In the era of AIDS and COVID, it is crucial to accentuate the tendency to the non-exclusivity of health technologies. The history of medicine shows that there are many alternatives to pharmaceutical capitalism.
Published after the Covid crisis, There are alternatives. Another story of drugs XIXe–XXIe century Explore other options than the privatization of health technologies. There would be alternatives to the current pharmaceutical system, which would open to more fair access to care. Maurice Cassier demonstrates it by relying on a sociohistory which claims to be Bourdieu to reopen the “ field of possibilities ». The author is socioeconomist, research director emeritus to Cnrsspecialist in pharmaceutical patents and access to drugs. He has traveled contemporary history since the end of XVIIIe century until today, in order to find “ Alternative models to exclusive property Drugs (p. 23).
Medicines, a common good
The book is based on remarkable research work both by its precision and by its diversity, which mobilizes the archives of the Academy of Medicine, the Academy of Sciences, the Institut Pasteur, the National Institute of Industrial Property, but also the resources of the University of Toronto or those of the Institute of Social Medicine of the University of the State of Rio de Janeiro, as well as many interviews with various actors in the world of health.
It is this exploration that is both diachronic and international that allows Maurice Cassier to flush out alternatives to pharmaceutical capitalism. The pandemic, he explains as soon as it was introduced to the title-maver (“ We have never been owners »), Pushes us to imagine sharing and transfer solutions for vaccines, drugs and biological tests.
These representations of health technologies as common goods are part of the author, in a long history. Health news meets the history of medicine: the reaction of the Biden administration against Moderna, in October 2021, is compared to government negotiations about penicillin in the 1940s. Maurice Cassier defends, quoting Marx, Engels and Foucault, a “ right to health (P. 16) which makes it possible to regulate the capitalist management of our health goods. Sometimes a little technical for the neophyte, this work as demanding as stimulating reads pencil in hand. It is completed by a welcome index of the many acronyms, as well as by a table of alternative models to exclusive rights on health technologies.
Alternatives to the privatization of health
The first part of the work lists happy alternatives to the appropriation of health goods by a small number. If they have emerged between 1790 and 1950, we can learn today and left. Each chapter analyzes an example of an alternative borrowed from the past, in order to highlight “ solutions families (P. 24) for the present.
Cassier begins by detailing tensions between liberal ideology and the public redemption system of remedies that animated France of the first XIXe century. The state intervention is far from belonging to an outdated system: in 2021, the Council of Economic Analysis with the Prime Minister envisaged a reward system so that the public authorities can encourage useful innovations to public health.
The discovery of the quinine by Pelletier and Caventou provides another way to explore: that of the publication of unrealized inventions. The two scholars wanted to make quinine a “ public and free (P. 60). This requirement for knowledge sharing increases scientific collaboration. It provides another, deeply ethical alternative to the privatization of drugs. Maurice Cassier here operates an interesting rapprochement, on the synchronic level this time. He puts in parallel the attitude of Pelletier and Caventou with that of Lyonnais silky and industrialists of the Lancashire steel industry: XIXe century already flourish initiatives for what we would today call theOpen Technology.
The third solution highlighted in the book is the amazing “ copy economy (P. 91). Maurice Cassier takes the example of researchers from the Pasteur Institute who copied German pharmaceutical patents, in a context of Franco-German wars where the copy of drugs covers patriotic and warriors.
We then change scale, leaving France for North America and the world, by studying how the discovery of insulin gave rise to the creation of a pool patents. At the initiative of the University of Toronto, this pool offers the virtuous example of a “ management of therapeutic innovation in the interest of patients and the public (P. 155).
Faced with pharmaceutical patents
The second part of the book explores alternatives to pharmaceutical patents proposed by recent history (1950 to the present day). The first defended case is in the field of medical genetics. Maurice Cassier explains how, between 1994 and 2016, European geneticists rose up against patents filed by Myriad company relating to discoveries on the links between breast cancer and genetics.
The chapter resonates even more strongly than the others, since the author himself supported this fight, alongside in particular researchers from the Institut Curie ; He has taken a public position in favor of invalidating patents. It restores with a particular power this intellectual, legal and political battle for “ Defend universal and free access to genetic diagnosis (P. 189).
We then change geographic sphere, to dissect the attitude of Brazil in the face of HIV and viral hepatitis. Based on the visionary conferences of Michel Foucault in Rio de Janeiro in 1974, devoted to social medicine, Maurice Cassier argues that another social medicine was born in Brazil in the 1990s. To fight AIDS, the Ministry of Health and Pharmaceutical Laboratories organize free distributions ofAZTbut also the national production of molecules, establishing drugs in public and common goods.
The fighting of the World Health Organization
The last two chapters are dedicated to alternatives tested on a global scale. First of all, Maurice Cassier looks at the fight of the World Health Organization (WHO) and doctors without borders (Msf) to combat tropical diseases. Humanitarian medicine has managed to set up therapies without profit for public sector markets in developing countries. The author encourages to also apply this strategy to markets deemed profitable by multinationals.
Next comes the highly anticipated analysis of the management of the COVVI-19 pandemic. The approach is original: the book compares the vaccination policy of the early 2020s to the sharing system developed by theWHO The year of its creation, in 1948, to fight against the influenza virus. These two examples allow us to better understand how “ support the production and distribution of global commons (P. 262) from a technological, institutional, economic and political point of view.
The conclusion of the book does not only offer a luminous summary: it invites to “ Open the field of possibilities (P. 297) and to accentuate the general trend to the non-exclusivity of health technologies. Maurice Cassier salutes the role of developing countries, humanitarian organizations and civil society, but also the impact of common work between states and pharmaceutical industries.
This story of drugs shows us how much the health crises, in particular those of AIDS and COVVI, intensify the proposals of alternatives to pharmaceutical capitalism, to strengthen, in the face of property rights, a right to health. Maurice Cassier’s work makes it possible to grasp the capital importance and the very concrete implications of the struggle for the access of all and all to care.