South Africa’s health minister, Nkosazana Zuma, admires the generic-drugs policy in the U.S. so much that when she drafted her health care reform proposal, she called on the Food and Drug Administration for advice. But now Zuma has a bitter pill to swallow: Her efforts to make generic drugs widely available in her country are being blocked by the United States’ brand-name pharmaceuticals industry, Commerce Secretary William Daley, and even Vice President Al Gore.

At a meeting of U.S. and South African officials in Washington, D.C., in July, both Daley and Gore warned that South Africa could face trade sanctions and be held in violation of the World Trade Organization’s intellectual property agreement if it implements Zuma’s reform proposal. The policy would give South African pharmacists the ability to suggest generic substitutions to customers whose doctors don’t object, and would require that public health care facilities use only generics whenever they are available. Her opponents say that by discriminating against brand-name drugs, her proposal may pose “unjustified encumbrances” on trademarks, a violation of intellectual property rights.

According to Stephen W. Schondelmeyer of the University of Minnesota College of Pharmacy, Zuma’s proposed policy essentially matches what Medicaid does here in the U.S.—Medicaid pays for brand-name drugs only when generics are unavailable. But in South Africa, close to 70 percent of the population depends on publicly provided health care. That’s a huge market for American drug companies to be shut out of, and they have acted swiftly to enlist the help of Washington’s most powerful players in their fight against the reform. “Political leverage in the Commerce Department is being used to represent the interests of the pharmaceutical companies,” says Gordon Johnston of the FDA’s division of generics.

The drug companies, represented by the Pharmaceutical Research and Manufacturers of America (PhRMA) and the U.S.-South Africa Business Council (conveniently chaired by Johnson & Johnson exec Aldrage Cooper Jr.), have also reacted swiftly on their own, freezing all pharmaceutical investment in South Africa and threatening divestiture. South Africa’s Pharmaceutical Manufacturing Association, which has close ties to PhRMA, has even launched a scare advertising campaign featuring full-page newspaper ads (left) that read: “Health Warning! Remain Silent and the Unsafe Control of Medicine Could Cost You Forever,” complete with a photograph of a wailing baby.

“It’s not fair to mischaracterize our generics policy,” says Dr. Ian Roberts, Zuma’s special assistant. “But if they want to use those tactics, it’s their democratic right…. We aren’t backing down. People are living in squalor here; we’re trying to change that.”


The more we thought about how MoJo's journalism can have the most impact heading into the 2020 election, the more we realized that so many of today's stories come down to corruption: democracy and the rule of law being undermined by the wealthy and powerful for their own gain.

So we're launching a new Mother Jones Corruption Project to do deep, time-intensive reporting on systemic corruption. We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We'll publish what we find as a major series in the summer of 2020, including a special issue of our magazine, a dedicated online portal, and video and podcast series so it doesn't get lost in the daily deluge of breaking news.

It's unlike anything we've done before and we've got seed funding to get started, but we're asking readers to help crowdfund this new beat with an additional $500,000 so we can go even bigger. You can read why we're taking this approach and what we want to accomplish in "Corruption Isn't Just Another Scandal. It's the Rot Beneath All of Them," and if you like how it sounds, please help fund it with a tax-deductible donation today.

We Recommend


Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.


Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.