1AC - COVID Vaccines 1NC - T - Medicines = Plural T - Vaccines CP - Adv vs Vaccines DA - Infrastructure DA - Modi Adventurism Case 1AR - theory - Can't say T ow 1ar theoyr no rvis ci dtd condo all 2NR - theory stuff DA - infrastructure 2AR - cant say t ow 1ar theory no rvis ci dtd condo shell
Greenhill RR
3
Opponent: Harrison AC | Judge: Kumail Zaidi, Holden Bukowsky
1AC - Biocolonialism 1NC - T - Framework Theory - Ev Ethics K - Set Col vs Disidentification 1AR - All 2NR - T - Framework 2AR - Case
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0 - Contact Information
Tournament: Contact Information | Round: 1 | Opponent: na | Judge: na Pre-Round:
Tournament: Greenhill RR | Round: 3 | Opponent: Harrison AC | Judge: Kumail Zaidi, Holden Bukowsky Interpretation: the resolution should define the division of affirmative and negative ground. To clarify, the aff must defend a world where the member nations of the World Trade Organization have reduced intellectual property protections for medicine. Resolved” means to enact by law. Words and Phrases ’64 (Words and Phrases; 1964; Permanent Edition) Definition of the word “resolve,” given by Webster is “to express an opinion or determination by resolution or vote; as ‘it was resolved by the legislature;” It is of similar force to the word “enact,” which is defined by Bouvier as meaning “to establish by law”. Reduce is to diminish Merriam Webster ND https://www.merriam-webster.com/dictionary/reduce aaditg to diminish in size, amount, extent, or number
Medicine is a substance used to treat something Merriam webster ND https://www.merriam-webster.com/dictionary/medicineaaditg a substance (such as a drug or potion) used to treat something other than disease WTO is one of three major economic organizations in the world Krueger 2K Anne O. Krueger is a Research Associate in the NBER's Programs on International Trade and Investment and International Finance and Macroeconomics and a professor of economics at Stanford University. “International Economic Organizations, Developing Country Reforms, and Trade” https://web.archive.org/web/20170518033322/http://www.nber.org/reporter/winter00/krueger.html aaditg The three major international economic organizations are the World Bank, the International Monetary Fund (IMF), and the World Trade Organization (WTO). The WTO emerged out of the General Agreement on Tariffs and Trade (GATT) in 1995; it is an arrangement across countries that serves as a forum for negotiations on trading rules as well as a mechanism for dispute settlements in trade issues.(1) By contrast, the World Bank and IMF deal with their member countries one at a time. They have little influence with industrial countries but can affect developing countries during times of economic crisis and when those countries seek additional foreign exchange resources. The origins and evolution of the three organizations are of considerable interest.(2) Perhaps even more important in light of the recent financial crises in Mexico, East Asia, and a few other countries, are the questions that arise about the current and future roles of the IMF and the World Bank.
Standards: 1 procedural fairness – their interpretation eviscerates predictable limits – all negative strategy is premised off a stable reading of the resolution. The lack of a stable mechanism lets them radically re-contextualize their aff and erase neg ground via perms. Including their advocacy authorizes any methodology or orientation tangentially related to the topic, which renders research burdens untenable. That outweighs and precedes their offense – debate is a game that we’ve all chosen to participate in and requires effective negation. It makes no sense to skew a competitive activity in favor of one side. The frame for evaluating offense is that debate is a game and we’re all here to win – that means procedural questions come first. TVA – Plan: The member nations of the World Trade Organization should eliminate patents on medicines based on Indigenous knowledge from patentability. IPW ‘06 Intellectual Property Watch quoting Debra Harry -- executive director of the Indigenous Peoples’ Council on Biocolonialism, and a member of the Paiute tribe in the United States, “Inside Views: Indigenous Groups Tell WIPO, ‘Don’t Patent Our Traditional Knowledge’”, https://www.ip-watch.org/2006/12/06/inside-views-indigenous-groups-tell-wipo-dont-patent-our-traditional-knowledge///pranav - Examples of medicines the plan would affect include reserpine, digitoxin, American ginseng medicines, Qualaquin, Neem, Turmeric, Aspirin, and many others. - The ev cites an actual joint statement from a tribal group - Ev also answers the “what if a company decides to j mass produce” question The joint statement of tribal group says: “Any attempt to develop IPR-based mechanisms to ‘protect’ IK indigenous knowledge actually poses much more threat to our knowledge, as a whole, than it can ever claim to prevent. Rather than protect, the imposition of IPRs over IK actually would serve to facilitate the alienation, misappropriation, and commercialization of IK.” “We believe patent applications that include or are based on IK should be specifically excluded from patentability. In IP terms, we’re sure you understand that these patent claims would fail to meet the test of innovation, novelty or inventiveness. But more importantly for Indigenous peoples, such patent claims should be denied because IK is in the Indigenous domain; that is, it is already under the jurisdiction of Indigenous legal systems, which protect the IK in perpetuity as the inherent and inalienable cultural property of Indigenous peoples. T first – 1 T indicts your reading of the aff in the first place, so it’s an evaluative mechanism to adjudicating substance of the 1AC. It’s silly nonsensical to leverage the aff against T since it presupposes that the aff is being won. 2 T is a question of jurisdiction- judges don’t have the jurisdiction to vote on a non-topical aff that hasn’t met the burden of proof of the resolution. 3 Topic ed – we only have 2 months to talk about the topic, but we can learn about the K outside of debate 4 Extra-topicality – even if the affirmative claims to advocate the resolution, they skirt discussion of its instrumental intent by arguing the benefits derived from their contextualized advocacy outweigh. 5 FX T – conceded violation – independent reason to reject them for limits – infinite possible actions that could lead to the rez which kills predictability and fairness.
