If anyone is interested in what
Pogge is trying to do to get this “full-pull plan” actually implemented, check
out their website here (http://healthimpactfund.org/).
They run a non-profit called Inventives for Global Health that is trying to
implement something call the Health Impact Fund (HIF), that is his “full-pull
plan.”
Pogge’s plan is designed to create
a system that will incentivize pharmaceutical companies to combat neglected
tropical diseases and other diseases that disproportionately effect the worlds
poor by paying them on a pay-per-performance basis that links their drugs to a
reduction in the Global Burden of Diseases (GDB): “There is an alternative
scheme for incentivizing pharmaceutical innovation that would extend the
protection afforded by new medicinces immediately to all human beings and would
thus be much better at suppressing and eradicating (esp. infectious) diseases”
(Pogge, 39). Pogge not only believes his scheme is morally superior to the
current system, as it doesn’t place profits above the lives of the world’s poor
for pharmaceutical companies, but also that his plan is economically and
politically feasible. While I can agree that a pay-per-perfomance system is a
feasible one, one that many would agree is a positive shift, and that Pogge’s
system would appeal to the four groups he identifies as stake holders,
Pharmaceutical companies and their investors, affluent people/patients,
generics manufacturers, and poor people/patients, I think he will still
struggle with the political feasibility of implementation. While most would
agree to the system, I see Pogge struggling to actually get anyone to sign on.
Pogge
claims that the people of the world “bear ultimate responsibility” for the
implementation of their plan through holding their respective governments
accountable for their decisions (Pogge, 3). At the same time, he notes that in
many of nations that would be most effected by this proposal, especially the
poor ones in politically unstable environments, the people have little say.
Instead it is dictators that benefit from the current system. If Pogge says
that “consent by the ruling elite is not, then, a valid indicator of advantage
to the general population,” and those are the people making the decisions to
send money to pay these pharmaceutical companies, how on earth can he expect
them to sign on (Pogge, 12). One has to only look at how long Pogge has been
trying to get this done, and the distinct lac of supporters for his HIF or
mini-HIF scaled project, to see the difficulties and unfeasibility of the
project.
Hi Campbell!
ReplyDeleteThanks for the links! This is an interesting post because it does seem to have current facts on its side. According to Wikipedia (I tried to use the website as a primary source but couldn't find this) he proposed the HIF in 2008, which means he's been at this for about 8 years. That's definitely not a short period of time, but not solid evidence to me that this plan is doomed to fail.
He outlines a pretty comprehensive plan as to how he believes this could be feasibly implemented. In doing so he lists exactly what the plan would look like, fully specified, and also clarifies ways in which the implementation might come about. The comments on Becca's post provide a really interesting discussion of the positional arms race of pharmaceutical companies -- Pogge seems to think that his plan is at least plausibly within the interests of these companies. This is important in terms of political implementation because these companies clearly have serious lobbying power as evidenced by their ability to get TRIPS implemented globally. If the plan did not solve some problem for them, political feasibility would probably be squashed.
So he starts with why the companies should want it too. It could solve the current incentive structure which creates the complaints of "tool little genuinely innovative research, too much marketing, and manipulation of doctors, price-gouging protected by monopoly patents..." (31). He continues "it is said, and not without plausibility, that there is not much each pharmaceutical company can do on its own to stay clear of these complaints" (31). So they would all need a structural change. He then gives two criteria for a structural reform to be successful: a "clearly limited objective" and assurance "that the reform process will observe these limits". "One beauty of the full-pull scheme lies in the fact that the actually implemented solution can be worked out with the pharmaceutical and biotechnology industries." He is essentially changing the structure in a way that these companies stand to benefits as long as the proper concessions (listed above) are made. He believes this is the keystone for making it politically realistic.
With that taken care of, he then describes the justification to affluence citizens and their representatives. This is largely a moral argument that also addresses concerns of costs and feasibility as well as other advantages this group stands to gain.
I think the following statement sums why Pogge's thinks his plan is political feasible (and why I am inclined to agree): "The unjust rules we are seeking to reform exist because others have managed to coordinate in their support. The agribusiness, software, entertainment, and pharmaceutical industries have overcome their differences to throw their political clout behind a joint strategy that -- together -- they got their governments to impose on the world" (34).
I think this raises a couple of interesting questions:
ReplyDelete(1) Pogge seems to believe that this alignment of incentive structures could get the major players to back his plan. He states "With support from the US and/or the European Union, joined by dozens of developing countries, the full-pull plan could be worked into the global economic architecture by the end of the decade" (37). *He has 2 more years!* But, this implies that the plan might be implemented in a similar fashion to the TRIPS agreement, by sort of strong arming poorer countries with little bargaining power. He seems to believe that this was morally problematic at the beginning of his essay.
- Is this no longer morally problematic when poor people in these countries stand to gain from the agreement? By this logic, we can strong arm poor countries into agreements when we believe it will help the poor within those countries. But he was originally using this logic to undermine the validity of the TRIPs agreements in the first place. So he seems to have a slight inconsistency here that will require clarification.
- He says "few countries would find it morally bearable and politically opportune to adopt this role, especially if the GBD patent regime would exclude the biotechnology, pharmaceutical, and generic companies of non-participating countries" (37). This sort of gives him a way out of the "strong-arm" problem by implying that countries will likely voluntarily choose not to free ride. But again, this sort of undermines his original point that governments of poor countries's incentives don't always align with the incentives of the country as a whole. Also, they don't appear to be swayed by moral arguments since they are "tyrants" of "brutality and corruption." Political viability would again rest on potentially strong arming these countries. So -- to answer your question -- I think Pogge has good reason to believe this plan might be politically viable. These things take time. But the viability might depend on coercing poor countries.
Which brings us back around to the moral question: When can wealthy countries strong arm poor countries?
Sorry -- I had to this up, but its actually one big comment.
ReplyDeleteHi Melissa,
ReplyDeleteThanks for the response! You raise some interesting points, and I agree with most of them. I particularly agree with your outlining of why the plan is economically feasible. I agree with Pogge that he has built a plan that will appeal to the pharmaceutical and biotech companies. I still see a problem with the political implementation of the plan, though. You pointed out that Pogge notes "The agribusiness, software, entertainment, and pharmaceutical industries have overcome their differences to throw their political clout behind a joint strategy that -- together -- they got their governments to impose on the world" (34). While this worked in getting TRIPS passes, I don't see it working for the HIF he proposes. With TRIPS the governments were not on the hook for any payments, they were just protecting companies based within their boarders. With the HIF those countries, I assume from the structure of his plan, would be on the hook for paying the companies their prizes. Since it is going to take a player like the US or the EU stepping up to be the first one to put the money on the line, with little assurance that anyone else will back them up, I am not sure the countries are inclined to risk changing the system. With patents they weren't paying nearly as much with their own money, the companies were getting profits from their sales to customers. Under Pogge's HIF, they will have many many more dollars on the line themselves.
*passed
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