letter on impact of globalization and drug companies

[Guest guest]

http://www.policyalternatives.ca/publications/articles/article338.html THE

GLOBAL DRUG-PUSHERS: Globalization is not good for women's health. Here's why

By Jackie Kennelly

I recently attended a protest in Vancouver organized by the Grassroots Women's

Network. The protest was staged outside the Pan Pacific Hotel, a swanky

establishment on the waterfront that was hosting the Premiers' meetings to

discuss Canada's health care system.

The women were protesting the possible privatization of health care, expressing

their concern that women's health would be particularly impacted. In their

literature, they made explicit links to the larger global trends of

neoliberalism and globalization.

This was the first time I had seen these links being made in a Canadian protest,

although the women's health movement in the Global South has been discussing

these issues for years. Canadian women might be wondering: how can globalization

hurt my health?

The debates and language that surround globalization often make it seem like

some distant and unknowable entity, one that is not likely to touch our lives in

any immediate way. The truth, however, is that the forces of globalization are

shaping our lives at every level, and this includes at the immediate level of

our health.

Women, in particular, are vulnerable to the changes being wrought in the name of

globalization. To illustrate this, let's look at the pharmaceutical industry and

its impacts on women's health.

Women consume between 60% and 70% of pharmaceuticals worldwide, largely due to

the fact that they generally take full responsibility for contraception. This

leaves them more vulnerable to the machinations of the pharmaceutical industry,

as well as making them a key market to be targeted. This combination has

resulted in various health care disasters over the last 40 years or so.

Three examples that may be familiar to Canadian women are the DES cancer

daughters, the Dalkon Shield fiasco, and the Depo Provera controversy. Each of

these stories received significant press coverage in their time; each then faded

into relative obscurity. Each is also an example of how the quest for profits by

some pharmaceutical companies resulted in the deaths and suffering of thousands

of women around the world.

DES, or diethylstilbestrol, is a synthetic estrogen that was prescribed to women

from the 1940s until the 1970s to prevent miscarriages. Evidence soon began to

mount, however, that DES might increase risks of cancer and perhaps even

increase the risk of miscarriage. Nonetheless, the pharmaceutical industry

continued to push the drug on medical doctors and encouraged them to prescribe

it to pregnant women.

It was not until 1971--some 30 years after DES was introduced on the

market--when Dr. A. L. Herbst established the connection between a rare form of

vaginal cancer in the daughters of women who had taken DES during pregnancy,

that the pharmaceutical companies began to respond.

Their response, however, was slow. In the Netherlands, the Ministry of Public

Health told the pharmaceutical industry that the use of DES during pregnancy was

banned; in spite of this, the directive " for use in cases of risk of

miscarriage " continued to appear on the package inserts until 1975. This breach

is even more astounding when considered in light of the fact that Eli Lilly, the

prime manufacturer of DES in the United States, conceded in a trial that it was

aware by 1947 that prenatal DES posed the threat of cancer to pregnant women,

that it had been shown to cross the placental barrier, and that it had caused

malformations in the offspring of pregnant mice.

Lest we think that the DES story ended there, it continued to be distributed to

countries of the South and prescribed to pregnant women to prevent miscarriage

as late as the mid-1980s.

The Dalkon Shield was an intra-uterine device (IUD) form of contraception for

women. There are several different brands of IUDs, and all IUDs come with the

risk of infertility caused by pelvic inflammatory disease, or PID. This is

problematic enough on its own; however, the Dalkon Shield came with a risk of

PID that was five times greater than that faced by other IUD users. Unlike other

IUDs, the Dalkon Shield had been marketed by its manufacturer, A. H. Robins, as

the first IUD specifically for women who had not yet had children. This is

rather remarkable, given the known risk of pelvic inflammatory disease with IUD

use and its link to infertility.

Another unique aspect of the Dalkon Shield was its connection to septic

abortions (abortions accompanied by toxic infection). Of the 287 septic

abortions caused by IUDs that the U.S. Food and Drug Administration had recorded

by 1974, 219 of them were caused by the Dalkon Shield. Fourteen shield users

also died.

