The true story of how multinational drug companies took liberties with African lives

The pharmaceutical industry is bracing itself for criticism when the film 'The Constant Gardener' opens next month. But Jeremy Laurance reports that away from the Hollywood script is a true story of how multinational drug companies took liberties with African lives with devastating consequences

Nobody knows what caused Anas' pain but suspicion has fallen on Big Pharma. Six years earlier, Anas was a patient in a trial of a new drug run by one of the world's biggest companies. A known side effect of the drug, called Trovan, was joint pain. The issues raised by Anas' story have become the subject of a major British film.

The multinational pharmaceutical industry is bracing itself for an uncomfortable autumn. Next month, The Constant Gardener, the film based on the novel of the same name by John Le Carré, opens in London.

Directed by Fernando Meirelles, of City of God fame, it is a thriller, a love story and a blistering attack on the drugs industry and the way it carelessly expends the lives of innocent citizens in the Third World in the quest for billion-dollar medicines to sell to the first world.

As with dramas of this kind - such as the 1999 film, The Insider, which detailed the perfidious dealings of the tobacco industry - it raises the question of how far fiction resembles fact. So it is worth examining the background to The Constant Gardener. The film opens in a remote area of northern Kenya where Tessa Quayle (played by Rachel Weisz), the wife of a British diplomat, has been murdered. Her travelling companion, a local doctor, has disappeared, and the evidence points to a crime of passion.

At the time of her death, Tessa, an activist and passionate campaigner, was on the verge of uncovering a conspiracy involving the testing of a new drug. In personality she was the opposite of her husband, the mild-mannered Justin Quayle (Ralph Fiennes), whose chief passion is his plants - he is the gardener of the title.

But in his grief, and goaded by whispers of her infidelity, he sets out to complete what she started, embarking on a quest to expose the truth about the pharmaceutical industry.

What he uncovers, as the film's blurb puts it, is "a vast conspiracy, at once deadly and commonplace, one that has claimed innocent lives - and is about to put his own at risk". At the centre of this conspiracy is the idea that pharmaceutical companies use African people to test drugs which are destined to become huge profit-earners in the West.

It is not the first time such allegations have been made, but they have rarely been levelled with such dramatic effect. Some will find The Constant Gardener's thesis overblown, but it is a gripping thriller, ravishingly shot by César Charlone, that conveys the chaos, grandeur and darkness of Africa with unequalled authenticity. After the credits roll, a note from John Le Carré appears on screen that reads: "Nobody in this story, and no outfit or corporation, thank God, is based upon an actual person or outfit in the real world. But I can tell you this; 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." This is hard to credit. The film features two brutal killings, a savage beating, a campaign of harassment, intimidation and threats involving two governments and their security services - all to protect the interests of a pharmaceutical company that is testing a drug on mothers and children and quietly burying its failures.

Maybe there are pharmaceutical companies that have engaged in such crimes and enlisted the support of corrupt governments. Who can say? But it is not necessary to posit such a gargantuan conspiracy, where paranoia is the only rational response. The crimes of the pharmaceutical industry - from the price protection of Aids drugs which have denied life-saving medicines to millions, to the cover up of lethal side effects to protect profits - are well documented.

But there are two cases in which named companies have been accused of wrongdoing that partly inspired The Constant Gardener and which give resonance to the allegations about the secret testing of drugs on the unsuspecting and the suppression of any negative findings.

In 1996, Kano was suffering from outbreaks of cholera and measles when a third, even more deadly, disease arrived: meningitis. The infection spread quickly through the cramped slums of the city and within weeks thousands of children were ill.

The outbreak was not reported in the West but it did not go unnoticed. An internet message alerted scientists at the research headquarters in Connecticut, of one of the world's biggest drug companies: Pfizer.

The company reacted swiftly. It chartered a plane to Kano with a new drug called Trovan that was a potential life-saver and a potential billion-dollar profit earner. But Trovan had never been tested on children.

The Infectious Diseases Hospital in Kano was under siege from desperate parents who brought their dying children begging for help. One of these was Anas, then aged six. His father, Mohammed, said his son was given a drug by "a doctor from overseas" and put to bed. Mohammed assumed the doctors who treated his son were from Médecins Sans Frontièrs, an independent medical organisation, who had arrived several weeks before the Pfizer team.

Only later when he examined a card he was given did he realise that Anas had been included in a trial of the new drug Trovan. The card was numbered 0001 - Anas was the first.

