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The Paradox of AIDS and 'Harm Prevention' Drugs

The authors are also worried that the drug, being so expensive, will not be available to all who might benefit from it, not only in the United States but in the whole world. This raises problems of equity and justice. Would it be better, then, that it should be available to no one, rather than to the well-off alone?

To answer yes to this question would be dog-in-the-manger. But the authors are able to console themselves with the natural history of such innovations: for means are generally found within a relatively short time to make them much cheaper and therefore more widely available than they were to begin with.

What they fail to point out is that, for such innovation to occur, there has to be a period of what they would no doubt consider injustice or inequity, at least if it is admitted (as surely anyone other than a Utopian socialist must) that commercial gain is a powerful, indeed the most powerful, incentive to such innovation. Gilead Sciences would almost certainly not have striven to develop their balm if, from the very beginning, that balm had to be sold to everyone who could benefit from it at a knock-down price.

Injustice and inequity – if that is indeed what the authors of the article are describing – are thus a normal precondition of progress, not an alarming consequence of it. When penicillin was first developed, after all, it was available to very few, whose lives were saved by it most inequitably.


Thumbnail courtesy shutterstock / Peter Kim