Although A. H. Robins, the Dalkon Shield manufacturer, had notice of these

adverse effects as early as 1971, it not only continued to market its IUD, but

covered up the negative results of its own studies. In the trials that later

ensued, a former Robins attorney testified that he was ordered to destroy

evidence of the negative health impacts of the Shield.

In 1972, aware that they would need to " diversify their markets " if they wanted

to stay in business, A. H. Robins executives contacted the Office of Population

at AID (the U.S. Agency for International Development) and offered a 48% bulk

discount on unsterilized Shields. The Shield was then distributed in 42 Third

World countries; what's more, there was only one set of instructions for every

1,000 Shields, and in only three languages: English, French and Spanish.

Depo-Provera, another contraceptive drug, was involved in a particularly long

and drawn-out approval process by the U.S. Food and Drug Administration (FDA).

Many animal studies had shown multiple adverse effects, including uterine cancer

in monkeys, breast cancer and tumors in dogs, and deaths due to

Depo-Provera-induced diabetes in dogs. Although not approved for contraceptive

use in the United States until 1992, AID advocated the use of Depo-Provera in

family planning programs in the Third World before this time.

As in the cases of DES and the Dalkon Shield, the possibility of corporate

deception looms. Upjohn Corporation, the manufacturer of Depo-Provera, has been

accused of withholding evidence of multiple health risks for many years while it

promoted the drug worldwide.

As an injectible drug, with contraceptive effects lasting from three to six

months, Depo-Provera is seen as an excellent candidate for population control

strategies in the South. But all the aspects of the drug that are considered

positive by the population control establishment can be seen as negative when

considered from the perspective of women's rights to control their own

fertility.

For example, if a woman experiences one of the many common adverse effects of

Depo-Provera, such as depression, hair loss, headaches, weight gain or loss,

menstrual spotting, heavy bleeding, amenorrhea (absence of menstruation),

anaemia, skin changes, and/or loss of libido, there is nothing she can do until

the injection wears off. Its injectible nature also opens it up to the

possibility of abuse, since it can easily be administered without full

explanation of its effects or side-effects.

While the use of Depo-Provera has not come to the point of litigation, as in the

cases of DES and the Dalkon Shield, its high potential for abuse, its multiple

adverse side-effects, and its possible long-term effects make it a likely

candidate for legal action, as were its contraception predecessors.

Of course, one significant difference lies in the demographics of women who use

Depo-Provera; that is, most of them live in the Third World, where weaker

regulations exist and where women are less aware of--or even have fewer--legal

rights. That this is the case points again to the role of profit in guiding the

decisions of pharmaceutical manufacturers: with less likelihood of litigation,

they are more free to dispense risky pharmaceutical drugs in the pursuit of the

highest profits.

Which brings us back to the question: how can globalization affect my health as

a Canadian woman? From the three examples above, it is obvious that

pharmaceutical companies do not always have the best interests of women in mind.

The response to this reality, one would think, is to ensure greater regulation

and a loosening of the grip of " the market " on health care and the

pharmaceutical industry. Instead, it is the opposite that is occurring as trade

deals continue to be negotiated and the World Trade Organization continues to

gain power.

Economic globalization is driven by a neoliberal agenda that promotes the

following three beliefs about a healthy economy: that unfettered free markets, a

reduced role for the state, and integration into the global economy offer the

only way towards peace, health, and prosperity for all.

It seems likely that reducing the role of the state (i.e., loosening government

regulations) and leaving the markets unfettered (i.e., making profit the highest

of goals) will merely result in less control over unscrupulous drug companies

and other for-profit corporations. And women, as the main consumers of

pharmaceutical drugs, and as the primary care-givers when social services begin

to collapse, are going to end up with a heavier and more dangerous burden to

bear.

Given the not-so-distant history of pharmaceutical deception and a disregard for

women's health, perhaps we should be thinking seriously about limiting rather

than increasing the powers of such corporations. If our government is not

vigilant in face of the pressures to become " globally competitive, " women's

health--and the health of all citizens--will suffer.

(Jackie Kennelly recently completed her MA in environmental studies at York

University in Toronto and is now living in Vancouver. This article is a summary

of her MA thesis.)

Taken from The CCPA Monitor, July/August 2002

Canadian Centre for Policy Alternatives

http://www.policyalternatives.ca

 

 

 

 

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