Affordable medicines, affordable justice

Tommy Dharmawan ,  Jakarta   |  Mon, 11/02/2009 1:47 PM  |  Opinion

Oct. 6, 2009. It was 3 a.m. when the phone rang at the home of Elizabeth H. Blackburn. Blackburn received the phone call from the Nobel Prize committee. Blackburn, along with her colleagues, Carol W. Greider and Jack W. Szostak, had just been named the recipient of the 2009 Nobel Prize for Medicine.

They never expected their work would receive the Nobel Prize.

"When we started the work, of course, we were really just interested in the very basic question about DNA replication, how the ends of chromosomes are maintained," Szostak said in an interview with the Associated Press.

"At the time, we had no idea there would be all these later implications."

The trio solved the mystery of how chromosomes, the rod-like structures that carry DNA, protect themselves from degrading when cells divide. The Nobel citation said the laureates found the solution in the ends of the chromosomes - features called telomeres that are often compared to the plastic tips at the ends of shoe laces that keep the laces from unraveling. It was the mechanism by which it adds DNA to the tips of chromosomes to replace genetic material that has eroded away.

Their research triggered many more on cancer drugs, driven by their discovery of telomeres. Szostak says telomerase is very active in many cancer cells, "and if you turn it off or destroy the cells which have this high activity, you could be able to treat cancer".

The Nobel committee says there is a lot of work yet to do to develop therapies for blood, skin and lung disease based on the winners' breakthroughs.

Later on, many pharmaceutical companies began to investigate new cancer drugs based on telomere research. Many new cancer drugs came to the market and many doctors began to prescribe the drugs. But can all patients really afford to buy the new cancer drugs, since the development of new drugs needs a lot of research, and research needs a lot of money?

Who benefits from the science, from the research by Blackburn and her colleagues? Who benefits from the development of cancer research? Is it only the rich who can use it? Is it people from developed countries, or people all around the world, irrespective of their origin, who can benefit from the scientific developments? It is a big question for us to answer it.

In Indonesia, there have been a lot of advertisements for new vaccines for the human papillomavirus. HPV can cause cervical cancer. The development of the HPV vaccine was also triggered by Blackburn and her colleague's research on telomeres. It seems a miracle that a tiny HPV vaccine can save many lives. But did you know that only a small percentage of Indonesian people can afford it? The price for one HPV vaccine is almost US$100. Only the rich can afford it.

The commerce of science creates a disparity between those who can afford new developments and those who cannot, especially in health science. Pharmaceutical companies race to make the newest and best treatment against all diseases.

When they get a result, they must sell the new therapy at no cheap price. It is not their fault, because to make the new drugs takes a lot of money.

The other reason for the disparity is the lack of agreement between countries to make equal and fair agreements about science and technology transfer. For example, avian flu is a problem in developing countries, which agree to send the virus specimen to developed countries.

Then pharmaceutical companies from developed countries make a vaccine for it. But the irony is the companies sell them at expensive prices to developing countries. It is unfair. Developing countries are supposed to have the right to benefit equally from virus specimens that they have shared.

Affordable new medicines for everyone are what we need, to make a just, prosperous, sustainable world for all, because all people have the right to benefit from scientific development.

The government can subsidize the production costs for new drugs that are not cheap. Developed countries that have the technology to create new drugs can agree to transfer their technology and expertise to developing countries. The United Nations also can support the fund to develop new affordable drugs for all countries.

Science is useless if only those in any one part of the world can benefit from its development. These problems are not easy and need major commitment from all parties. We must be aware of how important safe, affordable science is for all. Now is the time to make that science more just, prosperous and sustainable for all. Viva science!

The writer is a medical doctor and graduate of the University of Indonesia, and a Leiden University scholar in cancer research.

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