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Roger Bate

FDA should approve Truvada

By Roger Bate

May 7, 2012, 11:15 am

On Thursday, the Food and Drug Administration will decide whether cocktail HIV therapy Truvada, made by U.S. drug company Gilead, should be approved for use as a preventative drug. If the FDA grants approval, Truvada will be the first HIV drug to be used prophylactically.

Opinion is divided over the application. Some balk at the cost: the current treatment regimen costs $14,000 per patient per year. Others argue that the side effects (which are minimal compared to most other HIV drugs) are too problematic for widespread use. Still others argue that deploying a prophylactic drug will discourage condom use.

These are valid concerns, which means that targeted use by at-risk groups is probably most warranted. Anyone who has seen the effectiveness of Truvada will surely be pleased that more people are likely to have access to it.

The key question is who will pay for the drug in these straightened financial times, especially when the most sensible public health option is targeting those most at risk, which are those working illegally in the sex industry. I somehow doubt that the drug, if approved, will be deployed where it could do most good.

But that is a debate for later; right now the FDA should approve the drug for prophylactic use.

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Roger Bate

Segmenting the medicine market would reduce costs and increase access

By Roger Bate

April 23, 2012, 10:19 am

In my editorial today in the New York Times, I outline how to safely buy medicines from credentialed foreign online pharmacies based on the empirical evidence from 23 approved sites. That this is possible should be no surprise, since all 211 samples are medicines that are also sold in the U.S. But the real question, which there was not enough room in the article to discuss, is: Could allowing such purchasing be efficient?

Importing drugs imports foreign price caps, which may undermine profitability of pharmaceutical companies and hence their future research and development budgets. If importation occurred wholesale and was reimbursed by insurance companies, it certainly would undermine profits.

But who is buying from overseas pharmacies?

No doubt some people who buy online can afford U.S. prices and are just looking for a deal on products they want but are not (fully) covered by their insurance. But a lot of people buying online may do so because they cannot afford their medicines in the U.S. Crucially, these people are NOT buying products in the U.S. If patients formerly going without their medicine are now buying online, these sales may actually bolster companies’ profits.

The bottom line is that no one really knows what these market participants were doing before, or would do now, if they couldn’t buy online. Pharma companies assume that they are losing sales to foreign internet sites. But as I’ve seen firsthand in emerging markets, pharma company decisions are often not based on empirical evidence. Sometimes odd or illogical assumptions are repeated endlessly until whole companies believe them. The starkest example is the industry-wide defense of the very high HIV drug prices in Africa in the late 1990s. Now, at least most of western companies logically tier HIV prices by the consumer’s income, making small but sustainable profits in emerging markets. Maybe someday companies will support personal importation of their own drugs from overseas, and allow poorer, underinsured people in the United States to pay less. It would be equitable and might be more efficient. It is time to investigate the market.

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Categories:  Economic Policy, Global Health, Health Policy   |   Tags: ,

Roger Bate

World Bank’s Jim Kim: Not even good for public health

By Roger Bate

April 17, 2012, 10:19 am

Much as expected, Dr. Jim Kim, President Obama’ s nominee, is to become the new head of the World Bank. Many articles and blog posts have decried his lack of economic policy experience, which is normally considered crucial at the World Bank. But while this concern is undoubtedly true, most commentators assume that since he is a health expert, he’ll at least be good for global public health. I beg to differ.

Kim ran the World Health Organization’s 3 by 5 Initiative, a program to treat three million people with HIV drugs by end of 2005. It failed to hit its target, but more importantly caused major problems that were glossed over by the HIV community in their glee over all the money the program attracted. As I wrote in November 2006: “in a rush to improve access mistakes have been made. The ’3 by 5′ initiative cut corners on drug quality, exposing thousands of patients to drugs of unknown quality (all over Africa); it over-strained poor countries’ fragile health systems, potentially undermining small-scale but successful treatment programs (notably in Sierra Leone and Lesotho); it failed to maintain dialogue or even consult with some countries that disagreed with its targets and methods (notably South Africa); furthermore, it failed to promote good clinical practice, so it is unknown how many patients are failing treatment (all over Africa).”