9/16/21
1 - Theory - Ev Ethics Paragraph Skipping
Tournament: Greenhill RR | Round: 3 | Opponent: Harrison AC | Judge: Kumail Zaidi, Holden Bukowsky Interp: debaters may not skip paragraphs or portions of literature in one piece of evidence and write “they add”. Violation – vats 1 does. Standards – academic integrity – ncentivizes debaters to ignore parts of ev that contradicts what’s cut which is a terrible norm – this is an independent reason to reject them and is the heighest layer – ethics violations frame how debater ought to operate. Education comes first – only terminal impact from debate. Dtd – k2 setting good norms Ci – reasonability causes a race to the bottom where debaters keep being marginally abusive and incentivizes judge intervention No rvi or cross application of case – 1 testing – indicts starting point – illogical u should be able to leverage it 2 logic – u don’t win for proving that ur evidence isn’t cheating – that should be a starting point
9/16/21
3 - NC - Util
Tournament: Grapevine | Round: 5 | Opponent: Marcus JR | Judge: Grant Brown The standard is minimizing material violence. 1 Personal identity reductionism is true – if the hemispheres of my brain were transplanted into 2 different people, neither would be me. Parfit 84. Derek Parfit 1984, “Reasons and Persons”, Oxford Paperbacks It is in fact true that one hemisphere is enough. There are many people who have survived, when a stroke or injury puts out of action one of their hemispheres. With his remaining hemisphere, such a person may need to re-learn certain things, such as adult speech, or how to control both hands. But this is possible. In my example I am assuming that, as may be true of certain actual people, both of my hemispheres have the full range of abilities. I could thus survive with either hemisphere, without any need for re-learning.¶ I shall now combine these last two claims. I would survive if my brain was successfully transplanted into my twin's body. And I could survive with only half my brain, the other half having been destroyed. Given these two facts, it seems clear that I would survive if half my brain was successfully transplanted into my twin's body, and the other half was destroyed.¶ What if the other half was not destroyed? This is the case that Wiggins described: that in which a person, like an amoeba, divides.40 To simplify the case, I assume that I am one of three identical triplets. Consider¶ My Division. My body is fatally injured, as are the brains of my two brothers. My brain is divided, and each half is successfully transplanted into the body of one of my brothers. Each of the resulting people believes that he is me, seems to remember living my life, has my character, and is in every other way psychologically continuous with me. And he has a body that is very like mine.¶ This case is likely to remain impossible. Though it is claimed that, in certain people, the two hemispheres may have the same full range of abilities, this claim might be false. I am here assuming that this claim is true when applied to me. I am also assuming that it would be possible to connect a transplanted half-brain with the nerves in its new body. And I am assuming that we could divide, not just the upper hemispheres, but also the lower brain. My first two assumptions may be able to be made true if there is enough progress in neurophysiology. But it seems likely that it would never be possible to divide the lower brain, in a way that did not impair its functioning.¶ Does it matter if, for this reason, this imagined case of complete division will always remain impossible? Given the aims of my discussion, this does not matter. This impossibility is merely technical. The one feature of the case that might be held to be deeply impossible—the division of a person's consciousness into two separate streams—is the feature that has actually happened. It WOULD have been important if this had been impossible, since this might have supported some claim about what we really are. It might have supported the claim that we are indivisible Cartesian Egos. It therefore matters that the division of a person's consciousness is in fact possible. There seems to be no similar connection between a particular view about what we really are and the impossibility of dividing and successfully transplanting the two halves of the lower brain. This impossibility thus provides no ground for refusing to consider the imagined case in which we suppose that this can be done. And considering this case may help us to decide both what we believe ourselves to be, and what in fact we are. As Einstein's example showed, it can be useful to consider impossible thought-experiments.¶ It may help to state, in advance, what I believe this case to show. It provides a further argument against the view that we are separately existing entities. But the main conclusion to be hdrawn is that personal identity is not what matters.¶ It is natural to believe that our identity is what matters. Reconsider the Branch-Line Case, where I have talked to my Replica on Mars, and am about to die. Suppose we believe that I and my Replica are different people. It is then natural to assume that my prospect is almost as bad as ordinary death. In a few days, there will be no one living who will be me. It is natural to assume that this is what matters. In discussing My Division, I shall start by making this assumption.¶ In this case, each half of my brain will be successfully transplanted into the very similar body of one of my two brothers. Both of the resulting people will be fully psychologically continuous with me, as I am now. What happens to me?¶ There are only four possibilities: (1) I do not survive; (2) I survive as one of the two people; (3) I survive as the other; (4) I survive as both.