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reasonsforhope · 1 year ago

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"The Biden Administration last week [early December, 2023] announced it would be seizing patents for drugs and drug manufacturing procedures developed using government money.

A draft of the new law, seen by Reuters, said that the government will consider various factors including whether a medical situation is leading to increased prices of the drug at any given time, or whether only a small section of Americans can afford it.

The new executive order is the first exercise in what is called “march-in-rights” which allows relevant government agencies to redistribute patents if they were generated under government funding. The NIH has long maintained march-in-rights, but previous directors have been unwilling to use them, fearing consequences.

“We’ll make it clear that when drug companies won’t sell taxpayer funded drugs at reasonable prices, we will be prepared to allow other companies to provide those drugs for less,” White House adviser Lael Brainard said on a press call.

But just how much taxpayer money is going toward funding drugs? A research paper from the Insitute for New Economic Thought showed that “NIH funding contributed to research associated with every new drug approved from 2010-2019, totaling $230 billion.”

The authors of the paper continue, writing “NIH funding also produced 22 thousand patents, which provided marketing exclusivity for 27 (8.6%) of the drugs approved [between] 2010-2019.”

How we do drug discovery and production in America has a number of fundamental flaws that have created problems in the health service industry.

It costs billions of dollars and sometimes as many as 5 to 10 years to bring a drug to market in the US, which means that only companies with massive financial muscle can do so with any regularity, and that smaller, more innovative companies can’t compete with these pharma giants.

This also means that if a company can’t recoup that loss, a single failed drug can result in massive disruptions to business. To protect themselves, pharmaceutical companies establish piles of patents on drugs and drug manufacturing procedures. Especially if the drug in question treats a rare or obscure disease, these patents essentially ensure the company has monoselective pricing regimes.

However, if a company can convince the NIH that a particular drug should be considered a public health priority, they can be almost entirely funded by the government, as the research paper showed.

Some market participants, in this case the famous billionaire investor Mark Cuban, have attempted to remedy the issue of drug costs in America by manufacturing generic versions of patented drugs sold for common diseases."

-via Good News Network, December 11, 2023

#united states #us politics #biden administration #executive order #prescription drugs #medical news #healthcare #healthcare access #biden #big pharma #drug prices #public health #nih #national institutes of health #good news #hope

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mostlysignssomeportents · 24 days ago

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Every internet fight is a speech fight

THIS WEEKEND (November 8-10), I'll be in TUCSON, AZ: I'm the GUEST OF HONOR at the TUSCON SCIENCE FICTION CONVENTION.

My latest Locus Magazine column is "Hard (Sovereignty) Cases Make Bad (Internet) Law," an attempt to cut through the knots we tie ourselves in when speech and national sovereignty collide online:

https://locusmag.com/2024/11/cory-doctorow-hard-sovereignty-cases-make-bad-internet-law/

This happens all the time. Indeed, the precipitating incident for my writing this column was someone commenting on the short-lived Brazilian court order blocking Twitter, opining that this was purely a matter of national sovereignty, with no speech dimension.

This is just profoundly wrong. Of course any rules about blocking a communications medium will have a free-speech dimension – how could it not? And of course any dispute relating to globe-spanning medium will have a national sovereignty dimension.

How could it not?

So if every internet fight is a speech fight and a sovereignty fight, which side should we root for? Here's my proposal: we should root for human rights.

In 2013, Edward Snowden revealed that the US government was illegally wiretapping the whole world. They were able to do this because the world is dominated by US-based tech giants and they shipped all their data stateside for processing. These tech giants secretly colluded with the NSA to help them effect this illegal surveillance (the "Prism" program) – and then the NSA stabbed them in the back by running another program ("Upstream") where they spied on the tech giants without their knowledge.

After the Snowden revelations, countries around the world enacted "data localization" rules that required any company doing business within their borders to keep their residents' data on domestic servers. Obviously, this has a human rights dimension: keeping your people's data out of the hands of US spy agencies is an important way to defend their privacy rights. which are crucial to their speech rights (you can't speak freely if you're being spied on).

