Thursday, April 18, 2013

Marathon Max: Boston and Beyond

My good friend Max Elbaum has many good friends, more than most. All of us thought of Max somewhere in the swirl of reactions, shock and grief, brought on by the horrific termination of this year’s Boston Marathon. Max wasn’t running this year, but he had in recent years, and we shared his exhilaration and pride in the “good time” he achieved in his 60+ age group. Max dedicated all his marathon runs to garnering support for War Times, an online anti-war publication that he helped found early on during the Iraq and Afghanistan wars.

Today’s post is a sharp mood swing from my last one. Here is Max’s letter to his friends:

To My Dear War Times Comrades and All Friends,

Though using the gender-biased terminology of 1624, John Donne's Meditation 17 seems to me as if it could have been written in the first hour after Monday's carnage in Boston:

"No man is an island, entire of itself; every man is a piece of the continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friend's or of thine own were; any man's death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee."

For those of us who have crossed the Boston Marathon finish line, those last few blocks on Boylston Street are unforgettable, emotionally as well as physically. To see the pictures and videos of maimed instead of merely exhausted bodies there is an especially searing experience. Saying that the bombing instantaneously turned a moment of large-scale human triumph into horror has already become a cliché. But it is true nonetheless. Reading about the lives of the dead and wounded is heartbreaking. Seeing the heroism of so many people who immediately ran toward instead of away from the explosions – including Boston Athletic Association volunteers and peace activists – is an inspiring reminder of human beings' capacity to put the needs of others before their own. But also a reminder that almost all of the killed and wounded were present on Boylston Street for that very reason: to support a loved one who would need all the encouragement she or he could get over those last body-punishing yards. That's the spirit of"the people who watch marathons" – and after Monday I will never look at another person who turns out to cheer us runners in the same way.

All the above provides more than enough grief for this week. Or for that matter this year. Millions of people around the world share that grief and are expressing it in all the diverse ways people show their concern for others they've never met. But alas, we live in a world where not everyone (and certainly not those who wield disproportionate power in a horribly unequal world) responds based on universal human solidarity. Rather there is an outpouring of "us vs. them" thinking and action, which is present in way too big supply in the dominant politics and culture of our own country. Glenn Greenwald has already detected this pattern and writes about it in a thoughtful piece in the UK Guardian that begins this way:

"The widespread compassion for yesterday's victims and the intense anger over the attacks was obviously authentic and thus good to witness. But it was really hard not to find oneself wishing that just a fraction of that compassion and anger be devoted to attacks that the U.S. perpetrates rather than suffers. These are exactly the kinds of horrific, civilian-slaughtering attacks that the U.S. has been bringing to countries in the Muslim world over and over and over again for the last decade, with very little attention paid. My Guardian colleague Gary Younge put this best on Twitter this morning:

"'I'm up for us "All Being Bostonians Today." But then can we all be Yemenis tomorrow & Pakistanis the day after that? That's how empathy works.'"

Juan Cole addresses the same issue in a blog post yesterday titled "Can the Boston Bombings Increase Our Sympathy for Iraq and Syria, for All Such Victims?"  But concerned that the usual suspects are seizing the moment to push the country in the totally opposite direction, Cole followed up today with another post on why Islamic Law forbids terrorism. A U.S. invasion of another predominantly Muslim country does not seem in the cards. But intensification of Islamophobia; an uptick in arguments justifying drone killings; further intensified surveillance, harassment and scapegoating of Arabs and Muslims in the U.S.; and arguments that the Boston bombing means Congress should scuttle immigration reform – all these are already out there in the political mix. 

War Timers have been around this block before. This project in fact originated in response to an earlier moment when the powers-that-be responded to a horrible crime against humanity not by calling on universal human solidarity and justice via U.S. and international law, but by "with-us-or- with-the-terrorists" war, aggression and hatred. It's time to brace ourselves and get ready to do our part as people of conscience across the country and the world rise up to demand that this country take a different course this time around.

'There ain't no room for the hopeless sinner
Who would hurt all mankind just to save his own
Have pity on those whose chances grow thinner
For there's no hiding place against the Kingdom's throne.'
     -Curtis Mayfield, People Get Ready

Finally, please take special care of yourselves each and every day. Terrible events like those in Boston Monday are among other things a jolt to make us appreciate even more than usual how much we value, need and care for one another.

May peace be with you.


Sunday, April 7, 2013

Wish you were there.....

Sometimes a piece of music or a passage in a book fills you almost to bursting and you need to share the inspiration with everyone. The joys of music and art are many and various, but I’m talking about times when you soar to new heights of disbelief and wonder.

For me, one such moment was when Gustavo Dudamel came to Berkeley recently with his 135 person Venezuelan Simon Bolivar orchestra.  Most of the concert featured music by Mexican and Cuban composers. The climax was the signature performance of a Leonard Bernstein arrangement of his mambo from West Side Story.

Dudamel now conducts the Los Angeles Symphony Orchestra and is among the most celebrated conductors in the world. A big part of the excitement and creativity he brings to music grew out of the more than 35-year-old Venezuelan El Sistema, a program pioneered by José Antonio Abreu. It put musical instruments into the hands of all young children, especially in the poorest neighborhoods, and brought them and their families into the creation of youth orchestras all over the country. The link to sistema will tell you the story; a fuller and even more beautiful telling is in the Spanish language documentary, Tocar y Luchar.

If you haven’t yet met up with Dudamel, I hope the links here to You Tube will get you soaring too.