The Canadian government funded a report of 3 by 5 which was just as damning as my own assessment. Proponents of the initiative nevertheless claim it generated massive interest in increasing treatment and motivated those working in health and aid agencies. This apparently is enough to mark Dr. Kim’s reign as a success—it is a shame that even conservative commentators fail to notice this simply isn’t an acceptable standard for success. Dr. Kim will not be good for the World Bank or for public health.

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Roger Bate

Should foreign companies be able to sell drugs directly to Americans?

By Roger Bate

April 2, 2012, 11:41 am

The National Bureau of Economic Research just published my latest research which compares the quality and price of medicines sold over the internet. While no study of several hundred samples, and only a few dozen samples each of five drug types, can establish safety, the evidence shows that foreign-credentialed web sites sell good quality drugs at roughly half the price we pay in the US. After all, they sell the same branded drugs made by the same companies. Such sales are illegal under US law, but hundreds of thousands of Americans buy them anyway. The most important question is economic: Should foreign companies be able to sell drugs directly to Americans?

Economic theory is quite straightforward when it comes to efficient levels of pricing of most goods, but products like medicines are more complicated. Since it costs hundreds of millions to develop the first pill but very little to make subsequent pills, pricing is complicated. In general, manufacturers want to sell for as much as possible, buyers (insurance companies, governments and ultimately patients), want to pay as little as possible.

It makes sense to differentiate drug prices based on consumer’s income level. Since this is not possible at an individual level (means testing can never be that precise), drug pricing tends to be segmented by country. Within nations, prices may be segmented by insurance program; national schemes like Medicaid or Medicare probably pay lower premiums than smaller insurers. Companies also create membership programs which offer discounts to increase product loyalty. But millions of Americans who are uninsured or have no drug coverage often pay the expensive full drug price; this is both inefficient and inequitable.

It makes sense for these impoverished and sick people to be able to buy cheaper drugs from foreign pharmacies. But if many of uninsured people are simply not taking their medications because they are unaffordable, it is quite possible that drug manufacturers could profit from these sales as well. Of course, the market is likely to remain segmented – with just the uninsured buying from overseas – as long as insurers do not have to provide reimbursement for such purchases.

Data simply don’t exist to measure this accurately, at least as far as I’m aware. But it must be possible to ascertain buying habits of clients of certain web pharmacies via questionnaires. I suspect that, as economic theory suggests, foreign web sellers could prove egalitarian and efficient. This is something I hope to investigate.

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Roger Bate

World Bank president nominee is a risky choice

By Roger Bate

March 23, 2012, 2:53 pm

President Obama has nominated Dartmouth College President Jim Kim to be head of the World Bank—in the six decades of World Bank existence, all presidents have been Americans, so Dr. Kim is likely to get the job.

Dr. Kim is a physician and public health expert. He ran the World Health Organization’s HIV effort for several years, an effort which I openly criticized.

Dr. Kim is quite the operator and recognizes his opponents early. He encouraged a WHO consultant to monitor my work on HIV, ensuring that the media was aware I was “hostile” to WHO. I guess I was pretty hostile, although I’d like to say I was just critical of the inappropriate endorsements they were giving some Indian drugs at the time. The WHO program improved, and now its endorsements are far better, but still occasionally flawed. I doubt I’ll be getting an invitation to the Bank anytime soon.

What will be interesting is how a left-wing physician will run the only aid organization with a decent smattering of free market economists, who have tried, sometimes successfully, to help nations build private insurance-based healthcare systems. My suspicion is that more and more of the competent staff will leave, and the Bank will endorse more centralized medical systems development. I guess it has symmetry that as Obamacare is about to be challenged in the Supreme Court, the president doubles down on his intent to move the rest of the world away from private healthcare.