¶ The objection to (1) is this. I would survive if my brain was successfully transplanted. And people have in fact survived with half their brains destroyed. Given these facts, it seems clear that I would survive if half my brain was successfully transplanted, and the other half was destroyed. So how could I fail to survive if the other half was also successfully transplanted? How could a double success be a failure?¶ Consider the next two possibilities. Perhaps one success is the maximum score. Perhaps I shall be one of the two resulting people. The objection here is that, in this case, each half of my brain is exactly similar, and so, to start with, is each resulting person. Given these facts, how can I survive as only one of the two people? What can make me one of them rather than the other?¶ These three possibilities cannot be dismissed as incoherent. We can understand them. But, while we assume that identity is what matters, (1) is not plausible. My Division would not be as bad as death. Nor are (2) and (3) plausible. There remains the fourth possibility: that I survive as both of the resulting people.¶ This possibility might be described in several ways. I might first claim: ‘What we have called “the two resulting people” are not two people. They are one person. I do survive this operation. Its effect is to give me two bodies, and a divided mind.’¶ This claim cannot be dismissed outright. As I argued, we ought to admit as possible that a person could have a divided mind. If this is possible, each half of my divided mind might control its own body. But though this description of the case cannot be rejected as inconceivable, it involves a great distortion in our concept of a person. In my imagined Physics Exam I claimed that this case involved only one person. There were two features of the case that made this plausible. The divided mind was soon reunited, and there was only one body. If a mind was permanently divided, and its halves developed in different ways, it would become less plausible to claim that the case involves only one person. (Remember the actual patient who complained that, when he embraced his wife, his left hand pushed her away.)¶ The case of complete division, where there are also two bodies, seems to be a long way over the borderline. After I have had this operation, the two ‘products’ each have all of the features of a person. They could live at opposite ends of the Earth. Suppose that they have poor memories, and that their appearance changes in different ways. After many years, they might meet again, and fail even to recognise each other. We might have to claim of such a pair, innocently playing tennis: ‘What you see out there is a single person, playing tennis with himself. In each half of his mind he mistakenly believes that he is playing tennis with someone else.’ If we are not yet Reductionists, we believe that there is one true answer to the questionwhether these two tennis-players are a single person. Given what we mean by ‘person’, the answer must be No. It cannot be true that what I believe to be a stranger, standing there behind the net, is in fact another part of myself. That justifies util. Gruzalski 86. Bart Gruzalski 86 UChicago, “Parfit's Impact on Utilitarianism”, Ethics, Vol. 96, No. 4, July 1986. Parfit concludes his discussion of distributive moral principles by claiming that, “when we cease to believe that persons are separately existing entities, the Utilitarian view becomes more plausible. Is the gain in plausibility great, or small? My argument leaves this question open” (p. 342). In contrast, I have argued that the Reductionist View strongly supports the utilitarian account of desert and distributive justice. The argument has two aspects. One is the recognition of the utilitarian emphasis on secondary rules, including principles of distributive justice and policies of desert. These rules, principles, and policies are treated within the utilitarian account as if they have self-standing, whereas in fact they are justified on the principle of utility which alone has self-standing within the utilitarian program. The other aspect of the argument involves the recognition that the utilitarian’s dual treatment of secondary principles dovetails with the dual account of the nature of persons on the Reductionist View: persons exist, yet their existence just involves bodies and interrelated mental and physical events, and a complete description of our lives need not claim that persons exist. Furthermore, a body, brain, and interrelated series of mental and physical events are more fundamental and basic than the person whose existence just consists in them, much as the citizens and the territory are more fundamental and basic than the nation whose existence just consists in them. This corresponds precisely with the utilitarian account, for utilitarianism treats persons as fundamental and separate existents, while grounding this treatment on the impersonal elements of pain, suffering, happiness, and contentment. Because util-itarianism accurately reflects in this way the true nature of persons, it is much more plausible than has been previously recognized. In addition, since many of the current competitors to utilitarianism presuppose that the person is separate from the body, brain, and interrelated mental and physical events, it follows that these views err by being too personal and are therefore implausible. It follows that when we cease to believe that persons are separately existing entities, utilitarianism becomes significantly more plausible than any of its person-centered theoretical competitors. 