Sunday, 12 April 2015


“If I had to climb into hell and wrestle the devil himself for one of my films, I would do it.” - Werner Herzog

Eighty years ago if someone contracted pneumonia caused by any one of several types of bacteria, it was quite likely that he or she would die a very rapid and a very unpleasant death. Similarly, at that time, high blood pressure was very poorly controlled and often led to fatal outcomes. Diseases like cancer, which are now controlled by a number of successful drugs, in the recent past quickly killed hundreds of thousands of people a year. Drugs have been developed recently for many common conditions – drugs we take for granted nowadays, and which allow millions of people worldwide to survive potentially lethal diseases. These drugs were only a few decades ago completely unknown. The science of pharmacology (drug discovery, the uses, effects, and modes of action of drugs) has come a long way in the last 50 years or so.

Associated with this immense development of drug therapies is the development of the pharmaceutical industry, a multi-billion dollar industry where multinational companies spend enormous amounts of money to develop, test and market therapeutic drugs. It is a lucrative business and one whose profits have been escalating constantly as more and more new drugs are being discovered and marketed around the world. It is to these multinational drug companies that spend enormous amounts of money to develop and market new drugs that we owe thanks for ridding us of the fatal outcomes associated with many of the killers of the past. We owe them a great deal of gratitude, altruists that they are… Should we really be that grateful? Are they the golden-hearted altruists that they wish us to believe them to be?

Before a new drug is marketed it has to adhere to a set of standards and several safety requirements must be met. Each and every drug has numerous side-effects (some of which are potentially lethal), adverse reactions, risks of causing allergies and other untoward reactions in people who are prescribed the drug. Much research and clinical trials must be carried out in order to test not only the efficacy of a newly developed drug, but also its potential for causing these adverse reactions. Ultimately, the drug must be tested on a human population, as all of the cell culture toxicity trials and animal trials that are carried out will give an indication of how these drugs will work in the human and all favourable preliminary drug trials must be extended to human clinical trials.

The testing of drugs on humans is a thorny area, a veritable minefield of ethical and moral dilemmas, a legally and constitutionally controlled activity, which in most Western countries is regulated to the point of non-viability in many cases. Drug companies that need to develop effective (and profit-making) new drugs spend enormous amounts of money to develop and test these drugs, often taking the clinical trials to developing countries where legislation is laxer and people more willing to “volunteer” take part in the trials (for one another benefit – money, food, or curing of a disease they suffer from). More information on this can be obtained here.

Needless to say that when billions of dollars of profits are involved, some companies are willing to bend a few rules and regulations, some are willing to act illegally and risk thousands of human lives in these clinical trials. People in developing countries are willing to collude with the drug companies, government officials are willing to accept bribes and proper, ethical conduct in drug trials is unlikely to occur under these circumstances. By cutting corners and risking “expendable” lives, profits are increased and the company’s competitiveness in the marketplace is assured. This keeps the shareholders happy and of course, benefits the ultimate end-user of the drug in a Western country who is assured of a cheaper, human-tested drug that can be sold with the pledge of causing few side effects in humans.

For Movie Monday today, I am looking at a film that takes as its subject the dirty and corrupt world of drug development and clinical trials and in its scope attempts to raise public awareness of the magnitude of the problem. It is “The ConstantGardener” (2005), Fernando Meirelles’ film of the book by John Le Carré.  It stars Ralph Fiennes and Rachel Weisz who give good performances in this thriller. The film is also an accusation against big business, corporate corruption and unethical practices in business and government.

I found it to be a disturbing and emotionally challenging film, which contains many images that will stick in any sensitive person’s mind. The depth of the plot of the film is enhanced by several ideas that are also explored: How well do we know our partner in a marriage? How do we express our love in this most special of relationships? Who are our friends and how can we tell? Who can we trust in a difficult situation? How important is our career in our life and where do we place it in our scale of priorities? How active are we prepared to be in the social issues debate and what are we prepared to sacrifice in a quest for justice and fairness on a global level?

Fernando Meirelles has also directed the excellent “City of God” (2002) and he uses a similar documentary-style exposition in this film, and the non-linear plot working works very well, allowing us to delve into the lives of Justin and Tessa slowly, the horrible truth being finally revealed to us as though obscuring curtains are torn down successively. Justin’s journey of discovery and the gaining of wisdom is beautifully recounted and the immensity of his love for his wife is finally affirmed when he follows in her footsteps, realising her own immense love for him. We are challenged by this movie and we are forced to take a stand.

These days, we must realise that nothing remains hidden, no matter which distant part of the world it happens in and we must acknowledge the equal worth of every human life no matter which. We must take responsibility not only for our own actions, but also for the policies and actions of our governments, the ethics of the businesses we patronise and whose products we consume. This film is one that sounds an alarm bell and one that jars our conscience into full alertness and watchfulness…

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