His story was told in the Channel 4 documentary Dying for Drugs, broadcast in 2003, which alleged that Pfizer had failed to obtain informed consent from the parents of the children tested, and had back-dated a letter granting ethical approval for the trial from the ethics committee of the Aminu Kano Teaching Hospital. Pfizer said it remained satisfied the Kano experiment was conducted properly.

Since the trial, Anas has had a pain in his knee which X-rays showed was inflamed and which prevents him from running. Trovan was not used in the US because it caused side effects including joint pain. It is impossible to tell whether Anas's knee problem was caused by the drug or was a consequence of the meningitis. Trovan was later withdrawn from the market for unrelated reasons, after it was linked with a number of deaths of patients from liver damage.

But the case against Pfizer did not end there. Lawyers seeking damages for the children involved in the Trovan trial obtained a letter sent by Pfizer's childhood diseases specialist, Dr Juan Walterspiel, protesting strongly about it. Dr Walterspiel set out eight grounds for opposing the trial including the fact that Trovan had "not been tested for its sensitivity before the first child was exposed to a live-or-die experiment." His contract with the company was terminated soon after.

Brian Woods, who made Dying for Drugs, met Meirelles and Le Carré, during the development of The Constant Gardener. "We had an entertaining lunch in which we were all frothing about the pharmaceutical industry," said Woods, who last week won a commission from Channel 4 to make a follow-up film.

Meirelles, whose Brazilian background gave him a strong interest in the issue of first world/Third World exploitation, distributed copies of Dying for Drugs to cast members, and it had the desired effect. After watching it and reading other background material that Meirelles had given him, Ralph Fiennes said: "There are huge questions about Big Pharma. The companies are not obliged to disclose a lot of information about how they test or make their drugs. There's big, big money involved." Rachel Weisz concurred. "It's David and Goliath; the little people taking on the big corporations. They [the pharmaceutical companies] make all this money, yet people in developing countries can't afford the drugs that could save their lives."

A second case of dubious practice by the pharmaceutical industry also has echoes in The Constant Gardener. A Canadian specialist, Dr Nancy Olivieri of Toronto's Hospital for Sick Children, was among the world's leading experts in the blood disorder thalassaemia when she agreed to take part in the trial of a new drug, Deferiprone, made by the US company Apotex.

Deferiprone helps clear iron from the blood which builds up in patients with thalassaemia and can be fatal. At first the trial went well and Dr Olivieri published promising results in The New England Journal of Medicine.

Then she noticed worrying liver changes in some of her patients. She raised her concerns with the company and tried to find a way of adapting the trial. But she was unprepared for the response of the company, whose potential million-dollar drug she was now questioning.

Mike Spino, the vice-president of Apotex, informed her that the trial had been terminated, and warned her that she would face legal action if she spoke about it to anybody, in breach of her duty of confidentiality.

That triggered a dispute between Dr Olivieri and Apotex that has dragged on for more than five years, during which she has not published new research. Sir David Weatherall, Regius Professor of Medicine at Oxford University and a supporter of Dr Olivieri, said the case raised a "fundamental issue of academic freedom". Nor was it an isolated case. Sir David added that editors of medical journals including The Lancet and The Journal of the American Medical Association had come under pressure not to publish data or to change it.

This story is also told in Dying for Drugs. Deferiprone is now licensed in more than 24 countries, including the UK, and Apotex insist it is safe and effective. The company also accused Dr Olivieri of making errors in the trial that made her results worthless.

Wherever the truth in the cases of Pfizer and Apotex, the behaviour of Big Pharma will come under renewed scrutiny thanks to The Constant Gardener. Even if its picture of multinational corporations engaged in global conspiracies with corrupt governments seems excessively paranoid, there are real issues to confront. The bigger scandal lies not in the forging of consent forms to clinical trials, nor even in the intimidation of recalcitrant researchers. It lies in the rapacious pricing of the pharmaceutical industry that puts life-saving drugs out of reach of individuals, hospitals and even nations. The words used to justify these prices are "research and development". But in truth, the industry's biggest cost is marketing. Extraordinary sums are spent persuading doctors to prescribe new drugs only fractionally different from older, cheaper ones, which ramp up prices.

Great as this conspiracy is, unfortunately it does not provide for a blockbuster thriller.