2 Actor Spec— States must use util. Any other standard dooms the moral theory Goodin 90. Robert Goodin 90, professor of philosophy at the Australian National University college of arts and social sciences, “The Utilitarian Response,” pgs 141-142 RS My larger argument turns on the proposition that there is something special about the situation of public officials that makes utilitarianism more probable for them than private individuals. Before proceeding with the large argument, I must therefore say what it is that makes it so special about public officials and their situations that make it both more necessary and more desirable for them to adopt a more credible form of utilitarianism. Consider, first, the argument from necessity. Public officials are obliged to make their choices under uncertainty, and uncertainty of a very special sort at that. All choices – public and private alike – are made under some degree of uncertainty, of course. But in the nature of things, private individuals will usually have more complete information on the peculiarities of their own circumstances and on the ramifications that alternative possible choices might have for them. Public officials, in contrast, are relatively poorly informed as to the effects that their choices will have on individuals, one by one. What they typically do know are generalities: averages and aggregates. They know what will happen most often to most people as a result of their various possible choices, but that is all. That is enough to allow public policy-makers to use the utilitarian calculus – assuming they want to use it at all – to choose general rules or conduct. 3 Extinction comes first under any framework. Pummer 15 Theron, Junior Research Fellow in Philosophy at St. Anne's College, University of Oxford. “Moral Agreement on Saving the World” Practical Ethics, University of Oxford. May 18, 2015 AT There appears to be lot of disagreement in moral philosophy. Whether these many apparent disagreements are deep and irresolvable, I believe there is at least one thing it is reasonable to agree on right now, whatever general moral view we adopt: that it is very important to reduce the risk that all intelligent beings on this planet are eliminated by an enormous catastrophe, such as a nuclear war. How we might in fact try to reduce such existential risks is discussed elsewhere. My claim here is only that we – whether we’re consequentialists, deontologists, or virtue ethicists – should all agree that we should try to save the world. According to consequentialism, we should maximize the good, where this is taken to be the goodness, from an impartial perspective, of outcomes. Clearly one thing that makes an outcome good is that the people in it are doing well. There is little disagreement here. If the happiness or well-being of possible future people is just as important as that of people who already exist, and if they would have good lives, it is not hard to see how reducing existential risk is easily the most important thing in the whole world. This is for the familiar reason that there are so many people who could exist in the future – there are trillions upon trillions… upon trillions. There are so many possible future people that reducing existential risk is arguably the most important thing in the world, even if the well-being of these possible people were given only 0.001 as much weight as that of existing people. Even on a wholly person-affecting view – according to which there’s nothing (apart from effects on existing people) to be said in favor of creating happy people – the case for reducing existential risk is very strong. As noted in this seminal paper, this case is strengthened by the fact that there’s a good chance that many existing people will, with the aid of life-extension technology, live very long and very high quality lives. You might think what I have just argued applies to consequentialists only. There is a tendency to assume that, if an argument appeals to consequentialist considerations (the goodness of outcomes), it is irrelevant to non-consequentialists. But that is a huge mistake. Non-consequentialism is the view that there’s more that determines rightness than the goodness of consequences or outcomes; it is not the view that the latter don’t matter. Even John Rawls wrote, “All ethical doctrines worth our attention take consequences into account in judging rightness. One which did not would simply be irrational, crazy.” Minimally plausible versions of deontology and virtue ethics must be concerned in part with promoting the good, from an impartial point of view. They’d thus imply very strong reasons to reduce existential risk, at least when this doesn’t significantly involve doing harm to others or damaging one’s character. What’s even more surprising, perhaps, is that even if our own good (or that of those near and dear to us) has much greater weight than goodness from the impartial “point of view of the universe,” indeed even if the latter is entirely morally irrelevant, we may nonetheless have very strong reasons to reduce existential risk. Even egoism, the view that each agent should maximize her own good, might imply strong reasons to reduce existential risk. It will depend, among other things, on what one’s own good consists in. If well-being consisted in pleasure only, it is somewhat harder to argue that egoism would imply strong reasons to reduce existential risk – perhaps we could argue that one would maximize her expected hedonic well-being by funding life extension technology or by having herself cryogenically frozen at the time of her bodily death as well as giving money to reduce existential risk (so that there is a world for her to live in!). I am not sure, however, how strong the reasons to do this would be. But views which imply that, if I don’t care about other people, I have no or very little