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Categories:  Economic Policy   |   Tags:

Roger Bate

Fake drugs proliferating in the Middle East

By Roger Bate

March 7, 2012, 10:22 am

The increasingly despotic Syrian government is restricting access to healthcare for opposition areas. Even worse, President Assad’s intelligence operatives are targeting hospitals to identify opposition figures and their families who have been injured in clashes.

What is less well-known is that in the desperate opposition areas, some of the drugs making it through are not actually any good. Medicine smuggling has been a major trading activity across most of the Middle East over the past three decades; over the past eight years, the trade has localized and some of those smugglers have started making their own counterfeit products. While police actions in 2009 shut down many of these groups and imprisoned several dozen of the worst perpetrators, some of these criminals are now out of jail. They are taking advantage of chaos in Syria, and to a lesser extent in Egypt, to increase their revenue.

Sources in the region tell me that fake analgesics and antibiotics are the main problems, but all forms of drugs in the region may be suspect.

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Categories:  Global Health, Health Policy, Middle East   |   Tags: ,

Roger Bate

Bad cuts in Obama’s global health budget

By Roger Bate

February 21, 2012, 1:24 pm

Obama trusts foreign and unaccountable bureaucrats more than transparent U.S. entities.

Last week, the White House announced its proposed budget for FY 2013′s global health expenditure, set to begin on October 1. The headline is a reduction in funding of 3.5 percent, or $310.4m ($8,826.5m FY2012, $8,516.1m FY 2013). While no doubt conservatives in Congress will want the budget cut further, they should also challenge the priorities in this budget.

The budget for the U.S. malaria program is to be cut by 4.8 percent, and the tuberculosis program by 10 percent. Yet the former is the best-performing U.S. health program, and the latter its most underfunded. At the same time as these U.S. programs are cut, multilateral initiatives such as the vaccine alliance (GAVI) and the Global Fund have their budgets increase by a staggering 45 percent and 27 percent respectively. Both are good initiatives but both, especially the latter, have problems.

As I have pointed out on numerous occasions, the Fund is working with unaccountable, corrupt, and inefficient United Nations bureaucrats and continues to work with corrupt nations (something the U.S. malaria and TB programs do not), even after they are exposed as such. As other nations withheld money from the Fund last year due to corruption allegations, and the Fund’s head was forced out because his decisions were to be subjected to better scrutiny, Obama decides to increase U.S. taxpayer support.

One wonders what those working in the U.S. malaria program must think when their stellar work is rewarded with cuts, while corrupt multilaterals get more funding. European leaders may publicly applaud Obama’s support of these multilateral initiatives, but secretly they’ll be pleased that Obama is bailing them out.

Conservatives in Congress should demand no increase in the budget to the Global Fund (and a 50 percent cut if Global Fund doesn’t properly address the corruption problems), rather than the increase Obama proposes.

Congressional conservatives should also, as a sign of their desire to assist the less fortunate, demand the reinstatement of the U.S. government’s desired malaria budget and an increase in the TB budget. They can do this, save more lives, and cut the budget more than Obama proposes.

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Roger Bate

China bucks against EU green tax

By Roger Bate

February 6, 2012, 9:55 am

China says it will not allow its airlines to pay Europe’s green airline tax.

I suggested last fall that the attempt by the British government to raise revenue with airline taxes, while pretending it was for the good of the planet, was going to conflict with U.S. airlines. But it appears that the Chinese have reacted first and most aggressively to the EU-wide scheme. The last thing the EU (or United States) needs is a green trade war with China, but that is the direction we’re heading.

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Roger Bate

Malaria death estimate doubles

By Roger Bate

February 3, 2012, 1:27 pm

A new study published in the Lancet medical journal estimates that the actual number of malaria deaths is double previous estimates.

This is obviously sad news, but the advances made over the past few years are real (whatever the baseline disease rate one chooses). However, it means that failures in existing programs must be combated with renewed vigor, as I point out in my new outlook published next week.

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Roger Bate

Fake drug scandal, winding down?

