By Michael Kaufman

In the years since leaving sports writing to make a living as a medical writer I have had the opportunity to report on some developments that have dramatically changed the practice of medicine in the United States and around the world. Maybe one day I will write about some of them but today I want to tell you about one of the lesser endeavors of my career, a project I worked on in 2003 that I’d all but forgotten about until just the other day.

It was an eight-page highlights of a roundtable discussion titled “Current Concepts in Facial Hair Removal,” published by means of “an unrestricted educational grant from Women First Health Care, Inc.” In the publisher’s box it said, “Editorial content does not necessarily reflect the view of the sponsor or the publisher.” (That was the medical publishing equivalent of a used car salesman saying, “This car is a cream puff.”)

As editor I was responsible for the content, based on the comments of four leading dermatologists, all of whom spoke with great enthusiasm about Vaniqa (eflornithine), then as now the only prescription cream approved by the U.S. Food and Drug Administration “clinically proven to reduce the growth of unwanted facial hair in women.” The product is currently marketed by SkinMedica.

The doctors who took part are excellent clinicians, all of whom I know and respect. The information we provided in the newsletter is solid too. If I did not remember the piece it was only because the subject matter was not on the same level as the ones I alluded to in the first sentence. But, as I learned the other day, it might well have been so.

You see, I’ve been reading Medical Apartheid, a book by Harriet A. Washington, subtitled “The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present.” It is a powerful and well documented indictment of centuries of abuse of African Americans as unwilling and unwitting subjects of medical and pharmaceutical research.  Fortunately, according to Washington, most of the abuses against African Americans have been curtailed. But some shameful practices continue to take place on the continent of Africa and other Third World Countries. 

After reading some flagrant examples, I was stunned when I came to the following passage: “Some of the research on Africans by Western scientists has been more subtle but equally troubling from an ethical perspective. For example, trypanosomiasis, or sleeping sickness, kills as many as half those it infects in the central African regions of Uganda, the Democratic Republic of Congo, Sudan, Ethiopia, Malawi, and Tanzania….By 1995 the pharmaceutical company Aventis had completed research demonstrating that its drug eflornithine was effective against sleeping sickness, although not against cancer as the firm had hoped. But the company decided to abandon its use against trypanosomiasis, due to high production costs and low profits. It began seeking other profitable uses for the drug, and U.S. researchers soon found one: Eflornithine effectively banished facial hirsutism in women. Aventis and later Bristol-Myers Squibb began marketing the drug as Vaniqa, because many American women were able to part with fifty dollars a month to keep their faces free of hair, while few Africans were able to pay fifty dollars monthly to save their lives.

“It is completely understandable that the firm should focus its resources upon the profitable depilatory use of their medication, but it is disappointing that it chose not to make the drug available cheaply to Africans in order to vanquish sleeping sickness.” Sleeping sickness, explains Washington, threatens 60 million people, only seven percent of whom have access to medical treatment.

Disappointing? Reprehensible would be a better word to describe a system that places profit above the needs of millions of human beings for life-saving health care.

Michael can be reached at michael@zestoforange.com.