A little confused about the conspiracy

in the book at least, it wasn't so much that the drug was bad, it just had some very negative side-effects. It wasnt really suposed to be released to the developped world for a long time, after which it would have been more quickly perfected because of all the trials in africa. Faster to figure out a better dosage when testing on humans rather than on lab animals.

I figure the way aid works to is that even if the drug never left africa it would still be profitable to someone.

You are very naive or just completely ignorant. The Drug lobby in the Western World is very powerful many drugs that are on the open market have terrible side effects hell if you just watch any drug commercial you can hear the list of terrible side effects.

It's a good question. It makes a lot of sense, and I can't blame you for asking it.

Unfortunately, in the real world there is evidence that many drug companies release drugs to the west even with evidence of harmful side effects. Consider fen-fen and Celebrex, both of which were shown to cause heart problems. Even in drug studies done in the western world, there are often questions about drug testers who are on the payroll of the drug manufacturers, and questions about patients with bad outcomes being excluded from the final data.

I don't know if drug companies would stoop to murder as shown in the movie (although consider Big Tobacco which knew about smoking and cancer in the '50s), but at the very least they often delude themselves as to the safety and effectiveness of drugs because of the hundreds of millions required to develop them.

in order to portray big pharma as a monolithic evil entity, certain things were embellished at the expense of realism and plausibility.

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Also in the book, KVH the pharma, is screwing 3Bs the African distributor, letting them hold the bag for any deaths while getting in vivo testing so that dosage can be perfected for the western market, KVHs fortune.

The quote from the book's author is quite realistic. Even though this is a fictional story, and quite sad and horrible in the implications of the shady behavior of the pharmaceutical industry, you are a damn fool if you don't realize that real life is MUCH, MUCH WORSE. The pharmaceutical industry in the US spends more on marketing than research. To quote the brilliant John Oliver, "The pharmaceutical industry is like your high school boyfriend; they are more worried about getting inside you than actually being effective inside you." (Loosely parahphrasing)