Devastating societies through war and drugs

Illustration: Yogendra Anand / CSE

Israel’s scorched earth policy in Gaza has left the world scouring for terms that capture its horror at the barbarism they are witnessing. Humanitarian organisations such as Médecins Sans Frontières (MSF) and the International Committee of the Red Cross (ICRC) appear to have struggled with their statements of condemnation as the relentless bombing of the small strip of land, which is home to 2.2 million Palestinians, left searing images of the dead and dying in a devastated landscape. Even academics were hard put to describe the holocaust unleashed by the Israeli government; some settled for genocide, as did the Colombian President.

An MSF official described as outrageous Israel’s 24-hour notice to over one million people in Northern Gaza to leave their land, homes and hospitals. “Unprecedented” does not even cover the medical humanitarian impact of this order, the official said. ICRC described the situation in Gaza as “abhorrent” as residents scrambled for water and food while health facilities and medical personnel were targeted in the bombing of the world’s most densely populated area.

A statement issued by Gaza’s authorities after the Tel Aviv regime began a complete siege of Gaza in response to the Hamas attack described the action as “the dirtiest crime of collective punishment against defenceless civilians in modern history”. Since half the population of Gaza are children, it did capture the true horror of the bombing. Al Jazeera news agency quoted an Israeli official saying it had dropped 6,000 bombs weighing 4,000 tonnes on Gaza in the first six days of its war, killing vast numbers of children.

The vocabulary of outrage indignation is patently limited for a catastrophe on this scale. Responses also depend on a nation’s and an individual’s moral compass and political ideology. Sensitivities can be sharpened by a familiarity with a situation.

Letitia James, Attorney General of the state of New York, made headlines when she issued this statement: “Today, I am left thinking about all those families that will never be whole again. For everyone who lost their life. For every parent who will never hold their child again. For every community that’s been devastated.” James, however, was speaking not of the horrors perpetrated in Gaza by Israel and its defence forces but on the role of an Israeli drug company Teva Pharmaceuticals usa after a jury found it guilty last year of fuelling the opioid crisis in the US. “Devastated communities” is a phrase that James uses in all her references to the opioid cases in which she played a stellar role in getting a clutch of drugmakers—the six companies included Purdue Pharma, Johnson& Johnson and Allergan—and a large number of distributors to agree to pay as much as $50 billion in compensation.

Among these companies, Teva stands out because it chose to go to court while others settled. Teva Pharmaceuticals usa is the American subsidiary of Teva Pharmaceutical Industries of Tel Aviv, the iconic Israeli company which is the world’s top generics manufacturer. Teva was in the limelight because it had falsely claimed its parent company in Israel had no role in the manufacture and sale of opioids in the US. After the jury voted to find Teva liable for the harm it had caused, James called it a significant day for New York state and for the nation, but, more importantly, for every family and community torn apart by opioids.

The opioid epidemic or opioid crisis is the rapid rise in the overuse, misuse/abuse, and overdose deaths attributed to the class of drugs called opioids since the 1990s. Opioids are powerful painkillers used by cancer patients and others suffering from acute pain. The opioid crisis has been termed a particularly American crisis as the misuse and overuse of these drugs is more rampant in the US than elsewhere because of a significant diversion to other users in the open market without prescription. Opioid use disorders affect over 2.1 million in the US, according to the Centers for Disease Control and Prevention, which estimates that close to half a million people have died in the US of opioid overdose over a 20-year period till 2019. That’s when James filed the most comprehensive case against opioid makers and distributors.

More than 3,300 lawsuits have been filed against opioid producers accusing the pharma firms of misleading the public about the potential for abuse of their addictive opioid painkillers. The complaint by New York state alleged that manufacturers implemented a common “playbook” to mislead the public about the safety, efficacy and risks of their prescription opioids. Manufacturers pushed claims that opioids could improve quality of life and cognitive functioning, promoted false statements about the non-addictive nature of these drugs, masked signs of addiction by referring to them as “pseudo-addiction”. They also encouraged greater opioid use to treat the addict and unconscionably suggested that alternative pain relief drugs were riskier than opioids. “They utilised a vast network of sales representatives to push these dangerous narratives and to target susceptible doctors, flood publications with their deceptive advertisements, and offer consumers discount cards and other incentives to entice them to request treatment with their products.” 

The lawsuit further asserts that the manufacturers and distributors obtained their licenses to sell opioids and other controlled substances in New York by representing, falsely, that they had complied with the regulations governing the distribution of these products. On account of these prescriptions, huge sums were paid under state health programmes. Deceptive marketing is one of the main charges against opioid manufacturers and distributors.

In January this year, Teva proposed a blockbuster $4.25 billion settlement that covered most of the claims filed against it while insisting there has been no wrong doing on its part. Still fragments of the litigation remain to be settled. Just two months ago, Teva agreed to fork out more money—a payment up to $126 million to 500 hospitals that had sued the company for increasing their operating costs.

While a jury has found “an opioid manufacturer responsible for the death and destruction they inflict on the American people”, will there be any accountability for the devastation and deaths of the Palestinian people by the US which supports Israel to the hilt? There is clearly no analogy here but the question arises as the war gets more brutal by the day in Gaza. On October 16, civil society organisation Defence For Children said more than 1,030 Palestinian children had been killed in the bombardment of Gaza since October 7. That is one child killed every 15 minutes.

This will be published in the 1-15 November, 2023 print edition of Down To Earth

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