reason to help them are not even minimally plausible views (in addition to hedonistic egoism, I here have in mind views that imply that one has no reason to perform an act unless one actually desires to do that act). To be minimally plausible, egoism will need to be paired with a more sophisticated account of well-being. To see this, it is enough to consider, as Plato did, the possibility of a ring of invisibility – suppose that, while wearing it, Ayn could derive some pleasure by helping the poor, but instead could derive just a bit more by severely harming them. Hedonistic egoism would absurdly imply she should do the latter. To avoid this implication, egoists would need to build something like the meaningfulness of a life into well-being, in some robust way, where this would to a significant extent be a function of other-regarding concerns (see chapter 12 of this classic intro to ethics). But once these elements are included, we can (roughly, as above) argue that this sort of egoism will imply strong reasons to reduce existential risk. Add to all of this Samuel Scheffler’s recent intriguing arguments (quick podcast version available here) that most of what makes our lives go well would be undermined if there were no future generations of intelligent persons. On his view, my life would contain vastly less well-being if (say) a year after my death the world came to an end. So obviously if Scheffler were right I’d have very strong reason to reduce existential risk. We should also take into account moral uncertainty. What is it reasonable for one to do, when one is uncertain not (only) about the empirical facts, but also about the moral facts? I’ve just argued that there’s agreement among minimally plausible ethical views that we have strong reason to reduce existential risk – not only consequentialists, but also deontologists, virtue ethicists, and sophisticated egoists should agree. But even those (hedonistic egoists) who disagree should have a significant level of confidence that they are mistaken, and that one of the above views is correct. Even if they were 90 sure that their view is the correct one (and 10 sure that one of these other ones is correct), they would have pretty strong reason, from the standpoint of moral uncertainty, to reduce existential risk. Perhaps most disturbingly still, even if we are only 1 sure that the well-being of possible future people matters, it is at least arguable that, from the standpoint of moral uncertainty, reducing existential risk is the most important thing in the world. Again, this is largely for the reason that there are so many people who could exist in the future – there are trillions upon trillions… upon trillions. (For more on this and other related issues, see this excellent dissertation). Of course, it is uncertain whether these untold trillions would, in general, have good lives. It’s possible they’ll be miserable. It is enough for my claim that there is moral agreement in the relevant sense if, at least given certain empirical claims about what future lives would most likely be like, all minimally plausible moral views would converge on the conclusion that we should try to save the world. While there are some non-crazy views that place significantly greater moral weight on avoiding suffering than on promoting happiness, for reasons others have offered (and for independent reasons I won’t get into here unless requested to), they nonetheless seem to be fairly implausible views. And even if things did not go well for our ancestors, I am optimistic that they will overall go fantastically well for our descendants, if we allow them to. I suspect that most of us alive today – at least those of us not suffering from extreme illness or poverty – have lives that are well worth living, and that things will continue to improve. Derek Parfit, whose work has emphasized future generations as well as agreement in ethics, described our situation clearly and accurately: “We live during the hinge of history. Given the scientific and technological discoveries of the last two centuries, the world has never changed as fast. We shall soon have even greater powers to transform, not only our surroundings, but ourselves and our successors. If we act wisely in the next few centuries, humanity will survive its most dangerous and decisive period. Our descendants could, if necessary, go elsewhere, spreading through this galaxy…. Our descendants might, I believe, make the further future very good. But that good future may also depend in part on us. If our selfish recklessness ends human history, we would be acting very wrongly.” (From chapter 36 of On What Matters) 4 Pleasure and pain are intrinsic value and disvalue. Blum et al. 18 Kenneth Blum, 1Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University, Dayton, OH, USA 2Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA 3Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California, Los Angeles, CA, USA 4Division of Applied Clinical Research and Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA 5Department of Precision Medicine, Geneus Health LLC, San Antonio, TX, USA 6Department of Addiction Research and Therapy, Nupathways Inc., Innsbrook, MO, USA 7Department of Clinical Neurology, Path Foundation, New York, NY, USA 8Division of Neuroscience-Based Addiction Therapy, The Shores Treatment and Recovery Center, Port Saint Lucie, FL, USA 9Institute of Psychology, Eötvös Loránd University, Budapest, Hungary 10Division of Addiction Research, Dominion Diagnostics, LLC. North Kingston, RI, USA 11Victory Nutrition International, Lederach, PA., USA 12National Human Genome Center at Howard University, Washington, DC., USA, Marjorie Gondré-Lewis, 12National Human Genome Center at Howard University, Washington, DC., USA 