[speff]

Is this system not preferable over just trashing anything not perfectly made? Sure it would be nice if everyone can have perfectly manufactured medicine, but that's not reality. I would think something that's still likely good is still better than nothing.

[selcuka]

How do we assess that it's "still likely good" and "still better than nothing"? If they are defective it also means that they might make things worse.

[ben_w]

Hopefully that's up to the laws of where the incorrectly processed stuff was allowed to be sold.

Hopefully those countries don't reduce standards due to lobbying.

[gmueckl]

A fair number of countries can't do the proper inspections required for this, either due to lack of resources or government corruption (or both). They could put a literal carbon copy of FDA standards into their regulations, but it's meaningless without enforcement.

[lotsofpulp]

>They could put a literal carbon copy of FDA standards into their regulations, but it's meaningless without enforcement.

This is funny because the USA itself doesn't do proper inspections.

https://en.wikipedia.org/wiki/Katherine_Eban

See the book "Bottle of Lies".

[Hikikomori]

I believe we have a long history of companies selling toxic or non working stuff to countries not able to test or make sure its safe themselves.

[reginald78]

See the HIV infected blood products scandal with Bayer. The infected blood was pawned off on the third world since they (correctly) figured they'd have much less success suing them.

[hinkley]

You can tell what a bunch of assholes Bayer is made up of by the fact they were even willing to entertain purchasing Monsanto. Which they ended up doing. The lawyers are clearly in charge there.

[hinkley]

Including the article we are all responding to.

[hinkley]

And this is victim blaming. It’s not the government that suffers it’s billions of people.

[colechristensen]

There's a difference between a few percent difference in efficacy which is understandably still marketed (the same kind of thing happens when you leave meds on the shelf a while) and meds that are no longer effective at all to a reasonable level or toxic.

[hinkley]

This is literally a post about bad drugs being sold to brown people because they can.

[Spooky23]

Why should a person in Somalia suffer and die from cancer while a person in Ohio, lives, soley on the basis of where they live?

[protocolture]

Why should they not get access to drugs because the drugs would fail some bogus test made up by an american senator?

[bilbo0s]

More accurate to say they should get access to drugs that contain the actual molecules they are advertised to have across markets.

You shouldn't be able to sell what is basically sugar water in Somalia and call it cyclophosphamide. That's fraud if I do it as a private citizen.

In fact it's even fraud for me if I buy actual cyclophosphamide, and cut it with a bio compatible totally non reactive filler compound. How are these people getting away with it without the president and senators being on the take? When they'd run you or I down in less than a month for effectively the same act?

To be clear, I don't believe you or I should be able to do this. But I know what happens to private citizens who try to do things of this nature. So there is no question that this is a crime. The only question is why is it not prosecuted for larger corporations.

[MichaelZuo]

How do you know they would advertise it as unmodified cyclophosphamide (identical to the US product) in Somalia?

[hinkley]

Do you remember what thread yours responding to?

Here I’ll remind you: nearly 20% of cancer drugs defective in four African nations.

That’s the context. What on earth are you talking about?

[protocolture]

Did you read tfa?

>roughly one in six — were found to have incorrect active ingredient levels

>But some drugs are also counterfeit, and that increases the risk of discrepancies between what's on the product label and the actual medicine within.

If I was desperate, and given a choice between either 1 of "Might have incorrect active ingredient levels" "Might be counterfeit" "Might have been stored improperly" or "No cancer drugs for you" I know which way I would be leaning.

"Defective" is doing a lot of work in this headline.

[Spooky23]

The point of the article was that counterfeit drugs are ineffective or killing people, bro.

[EnPissant]

Who is going to pay for the replacement drug?

[beeflet]

the person in somalia likely has a different cost/effectiveness preference vs the american, which is expressed through the lack of regulation.

[jenny91]

To elaborate on this, if the individual in Somalia didn't want to die from said cancer and preferred better regulation, they would readily move to Ohio.

[nhaehnle]

I sincerely hope both of you are just trying to make a joke. I don't think a web forum like this one is the right place for it, though.

[itsanaccount]

hope all you want i think understanding what this site reveals about the world view of investor/dev types is a kind of sociological? shock.

its like everyone learning during covid their neighbors would kill every service worker to avoid the inconvenience of making their own coffee. it leaves a mark.

see what happened to the poor n-gate.com fellow, burned him out

[LtWorf]

The person in somalia doesn't live in a country where the managers of the pharmaceutical company live and can be arrested.

