Courtesy of Mental Floss, with over 18,000 likes and 5,300 shares.  This meme is generally shared as an indictment on capitalism, to show how the polio vaccine was created without concern to profit, contrasted with today’s “big pharma” and their less pure motivations.  While the quote is valid, there is much more to the story than this meme gives its viewers.

Private Charity and the Polio Vaccine

Polio is one of the most destructive diseases in history.  In the early 20th century it killed more people in America than any other communicable disease, not to mention the millions who were crippled by it.  It’s not widely known, but it was private charities and Americans voluntarily donating money that lead to the demise of polio.

The Rockefeller Institute funded basic research into the virus for years.  Then, the National Foundation for Infantile Paralysis (which later became the March of Dimes) spearheaded the effort.  Their budget soared to more than $50 million in 1953 (equivalent of over $700 million today).  This was 25 times more than the NIH spent that year.  An astounding 80 million people donated money to the cause in a single year, some contributing as little as a dime, but a remarkable example of private charity at work.  An entire generation of scientists, including Watson and Crick of DNA fame, received money from this foundation.

One of the researchers who received these funds was the brilliant young Dr. Jonas Salk of the University of Pittsburgh, who ended up developing the polio vaccine.

The Polio Vaccine Patent Attempt

What’s left out of this meme is the fact that lawyers for the National Foundation for Infantile Paralysis did look into patenting the vaccine!  However, they concluded it didn’t meet the standards of the day for a patentable invention, so they stopped pursuing it.

Some have used this fact to question Dr. Salk’s honesty in regards to his quote, but this is probably unfair.  It’s not clear what the Foundation would have done with the patent, but since it was a non-profit organization solely dedicated to eradicating child paralysis, it would likely use the polio vaccine patent in that vision.  However, when Salk said that this patent belonged to “the people” it wasn’t just a socialist bromide in this context.  The vaccine did belong to the people in effect; the millions who donated money to the Foundation.  He didn’t say, or likely mean, that all vaccines belong to “the people”, just this vaccine.  It was the prevailing wisdom at the Foundation, and rightly so, that since the public had directly financed the polio vaccine, profiting on it would be double-charging, not in line with the mission of a private charity.

Conversely, if a private company had come up with a vaccine, it would rightly belong to the investors of that company, provided the patent was legal and applicable.

Other Medical Patents

The list of important medical breakthroughs that have been patented are too numerous to list, but it’s hard to get bigger than penicillin, which could be arguably the most important medical discovery in history.  While the discovery of penicillin wasn’t patented, the manufacturing process was.  In 1944, Andrew J. Moyer developed techniques for the mass production of penicillin.  Before his research, chemists could only make small amounts of the antibiotic for clinical trials.  The ability to mass produce the drug had tremendous benefits, quickly realized during World War II, as 2.3 million doses were churned out just prior to the Normandy invasion.  The antibiotic saved 12-15% of the Allied lives during the war.

While much money was made from this patent, it did not result in gouging the consumer, precisely the opposite.  The price of penicillin dropped from $20 a dose in 1943 prior to the patent, to just $.55 by 1946, making it accessible to virtually anyone.  This mass production also allowed scientists from all over the world to easily obtain and study penicillin, and make countless other breakthroughs with different strains of bacteria.  It’s hard to think of a better way “the people” could have benefited.

Even the Dr. Salk of this meme ended up founding a company later in life that worked on an HIV vaccine.  They tried to patent it when the research was promising, although unfortunately the vaccine didn’t succeed.  Clearly, he either changed his mind about his earlier quote, or it never meant what some take it as.

