International Public Health: Patients' Rights versus the Protection of Patents.(Book review)

INTERNATIONAL PUBLIC HEALTH: PATIENTS' RIGHTS VERSUS THE PROTECTION OF PATENTS Yves Beigbeder Ashgate, Aldershot UK: 2004, ISBN 0 7546 3621 6; HB only; 173pp; USD 94.95 / 47.50 [pounds sterling]

I found this book both fascinating and frustrating. The frustration begins with the title, which does not clearly reflect the author's purpose. The book focuses on United Nations' (UN) organisations, in particular the World Health Organisation (WHO), and their recently established partnerships with corporations and corporate-sponsored foundations. Beigbeder states:

 
   The main object of this book is to weigh the 
   costs and benefits of this 'new partnership' or 
   alliance, to assess the compatibility of the global 
   mandate of the UN organisations concerned 
   with public health with the profit objectives of 
   business firms, to set possible limits on their 
   interaction (p.10). 

The author addresses this purpose mostly via a compendium of case studies: details of intersections between specific UN organisations, transnational corporations (TNCs) and others over the last fifty years. The book is in four parts plus an introduction and a conclusion. The introduction characterises international health policy as a contest between governments, rich and poor, and three constituencies: TNCs, NGOs, and intergovernmental organisations (IGOs) such as the UN, The World Bank, the World Trade Organisation (WTO), WHO and regional organisations. Part One sets out a history of relationships between the constituencies. Part Two presents three issues over which the constituencies have clashed: the promotion of breastfeeding and its substitutes, access to essential drugs, and HIV/ AIDS. Part Three discusses private-public partnerships in four areas: onchocerciasis, poliomyelitis, malaria and tuberculosis, and vaccines and immunisation. Part Four focuses on the WHO's war with the tobacco industry.

Beigbeder has spent time in UN organisations including WHO, and the book's style and content seem to reflect this, although he makes clear that it was written 'in a personal capacity' (p.11). Beigbeder's sources include UN and WHO officials and he adopts 'the vantage viewpoint of WHO' (p.10): a straightforward reporting style and with empirical rather than philosophical or theoretical questions. Constituencies' arguments, descriptions of events, economic and epidemiological data and intricate detail of WHO codes and conventions are collated with little intrusion aside from the most even-handed summations. There were times when I wanted less description, more analysis, and a more transparent admission of the author's own position, which was partly implied via the ideas presented as given: that the WTO is creating health inequities and this is a bad thing, for example, an idea contested by exponents of unfettered trade liberalisation.

Beigbeder sometimes gets caught up in details without clearly relating them to his broader purpose. However, the ...