So when the EU, a largely democratic bloc, enacted data localization rules, they were harnessing national soveriegnty in service to human rights.

But the EU isn't the only place that enacted data-localization rules. Russia did the same thing. Once again, there's a strong national sovereignty case for doing this. Even in the 2010s, the US and Russia were hostile toward one another, and that hostility has only ramped up since. Russia didn't want its data stored on NSA-accessible servers for the same reason the USA wouldn't want all its' people's data stored in GRU-accessible servers.

But Russia has a significantly poorer human rights record than either the EU or the USA (note that none of these are paragons of respect for human rights). Russia's data-localization policy was motivated by a combination of legitimate national sovereignty concerns and the illegitimate desire to conduct domestic surveillance in order to identify and harass, jail, torture and murder dissidents.

When you put it this way, it's obvious that national sovereignty is important, but not as important as human rights, and when they come into conflict, we should side with human rights over sovereignty.

Some more examples: Thailand's lesse majeste rules prohibit criticism of their corrupt monarchy. Foreigners who help Thai people circumvent blocks on reportage of royal corruption are violating Thailand's national sovereignty, but they're upholding human rights:

https://www.vox.com/2020/1/24/21075149/king-thailand-maha-vajiralongkorn-facebook-video-tattoos

Saudi law prohibits criticism of the royal family; when foreigners help Saudi women's rights activists evade these prohibitions, we violate Saudi sovereignty, but uphold human rights:

https://www.bbc.com/news/world-middle-east-55467414

In other words, "sovereignty, yes; but human rights even moreso."

Which brings me back to the precipitating incidents for the Locus column: the arrest of billionaire Telegram owner Pavel Durov in France, and the blocking of billionaire Elon Musk's Twitter in Brazil.

How do we make sense of these? Let's start with Durov. We still don't know exactly why the French government arrested him (legal systems descended from the Napoleonic Code are weird). But the arrest was at least partially motivated by a demand that Telegram conform with a French law requiring businesses to have a domestic agent to receive and act on takedown demands.

Not every takedown demand is good. When a lawyer for the Sackler family demanded that I take down criticism of his mass-murdering clients, that was illegitimate. But there is such a thing as a legitimate takedown: leaked financial information, child sex abuse material, nonconsensual pornography, true threats, etc, are all legitimate targets for takedown orders. Of course, it's not that simple. Even if we broadly agree that this stuff shouldn't be online, we don't necessarily agree whether something fits into one of these categories.

This is true even in categories with the brightest lines, like child sex abuse material:

https://www.theguardian.com/technology/2016/sep/09/facebook-reinstates-napalm-girl-photo

And the other categories are far blurrier, like doxing:

https://www.kenklippenstein.com/p/trump-camp-worked-with-musks-x-to

But just because not every takedown is a just one, it doesn't follow that every takedown is unjust. The idea that companies should have domestic agents in the countries where they operate isn't necessarily oppressive. If people who sell hamburgers from a street-corner have to register a designated contact with a regulator, why not someone who operates a telecoms network with 900m global users?

Of course, requirements to have a domestic contact can also be used as a prelude to human rights abuses. Countries that insist on a domestic rep are also implicitly demanding that the company place one of its employees or agents within reach of its police-force.

Just as data localization can be a way to improve human rights (by keeping data out of the hands of another country's lawless spy agencies) or to erode them (by keeping data within reach of your own country's lawless spy agencies), so can a requirement for a local agent be a way to preserve the rule of law (by establishing a conduit for legitimate takedowns) or a way to subvert it (by giving the government hostages they can use as leverage against companies who stick up for their users' rights).

In the case of Durov and Telegram, these issues are especially muddy. Telegram bills itself as an encrypted messaging app, but that's only sort of true. Telegram does not encrypt its group-chats, and even the encryption in its person-to-person messaging facility is hard to use and of dubious quality.