13Departments of Anatomy and Psychiatry, Howard University College of Medicine, Washington, DC US, Bruce Steinberg, 4Division of Applied Clinical Research and Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA, Igor Elman, 15Department Psychiatry, Cooper University School of Medicine, Camden, NJ, USA, David Baron, 3Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California, Los Angeles, CA, USA, Edward J Modestino, 14Department of Psychology, Curry College, Milton, MA, USA, Rajendra D Badgaiyan, 15Department Psychiatry, Cooper University School of Medicine, Camden, NJ, USA, Mark S Gold 16Department of Psychiatry, Washington University, St. Louis, MO, USA, “Our evolved unique pleasure circuit makes humans different from apes: Reconsideration of data derived from animal studies”, U.S. Department of Veterans Affairs, 28 February 2018, accessed: 19 August 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446569/, R.S. Pleasure is not only one of the three primary reward functions but it also defines reward. As homeostasis explains the functions of only a limited number of rewards, the principal reason why particular stimuli, objects, events, situations, and activities are rewarding may be due to pleasure. This applies first of all to sex and to the primary homeostatic rewards of food and liquid and extends to money, taste, beauty, social encounters and nonmaterial, internally set, and intrinsic rewards. Pleasure, as the primary effect of rewards, drives the prime reward functions of learning, approach behavior, and decision making and provides the basis for hedonic theories of reward function. We are attracted by most rewards and exert intense efforts to obtain them, just because they are enjoyable 10. Pleasure is a passive reaction that derives from the experience or prediction of reward and may lead to a long-lasting state of happiness. The word happiness is difficult to define. In fact, just obtaining physical pleasure may not be enough. One key to happiness involves a network of good friends. However, it is not obvious how the higher forms of satisfaction and pleasure are related to an ice cream cone, or to your team winning a sporting event. Recent multidisciplinary research, using both humans and detailed invasive brain analysis of animals has discovered some critical ways that the brain processes pleasure 14. Pleasure as a hallmark of reward is sufficient for defining a reward, but it may not be necessary. A reward may generate positive learning and approach behavior simply because it contains substances that are essential for body function. When we are hungry, we may eat bad and unpleasant meals. A monkey who receives hundreds of small drops of water every morning in the laboratory is unlikely to feel a rush of pleasure every time it gets the 0.1 ml. Nevertheless, with these precautions in mind, we may define any stimulus, object, event, activity, or situation that has the potential to produce pleasure as a reward. In the context of reward deficiency or for disorders of addiction, homeostasis pursues pharmacological treatments: drugs to treat drug addiction, obesity, and other compulsive behaviors. The theory of allostasis suggests broader approaches - such as re-expanding the range of possible pleasures and providing opportunities to expend effort in their pursuit. 15. It is noteworthy, the first animal studies eliciting approach behavior by electrical brain stimulation interpreted their findings as a discovery of the brain’s pleasure centers 16 which were later partly associated with midbrain dopamine neurons 17–19 despite the notorious difficulties of identifying emotions in animals. Evolutionary theories of pleasure: The love connection BO Charles Darwin and other biological scientists that have examined the biological evolution and its basic principles found various mechanisms that steer behavior and biological development. Besides their theory on natural selection, it was particularly the sexual selection process that gained significance in the latter context over the last century, especially when it comes to the question of what makes us “what we are,” i.e., human. However, the capacity to sexually select and evolve is not at all a human accomplishment alone or a sign of our uniqueness; yet, we humans, as it seems, are ingenious in fooling ourselves and others–when we are in love or desperately search for it. It is well established that modern biological theory conjectures that organisms are the result of evolutionary competition. In fact, Richard Dawkins stresses gene survival and propagation as the basic mechanism of life 20. Only genes that lead to the fittest phenotype will make it. It is noteworthy that the phenotype is selected based on behavior that maximizes gene propagation. To do so, the phenotype must survive and generate offspring, and be better at it than its competitors. Thus, the ultimate, distal function of rewards is to increase evolutionary fitness by ensuring the survival of the organism and reproduction. It is agreed that learning, approach, economic decisions, and positive emotions are the proximal functions through which phenotypes obtain other necessary nutrients for survival, mating, and care for offspring. Behavioral reward functions have evolved to help individuals to survive and propagate their genes. Apparently, people need to live well and long enough to reproduce. Most would agree that homo-sapiens do so by ingesting the substances that make their bodies function properly. For this reason, foods and drinks are rewards. Additional rewards, including those used for economic exchanges, ensure sufficient palatable food and drink supply. Mating and gene propagation is supported by powerful sexual attraction. Additional