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by Andy DellaRocca/PNN Media intern
"Andy, grab yourself something to eat." I was startled to hear somebody
call me by my first name. How did this woman know my name? Why was she so
concerned about my diet? I then remembered the name tag that I had been
given at the front entrance, on which I wrote "Andy: Poornewsnetwork." The
tag hung from my upper chest, and as I sat in the wooden fold-up chair in
Susan Cieutat's living room, I pondered how nice it would be if we all wore
name tags, all of the time. "Please, you must be hungry."
I wasn't at all hungry, I had just eaten. But after a third person
requested that I take advantage of the platter that was spread out in the
dining room, I rose and squeezed past the others to arrive at the table.
There before me stood a table full of bagels, cream cheese, and fruit salad.
"Have you been eating enough fruit?" rang my mother's voice in my head,
and despite the affirmative responses I've always given her, I knew that I
hadn't been, so I filled my plate with blueberries, bananas, melon, and
apples, and went back to my seat. I ate the food quickly, eager to get back
to reading the pamphlets that were handed to me concerning Oregon's
comprehensive Health Care Finance Act, Universal Health Care in San
Francisco, and the Universal Single Payer Health Care Resolution. As I read
these, and ate my fruit, I thought about how justified my mother's concerns
were, both that I was living without a health plan, and that I didn't eat
enough fruit.
"I have to pay $100 dollars to find out if I still have cancer? That's
immoral," Jose Ramirez, a Cuban emigrant, now living in the United States,
told us he had said to a doctor from whom he received treatment in the past,
and who had presented to him a bill for a medical exam. We were all
introducing ourselves, and when I heard the statement by Jose, I realized
that I'd better start the tape recorder.
Health Care For All San Francisco, a local non-profit group, was hosting
this event in Susan Cieutat's living room. Amongst the tall bookcases that
lined the walls of her bright home sat about 25 adults of all ages, who
represented a variety of organizations such as the Gray Panthers, Neighbor
to Neighbor, and Health Care for All. The featured guest was Anne
Sunderland, who works for the Institute of Global Health at the University
of California, San Francisco. She recently attended the World Health
Organization's conference on biotechnology and health in Havana, Cuba, and
was here to speak about Cuba's biotech industry, as well as the state of
health care around the world. My tape recorder whirred as she stood up to
speak.
"Although it's relatively easy to be unaware of this while living in the
United States, we are really living in a time of great crisis in terms of
health around the world. And this crisis is fueled in large part by what
are referred to as 'diseases of poverty'. These are infectious diseases
that disproportionally affect poorer regions of the world."
Her discussion had begun, and she outlined for us the statistics that many
of our brothers and sisters are coping with in the more impoverished areas
of the world. Ten to fourteen million people dead of infectious diseases
each year, 90% of whom live in developing countries. Sixty-five to 75% of
the 40 million individuals infected with HIV live in sub-Saharan Africa.
Ninety percent of the one to two million malaria deaths that occur each year
are children, under the age of five, living in the same region. And two
million people die each year of tuberculosis. The numbers are astounding.
"Imagine looking around the room today and knowing that, without a doubt,
one in every four of us was HIV positive."
The room was overwhelmingly filled with middle-class white folks, and I was
fairly confident that very few of those around me, if any, were infected
with the virus. In sub-Saharan Africa however, almost everyone would be
poor and black, and one in four would be positive.
"How many of you in the room have been impacted by tuberculosis, or have had
a loved one impacted?" Anne asked.
Two hands went into the air, and one of the women that raised hers conceded
that it were elephants in the zoo which she knew were infected.
Anne explained that much of the disparity between health care systems around
the world is due, in large part, to the lack of biotech industry in
developing countries. Biotechnology is the application of biological
knowledge and techniques to create new products and technologies. It is the
medical implications of this technology that is relevant to international
health. Vaccines, for example, are a biotechnological creation. The
establishment of biotech industries in richer countries, and the absence of
such industry in poorer ones, has been labeled the "genomics divide."
"Only 1% of the new drugs that were brought to market between 1975 and 1997
were developed specifically for a disease of poverty. Why is this
happening? Well, essentially, most of the biotech capacity, in terms of
technology and infrastructure and funding and trained scientists, just
resides in the developed world. Many of these resources reside in companies
of the developed world which function in market economies, where making a
profit is the overwhelming objective.
"Despite the huge numbers of potential patients in the developing world for
treatment for a disease of poverty, they don't necessarily represent BUYERS,
or customers, in the fact that neither they, nor their government in many
cases, can afford to pay the prices that the drug companies feel they need
to charge to recoup their investment costs to get a profit... to give you
the background of the INDUSTRY perspective of why this market failure has
occurred and is continuing to occur."
Cuba is important because it stands as an exception to the rule of the
genomics divide. Cuba's biotech industry is extensive. This is due to the
country's leader, Fidel Castro's, commitment to health and the health
sciences and his continued investment in the biotech sector. Even during
the 1990's, after the collapse of the Soviet Union and the economic aid for
Cuba that went with it, Fidel put one billion dollars into the industry.
What has been the result of this investment? The development of original
vaccines for certain forms of hepatitis and meningitis. The production of
generic drugs which have been exported to regions of the world where the
high prices demanded by the biotech corporations of the industrialized world
cannot be paid.
Cuba's health system has treated many individuals from outside of Cuba.
Persons from the Ukraine, who were affected by the Chernobyl disaster, went
to Cuba for treatment. Many Americans have likewise been treated by the
Cuban health system.
"We are really talking about a needs-based system where the health needs of
the citizens dictate what products are researched or developed by the
industry. The meningitis vaccine, for example, was developed after an
outbreak of meningitis in the 1970s."
As she said this, I couldn't help but think about the way that the market
has failed to address the health needs of the capitalist world. At POOR, we
once discussed "sleeping sickness," a disease for which there is a very
simple treatment. However, many people throughout the poorer regions of the
world continued to die from the disease. The cure, in the meantime, was no
longer being produced, because it was deemed unprofitable. Once the drug
was discovered to help relieve acne, however, companies began to produce it
once again. Only because well-to-do adolescents were worried about
"pizza-face" were impoverished individuals in the poor world allowed access
to the easy treatment of sleeping disease.
The state-run health system of Cuba, which is free to all of its citizens,
has resulted in infant mortality rates and life expectancy rates almost
identical to those in the US, "despite the fact that Cuba continues to live
in what we consider third world poverty, in terms of material poverty,"
emphasized Anne.
The successes of Cuba's health sector lies in stark contrast to the
deficiencies of the United States health care system, where I've been denied
coverage because of a past bout with bronchitis, and where Jose needs to
fork over $100 for his doctor to tell him the results of his cancer test. I
looked around the room and saw many seniors in the chairs, listening to Anne
talk. Some of them may be dealing with health issues as we speak. Perhaps
their retirement portfolios have dissolved in the wake of the Wall Street
scandals. Who is going to provide them with the necessary health care? If
I break my foot and can no longer work my job, will I need to go onto the
street because I can't cover my medical expenses?
Health Care for All has been advocating a Universal Single Payer Health Care
Resolution for the state of California. To learn more, check their website
at www.healthcareforall.org.
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