. If we can improve life for these people, we can build our own market, create our own demand. As people get healthier and more prosperous, they will have the money and desire for more and better drugs of all kinds - and here we are to supply them. Imagine, everyone wins!"

"A simple enough proposition," I told my down-at-the-heels acquaintance.

"Too simple," he said. "My boss scribbled me a note."

"Offered a few ideas of his own?"

"He spoke for the entire drug industry," my acquaintance muttered, adding, the note said, "Too much trouble. Profit's not there. Let them die. "

"Hmm," I said. "Not very encouraging."

"He wrote one more thing: 'P.S. You're fired.' "

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