Dating well back before Sister Catherine Sienna drummed it into our heads at Immaculate Heart of Mary elementary school, I knew that I was commanded to love both my neighbor and my enemy. The instruction I received referenced the Gospels of Mark and Matthew . But similar decrees come from the Torah , the Koran , and other sacred texts.
When I think of pharmaceutical corporations, I reflect on these obligations. I particularly think about them when I run across news of Eli Lilly and Company.
The enemy context is kind of obvious. It is important in access to medicines advocacy to keep the eye on the prize: the goal is the widespread embrace of essential medicines as a public good and a moral imperative, not to take down pharmaceutical corporations. But there is no avoiding the fact that those corporations are the chief obstacle to change. They are the only winners in the current inhumane system, where 10 million people each year die because they could not afford the medicine that would have saved them.
And the pharma industry fiercely defends the dysfunctional status quo. It relentlessly pursues extended monopolies on medicines and uses purchased political muscle to erect barriers between patients and affordable generics. It leverages for its own profit massive taxpayer contributions to the discovery and purchase of medicines, and is largely indifferent to the critical health needs of the global majority that cannot afford to pay huge drug prices.
So I am certainly not surprised when I read news of a pharmaceutical corporation engaging in harmful practices that hurt patients. But I cringe with a little extra disappointment when the pharma corporation overreach includes Eli Lilly. Which, unfortunately, is often the case. A quick summary of some of the recent Lilly scandals:
- Lilly is at the center of the shameful triple-digit price hikes and market exploitation of insulin, a drug whose patent was sold by its inventors for $3. One U.S. Senator calls the insulin situation “price-gouging, plain and simple.” A class action lawsuit and public officials have alleged price collusion between Lilly and other corporations.
- The company serves as Exhibit A for the dangers of the democracy-busting Investor-State Dispute System in trade agreements, having sued Canada for $500 million under NAFTA because that country’s elected government and courts dared to allow Canadians to obtain generic versions of lifesaving mental health medicines.
- Endless TV commercials for Eli Lilly’s Cialis erectile dysfunction drug--the most-advertised brand of recent years--illustrate the upside-down priorities of the current medicine system, where saturation marketing of non-innovative drugs for the global wealthy dwarfs the industry’s investments in meaningful research.
- The company was convicted of criminal charges and forced to pay a $1.4 billion penalty for illegally promoting one of its top drugs for non-approved uses, a practice that the Harvard Medical School professor singled out for harsh condemnation for the danger it placed on patients. It was also a practice that email messages suggested that a top company executive directly encouraged. That executive was later promoted to CEO.
I could go on. But you get the idea, and I would rather not go on. Because Lilly is not just my "enemy." It is my neighbor, too.
I live in Indianapolis, Indiana, USA, and was born and raised here. So was Eli Lilly and Company. All of my life, Lilly has been the core business presence in our community. I see every day the positive impact of the company’s direct and indirect philanthropy and the benefits flowing from its employment of over 10,000 workers in and around my hometown, most of them in good-paying jobs.
For me, that positive impact is not an abstraction. I played with childhood friends whose homes were bought with their parents’ Lilly paychecks. In adulthood, I still know plenty of families whose livelihood is dependent on Lilly salaries. When I worked for a non-profit global health program, I went asking for donations of cash and medicines from Lilly and other pharma companies, notably Abbott/AbbVie. Largely, the companies came through, and the resulting gifts saved lives.
The Lilly employees I know are unfailingly kind and generous. My guess is that most of them wake up every morning and head to work believing in their employer’s mission statement. According to that statement, Eli Lilly and Company is devoted to “unite caring and discovery to make life better for people around the world.”
But the track record does not support that claim.
Eli Lilly and its companion pharmaceutical giants have gone all-in on a business model that makes record profits and pays CEO’s exorbitant salaries, all while perpetuating suffering and death. There is a jarring dissonance between the good people I know in the industry and their employers’ corporate behavior. And it reminds me of what several current and former pharmaceutical company employees have confided: they started their jobs with high hopes that they would be discovering and developing lifesaving drugs, only to learn that their talents would be devoted to products and strategies that elevate profits above health.
The current medicines system is unsustainable, both financially and politically. The U.S. government has been propping up the profit-focused approach, but now a huge majority of the U.S. voting public is furious about sky-high drug prices, an anger even Donald Trump tapped into. Massive reform is coming.
I am not sure what that will mean for Eli Lilly and Company. The venerable Jamie Love of Knowledge Ecology International, who has been on the front lines of the medicines access struggle for decades, says that pharmaceutical companies can survive the shift. But they will need to rededicate themselves to true innovation of the most impactful medicines, as opposed to pushing duplicate drugs, buying TV commercials, and extending monopolies.
The economist Dean Baker has suggested that a better model for drug development and manufacturing would be for private companies to bid for government contracts, as is done in the defense industry. After all, the most critical medicines research is already government-supported. Under this model, the companies can still make good profits, but the medicines would be available at far lower cost and there would be no platform for monopolies and the price-gouging that comes with them.
For the sake of my neighbors and my community, I hope Lilly can adapt to a changed environment. Heck, I hope the other pharma corporations can, too. There are good people working there as well.
But, for the sake of the millions who suffer and die because of the industry’s current toxic business model,I hope even more fervently that this change comes very, very soon.
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