Democratizing drug policy, a public health objective

On September 22, the Leem, the French pharmaceutical industry union, declared that "the spiral of downgrading the health system in our country [had] begun" and called for a "General Assembly on Medicines." While multinational pharmaceutical groups are doing very well, the network of small and medium-sized industrial structures in France and Europe often struggles, confined to the role of subcontractor to large groups and dependent on their wishes. At the same time, shortages of old drugs and increasingly extreme prices for new ones are weighing on patients and health systems.

The current state of drug policies is the result of a social and political history that can be traced. Sociology allows us to revisit the contexts in which the complex system of rules governing the production and use of drugs was created, as well as the relationships between the actors (public authorities, industry, health professionals, patients) who presided over it.

Various studies have documented how collective action, initiated and fueled by actors from pharmaceutical multinationals, developed. Originating in wealthy countries where it has become highly institutionalized, and drawing on significant economic resources and access to elites, this action has led to numerous transformations of the legislative framework regarding "intellectual property" since the 1980s. These include, firstly, the international rules included in the agreements of the World Trade Organization at its creation in 1994. Then, their national versions: laws amended using texts introduced by industry representatives, directly or through the signing of "free trade" agreements. But also, since the 2010s, new rules on "trade secrets."

However, these two types of power – having a monopoly on the markets and being able to impose secrecy on the value chain of health products – determine the political economy of the sector and the impasses in which we find ourselves. Especially since the State has gradually dispensed with skills and relied on advice from the industrial world – legally qualified but also driven by its own agenda, different and often far removed from that of the general interest and public health.

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