A real innovation withstands the rigors of due process



Sometime in 2011, I spent time talking to new mothers and women who had just been pregnant, at a few postnatal clinics in Harare. I wanted to find out from them, the unconventional medicines they had been offered and those that they had taken, during their pregnancies. Everything from guava leaf tea to things bordering on the horrific, is reportedly offered to and ingested by pregnant women for a wide range of real and imagined conditions. This in itself is not interesting.

What was particularly interesting for me was discovering that of the women who had been offered medicines and concoctions of mysterious ingredients, the proportion of those who had accepted them, was higher for women who had been offered these things in the context of a religious setting. That is insidious power.

There is almost universal outrage in the medical fraternity, over the recent broadcast claims by one religious leader over what is now being purported to cure HIV infections and cancers. The tragedy is, the fraternity can express their collective outrage until they froth at the mouth, but if the religious leader who made these claims does not himself convincingly retracts his statements, all his followers will see is their leader being persecuted. It’s a basic Machiavellian principle that laying siege on a jurisdiction, using the media and legitimate expert power for instance, may actually result in occupants of that jurisdiction loving their leader more, reinforcing his influence on them.

As a people, we love the mysterious, the nebulous, the mythical, the magical and the lurid. That love can even blind us to common sense. Couple that love with what I describe as a strong movement towards democratising knowledge (murmurings that expert medical knowledge for example cannot possibly be exclusively remain the preserve of trained professionals anymore) and the general problems to do with consistent access to safe medicines in Zimbabwe and we have a very flammable situation indeed.

The reason healthcare professionals were horrified when the claims that a herbal product can cure HIV and cancer were broadcast was that, they are acutely aware of the many laws that were breached in that short announcement and the purpose those laws serve. They spent a significant portion of their training, learning about those very laws and why they exist.

I read somewhere that it is difficult to be a disruptive innovator without being a person describable using unprintables. This is prone to misinterpretation by innovators who find every excuse to be disagreeable, militant, and disrespectful of due process and laws, then claim persecution when they are called to order. Real innovation survives the rigors of due process and scientific inquiry. They are not announced in a live broadcast in emotive language to an audience of people of lesser social power than the announcer. A real disruptive innovation disrupts the market, it does not disrupt obligations to follow laws put in place to safeguard the desperate and vulnerable. If laws are unjustified, then they can and should be changed, not broken.

Before a medicine, or a substance to which a medical claim is broadcast can be allowed for public consumption, it is first tested in animals, then a small number of humans, then a large number of humans under controlled conditions then the data, collected, crunched and audited by experts of various skills said used to determine effectiveness, safety, dosing schedules, the appropriate populations to use them and the conditions for which it can be used for. This process takes years and millions of dollars.

After being proven to be safe and effective, there is a regulated way to market and sell them because medicines are not trinkets. In sufficient quantities and certain conditions, all medicines are poisons. Profitable poisons. So, even for safe and registered medicines that passed these tests centuries ago, the broadcasting of information regarding them is regulated or prohibited.

The prohibition or strict regulation of Directto-Consumer advertising of medicines so the reason you cannot find a pharmacy putting out a sign that reads, ‘ Hey! We have X medicine here! Hurry hurry while stocks last!’ Medicine advertising is simply not allowed in Zimbabwe and pretty much everywhere else except North America and New Zealand.

This is the case, whether that medicine is a herbal or allopathic formulation. As long as you attach a medical claim to a substance, the implication is that it is a medicine. Why is medicine advertising tightly controlled when other commodities are advertised unfettered, you may ask. For the simple reason that it opens the door to misleading and inaccurate claims reaching vulnerable people, due to the profit incentive attached to the sale of medicinal products, claims that will have very tragic consequences.

The business of medicines is lucrative so I can understand the attraction for people with a keen sense of entrepreneurship but that’s not enough. Esoteric medical knowledge and permissions from regulatory bodies is also a nonnegotiable requirement for those that want to serve in this area. What you may be perceiving as poor marketing of medicines from medical professionals is simply them adhering to necessary laws and observing due process. Many of us are waiting in line, innovations in hand, innovations that would save lives. But we are waiting for them to be legitimized the right way. A great innovator is not afraid to stand in line and tick all the boxes.