HEALTH CARE/Joan Retsinas

A Nonprofit Drug Company

Diogenes the Cynic scoured the world for a few honest men. I'm searching for a few altruistic healthcare organizations.

I don't expect to find them among the nonprofit hospitals. After exhaustive hearings, Senate Finance Committee Chair Charles Grassley declared, "Nonprofit doesn't necessarily mean pro poor patient" (Kathleen Day, Washington Post, Sept. 13). The committee found instances where nonprofit hospitals overcharged poor, uninsured patients -- or turned them away. And nonprofit hospital executives' perks rival those of private-sector honchos. The Diogenes in me will have to search further.

I won't find altruism among the insurers. They all, nonprofit and for-profit, sponsor health fairs, distribute bicycle helmets and fund 5K races. Yet those activities are tangential to the total budget, and marginal in the mission of bolstering the bottom line. Self-interest, not altruism, reigns here.

As for drug companies, their executives answer to the shareholder-owners. While the companies do give free drugs to impoverished, uninsured sufferers, these companies lobby to keep prices high. Americans can't import cheaper drugs from Canada. Medicare doesn't negotiate prices for its Part D program. Third-world countries face patent restrictions. To focus on rare diseases, the companies often demand subsidies. Lobbyists have earned their fees. Doing good has paid off handsomely.

So what a happy surprise to find a genuine oxymoron: a nonprofit pharmaceutical company, dedicated to developing a drug that will primarily help people, not primarily enrich shareholders.

The notion of a nonprofit pharmaceutical company is bizarre. Indeed, when Victoria Hale sought to incorporate OneWorld Health as a nonprofit venture, the IRS initially turned her down. The IRS had never encountered such a hybrid; reviewers decided it had to be a scam to shelter profits.

But OneWorld Health, headquartered in San Francisco, is real. Once blessed with nonprofit status, OneWorld solicited funds from private philanthropists, including the Bill and Melinda Gates Foundation. OneWorld joined forces with Gland Pharma Limited (an Indian drug manufacturer), the International Dispensary Association, the World Health Organization's Special Programme for Research and Training in Tropical Diseases, and the Government of India. After clinical trials, OneWorld reported success: an injectable treatment (Paromomycin) for black fever. The cost: $10 per lifetime cure. The price: $10 per lifetime cure. This is a nonprofit venture.

Black fever is a scourge of the developing (and the yet-to-develop) world. It is a parasitic disease, almost always fatal, second to malaria in the number of people it infects. It is one of those diseases that attack millions of people, but not millions of paying customers. A costly treatment already existed. Patients, though, could not afford the cost.

And profit-drive companies had no incentive to develop a cheaper treatment. The need for treatment didn't translate into "demand," in the market-sense; and the companies that had to answer to their shareholders couldn't or wouldn't take up this challenge.

That left millions of people destined to die of black fever.

Enter OneWorld. They took up the gauntlet to help the millions of patients-who-are-not-customers. OneWorld started with India. It plans to forge distribution networks in Bangladesh, Nepal, Sudan, Ethiopia, Kenya and Brazil.

The MacArthur Foundation recently awarded Dr. Hale a "genius" award.

She, and OneWorld Health, also deserve a "Diogenes" award, for creating a marvel of altruism, a nonprofit pharmaceutical company.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, November 1, 2006

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