Another such moment was when I read Of the Passing of the First-Born, Chapter XI in W.E.B. DuBois’ The Souls of Black Folk (1903). It’s the most lyrical and moving gem of genius planted in the middle of a remarkable sociological work on the aftermath of slavery. In its totality, this book is a masterpiece of literature as well as of social science, beautifully written, deeply personal as well as social, full of humanity and wisdom. The particular passage is about his own baby and “the veil” that is the subject of the book as a whole.

Whether or not you’ve read the book in years gone by, click on the link above and read it with me.

Tuesday, April 2, 2013

Pills and Patents

It's never been clearer than in the battle between patents and generics: all around the world and in the USA, Big Pharma's "free market" is the arch enemy of public health.

The story of the ruling by the Supreme Court of India against Novartis is told clearly in the lead article of today's NY Times : "Low Cost Drugs in Poor Nations Get Lift in Court", by Garnier Harris and Katie Thomas (4/2/2013).  If you don't have access to it, here are  extended quotes, which I'll follow with a comment:

"People in developing countries worldwide will continue to have access to low-cost copycat versions of drugs for diseases like H.I.V. and cancer, at least for a while.
"Production of the generic drugs in India, the world’s biggest provider of cheap medicines, was ensured on Monday in a ruling by the Indian Supreme Court.
"The debate over global drug pricing is one of the most contentious issues between developed countries and the developing world. While poorer nations maintain they have a moral obligation to make cheaper, generic drugs available to their populations — by limiting patents in some cases — the brand name pharmaceutical companies contend the profits they reap are essential to their ability to develop and manufacture innovative medicines.
"Specifically, the decision allows Indian makers of generic drugs to continue making copycat versions of the drug Gleevec, which is made by Novartis. It is spelled Glivec in Europe and elsewhere. The drug provides such effective treatment for some forms of leukemia that the Food and Drug Administration approved the medicine in the United States in 2001 in record time. The ruling will also help India maintain its role as the world’s most important provider of inexpensive medicines, which is critical in the global fight against deadly diseases. Gleevec, for example, can cost as much as $70,000 a year, while Indian generic versions cost about $2,500 a year…. (my emphasis — LW)
"Gleevec is widely recognized as one of the most important medical discoveries in decades. In a televised interview, Ranjit Shahani, vice chairman of the Indian subsidiary of Novartis, said that companies like Novartis would invest less money in research in India as a result of the ruling. 'We hope that the ecosystem for intellectual property in the country improves,' he said.
"India exports about $10 billion worth of generic medicine every year. India and China together produce more than 80 percent of the active ingredients of all drugs used in the United States.
"In Monday’s decision, India’s Supreme Court ruled that the patent that Novartis sought for Gleevec did not represent a true invention. ….
"Leena Menghaney, a patient advocate at Doctors Without Borders, said that the ruling was a reprieve from more expensive medicines, but only for a while….
"Others decried the ruling, saying it was further evidence that India does not respect the intellectual property rights of pharmaceutical companies. Last year, India granted what is known as a compulsory license to a generic drug manufacturer to begin making copies of Bayer’s cancer drug Nexavar, and revoked Pfizer’s patent for another cancer drug, Sutent. Both companies have appealed the decisions.
“ 'It really is in our view another example of what I would characterize as a deteriorating innovation environment in India,” said Chip Davis, the executive vice president of advocacy at the Pharmaceutical Research and Manufacturers of America, the industry trade group. “The Indian government and the Indian courts have come down on the side that doesn’t recognize the value of innovation and the value of strong intellectual property, which we believe is essential.'
"In the United States, companies can get a new patent for a drug by altering its formula or changing its dosage. The companies contend that even minor improvements in medicines — changing a pill dosage to once a day instead of twice a day — can have a significant impact on patient wellness. But critics say a majority of drug patents given in the United States are for tiny changes that often provide patients few meaningful benefits but allow drug companies to continue charging high prices for years beyond the original patent life.
"They point to AstraZeneca, for example, which extended for years its franchise around the huge-selling heartburn pill Prilosec by slightly altering the chemical structure and renaming the medicine Nexium. Amgen has won so many patents on its expensive erythropoietin-stimulating drugs that the company has maintained exclusive sales rights for 24 years, double the usual period. A result of this practice is that the United States pays the highest drug prices in the world, prices that only a tiny fraction could afford in India, where more than two-thirds of the population lives on less than $2 a day.
"While advocates for the pharmaceutical industry argue that fairly liberal rules on patents spur innovation, a growing number of countries are questioning why they should pay high prices for new drugs. Argentina and the Philippines have passed laws similar to the one enacted in India, placing strict limits on patents. And Brazil and Thailand have been issuing compulsory licenses for AIDS drugs for years under multilateral agreements that allow such actions on public health grounds.....
"The United States government has become increasingly insistent in recent years that other countries adopt far more stringent patent protection rules, with the result that poorer patients often lose access to cheap generic copies of medicines when their governments undertake trade agreements with the United States. Washington is currently negotiating the terms of a new Pacific Rim trade agreement, called the Trans-Pacific Partnership, which might be completed later this year. The pharmaceutical industry has lobbied the United States to require other countries to enforce tougher patent restrictions, although the details are still being worked out."
. . . . . .

The story doesn't need a heck-of-a-lot of comment. The developing countries will not accomodate Big Pharma at the expense of the health needs of their vast populations. Neither should we. The lament that  research and innovation will suffer if people can afford their medical needs is a serenade of fear — fear that super profits will erode if access to proper medical care gains universal recognition as a human right. What's more, the rapid progress of many developing countries in the production of generics gives the lie to notions that all wisdom, initiative and competence reside in our part of the world and depend on satisfying the greed of the drug and insurance monopolies. 

The fact is that the developing countries are doing far more to improve the access of most Americans to affordable medicine than our vaunted "free enterprise" establishment. Thank you, India.