With COVID-19 bringing into stark view the inequality that surrounds access to medicines around the world, Youth Stop AIDS campaigner Jash Shah reflects on how human life and ethics are side-lined in the face of profit.

Life over profit.

Money, not morality is the principle of commerce in civilised nations. For too long, there has been a divorce between ethics in relation to; politics, business and international relations.  This is evident as leaders and CEOs look at prudence instead of humanity – they look at profit or loss while forgetting about life and death. Hence, by bringing in morality and focusing on what is right, there is power to save lives as well as furthering interests of states and businesses. Human civilisation on the whole is much more complicated than a balance sheet, thus more needs to be done in the name of progress for humanity not just the powerful.  

The first prominent ethical introduction to international relations was brought by Peter Singer. He states that; suppose there is a child drowning in the pond – you are the only one there that can save him and if you don’t the child will certainly die. From this scenario Singer proposes the question; how should you act? Do we have a moral duty to get into the pond and rescue the child? The majority of people would believe that saving the child is morally required and it is a good thing to do as the cost to saving the child is insignificant compared to the cost of the child dying. 

Now if we relate the above example to medicines, shouldn’t pharmaceutical companies be morally required to provide lifesaving medication at an affordable price if the costs of providing medicine are insignificant compared to the costs of millions of people dying?

If the cost of saving lives would be minimal to the pharmaceutical companies in terms of loss of profit shouldn’t they be morally obliged to provide lifesaving medication? What Singer is trying to show is if a person or country has the capacity to help another, while only incurring a minimum cost to themselves in doing so, they are morally obliged to help. So if charging lower prices or wavering patent clauses and allowing lower-income countries to access cheaper forms of HIV drugs will only cause Pharmaceutical companies to lose about 1% of their revenue, shouldn’t they reconsider their policies that have caused many deaths due to expensive drug treatments as they have the capacity to help millions of people while only personally incurring a small cost? 

Some people may argue that high costs are necessary to fund research and development, resulting in more treatments and ultimately protecting us from illness. This may seem logical until you look at where most of the research is directed and where these companies really spend their money. 

Firstly, pharmaceutical companies have no real incentive to fund medicines that primarily effect people in lower-income countries as this is not where they can make their profit. So, if we continue the cycle of high prices to fund research (which develops medication only for richer countries) then medicines will continue to be missing for billions of people. But if governments spend a fraction of their GDP to fund research that can be directed to support lower-income counties, the cost of millions of lives being saved will be insignificant to the loss of GDP. Ultimately this shows that governments in higher-income countries have a moral duty to help provide these medicines as it is well within their capacities and we can’t keep relying on profit motivated pharmaceuticals. Another reason governments should step in is because a large proportion of pharmaceutical income is spent on marketing and a lot of life saving drugs comes from publicly funded research. Tax payer money should not be funding pharma profit. 

To add on to the above notion, Thomas Pogge, another prominent philosopher that explored ethics and international relations, advocated for a Health Impact Fund. The hope of this fund is to incentivise the production of medicines that help people with all sorts of illnesses not just ones that occur in higher-income countries or ‘the West’. An example of this would be to incentivise production of malaria medication rather than simply focusing on a new fancy headache relief medication. Thus, the Health Impact Fund would create complementary incentives that delink the price of medicines from the fixed costs of innovation and cover the latter through health impact rewards. This would hope to direct research where it is most needed, not just where there is most profit to be made, while also ensuring prices of medicines are kept low and affordable. 

In conclusion, we must move from a profit-oriented mind-set to a more humane mind-set if we want the world to receive proper healthcare. In order to do this, we would need to abolish the patent system that keeps profits and high prices as a priority rather than providing the right medications. Instead we need to replace it with a system like the Health Impact Fund which incentivises maximising social welfare over profits. All in all, we need to ensure that life is considered over profit! 

Learn more about the work Youth Stop AIDS are currently doing on access to medicines here