[Kwpolska]

Can the managers of the pharmaceutical company really be arrested in the US? Arrests are for poor people.

[overfeed]

As Matt Levine would say: inefficacious cancer drugs sold in the American market would be egregious securities fraud[1] if the shareholders are not informed by company offices ahead of time. The resulting shareholder lawsuit may cost some managers their jobs. There is also the (minute) risk of getting Luigi'd by someone a state over, whose loved one they suspected to have gotten a bad batch and didn't get better.

1. "Everything is securities fraud" is a running series showing the breadth and depth of how shareholders exercise their rights in creative ways.

[supertrope]

Larry Summers is that you?

[monero-xmr]

Why shouldn't every single person on earth immediately be granted citizenship to America and allowed access to all forms of welfare given to citizens? It's unfair to them

[ben_w]

Speaking as a non-American, the dysfunction of US healthcare was one of the reasons I decided against the USA when considering an international move.

Not the primary reason, but it was part of it.

[monero-xmr]

America is weird in that the poorest get significantly more benefits than the merely lower-middle class. And the majority of Americans pay no federal tax after EITC and other refunds.

You can get SNAP (free food), Section 8 (free housing), Medicaid (healthcare, CHIP for kids is easier than adults, but still many people get it), and if you manage to raise smart kids despite poverty they will get college for free as well (most highly-selective universities are free for the poor, but extremely expensive for even the middle class).

I own a lot of rental property and I have a Section 8 tenant who has never worked, completely gamed the system with a subjective disability that renders her unable to ever hold a job (supposedly). A good tenant but is constantly trying to give away tons of food she buys because she always tries to spend the SNAP she gets every month. And she gets free heat, and electricity, and public transportation pass, and on and on.

[xandrius]

What a weird take: I'd definitely expect the poorest/sickest to get the most additional benefits of all, the middle to get none and the top to get charged extra to cover up.

If you're middle class, that should be the average and that means you only get things which are the foundation of the system covered by the taxes.

[Workaccount2]

Let me elucidate why this system kind of sucks, as someone else who knows someone personally who lives a "full benefits" poverty life.

These benefits are binary, not tiered, so once you earn a dollar over the incredibly low threshold, they vanish. So the person I know cannot get a job and work, because if they earn over ~$16k in a year all the benefits go away. And where she lives you need about $50k/yr minimum to scrape by. So there is this $34k/yr gap which creates a no-mans land of livelihood.

[lotsofpulp]

The problem with these discussions is the errant use of poor/middle/upper/top as class identifiers.

The more useful identifiers would be roughly young and/or working, and old and/or non working. The latter category also covers the beneficiaries of wealthy people (who are among the old and/or non working).

The USA (and many countries, especially democracies) has a situation where your expected quality of life is lower (or not sufficiently higher) for the young and working than the young and non working for those not lucky enough to be born to the right families or prudent enough to make the right choices in school, etc.

The incentives should always be such that expected quality of life is always greater for those working than non working.

Note that this is a different topic than whatever the floor for quality of life should be.

[Spooky23]

The US has a weird class stratification system, that some people think has been embedded into society dating back to the Calvinist New England and slaveholding days.

It's developed since then in interesting ways and shows up everywhere. The biggest thing is that each cohort looks down on those "beneath" them. This manifests in different ways... people living in public housing, getting housing and typically SNAP benefits, will often scoff at people collecting temporary assistance (cash) as loafers.

If you're looking at families, the prevailing rent in Onondaga County, NY (Syracuse) is $1475 for a two-bedroom apartment. "Prevailing" rent is the metric used for Section 8 is essentially the price floor for an adequate apartment. The median household income in the county is $74,000, which is 23% rent to income ratio, so pretty good, right? (Keep in mind, this is from a not so great apartment that passes Section 8 inspection, but little else) Eh, not really, the well-off suburbs skew the statistic... if you look at the City of Syracuse, more representative of the blue collar working class and poor, the median income is $45,500 -- 39% rent to income. The median household in the city requires some support to live -- in Syracuse that's like 70,000 people

As you see purchasing power decline for working people, traditional "middle class" respectable jobs are falling off the ladder in terms of livability. A parent in a 90% of retail and semi-skilled labor jobs is making $80-90k max, and is basically a car disaster away from financial ruin. Many, many of these people are stuck with non-dischargeable student debt for life as well.

