A few days ago at the National Institute of Cancerology (InCan) the book “Cancer of cancer. Neoliberalism in oncology” was presented, written by Dr. Alfonso Dueñas González, who was Director of Research at said institute in previous years.
The title alone already generates controversy in the current context of Mexico where the word neoliberalism is used recurrently every day by President López Obrador in the morning conference to refer to his political opponents.
However, Dr. Dueñas, who is currently a researcher at UNAM’s Biomedical Research Institute and at InCan itself, poses the situation in a global context and not of a particular country, that is, his analyzes reflect much more than what that today for Mexicans could tell us the title.
The author explains why, from his point of view, the research and practice of oncology in the world is sick, driven above all by the search for profit on the part of the main pharmaceutical multinationals. He questions the value of innovation with hard data: the average survival for the 124 new drugs approved by the FDA between 2003 and 2021 is 2.8 months. And the cost of 71% of those approved between 2017 and 2021 ranges from 166,000 to 833,000 pesos per month. The source he gives is IQVIA Institute, a world leader in data use and advanced analytics for the healthcare industry.
It is relevant that Dr. Dueñas exposes his position because he is a candidate to lead the Incan – until today the only one who has raised his hand – now that the change of post comes next August when the second term of Dr. Abelardo Meneses, who has been leading, ends said Institute since 2013.
After presenting generalities of globalization and neoliberalism, Dr. Dueñas exposes in his book a look at the health systems in representative countries such as the USA, the United Kingdom, the European Union, China, India, Australia, Latin America, the Caribbean and Africa, and then he talks about public health policies that have generated negative consequences due to their commercialization.
He gives an overview of oncology worldwide and explains how from his vision, there is a dysfunctional situation in the efforts against cancer, affected by the large pharmaceutical and biotech corporations collectively called Big Pharma. He talks about how with its great economic, political and social influence, the transnational pharmaceutical sector ends up capturing health regulators, international organizations, civil society associations and the medical and scientific community, having an impact on prevention, early detection and treatment of cancer.
With various examples, Dr. Dueñas supports the reality that low-income countries experience in terms of cancer management: “they tend to use ‘latest generation’ treatments -very expensive- which, for obvious reasons, can consume the few existing resources without benefiting the majority of its population”. And he underscores the sensitivity of this phenomenon considering that low- and middle-income countries (such as Mexico) have 5% of the world budget for cancer care, but represent more than half of the global burden of this disease.
A chapter that draws attention is the so-called Manipulation of the biosimilars market. It simply explains the history of molecular biology and biotech drugs from their inception in the 1990s to when they account for half of the global drug market. In the year 2000, only one biopharmaceutical was among the top 10 in sales, and by 2020, of the 10 best-selling medicinal products, 5 are biopharmaceuticals and, of these, 2 are for cancer.
It shows how the competitive terrain is quite uneven with the national pharmaceutical industries always at a disadvantage before the Big Pharma that manage to influence and put legal, regulatory and commercial incentives in their favor, discouraging local research and development. Total, that apart from philias and phobias around neoliberalism, it is necessary to read the book by Dr. Dueñas edited by Oncomedic.