By Roger Bate

January 27, 2012, 5:49 pm

The saga over the quality of medicines produced by Indian company Ranbaxy looks to be coming to a close. Back in 2004 and 2005, a Ranbaxy whistleblower contacted me to provide information about quality infringements at one of Ranbaxy’s plants. Despite FDA warnings and the WHO’s awareness of the problem, the problem was not fully resolved.

Ranbaxy is a good company and it is endeavoring to set things right. But its problems demonstrate the cost of not successfully inculcating good standards through all levels of management. My reading of the infringements made by Ranbaxy staff suggests that they may have saved the company at most a few thousand dollars from their regulation-infringing cost-cutting. Yet the loss of business has now run in the millions of dollars—and who knows what the cost of poor quality medicines has been to patients. It should be noted that none of the drugs the FDA tested failed quality control. But, as drug experts explain to me, there are some flaws it is hard to test for; it is possible dangerous products slipped through, especially if the production processes are careless.

The United States now sources 80 percent of its intermediate drug chemicals from overseas, a growing number from China. Chinese companies probably suffer worse quality control problems than most of the large Indian companies—but so far no whistleblowers have emerged. I expect many more Ranbaxy-type problems to crop up in the near future, with the likelihood of serious implications for at least some American patients.

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Roger Bate

Lethal medicines in Pakistan and beyond

By Roger Bate

January 27, 2012, 2:28 pm

News is filtering in about another fatal incidence of fake drugs, this time lethal heart medication in Pakistan. In my forthcoming book “Phake: The Deadly World of Falsified and Substandard Medicine,” I discuss the kinds of dangers the poor in emerging markets face every day from bogus medicines of all varieties. Counterfeiters don’t care what your disease or condition is, they just care that they can make a pill look like the drug you need. Lethal fakes of painkillers, antibiotics, hyper-tensives, heart medication, and every other type of medicine exist and, in some instances, dominate markets. But while our risk is lower, even in North America it is not zero. In 2006-7, 149 Americans died from fake heparin, a blood thinner. A couple of years earlier Vancouver native Marcia Bergeron died from a fatal arrhythmia brought on by heavy metal contaminants in her bogus heart medicine—exactly the alleged cause of death of the patients in Pakistan.

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Roger Bate

Africa’s ‘Last Dictator Standing’

By Roger Bate

December 2, 2011, 10:01 am

No one ever accused Zimbabwe’s despot in chief, President Robert Mugabe, of having a sense of humor, and neither apparently do his supporters. Nandos, a South African fast food chain, has pulled its amusing commercial ridiculing Mugabe as Africa’s “last dictator standing.” In the commercial, Mugabe is seen having a water pistol fight with Moammar Ghadafi and riding a tank (with allusions to Titanic’s Di Caprio and Winslett bow shot) with Idi Amin. The commercial was being aired across Southern Africa, but Mugabe’s supporters have threatened staff at Nandos outlets in Zimbabwe and so the company has pulled the commercial. Hopefully it will now get even more views on YouTube.

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Roger Bate

PEPFAR and World AIDS Day

By Roger Bate

December 1, 2011, 9:43 am

Today is World AIDS Day and President George W. Bush writes in the WSJ about the progress made against the disease around the world. He appeals for continued HIV funding through the plan (PEPFAR) his administration established eight years ago. While PEPFAR has been a huge success, new infections continue to rise; what was seen as generous assistance a few years ago has now morphed into something else. The largesse of the American people, which is still praised around the world, is now seen as a right by those receiving treatment and by international aid actors always clamoring for money. Since there is no cure, are U.S. taxpayers on the hook for billions of dollars of treatment funding every year from now? Cutting funding to PEPFAR may not be warranted right now even in these straightened financial times, but at some stage we should demand that the countries with the infected take up the cost for treating them.

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Categories:  Development, Global Health, Health Policy   |   Tags: , , , ,

Roger Bate

Millenium Village a total bust

By Roger Bate

November 29, 2011, 10:51 am

The first independent evaluation of the United Nations Millennium Village project, which aimed to increase incomes of targeted Kenyans by subsidizing agricultural development, has just been published.

