The BMJ Today: A good idea gone wrong?

At the 2008 World Economic Forum in Davos, Bill Gates highlighted a new US Food and Drug Administration (FDA) law that rewarded sponsors of drugs for tropical diseases with a voucher that entitles the bearer to a “priority review” of another new drug application. It was intended to encourage for-profit companies to invest in treating diseases that affect the poor. Seven years on, the FDA has awarded just three vouchers, and two of the three drugs were developed and registered outside the US well before the voucher system was established. Peter Doshi looks at the controversy surrounding the voucher scheme, and asks if it is a good idea gone wrong.

Poor and middle income countries may be affected by diseases that big pharma is not interested in developing treatments for but, as Matthew J Harris points out, we could all learn from Brazil’s exceptional Family Health Programme. We in the UK have, he says, been slow to admit that Brazil and other low and middle income countries—such as Ethiopia and Pakistan—have got it right.

The repeal of a carbon pricing mechanism by Australia’s conservative government was described by Roger Jones, professorial research fellow at the Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne, as a “perfect storm of stupidity” and a “total failure of governance by government.”

The chief executive of the Australian Healthcare and Hospitals Association points out that it is hospitals and healthcare services that will “bear costs associated with responding to altered distributions of infectious diseases and illnesses and injuries related to severe weather events.” The convenor of the Climate and Health Alliance called the removal of the scheme “an act of vandalism on healthy and equitable human society.” Not so much a good idea gone wrong, but a case of an idea that seemed to be working scrapped by a government “backed by billionaires and corporate power.”

The assisted dying bill was given a second reading in the UK’s House of Lords last week. The bill would legalise physician assisted suicide for terminally ill people in England and Wales who were deemed to have no more than six months to live. Former archbishop of Canterbury, George Carey, and the retired archbishop of Cape Town, Desmond Tutu, think it’s a good idea. However, Elizabeth Butler-Sloss, former president of the High Court’s family division, has said that the bill’s safeguards are “utterly inadequate”—with the potential to go very, very wrong. She agreed that it should pass the second reading so it could receive greater scrutiny at committee stage.

Jett Aislabie is an assistant editor on