[Aeglaecia]

through my eyes i see a similar implication to disproprortionate judicial punishment - aspects of a hegemonic system designed to suppress individual voices. for example, pirates in the UK being handed jail terms of greater duration than those given to individuals having killed other humans - people daring to go against the powerful have their lives taken away from them, whereas infighting within the working class is almost encouraged by miniscule sentencing.

or in this case, why bother putting any effort into life when doing nothing provides a greater reward? why attempt to make something of oneself at the risk of losing everything forever?

all in all, whether or not intentionally curated, these societal facets serve to foment an atmosphere of fear - individuals are forced to exist either in ignorance, or otherwise must live with the knowledge that minor infractions may end one's dreams, while concurrently one's dreams may be ended at any time for no reason but the whim of another.

such a dichotomy between ignorance and fear effectively suppresses societal change, which if it were to happen anyway, would be instantly detected by automated surveillance, and promptly quashed under fully legal pretences. but that's not even necessary. the populace is already addicted to living vicariously through screens (now from birth thanks to parents being forced to devote energy to work instead of their children).

yet the world keeps turning

[watwut]

The say you write about it, being poor in America is easy and great. And then you look at powerty in America and see hopeless desperate people with no access to justice,lite chances in life, little access to healthcare and raising homelessness on top of it.

And funny enough, the poor are just about to loose their healthcare and food stamps via big beautiful bill. Which is official name of that bill.

[Spooky23]

You're so programmed to knee-jerk about some political bullshit that you're not thinking.

These companies are making defective drugs and shipping them to people. The only thing preventing that from happening in the United States is the regulatory system, which we are in the process of smashing.

[SoftTalker]

They will both die. Cancer treatment is largely useless (this is an editorial statement) Survival statistics are largely dependent on early detection. Detect the cancer early, you live longer after treatment.

[andsoitis]

> Cancer treatment is largely useless

Cancer treatment effectiveness has improved substantially, with many treatments now achieving high cure rates or significantly extending survival.

Highly effective treatments:

Surgery remains the most curative treatment when cancer is localized and can be completely removed. Complete surgical resection often leads to cure for early-stage solid tumors.

Chemotherapy can be curative for several cancers, particularly blood cancers like leukemias and lymphomas. Some testicular cancers and certain pediatric cancers also respond extremely well to chemotherapy alone.

Radiation therapy achieves excellent local control and can be curative, especially when combined with surgery or chemotherapy. It’s particularly effective for head and neck cancers, early-stage lung cancers, and certain brain tumors.

Revolutionary newer treatments:

Immunotherapy has transformed outcomes for melanoma, lung cancer, kidney cancer, and others. Some patients with advanced disease achieve long-term remissions that were previously impossible.

Targeted therapies work exceptionally well when tumors have specific genetic mutations. Examples include imatinib for chronic myeloid leukemia (transforming a fatal disease into a manageable condition) and HER2-targeted drugs for breast cancer.

CAR-T cell therapy has achieved remarkable results in certain blood cancers that failed other treatments, with some patients achieving complete remissions.

Combination approaches:

Modern treatment often combines multiple modalities - surgery plus chemotherapy plus radiation, or immunotherapy plus targeted therapy. These combinations frequently outperform single treatments.

Current limitations:

Some cancers like glioblastoma and pancreatic cancer still have limited treatment options, though research continues. Metastatic disease remains challenging, though increasingly manageable as a chronic condition rather than immediately fatal.

[mrosett]

This is an oft-refuted trope that does harm to patients. Numerous randomized phase 3 studies show meaningful survival advantages for modern treatments.

[DangitBobby]

If the treatment were useless, early detection wouldn't help. Or are you saying, the extended lifespan is just the difference in time between "early" and "late" detection?

[SoftTalker]

Yes. I'm not saying all treatments are useless. Surgical removal of an isolated tumor or melanoma for example. But medical/chemo/radiation in all cases I've seen the person died anyway and spent many of their remaining days feeling awful from the side-effects.

[drawfloat]

"Cancer treatment is largely useless" is an objectively false statement.