To those of us who have seen the Villages or read about the practices at the Villages, it comes as no surprise that there is no increase in income. For while there is an increase in agricultural returns to affected households due to the massively subsidized projects supported by taxpayers, these same households have had to be less innovative in other areas of income generation. No doubt the UN and Columbia University’s Jeff Sachs, who champion the project, will spin their own reasons why this new report is flawed, but for the rest of us it is just another failed aid project.

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Roger Bate

Polio’s dangerous resurgence

By Roger Bate

November 22, 2011, 10:42 am

Polio is making a comeback. According to Thomas Moran of the World Health Organization, there has been a four-fold increase in polio in Nigeria in the past year. There were still only 43 cases this year, but while this is fortunately still a small number, the chances have risen significantly that the disease will take hold in other African countries soon. As experts at WHO and elsewhere have explained to anyone bothering to listen, curbing the polio virus in Nigeria is key to eradicating the crippling disease in Africa. Nigeria’s neighbors, especially Cote D’Ivoire, Mali, and Niger, have had more cases in the past few years, and all because Nigeria never managed to eradicate the disease. Poverty and political dysfunction create the right breeding ground for the disease to survive and Pakistan, India, and Afghanistan are the only other countries where the disease is still a major health risk today.

Polio vaccination is a miracle. There is no need for an injection: just suck on a vaccine-encrusted sugar cube and you’re protected for the next decade. Yet, when I was in Kano, in Northern Nigeria a few years ago, I saw muscular upper bodies moving with acrobatic abilities on their hands—a novelty until you realize they have no legs. These are the crippling results of polio.

When a World Health Organization campaign was launched in 1988 to eliminate polio from the 123 countries still afflicted, it almost succeeded. By 2003 only seven countries still had cases and the end was in sight.

But clerics in Kano counseled parents against the vaccination, proclaiming it an American plot to sterilize Muslim youth and give them HIV. When Muslim parents obeyed, the southern-based and largely Christian Nigerian government refused to demand vaccination in the north, since it did not want to create religious tension. By 2007, Nigeria had over 70 percent of the world’s cases and was exporting polio. After the boycott it moved from Nigeria to Ivory Coast, from West Africa to Sudan, then across the Red Sea into Saudi Arabia and Yemen—which had been polio-free for a decade—even jumping continents to surface in Indonesia. Since the 2003 boycott, about 25 countries previously declared polio-free have been reinfected.

To its credit the Nigerian government and affected state governments have done more recently, and according to WHO Nigerian authorities have been carrying out large scale vaccination programs to prevent the disease from spreading further. At a Commonwealth meeting in October, the leaders of Canada, the UK, and Australia, as well as Nigeria, pledged millions of dollars towards the global effort to eradicate polio. All this is welcome, but it’s such a tragedy that these pledges are necessary today, when success was so near eight years ago.

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Roger Bate

Fake drugs and the Internet: Consumer Reports misleads, but it’s for your own good—honest!

By Roger Bate

October 28, 2011, 10:59 am

St. Lucia—Investigating fake medicines has its glamorous side. For every investigation I’ve done in the dangerous and dingy back alley of Lagos, Luanda, or Lubumbashi there are far prettier and less lethal locations, such as the one I find myself in today. Increasing numbers of islands in the Caribbean have been used as transit points for websites selling unregistered drugs, some of which are fake and could be lethal to patients. Such fake Web sellers are a menace and it’s good the government tries to protect U.S. citizens from them. It is also helpful when independent organizations write about the fake drug trade and expose its dangers.

For example, Len Maniace has a well written and largely correct article for Consumer Reports today.

I was interviewed by Maniace for this article in March this year, and although he doesn’t quote me for the piece, he cites my study in a Public Library of Science peer-reviewed journal (incidentally, this is the only peer-reviewed study he quotes). His interpretation of that study is accurate, as far as it goes. But it misleads the reader by not explaining the main conclusion of the study. My research team concluded that if one bought from foreign online sellers credentialed by independent group www.pharmacychecker.com, there was no more demonstrated risk than buying from sites approved in the United States by the National Association of Boards of Pharmacy. But to mention this would undermine the message Maniace and Consumer Reports were making in the rest of the article.

