The Constant Gardener

Has pharma been forced into the bad guy role, or will viewers see a different story?

It had to happen at some point. Most movies need bad guys and in the past, different industries have found themselves in the spotlight after unwittingly being cast as the villains in the latest blockbuster film.

In Michael Mann's The Insider, which starred Al Pacino and Russell Crowe, multi-national tobacco firms were portrayed (though some would argue justifiably) as ruthless exploiters of the common man.

Morgan Spurlock's documentary Supersize Me made mincemeat of the US food and drink industry, in particular McDonalds, for putting profits before the health of the world's population. Now, it is the turn of the pharmaceutical industry.

The Constant Gardener, directed by Fernando Meirelles, and based on a John Le Carr novel, is out on general release this month. Starring Ralph Fiennes and Rachel Weisz, it is a mixture of a powerful thriller and a moving love story played out under the backdrop of an impoverished but stunningly beautiful Kenya.

One of the central themes of the film is an unscrupulous scheme concocted by the fictitious Swiss-Canadian pharma firm (KDH Pharma) to test a potentially toxic experimental tuberculosis drug on poverty-stricken Kenyans (according to rumour, the plot is based loosely on a real 1996 trial of meningitis antibiotic Trovan in Nigeria).

Without wishing to give too much away, as the film is well worth seeing, it suffices to say that the average moviegoer will not leave the cinema with a positive image of the pharmaceutical industry in their mind.

Why? Well, besides clinical trials malpractice, other uneasy themes are touched on: inflated prices of anti-viral AIDS drugs in sub-Saharan Africa, the dumping of expired, unusable drugs in poor countries to reap generous tax breaks and, not least, the implication that the industry is not averse to bribery, blackmail and enlisting the help of corrupt governments, not to mention murder.

‚ÄúThe pharmaceutical industry makes an interesting bad guy, because there are two sides to the story,‚Ä the Brazilian director told Time Out. ‚ÄúThey produce great medicines and our lives are obviously better because of them, but on the other hand, they use whatever methods and charge whatever they want because they're such a powerful interest.‚Ä

To gauge the industry's reaction, contract sales organisation In2Focus arranged for several pharmaceutical executives, as well as representatives from the Association of the British Pharmaceutical Industry (ABPI), to view an advance showing of the film at the London Film Festival.

The consensus opinion was that there is no need to push the panic button and companies will not find themselves deluged by a stream of negative publicity.

“I don't believe there will be any political repercussions from this film,†says In2Focus managing director Steve Kerridge, who described it as an excellent piece of fiction.

‚ÄúIt was a great film,‚Ä says ABPI deputy director, Andrew Curl. ‚ÄúBut I would be disappointed if anybody saw the film and thought that is how the pharmaceutical industry actually behaves. Some people have problems separating fact from fiction, but it has absolutely no basis in reality.‚Ä

Matt Worrall at the ABPI adds that the central criminal motive of the film - that a firm would be prepared to launch a lethal drug in the Western world despite it having killed Africans - simply doesn't hold up.

“It's important that we don't appear to be defensive,†notes Teva Dawson, a PR executive at Roche, adding that the media has only to look to the many patients whose lives have been saved and improved by medicines for a powerful testimony to the good work the industry does.

Ania Mitan, a business development manager at Lilly, points out that Meirelles himself has revealed in interviews how passionate he is about the subject matter - but also that he has acknowledged the valuable role the industry has to play.

So, the message is that pharma should not get too entrenched in the debate and should, instead, take the opportunity to showcase its more charitable initiatives, such as accelerated access to AIDS drugs in the developing world.

However, dark clouds are still looming on the horizon. Michael Moore, (in)famous now for the damning critique of the Bush administration in his film Fahrenheit 9/11, is working on an exposé of the US healthcare system, with the working title of Sicko. Whatever people's views are on Moore's allegedly agenda-ridden style of documentary film-making, one thing is certain: when the film finally sees the light of day, the industry will likely be unable to dismiss it all as fiction.

If The Constant Gardener is the warm up act, Sicko could very well be the main event.