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Let's start at the beginning, in 1979, when scientists at the European drug company Aventis discovered that a drug called eflornithine was viritually a miracle cure for the parasite-caused disease trypanosomiasis, also called sleeping sickness. It was also thought the drug would be useful against cancer, so manufacture of the drug was started.
Alas, clinical tests revealed that eflornithine was useless as a cancer-fighting drug. So production was ceased. There is, after all, no money to be made from sleeping sickness, a disease entirely confined to central Africa -- Uganda, all iterations of the Congo, Sudan, low-rent-districts like that.
The vector of trypanosomiasis is the tsetse fly. There are two types of the disease; the more common one is usually fatal without treatment, according to the World Health Organization. It goes like this: Tsetse fly bites human, injecting the parasite. Parasite multiplies and crosses the blood-brain barrier. Then it begins eating the brain. Children who survive sleeping sickness often have retardation and other psycho-neurological impairments.
The World Health Organization has been working since the '50s to destroy tsetse-fly habitats near urban centers; one over-optimistic report in 1981 announced that trypanosomiasis had been virtually wiped out in Africa.
Then came a series of regional wars and revolutions, and tsetse-fly habitats returned, as did sleeping sickness. WHO estimates that 300,000 people a year are being infected.
Well sir, back in the States those busy drug chemists were trying to find some profitable use for eflornithine. Bristol-Myers Squibb finally had that "eureka" moment, almost by accident. It turned out that it was great for removing facial hair in women, a non-disease that "afflicts" millions of people with disposable incomes.
Bristol-Myers Squibb licensed the patents from Aventis, and just this year Vaniqua, for those embarrassing feminine mustaches, was introduced into the market. Smooth-lipped American women and dying African babies, linked by a common compound. It's a small world after all.
Doctors Without Borders, God bless them, was all over the problem. It did not take them long to convince the drug companies, already under fire for windfall profits and for ignoring developing countries, that they might have just a teeny image problem.
They agreed to make 60,000 medical doses by June and donate them free of charge. (Just for comparison: 300,000 people infected annually; 60,000 medical doses offered.) According to the New York Times, the parties are also negotiating for more pills, some donated, the rest purchased. DWB is holding out for a fixed price of $10 per dose; the drug companies are balking.
A month's supply of Vaniqua costs about $50 at big retail chains. The company thinks enough of the drug to mount a large cross-platform advertising campaign, including multipage supplements in women's magazines. They believe that investment will pay off.
Because both figures are confidential, we can only speculate how many medical doses of eflornithine could be made for the cost of six glossy pages in Cosmopolitan. Maybe we could put it in terms of African citizens saved from death per square inch of page.
That's an unfair way to look at it, of course. Drug companies must make profits in order to do the research that leads to the drugs that they fail to supply to Africa because there's no profit in it. There are stockholders to answer to. Besides, candidly: Don't we have too many people already?
As John Donne once wrote so movingly: No one's death diminishes me, because I'm still alive.
Stupid stuff, it makes us shout, oh dance with me, oh don't be
jcarroll@sfchronicle.com
San Francisco Chronicle
February 13, 2001