The pharmaceutical industry in the early part of the new millennium probably has no better reputation than perhaps the tobacco industry. How could this happen? What went wrong? Were we so busy making money that we lost sight of the future we were creating for ourselves'? The media are full of company scandals, such as:
Defrauding Medicare Promoting products outside their registered indications Making gargantuan profits while sick people can't afford the basic drugs to stay alive Denying the third world the AIDS drugs it needs to avert a population disaster of untold proportions
Whether we like it or not, the debate around the world, even in the United States, is pharmaceutical profit versus public good. At a time when health care systems around the world are creaking with an aging population, spiraling costs, and increased consumer expectation, the traditional industry profit margin is under attack. No other industry has the same opportunity to do good, no other industry has the opportunity in the future to deliver more. Eradication of previously lethal diseases via vaccination is now accepted as normal; pharmaceuticals reduce the cardiovascular impact of our twenty-firstcentury life styles; and we are starting to make progress in the treat-
ment of depression and other previously poorly understood psychiatric diseases, offering the hope of a normal life to people with countless conditions and diseases.