Merck Has Better Things To Do With Its Cervical Cancer Vaccine Than To Make A Serious Effort To Stop The Deaths Of Poor Women From Cervical Cancer.

I want to begin my talk with you this afternoon by sharing with you two covers from Time magazine.....

This first cover, from Time's August 18, 1952 edition, pictures a kindly looking George Merck, the modern-day founder of my company. His intelligent blue eyes gaze benevolently toward the future. In the background, a mortar and pestle, an ancient symbol of the pharmaceutical arts, is superimposed over a birds-eye view of Merck's modern research and production facility in Rahway, New Jersey. Under this picture, a George W. Merck quote: "Medicine is for people, not for profits."

Remarks of Raymond V. Gilmartin,
Chairman, President, and Chief Executive Officer,
Merck & Co., Inc.
at
Town Hall Los Angeles
Los Angeles, California
July 29, 2004

For people. Not for profits. Let's keep that in mind as we take a look at what Merck's been up to this week:

HPV vaccine can prevent genital warts in men

Study results bolster drugmaker’s plan to market shots to boys

ATLANTA - For the first time, an expensive vaccine aimed at preventing cervical cancer in women has proven successful at preventing a disease in men, according to a study released Thursday by the vaccine’s maker.

The disease is genital warts — sexually transmitted, embarrassing and uncomfortable — but not life-threatening.

Huh. Because you know what is life threatening? Cervical cancer. As a matter of fact, 260,000 women in the developing world die from cervical cancer every year. All it would take to make that number of deaths fall through the floor is an effort to get girls in the third world together with a physician, nurse, midwife, witch doctor, or pretty much anyone who isn't a total fuckup to administer a vaccine. Hell, even a pharmacist could do it. The result would be nothing short of a revolution in health care for the world's impoverished women. 

Instead, Merck chose to aggressively market Gardasil, its cervical cancer vaccine approved in 2006, not to the women dying of cervical cancer, but to the affluent women of the west who already had the means to prevent the disease. Now it wants to convince you to fork over almost $400 so your boy won't get bumps on his schlong if he's not careful where he sticks it.  

“This opens the door to a wonderful opportunity to prevent illness,” said Anna Giuliano, a researcher at the H. Lee Moffitt Cancer Center in Tampa, Fla.

Great, but you know what's even better than preventing illness? PREVENTING DEATH. Or at least that's what I would think if I were making medicine for people, and not for profit.  Maybe they see things differently at the H. Lee Moffitt Cancer Center. Maybe they could rename it the H. Lee Moffitt Center To Prevent Schlong Bumps. 

Reached for comment in the oncology ward of Uganda's Mulago Hospital, 28 year old cervical cancer sufferer Efia Matovu said, "I am so grateful for the nurse who paid for a bottle of alcohol out of her own pocket for me to use. It is such a relief at times to feel its coolness when my fever burns. My nurse shows me yet again the goodness that is in every human heart. It is just a shame that I have had the misfortune to be stricken by a disease for which nothing can be done. I can only hope that one day science will progress to the point where the suffering I have endured can be prevented in others." 

I don't have to tell you the quote from the cancer sufferer is made up. Because you know in the real world no one would care enough what a woman dying of cervical cancer in Africa thinks to make an effort to ask her for a comment. Or to stop her from dying. In the real world corporations like Merck serve up heaping plates of bullshit about people and profits, cover the bullshit in steak sauce, and tell you you've got a ribeye.

I am glad I don't have any bumps on my schlong though. Maybe my perspective would change if I did. 

We're Against Cervical Cancer. When We Can Make Some Money Off Stopping It That Is. No Other Time Really.

    Lemmie ask you a question. Your answer will tell me a lot about what you do for a living. Let's say there's a disease that kills 274,000 women a year, 260 thousand of which are in the third world.  The disease is almost entirely preventable with routine medical care, which is precisely why almost everyone who dies from it is in a developing country.

   Now you have a vaccine for the disease. What do you do with it?

   You may think the right answer is to get the vaccine into the bodies of the people who are dying of the disease, and at first glance, it would seem that Merck, the maker of the cervical cancer vaccine Gardasil, would agree with you. This is what Merck says about themselves on their website:

Merck & Co., Inc. is a global research-driven pharmaceutical company dedicated to putting patients first. Established in 1891, Merck discovers, develops, manufactures and markets vaccines and medicines to address unmet medical needs. The company devotes extensive efforts to increase access to medicines through far-reaching programs that not only donate Merck medicines but help deliver them to the people who need them.

Those of you with business degrees though, and who work for Big Pharma in particular, understand full well "people who need them" means "people with money"

Whether they need them or not. 

Don't get me wrong. Cervical cancer is real and pretty scary. If you're in a place like Africa where your chances of ever seeing a doctor are pretty damn slim that is. If you're here in the land of the free™ (certain restrictions apply)  routine Pap smears will stop cervical cancer long before it gets to the scary stage. So what is Merck doing to get Gardasil to the people that need it?

A hell of a lot of lobbying to force girls in this country to get injected, that's what. 

“There was incredible pressure from industry and politics,” said Dr. Jon Abramson, a professor of pediatrics at Wake Forest University who was chairman of the committee of the Centers for Disease Control and Prevention that recommended the vaccine for all girls once they reached 11 or 12.

“Merck lobbied every opinion leader, women’s group, medical society, politicians, and went directly to the people — it created a sense of panic that says you have to have this vaccine now,” said Dr. Diane Harper, a professor of medicine at Dartmouth Medical School.

The result? 

In the United States, 41 states have passed or begun considering legislation on cervical cancer, according to the National Conference of State Legislatures, and 24 have considered proposals to mandate the vaccine for girls, generally in middle school.

Even the Bush Administration is in on the act:

BUSH ADMINISTRATION FORCING HPV VACCCINE ON IMMIGRANTS: In July, U.S. Citizenship and Immigration Services quietly amended its list of required vaccinations for immigrants applying to become citizens. One of the newest requirements was Gardasil

Sooooo.......one more time.....95% of cervical cancer deaths happen OUTSIDE the western world. Meaning it would make more sense to require people LEAVING the US to get vaccinated, not people who are moving to a place where access to preventative care is routine. 

"What else is new Drugmonkey?" some of you might be saying. "The Bush administration has quite a track record of getting things exactly backwards, and science really isn't their strong point." I'll have to give you that. Many of the 41 states that have a sudden interest in cervical cancer though, are probably run by competent executives, which makes me think the $162 per dose of Gardasil, most of which goes straight into Merck's pocket, just might have something to do with this sudden awareness of what should be a medium to low priority disease. 

Meanwhile a girl in Africa just felt a weird pain.  Merck seems to have no interest in her.