Patent Horror

A documentary on how a Western medical mafia blocked cheap HIV/AIDS drugs in Africa, leading to over 10 million deaths

In the summer of 2004, Dylan Mohan Gray was shooting for Deepa Mehta’s Water in Sri Lanka when an article in The Economist on Dr Yusuf K Hamied grabbed his attention. Among other things, Dr Hamied, chief of the Indian pharma company Cipla, spoke of how over 10 million lives were lost in Africa and elsewhere between the late 1990s and early 2000s because Western drug monopolies had managed to restrict imports of affordable HIV/AIDS medication to a continent considered the world’s poorest and most in need. The article left Gray, trained in history with a special interest in historiography (the study of historical narratives), disturbed and wondering why he knew so little about such a man-made catastrophe.

Cut to January 2013. That chance article has led to Fire in the Blood, which explores the malice and motive behind the tragedy. Through interviews, testimonials, research data and news clippings, it holds responsible the US and other Western governments for doing the bidding of healthcare multinationals. The film was premiered at the Sundance Film Festival last month, where in “packed screenings”, a rapt audience bemoaned their ignorance of the tragedy, just as Gray had back in 2004. “It was such a great crime, surely one of the greatest in history, yet no book had been written on it nor a film made,” says Gray, “I felt it would have been extremely irresponsible of me to let that go unnoticed. With each passing day, the story was getting lost. Somebody had to document it, and I literally woke up one day having decided to make the film.”

A sharper picture began to emerge when Gray met Dr Hamied in Mumbai. “Through him, I met a man named Bill Haddad, a pioneer of generic medicine who is also part of our story. He is a historian in his own right, having written a number of books. It was he who put the whole episode in context for me. After speaking to him, it was clear that there was a film to be made here.”

The 84-minute documentary highlights how the medical mafia manipulated patent laws for profiteering. It also exposes various other dubious ways in which medical labs and the rest of the innovation chain are primed to serve essentially commercial purposes. A former Pfizer honcho is on record speaking of how big pharma companies exploit the entire system to maximise profits.

In mid-2007, Gray spent six months in research. It was easy to navigate Africa because of his earlier travels there. In 1999, he had shot a documentary in West Africa. Titled Balole, which means ‘unity’ in local Manjako, and set in both Guinea-Bissau and France, it was about a cluster of African villages running a restaurant in Paris as a way to provide for themselves and their community. For Fire in the Blood, Gray returned to Africa, this time to Mozambique, Uganda and South Africa, where much of the documentary was shot.

Getting investor funds for documentaries is usually a tall order, so most of Fire in the Blood was self-financed. “We also raised money through friends, with a huge number of people contributing their services, expertise or archival material either free or virtually free,” he says. The crew travelled light to keep costs in check. “We picked up local crews wherever we went. At times, we didn’t even take our cameraman along.”

Shot across eight countries, the film is a result of five-and-a-half years of work. The most difficult part of it, says Gray, was a decision to exclude some important stories, a few of which he hopes to carry as ‘deleted scenes’ on the DVD version. “We also shot in different parts of India, in Chennai, Aurangabad and Bombay, and in countries like the US, Peru, Colombia and Hong Kong—where we interviewed Bill Clinton.”

Distressed at the millions of avoidable fatalities, Clinton says in the film, “It’s fine for people in rich countries to say, ‘This is what it ought to be’. They don’t have to live in these little villages and watch people die like flies.” Gray says he had to tread cautiously every step of the way during its filming. The astonishing figure of 10 million lost lives was arrived at only after a careful examination of available statistics and expert analysis. “We have used a conservative estimate as I don’t want anyone accusing us of inflating the figure,” he says.

“I am personally convinced that the actual number is much higher, and it would be far higher still were it to take into account all the people who were infected but would never have been infected had those people from whom they contracted HIV been on treatment.”

Asked for his views on African poverty, Gray says that in his experience, having travelled and worked in numerous parts of both Africa and India, the Indian poor live in harsher conditions by and large than do Africans. “In African cities and villages, there at least tends to be a lot more space than is the case in comparable Indian contexts. Don’t forget, India has significantly more people than all of Africa does, and they are squeezed into far less territory.”

Gray considers himself a Mumbaikar. However, one wouldn’t guess this from his Caucasian features and foreign accent. Born to an Indian father and Irish mother, he has lived in Canada, the US, Germany and Hungary before moving to India, and has spent the last nine years in Mumbai on a Person of Indian Origin permit. Given his descent, I remark, a hybrid name like Dylan Mohan Gray suits him. On hearing this, he laughs and explains that he was adopted by another family, which resulted in his assuming the respective last names of his two fathers: Mohan and Gray.

Conceived, made and produced in India, Fire in the Blood is an entirely Indian project. The country, however, will have to wait till April for its official release. Gray says that NRIs and Indians who watched the film in the US and UK expressed pride in such Indian healthcare efforts. “They were happy to know that India is playing such a leading role in providing affordable medicine to the world. Indians are used to the most affordable drugs in the world, but they are generally unaware of that. If you look at, say, Pakistan just next door, medicines cost roughly ten times more.”

The world looks to India for affordable medicine. “India is called ‘the pharmacy of the developing world’, which is why we have to make sure that monopoly does not rule the day as Western governments pressure India to adopt ever-more-restrictive patent measures, but that there is vibrant competition between various producers. Unlike Barbie dolls or toasters or iPads, the difference between two prices [in healthcare] is often the difference between life and death.”

According to Gray, the open patent regime India adopted in 1970 boosted the domestic production of generic drugs, with companies competing to keep costs and prices low. “Because these medicines were made by private companies, not by the Government as in some other developing countries, people in other parts of the world—especially the global South—were also able to benefit from low-cost drugs from India. If you go to South America or Africa, you will be amazed to see how much people rely on high-quality affordable Indian drugs. Without them, millions of people would have suffered and died over the past few decades alone,” he says. “That’s part of the reason we made the film—to tell people about this incredibly positive Indian story.”

Besides Fire in the Blood, Gray has been working with director Vikramaditya Motwane on a script he wants to direct next.

“Vikram and I go back a long way,” he says, “I have known him since he was an assistant director on Hum Dil De Chuke Sanam. We also worked together on Water, both in Banaras and Sri Lanka, and on his first short film, which my company produced, and a bunch of other things.” Apart from his friendship with Motwane and a handful of others in the film industry, Gray seems to have little in common with Bollywood. “My interest in filmmaking is fundamentally political,” he says, “But I certainly think you can bring serious thought into a commercial medium, be it comedy, action or romance. But still, I don’t really see myself making a purely popcorn-munching type of film anytime soon.”

Gray is currently busy with his documentary’s release in the UK and Ireland later this month. It has been a “life altering” project. “I don’t know what the future brings, but this would still be the most important work I will ever do in my life.”

drugsHIV/AIDSmedical mafia