I have no objection to a robust debate about the dangers inherent in buying drugs from foreign websites, but I do object to misleading readers into thinking that all foreign pharmacies and foreign drugs might be lethal. The U.S. Food and Drug Administration is not the only competent regulatory agency in the world and Pfizer and AstraZeneca (the two manufacturers whose products we tested) do not produce worse versions of their medications for Europeans or Canadians as compared with what we might buy in the United States.

Searching out lethal sellers from China to the Caribbean is important, but misleading impoverished Americans into believing foreign means lethal is unacceptable.

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Roger Bate

A practical and informative guide to pharmaceutical anti-counterfeiting

By Roger Bate

October 25, 2011, 2:47 pm

Practical guides that are both well written and useful are, unfortunately, rare. So it is with pleasure that I recommend Pharmaceutical Anti-Counterfeiting: Combating the Real Danger from Fake Drugs by Mark Davison.

Make no mistake, this is not an easy read for those who are merely mildly interested in the topic, but it is a valuable insider’s handbook for professionals working in the fields of product security and brand protection.

Its thirty-plus chapters break the topic down into small chunks that allow practitioners to easily find the latest problems and technical solutions. I imagine it will be used as a reference book over the next few years, but the short chapters also help those who are just really interested in the material from a policy perspective or even for general interest. The entire book structure helps guide the reader through all the complex subject matter and significant detail.

I thought I already knew quite a lot about the technologies used to combat counterfeiters, but as I read the book I realized how incomplete my knowledge was. Details on transportation and packaging security, holograms, ink technologies, authentication techniques, and forensic markers are just a few of the many topics covered.

Davison’s book will help those working in the policy sphere to be better informed and realize the limitation of technologies that businesses are able to deploy against counterfeiters.

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Roger Bate

Dictators and double standards

By Roger Bate

October 21, 2011, 9:12 am

This has been a good week for African security. With the demise of Qadhafi, Libya has the chance to move in the right direction. It is also good news that the administration will send troops and otherwise assist in the desired demise of the Lord’s Resistance Army (LRA) in the Great Lakes region of Africa.

But as one despised dictator meets his end in the dirt of his home town in Libya, many other dictators survive to occasionally kill opposition figures, cripple free media, and otherwise suppress their own people. While few have operated on the odious scale of Libya’s former dictator, the leaders still in power in Zimbabwe, Ethiopia, Uganda—the list goes on—have all been suppressing opposition for far more than a decade; over 30 years in some cases. None of these are real democracies: elections are more fair in some than in others, but they all foment understandable dissent. While the LRA is odious, it has at least partially been able to find succor and support because of the myriad dictatorships it has operated within.

Supporting dictators apparently friendly to our interests often seems like the right move at the time. But as history repeatedly shows, advantages from such support often disintegrate over time, sometimes becoming counterproductive (think Mugabe and Mobuto). I suspect one day we will regret having provided staunch support for Meles, Museveni, and even Kagame.

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Roger Bate

On the verge of an effective malaria vaccine

By Roger Bate

October 19, 2011, 4:56 pm

Early trial results released yesterday suggest a significant breakthrough for public health: a malaria vaccine that works. Scientists have been searching for a malaria vaccine for decades. The most infamous efforts resulted in scientific fraud and total failure. But today we may be on the cusp of having an effective vaccine.

Even a moderately successful vaccine would be a great advance in combating a disease that kills nearly 800,000 people, mainly children, and sickens hundreds of millions of others every year.

Preventative measures, like using bed nets and insecticide sprays (indoors and out), combined with widespread treatment, has lowered prevalence of the disease by perhaps 20 percent in the past decade. A successful vaccine would lower this further and faster.

But we cannot declare victory yet. Trial results suggests the vaccine works only 50 percent of the time, so the vaccine must be repeatedly deployed in conjunction with existing policies in order to continue to suppress the disease. Problems with the vaccine’s safety may emerge as clinical trials proceed. The eradication of malaria is still a long way off, but this vaccine could be a small but important step to that desired eventuality.

