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In an attempt to discourage the cross-border flow of reasonably priced pharmaceuticals, the FDA recently announced fears that terrorists might target foreign drugs bound for the U.S. But for millions of needy Americans, the Bush administration’s friendly ties with health industry CEOs constitute a far greater danger. Now that Western intervention has brought Afghanistan boundless prosperity and the Iraqi model of freedom and democracy is inspiring backward Arab nations to abandon their despotic ways, the Bush Administration has seen fit to open up the next front in the War on Terrorism in the world's newest rogue nation: Canada. Our northern neighbor continues to provide safe haven that most loathsome of threats: affordable prescription medications for sick Americans. Good news for patients, but a danger to drug companies with an interest in keeping American drugs the most expensive on the planet and the deep pockets to buy politicians. After sustaining sufficient embarrassment over their charge that Canadian drugs were too “unsafe” for Americans to reimport, the FDA -- who has recently intervened in three lawsuits on behalf of potentially unsafe medical products -- announced a new reason for keeping inexpensive medicine on the far side of the border: terrorists might tamper with them. Citing unspecific “cues from chatter,” FDA Commissioner Lester Crawford declared on Aug. 11 that the threat from terrorists was now his most serious concern about Americans importing Canadian drugs. “Nothing like this has ever happened,” Crawford admitted when pressed by Associated Press reporters, “But it is a source of continuing concern.” The “terror threat” warning is the latest in a series of the allegations the FDA has made to justify its hard-line position against allowing drug reimportation that would pose a threat to exorbitant drug manufacturer profit. Administration claims that Canadian drugs, many of which were manufactured in the U.S. to begin with, are dangerous have been dismissed by everyone from municipal governments to the United States General Accounting Office. Canada earned a perfect score in June survey of online pharmacies: every one required a physician's prescription and came with proper labeling, patient instructions and warnings. By contrast, 24 of the 29 U.S. pharmacies surveyed didn't even ask for a prescription. Unsubstantiated claims of possible safety issues can't pose any more of a threat than that already faced by the 23 million Americans who are forced to do without medicine they can't pay for every year. The consequences are horrific. “I see it every day in the E.R.,” Dr. Robert Stone, an Indianapolis physician, told a crowd during a rally in support of universal health care, “a patient comes in with high blood pressure, but he can't afford the medication. A week later he's rushed in with a heart attack or stroke. There is no safety net." The administration's policy, implemented at the (sometimes ultimate) expense of low-income Americans, does serve a distinct purpose: protecting drug industry profits from price competition. The pharmaceutical industry is the most lucrative in America, the top 10 firms netted $36 billion in 2002. Americans have to pay more for medicine than anyone else on Earth, and the drug companies need special favors to keep it that way. Spending $96.4 million on an army of lobbyists during the same year -- including 26 former members of Congress -- buys you a lot of clout in Washington, and it shows. The once-subtle trend of Washington agencies intervening on behalf of the very industries they are supposed to regulate has become increasingly transparent under the Bush administration, providing some of the most odious examples of state-sanctioned gouging. In late July, the National Institute of Health handed down a death sentence to AIDS patients on the drug Norvir when it refused to provide for cheaper generics. Abbott Laboratories, the manufacturer of Norvir, hiked the price of its drug 400 percent in December, from $54 to $265 per month. Outraged patients and activists begged the NIH to make available generic versions of Norvir, which was developed with $3.4 million in public funds. Under the 1980 Bayh-Dole Act, NIH has the authority to grant licenses to other companies for the manufacture of drugs developed with federal funds to assure access. But the NIH refused them in a July 29th opinion, explaining that providing medicine to patients with a life-threatening condition wasn't worth “alter[ing]” the “market dynamics” of the drug industry. Lending further irony to the FDA's insistence that its Canada ban is motivated by concern for the safety of the American people, the agency has begun intervening in injury lawsuits on behalf of the manufacturers of allegedly unsafe products. When a Pennsylvania man's heart pump fell apart inside his chest, allowing an air bubble to enter his brain and kill him, his widow sued the manufacturer. Instead of allowing a judge to decide the merits of the case, the FDA stepped in, arguing that it was the Alpha and Omega of product safety. Once the minimum standard, the FDA now says its own approval “sets a ceiling” for consumer safety conditions, and any product it has given the nod to is safe beyond question. Shockingly, the FDA claimed that threat of lawsuits against unsafe products "can harm the public health" because the manufacturers might withdraw their products, thereby causing the “underutilization of beneficial treatments.” A Third Circuit Court of Appeals judge agreed, dismissing the widow’s lawsuit in a July 20 ruling. The mutual back-scratching between government and health-industrial complex shows no signs of slowdown. On Aug. 11, the Ohio State Board of Pharmacy, the agency which licenses and regulates drug merchants in the state, teamed up with the Ohio Pharmacists' Association to launch an “educational campaign” to warn residents that Canadian-imported drugs are “unsafe” and illegal. The FDA and the National Association of Boards of Pharmacy are sponsor the campaign together, already active in 15 other states, in effect using taxpayers’ money to deny them affordable medicine. Whether or not the claims of a terrorist threat will have an effect on Canadian reimportation remains to be seen, but some inevitable conclusions surface. It is an administration that aggressively conspires with business interests to keep prices so high as to be out of the reach of the most needy that presents a greatest threat to Americans, rather than the terrorists that they insist are there. The administration's brazen disregard for human life, the demonstrated priority of profits over people, these represent the most heinous results of the collusion of state and corporate power. They are a testament to the failures of market medicine, of politicians too crass to recognize the difference between health care and car stereos. And they are an illustration of the need to take a new direction in American health care, away from the bottom-line inhumanity inherent in for-profit medicine. The only worthy goal should be full care for every person: the hallmark of a healthy society. Nicholas Skala is a Health Policy Research Associate with Physicians for a National Health Program. He can be reached at: nick@pnhp.org.
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