Start your day with The Independent, sign up for daily news emails
News
Legendary blues and rock singer Joe Cocker has died of lung cancer, his management team as confirmed. He was 70
people70-year-old was most famous for 'You are So Beautiful'
News
people
Sport
Chelsea manager Jose Mourinho
footballLatest score and Twitter updates
Life and Style
fashionOne man takes the hipster trend to the next level
PROMOTED VIDEO
ebooks
ebooksA year of political gossip, levity and intrigue from the sharpest pen in Westminster
Life and Style
Approaching sale shopping in a smart way means that you’ll get the most out of your money
life + styleSales shopping tips and tricks from the experts
News
newsIt was due to be auctioned off for charity
Life and Style
A still from a scene cut from The Interview showing North Korean leader Kim Jong-un's death.
tech
Environment
Sir David Attenborough
environment... as well as a plant and a spider
Voices
'That's the legal bit done. Now on to the ceremony!'
voicesThe fight for marriage equality isn't over yet, says Siobhan Fenton
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Ashdown Group: IT Support Technician - 12 Month Fixed Term - Shrewsbury

£17000 - £20000 per annum: Ashdown Group: IT Helpdesk Support Technician - 12 ...

The Jenrick Group: Maintenance Planner

£28000 - £32000 per annum + pension + holidays: The Jenrick Group: Maintenance...

The Jenrick Group: World Wide PLC Service Engineer

£30000 - £38000 per annum + pesion + holidays: The Jenrick Group: World Wide S...

The Jenrick Group: Project Manager

£35000 per annum + Pension+Bupa: The Jenrick Group: We are recruiting for an e...

Day In a Page

Surrounded by high-rise flats is a little house filled with Lebanon’s history - clocks, rifles, frogmen’s uniforms and colonial helmets

Clocks, rifles, swords, frogmen’s uniforms

Surrounded by high-rise flats is a little house filled with Lebanon’s history
Return to Gaza: Four months on, the wounds left by Israel's bombardment have not yet healed

Four months after the bombardment, Gaza’s wounds are yet to heal

Kim Sengupta is reunited with a man whose plight mirrors the suffering of the Palestinian people
Gastric surgery: Is it really the answer to the UK's obesity epidemic?

Is gastric surgery really the answer to the UK's obesity epidemic?

Critics argue that it’s crazy to operate on healthy people just to stop them eating
Homeless Veterans appeal: Christmas charity auction Part 2 - now LIVE

Homeless Veterans appeal: Christmas charity auction

Bid on original art, or trips of a lifetime to Africa or the 'Corrie' set, and help Homeless Veterans
Pantomime rings the changes to welcome autistic theatre-goers

Autism-friendly theatre

Pantomime leads the pack in quest to welcome all
The week Hollywood got scared and had to grow up a bit

The week Hollywood got scared and had to grow up a bit

Sony suffered a chorus of disapproval after it withdrew 'The Interview', but it's not too late for it to take a stand, says Joan Smith
From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?

Panto dames: before and after

From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?
Thirties murder mystery novel is surprise runaway Christmas hit

Thirties murder mystery novel is surprise runaway Christmas hit

Booksellers say readers are turning away from dark modern thrillers and back to the golden age of crime writing
Anne-Marie Huby: 'Charities deserve the best,' says founder of JustGiving

Anne-Marie Huby: 'Charities deserve the best'

Ten million of us have used the JustGiving website to donate to good causes. Its co-founder says that being dynamic is as important as being kind
The botanist who hunts for giant trees at Kew Gardens

The man who hunts giants

A Kew Gardens botanist has found 25 new large tree species - and he's sure there are more out there
The 12 ways of Christmas: Spare a thought for those who will be working to keep others safe during the festive season

The 12 ways of Christmas

We speak to a dozen people who will be working to keep others safe, happy and healthy over the holidays
Birdwatching men have a lot in common with their feathered friends, new study shows

The male exhibits strange behaviour

A new study shows that birdwatching men have a lot in common with their feathered friends...
Diaries of Evelyn Waugh, Virginia Woolf and Noël Coward reveal how they coped with the December blues

Famous diaries: Christmas week in history

Noël Coward parties into the night, Alan Clark bemoans the cost of servants, Evelyn Waugh ponders his drinking…
From noble to narky, the fall of the open letter

From noble to narky, the fall of the open letter

The great tradition of St Paul and Zola reached its nadir with a hungry worker's rant to Russell Brand, says DJ Taylor
A Christmas ghost story by Alison Moore: A prodigal daughter has a breakthrough

A Christmas ghost story by Alison Moore

The story was published earlier this month in 'Poor Souls' Light: Seven Curious Tales'