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Roger Bate

PR for Equatorial Guinea’s Obiang Is Wrong

By Roger Bate

September 30, 2011, 9:16 am

I highly recommend the article published today in South Africa’s Business Day by George Pieler.

In it he explains how the malaria community has decided to get in bed with the notorious, illegitimate, despotic leader of Equatorial Guinea. I know malaria funds are under pressure due to the economic situation, but providing good public relations to President Obiang in return for funds is not the solution.

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Roger Bate

Helping the Poor Find Cheaper, Safe Drugs

By Roger Bate

September 28, 2011, 9:21 am

I’ve had quite a few comments on my article today on Google and foreign websites selling medicines into the United States. I just want to stress that the main point of this article is to argue that the poorest in society, the uninsured who get sick, should be helped with accurate information about where they can more safely buy cheaper drugs, if paying out of pocket. The status quo obscures which web entities are more likely to be safe, which to me is immoral.

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Roger Bate

Are Cheap Medicines Bad Medicines?

By Roger Bate

September 6, 2011, 9:38 am

Spotting poor quality medicines is very difficult. It is fairly easy for people to spot a fake Rolex watch or Gucci handbag, especially if they’ve seen the real thing. But show people two Lipitor pills, one real and one fake, and chances are they won’t be able to tell them apart. To protect us from the fakes, which won’t treat the condition for which they were taken and may kill the patient, we rely on regulatory systems and corporate practices. In the West, the vast majority of the time we’re right to put our trust in these systems. But in emerging markets, often—maybe one time in ten—we will be purchasing a dud.

In a paper published this week in the Journal of Health Economics, my co-researchers and I have investigated whether the price of a product is a reliable indicator of its quality. People buy fake Rolexes because they’re cheap, so if a drug is very cheap, should the consumer assume it’s a poor quality product? Unfortunately, the answer is not straight forward.

Continue reading →

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Roger Bate

Inspections of Chinese Drug Manufacturers Set to Increase

By Roger Bate

August 13, 2011, 11:08 am

Last month I wrote about the dangers of substandard drugs, and particularly poor quality ingredients coming from China. One of my recommendations was that U.S. Food and Drug Administration increase its inspections of plants in China. So it is great news that this is now set to happen.

As a story in the New York Times explains, $299m in fees will be collected by the FDA from generic manufacturers to increase overseas inspections. The result of this is that foreign plants will be inspected every two years, rather than not at all or every decade or so, as currently.

This proposed legislation is likely to be approved by Congress before the end of September, and it will be a welcome change that should lower the chance of really poor production facilities still selling products in the United States. But problems still remain. Notably, inspectors will not have unfettered access to plants in China. The FDA will still have to provide notice to Chinese authorities of their intent to inspect, which means minor infractions, which can cause major safety problems, may still occur.

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Roger Bate

Yob Mobs and Laissez Faire

By Roger Bate

August 9, 2011, 8:42 am

As a (former) Londoner it saddens me to see what is happening in my home town. I flew back to the United States from London yesterday, and while in Britain’s capital,  I didn’t see any violence or burning buildings. The only thing I saw was bemusement on the faces of the Londoners—they have no idea why people are rioting. If there is any good to come out of the riots it is that politicians with greater respect for law and order, as opposed to some laissez-faire attitude, will prevail. Right now we need laissez-faire in business not in policing.

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Categories:  Europe and Russia, Foreign and Defense   |   Tags:

Roger Bate

Mugabe’s Torture Camp

By Roger Bate

August 8, 2011, 8:40 am

Last month I wrote about the brutal diamond mining operations overseen by Robert Mugabe, despotic president of Zimbabwe. Now it appears the situation was worse than I had explained. In an area called Zengeni, Western observers have described a torture camp. This camp, less than one mile from the main Marange field diamond mine, houses men and women who are forced to dig out the diamonds, and are beaten, raped, and killed for not working hard enough. Here’s a fuller account of this terrible story.

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