properties, like body form, augment the chance to mate and nourish and defend offspring and are therefore also rewards. Care for offspring until they can reproduce themselves helps gene propagation and is rewarding; otherwise, many believe mating is useless. According to David E Comings, as any small edge will ultimately result in evolutionary advantage 21, additional reward mechanisms like novelty seeking and exploration widen the spectrum of available rewards and thus enhance the chance for survival, reproduction, and ultimate gene propagation. These functions may help us to obtain the benefits of distant rewards that are determined by our own interests and not immediately available in the environment. Thus the distal reward function in gene propagation and evolutionary fitness defines the proximal reward functions that we see in everyday behavior. That is why foods, drinks, mates, and offspring are rewarding. There have been theories linking pleasure as a required component of health benefits salutogenesis, (salugenesis). In essence, under these terms, pleasure is described as a state or feeling of happiness and satisfaction resulting from an experience that one enjoys. Regarding pleasure, it is a double-edged sword, on the one hand, it promotes positive feelings (like mindfulness) and even better cognition, possibly through the release of dopamine 22. But on the other hand, pleasure simultaneously encourages addiction and other negative behaviors, i.e., motivational toxicity. It is a complex neurobiological phenomenon, relying on reward circuitry or limbic activity. It is important to realize that through the “Brain Reward Cascade” (BRC) endorphin and endogenous morphinergic mechanisms may play a role 23. While natural rewards are essential for survival and appetitive motivation leading to beneficial biological behaviors like eating, sex, and reproduction, crucial social interactions seem to further facilitate the positive effects exerted by pleasurable experiences. Indeed, experimentation with addictive drugs is capable of directly acting on reward pathways and causing deterioration of these systems promoting hypodopaminergia 24. Most would agree that pleasurable activities can stimulate personal growth and may help to induce healthy behavioral changes, including stress management 25. The work of Esch and Stefano 26 concerning the link between compassion and love implicate the brain reward system, and pleasure induction suggests that social contact in general, i.e., love, attachment, and compassion, can be highly effective in stress reduction, survival, and overall health. Understanding the role of neurotransmission and pleasurable states both positive and negative have been adequately studied over many decades 26–37, but comparative anatomical and neurobiological function between animals and homo sapiens appear to be required and seem to be in an infancy stage. Finding happiness is different between apes and humans As stated earlier in this expert opinion one key to happiness involves a network of good friends 38. However, it is not entirely clear exactly how the higher forms of satisfaction and pleasure are related to a sugar rush, winning a sports event or even sky diving, all of which augment dopamine release at the reward brain site. Recent multidisciplinary research, using both humans and detailed invasive brain analysis of animals has discovered some critical ways that the brain processes pleasure. Remarkably, there are pathways for ordinary liking and pleasure, which are limited in scope as described above in this commentary. However, there are many brain regions, often termed hot and cold spots, that significantly modulate (increase or decrease) our pleasure or even produce the opposite of pleasure— that is disgust and fear 39. One specific region of the nucleus accumbens is organized like a computer keyboard, with particular stimulus triggers in rows— producing an increase and decrease of pleasure and disgust. Moreover, the cortex has unique roles in the cognitive evaluation of our feelings of pleasure 40. Importantly, the interplay of these multiple triggers and the higher brain centers in the prefrontal cortex are very intricate and are just being uncovered. Desire and reward centers It is surprising that many different sources of pleasure activate the same circuits between the mesocorticolimbic regions (Figure 1). Reward and desire are two aspects pleasure induction and have a very widespread, large circuit. Some part of this circuit distinguishes between desire and dread. The so-called pleasure circuitry called “REWARD” involves a well-known dopamine pathway in the mesolimbic system that can influence both pleasure and motivation. In simplest terms, the well-established mesolimbic system is a dopamine circuit for reward. It starts in the ventral tegmental area (VTA) of the midbrain and travels to the nucleus accumbens (Figure 2). It is the cornerstone target to all addictions. The VTA is encompassed with neurons using glutamate, GABA, and dopamine. The nucleus accumbens (NAc) is located within the ventral striatum and is divided into two sub-regions—the motor and limbic regions associated with its core and shell, respectively. The NAc has spiny neurons that receive dopamine from the VTA and glutamate (a dopamine driver) from the hippocampus, amygdala and medial prefrontal cortex. Subsequently, the NAc projects GABA signals to an area termed the ventral pallidum (VP). The region is a relay station in the limbic loop of the basal ganglia, critical for motivation, behavior, emotions and the “Feel Good” response. This defined system of the brain is involved in all addictions –substance, and non –substance related. In 1995, our laboratory coined the term “Reward