John Le Carré: The Constant Gardener

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As my journey through the pharmaceutical jungle progressed, I came to realise

that, by comparison with the reality, my story was as tame as a holiday

postcard. -- John le Carre

 

 

 

 

 

Le Carré, John

The Constant Gardener

 

 

Genre Novel (492 pp.)

Keywords AIDS, Colonialism, Death and Dying, Developing Countries,

Disease and Health, Epidemics, Grief, Homicide, Human Worth,

Infectious Disease, Medical Ethics, Medical Research, Mourning,

Poverty, Power Relations, Public Health, Racism, Society, Tuberculosis,

 

Summary

 

Tessa Quayle, the young wife of a British civil servant in Kenya, is

mysteriously murdered. Tessa, a lawyer, had been an outspoken human

rights activist, and something of an embarrassment to her husband. But

shaken from his marital and political complacency by her death and the

rumors that quickly surround it, Justin Quayle sets out to solve the

mystery and in doing so inherits her cause.

 

Tessa had discovered, as Justin now learns, that a new tuberculosis

drug was being prematurely tested on Kenyan patients: clinical trials

were effectively being carried out on the African population by the

drug's giant pharmaceutical producer without the patients' knowledge

or consent, but with the support and cover of a global corporation

with African interests and of the British High Commission in Kenya.

Lethal side effects and deaths were being concealed, the drug

retitrated and retested in preparation for its safer and more

lucrative release in the west in time for a predicted rise in

incidence of multi-resistant strains of TB.

 

Justin, now a kind of rogue agent, uncovers the layers of sinister

plotting to be expected in one of Le Carré's intelligence thrillers,

but in the process we are led to consider, vividly, the interlocking

roles of international biomedical research, postcolonial political

interests, and global capital in determining the fates of

impoverished, uneducated, and deeply vulnerable patients in developing

countries--as well as the fates of those who try, often against all

odds, to offer them the best available care. The novel also gives us,

in Justin Quayle's odyssey, a moving study of desire, loss, regret,

and, finally, outraged action.

Commentary This novel, as Le Carré himself avows, is fictional, its

primary purpose that of any intelligently-written mystery thriller. It

nonetheless explores some topical and contentious issues in the

financing of biomedical research and the global distribution of health

care. It engages in current debates about provision of HIV-AIDS

medication to developing countries, the production of cheaper generic

versions of such drugs, and the sociopolitical and economic

infrastructure factors that complicate the provision of health care to

these populations.

 

In his afterword, Le Carré asserts the importance of independent

medical research, saying that the important issue, in his novel, and

more broadly, is that of " individual conscience in conflict with

corporate greed " and " the elementary right of doctors to express

unbought medical opinions, and their duty to acquaint patients with

the risks they believe to be inherent in the treatments they

prescribe " (570).

 

This novel might form an engaging way to provoke student discussion of

these issues, not least in terms of the availability of information,

the role of the media in raising awareness of global bioethical

malpractices, and the status of popular fiction like this as a means

of arousing public interest in the actual conditions to which it

alludes. In his afterword, Le Carré makes this tantalizing and

sinister observation about researching the novel: " As my journey

through the pharmaceutical jungle progressed, I came to realize that,

by comparison with the reality, my story was as tame as a holiday

postcard " (568).

 

 

Publisher: Scribner (New York)