This is relevant because France – among many other governments – has waged a decades-long war against encrypted messaging, which is a wholly illegitimate goal. There is no way to make an encrypted messaging tool that works against bad guys (identity thieves, stalkers, corporate and foreign spies) but not against good guys (cops with legitimate warrants). Any effort to weaken end-to-end encrypted messaging creates broad, significant danger for every user of the affected service, all over the world. What's more, bans on end-to-end encrypted messaging tools can't stand on their own – they also have to include blocks of much of the useful internet, mandatory spyware on computers and mobile devices, and even more app-store-like control over which software you can install:

https://pluralistic.net/2023/03/05/theyre-still-trying-to-ban-cryptography/

So when the French state seizes Durov's person and demands that he establish the (pretty reasonable) minimum national presence needed to coordinate takedown requests, it can seem like this is a case where national sovereignty and human rights are broadly in accord.

But when you consider that Durov operates a (nominally) encrypted messaging tool that bears some resemblance to the kinds of messaging tools the French state has been trying to sabotage for decades, and continues to rail against, the human rights picture gets rather dim.

That is only slightly mitigated by the fact that Telegram's encryption is suspect, difficult to use, and not applied to the vast majority of the communications it serves. So where do we net out on this? In the Locus column, I sum things up this way:

Telegram should have a mechanism to comply with lawful takedown orders; and

those orders should respect human rights and the rule of law; and

Telegram should not backdoor its encryption, even if

the sovereign French state orders it to do so.

Sovereignty, sure, but human rights even moreso.

What about Musk? As with Durov in France, the Brazilian government demanded that Musk appoint a Brazilian representative to handle official takedown requests. Despite a recent bout of democratic backsliding under the previous regime, Brazil's current government is broadly favorable to human rights. There's no indication that Brazil would use an in-country representative as a hostage, and there's nothing intrinsically wrong with requiring foreign firms doing business in your country to have domestic representatives.

Musk's response was typical: a lawless, arrogant attack on the judge who issued the blocking order, including thinly veiled incitements to violence.

The Brazilian state's response was multi-pronged. There was a national blocking order, and a threat to penalize Brazilians who used VPNs to circumvent the block. Both measures have obvious human rights implications. For one thing, the vast majority of Brazilians who use Twitter are engaged in the legitimate exercise of speech, and they were collateral damage in the dispute between Musk and Brazil.

More serious is the prohibition on VPNs, which represents a broad attack on privacy-enhancing technology with implications far beyond the Twitter matter. Worse still, a VPN ban can only be enforced with extremely invasive network surveillance and blocking orders to app stores and ISPs to restrict access to VPN tools. This is wholly disproportionate and illegitimate.

But that wasn't the only tactic the Brazilian state used. Brazilian corporate law is markedly different from US law, with fewer protections for limited liability for business owners. The Brazilian state claimed the right to fine Musk's other companies for Twitter's failure to comply with orders to nominate a domestic representative. Faced with fines against Spacex and Tesla, Musk caved.

In other words, Brazil had a legitimate national sovereignty interest in ordering Twitter to nominate a domestic agent, and they used a mix of somewhat illegitimate tactics (blocking orders), extremely illegitimate tactics (threats against VPN users) and totally legitimate tactics (fining Musk's other companies) to achieve these goals.

As I put it in the column:

Twitter should have a mechanism to comply with lawful takedown orders; and

those orders should respect human rights and the rule of law; and

banning Twitter is bad for the free speech rights of Twitter users in Brazil; and

banning VPNs is bad for all Brazilian internet users; and

it’s hard to see how a Twitter ban will be effective without bans on VPNs.

There's no such thing as an internet policy fight that isn't about national sovereignty and speech, and when the two collide, we should side with human rights over sovereignty. Sovereignty isn't a good unto itself – it's only a good to the extent that is used to promote human rights.

In other words: "Sovereignty, sure, but human rights even moreso."

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/11/06/brazilian-blowout/#sovereignty-sure-but-human-rights-even-moreso

Image: © Tomas Castelazo, www.tomascastelazo.com (modified) https://commons.wikimedia.org/wiki/File:Border_Wall_at_Tijuana_and_San_Diego_Border.jpg

CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0/

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