A Swiss pharmaceutical firm is the chief villain in the latest novel by the bestselling British author, John Le Carré. "The Constant Gardener" tells the story of a company that will stop at nothing to conceal its criminal activities.
Set mainly in Kenya, "The Constant Gardener" pits its hero, Justin Quayle - an increasingly disillusioned British diplomat - against "KVH", a fictitious pharmaceutical multinational that sells a tuberculosis drug, Dypraxa.
As Quayle investigates his opponent, he learns how KVH, a Swiss-US-Canadian concern, distorted clinical trials in order to get Dypraxa on to the market quickly. In spite of a series of tragic deaths, KVH cynically goes on developing the drug.
Some of the crimes committed by KVH seem so atrocious as to be unbelievable, but many will strike readers as disturbingly plausible. The company's agents use Africans as guinea pigs, dump old drugs on third world markets, and bribe medical experts and politicians to help market drugs and maintain a monopoly position.
The novel contains clear references to Basel - where KVH's European headquarters are based - and at one point, the hero ponders his next move in the shadow of the chimneys next to the river Rhine.
Le Carré, who created George Smiley, the best-known cold war spy in literary history, makes clear in an author's epilogue that KVH does not exist - "thank God". But he adds that "by comparison with the reality, my story [is] as tame as a holiday postcard".
Himself a former spy, Le Carré is known for his exhaustive research and extensive contacts. Most of his novels, including "The Constant Gardener", acknowledge the help provided by informants "who cannot be named".
In a recent interview with the British newspaper "The Times", Le Carré defended the unscrupulous practices described in the novel, saying that most were based on reality. The Times quotes him as saying that the conduct of pharmaceutical companies in Africa was "absolutely disgraceful".
Two of the largest Basel-based pharmaceutical companies, Novartis and Roche, refused to comment on the book. A spokesman would only say: "I don't think anybody from management has had the time to read through the over 500 pages yet."
David Pilling, pharmaceutical correspondent of the Financial Times - who reviewed the novel - says it contains some truths, but is "flawed because Le Carré throws too many allegations into it".
For instance, KVH is accused of developing the fictitious drug, Dypraxa, only for the western market because selling it in Africa would yield no profit. At the same time, the company uses Africans for secret medical trials at the cost of many lives.
"The two notions are in conflict with one another", says Pilling. "On the one hand, Le Carré accuses pharmaceutical companies of exploiting Africa, while on the other he charges them with neglecting it."
Peter Baumgartner, Africa correspondent for the Zurich-based Tages-Anzeiger newspaper - who is based in Kenya - says at least some of the malpractices highlighted by Le Carré are real.
He says pharmaceutical multinationals have a record of colluding with doctors to exploit the attitude of Africans, who often ascribe supernatural healing powers to western drugs. "People are made to pay a lot of money for pills they don't need," Baumgartner says.
He adds that doctors have a stake in selling as many drugs as possible and as expensively as possible.
"This is why many are opposed to using generic drugs - inexpensive drugs with components that are identical with those in the original brand - as much as the pharmaceutical multinationals. Lobbying doctors is routine for pharmaceutical companies throughout Africa."
Le Carré also focuses on the practice of dumping old drugs in developing countries, and unethical clinical trials.
In 1997, experiments were conducted on over 12,000 pregnant women infected with HIV in Africa, Thailand and the Dominican Republic. While some women were given AZT, a drug that can prevent transmission of the deadly Aids virus to unborn babies, others were given placebos. However, the trial, highly controversial at the time, was not conducted by a pharmaceutical corporation, but by US government scientists.
The high cost of treating Aids has long been a controversial issue. At a recent UN-sponsored conference in Durban, South Africa, the five multinationals who share the SFr6 billion market in Aids drugs - including the Basel-based Roche -hinted for the first time that their drugs could be made available at a discount in Africa.
Critics pointed out, however, that the effects would be minimal as long as only multilateral assistance programmes could benefit.
Moreover, it remained unclear if the pharmaceutical firms, which oppose the use of generic substitutes for their Aids drugs, were making their offer conditional on African governments guaranteeing international patent rights.
by Markus Haefliger