Lives Of The Poor And The Nobel

Earlier this week the Nobel Committee decided to award the 2015 Nobel Prize in Physiology or Medicine to Dr. William Campbell and Dr. Satoshi Omura, "for their discoveries concerning a novel therapy against infections caused by roundworm parasites," and to Tu Youyou of China, "for her discoveries concerning a novel therapy against malaria."
Dr. Campbell and Dr. Omura have helped many potential patients who would have suffered from river blindness and lymphatic, mosquito-born diseases. Dr. Tu's work has contributed to a decline in the mortality rates of malaria patients. Malaria, river blindness, lymphatic filariasis and other diseases caused by roundworm parasites all disproportionately affect developing countries. More than 99 percent of this burden is carried by underdeveloped nations.
The recent Nobel announcement refreshed memories from my doctorate years. About 15 years ago, I was writing my dissertation on economics. My advisor, Dr. Michael Maloney, and I had decided that an analysis of pharmaceutical companies' research and development (R&D) investments would be a good one. It would hopefully land me a good academic position and also offer some useful policy implications. We started to work on the topic. Essentially we were looking at the factors affecting multinational drug companies' R&D investments by using standard statistical methods. Our analysis suggested that drug companies were motivated almost exclusively by profit, concentrating R&D funding where the profit potential was the highest. In particular, companies were focusing on rich-man diseases.
The drugs for cancers and cardiovascular diseases had priority. Diseases such as malaria, tuberculosis and river blindness were not making the cut, since neither their sufferers nor their states had the resources to pay for expensive would-be drugs. This reality simply confirmed previous studies on the topic as well as conventional wisdom, but since I had utilized a novel methodological approach I could still finish my Ph.D. and later publish my findings in a peer reviewed journal.
However, there was one odd result that I did not emphasize since I did not have any coherent explanation. If a disease was prevalent in developed countries but not in underdeveloped ones, the drug companies would pour R&D money into that region. The opposite was also true: Diseases that were prevalent in poor countries but not in rich ones would not receive any R&D investments. However, the interesting result was that if a disease was prevalent both in developed and underdeveloped countries, it still received fewer investments than are made in diseases prevalent in rich countries but not in underdeveloped ones. That is very difficult to explain with standard economic logic, let alone ethics. The results suggested that the diseases of the poor were so loathsome to the international drug companies that even if there were many rich patients suffering from the same health problems, they still would not invest in them. I guess I could come up with some stories involving public relations concerns as well as pressure from national and international bodies about this disdain for poor-man diseases. As a trained economist from an institution nicknamed “Little Chicago” to indicate very strong beliefs in free market ideology, I was still appalled by the pure profit motivation of drug companies. I was totally aware of the fact that they were, almost by definition, only chasing profits. However, I could not accept the fact that baldness (a health problem I happen to have) attracts the attention of scientists more than many of the diseases that kill thousands of people in Africa every year.
Since then, I have followed other pursuits, but am glad to see that the situation is getting a little better. International bodies and philanthropic institutions have developed novel mechanisms to encourage research and development on the diseases which disproportionately affect poor societies. Push and pull types of incentives support both the input and output of R&D in these areas. Moreover, it looks like international pharmaceutical companies have a new interest in these diseases. Even if I am not certain about their intentions, it is still a good thing.
So, as an economist who believes in the power of profit motivations with their good and bad consequences, I watch these developments with delight. However, none of these would have the same level of impact as genuine human concern. The scientist is also motivated by money, power, glory and genuine concern for their fellow humans' well-being. Even if a modern pharmaceutical research project is incredibly capital intensive and very costly, the ultimate determining factor of human success is creative human effort. The more those bright minds focus on the real problems of humanity, even those that offer no great earning potential, the sooner those problems will be solved. Thus, I wholeheartedly applaud the Nobel committee on their decision to reward work on diseases of the poor. Not only do Dr. Campbell, Dr. Omura and Dr. Tu rightfully deserve the awards, but researchers who are breaking ground in other areas where profit potential is not very high also need every bit of encouragement possible.

ABDÜLKADİR CİVAN (Cihan/Today's Zaman)