The FDA and High Costs to Develop Drugs

In the 1950s when Dr. Salk made his breakthrough, the FDA was much smaller and less onerous than today.  Developing a drug or vaccine and bringing it to market could be done quite rapidly, as shown with the quick roll out of penicillin and the polio vaccine.  That is not the case today, as the laws have become much more restrictive, and the bureaucracy much thicker.  As Milton Friedman put it in 1979:

The number of “new chemical entities” introduced each year has fallen by more than 50 percent since 1962.  Equally important, it now takes much longer for a new drug to be approved and, partly as a result, the cost of developing a new drug has been multiplied manyfold.  According to one estimate for the 1950s and early 1960s, it then cost about half a million dollars and took about 25 months to develop a new drug and bring it to market….By 1978, “it was costing $54 million and about eight years of effort to bring a drug to market”- a hundredfold increase in cost and quadrupling of time, compared with a doubling of prices in general.  As a result, drug companies can no longer afford to develop new drugs in the United Statees for patients with rare diseases.  Increasingly, they must rely on drugs with high volume sales.

It’s gotten even worse since then.  A recent Tufts study estimated the cost of developing a drug at nearly $2.6 billion!  Tufts is partially funded by drug companies, so the figure is validly questioned, but most sources put it at a minimum of $800 million to well over a billion.  It’s not too hard to see why no one is creating new drugs solely for “the people”.  Even if they wanted to, it would be quite daunting for a charity to raise enough money to navigate the bureaucracy.  Ironically, it’s government regulation that has necessitated large companies to become the only provider of drugs.

Is the FDA Necessary?

Many people instinctively assume a powerful FDA is necessary to protect us from poison drugs, but frequently it approves harmful drugs, while simultaneously creating huge hurdles for beneficial drugs to enter the market.  Instead of a system where the FDA sits atop a pyramid that controls the drug industry (leading necessarily to huge lobbying efforts and an incestuous relationship), it would be better to have a more competitive and decentralized system.  Allowing doctors and hospitals the freedom to make decisions on which medicines and innovations are best.  There are many examples of this working.  Since 1993, the group Worst Pills Best Pills has successfully predicted all 20 of the FDA’s withdrawals, often years before the government warned consumers.

One reason the FDA is so obtrusive and slow is since 1962 they have tried to ensure drugs are both safe and effective.  These are not objective terms in medicine, so there is a great deal of subjectivity and confusion.  There is no drug that is “safe”.  All drugs have side effects, and can kill.  Similarly, it’s impossible to say what is “effective”, as it depends on the patient and the severity of their condition.

For a terminally ill patient, the trade-off between “safe” and “effective” takes on a whole new meaning when considering an experimental, life-saving drug or vaccine.  For a perfectly healthy adult, the trade-off will be completely different.  Chemotherapy would be considered poison to a healthy person, and life-saving medicine to certain cancer patients.  Frequently, people and drug providers are prevented from making these decisions, as they can only legally do what is “FDA approved”.  As with most large bureaucracies, it paints with a wide brush.

Patent the Sun?

The comparison to patenting the sun is not relevant or apt.  Something that’s naturally available to everyone with little to no effort is nothing like an invention or discovery that takes brilliance and dedication.  It wasn’t “the people” who discovered the polio vaccine, it was mostly due to the efforts of Dr. Salk. Legally, the criteria to patent the polio vaccine might not have existed, but to compare a medical breakthrough to the sun, or attempt to portray profiting from medical technology as “greedy” and immoral is wrong.  Any common idiot can see the sun, perhaps only one in a million can figure out a polio vaccine.

Conclusion

This meme does accurately quote Dr. Salk, but leaves out information that will change many people’s interpretation of it.  In some cases, like when a private charity funds research, it may make sense that the vaccine be “the people’s”.  Even still, it still must be produced, which is usually done best through a profit seeking company.  In other cases, where a private company or individual does the research, it makes perfect sense that they be able to profit and market their invention.  Both motivations are moral, and will continue to move the field of medicine forward and improve the human condition.  Notice, the societies where everything was ostensibly “owned by the people” (i.e. the Soviet Union, Cuba, Venezuela and China) contributed extremely little to medical progress, while more individualist America and Britain contributed the lion’s share, benefiting billions across the world.

Whether one pursues medical technology for monetary gain, charity or both, is up to the individual, but the world is clearly better off when brilliant people are free to pursue their interests in whatever way they wish.