Deficiency Syndrome” (RDS) to describe genetic and epigenetic induced hypodopaminergia in the “Brain Reward Cascade” that contribute to addiction and compulsive behaviors 3,6,41. Furthermore, ordinary “liking” of something, or pure pleasure, is represented by small regions mainly in the limbic system (old reptilian part of the brain). These may be part of larger neural circuits. In Latin, hedus is the term for “sweet”; and in Greek, hodone is the term for “pleasure.” Thus, the word Hedonic is now referring to various subcomponents of pleasure: some associated with purely sensory and others with more complex emotions involving morals, aesthetics, and social interactions. The capacity to have pleasure is part of being healthy and may even extend life, especially if linked to optimism as a dopaminergic response 42. Psychiatric illness often includes symptoms of an abnormal inability to experience pleasure, referred to as anhedonia. A negative feeling state is called dysphoria, which can consist of many emotions such as pain, depression, anxiety, fear, and disgust. Previously many scientists used animal research to uncover the complex mechanisms of pleasure, liking, motivation and even emotions like panic and fear, as discussed above 43. However, as a significant amount of related research about the specific brain regions of pleasure/reward circuitry has been derived from invasive studies of animals, these cannot be directly compared with subjective states experienced by humans. In an attempt to resolve the controversy regarding the causal contributions of mesolimbic dopamine systems to reward, we have previously evaluated the three-main competing explanatory categories: “liking,” “learning,” and “wanting” 3. That is, dopamine may mediate (a) liking: the hedonic impact of reward, (b) learning: learned predictions about rewarding effects, or (c) wanting: the pursuit of rewards by attributing incentive salience to reward-related stimuli 44. We have evaluated these hypotheses, especially as they relate to the RDS, and we find that the incentive salience or “wanting” hypothesis of dopaminergic functioning is supported by a majority of the scientific evidence. Various neuroimaging studies have shown that anticipated behaviors such as sex and gaming, delicious foods and drugs of abuse all affect brain regions associated with reward networks, and may not be unidirectional. Drugs of abuse enhance dopamine signaling which sensitizes mesolimbic brain mechanisms that apparently evolved explicitly to attribute incentive salience to various rewards 45. Addictive substances are voluntarily self-administered, and they enhance (directly or indirectly) dopaminergic synaptic function in the NAc. This activation of the brain reward networks (producing the ecstatic “high” that users seek). Although these circuits were initially thought to encode a set point of hedonic tone, it is now being considered to be far more complicated in function, also encoding attention, reward expectancy, disconfirmation of reward expectancy, and incentive motivation 46. The argument about addiction as a disease may be confused with a predisposition to substance and nonsubstance rewards relative to the extreme effect of drugs of abuse on brain neurochemistry. The former sets up an individual to be at high risk through both genetic polymorphisms in reward genes as well as harmful epigenetic insult. Some Psychologists, even with all the data, still infer that addiction is not a disease 47. Elevated stress levels, together with polymorphisms (genetic variations) of various dopaminergic genes and the genes related to other neurotransmitters (and their genetic variants), and may have an additive effect on vulnerability to various addictions 48. In this regard, Vanyukov, et al. 48 suggested based on review that whereas the gateway hypothesis does not specify mechanistic connections between “stages,” and does not extend to the risks for addictions the concept of common liability to addictions may be more parsimonious. The latter theory is grounded in genetic theory and supported by data identifying common sources of variation in the risk for specific addictions (e.g., RDS). This commonality has identifiable neurobiological substrate and plausible evolutionary explanations. Over many years the controversy of dopamine involvement in especially “pleasure” has led to confusion concerning separating motivation from actual pleasure (wanting versus liking) 49. We take the position that animal studies cannot provide real clinical information as described by self-reports in humans. As mentioned earlier and in the abstract, on November 23rd, 2017, evidence for our concerns was discovered 50 In essence, although nonhuman primate brains are similar to our own, the disparity between other primates and those of human cognitive abilities tells us that surface similarity is not the whole story. Sousa et al. 50 small case found various differentially expressed genes, to associate with pleasure related systems. Furthermore, the dopaminergic interneurons located in the human neocortex were absent from the neocortex of nonhuman African apes. Such differences in neuronal transcriptional programs may underlie a variety of neurodevelopmental disorders. In simpler terms, the system controls the production of dopamine, a chemical messenger that plays a significant role in pleasure and rewards. The senior author, Dr. Nenad Sestan from Yale, stated: “Humans have evolved a dopamine system that is different than the one in chimpanzees.” This may explain why the behavior of humans is so unique from that of non-human primates, even though our brains are so surprisingly similar, Sestan said: “It might also shed light on why people are vulnerable to mental disorders such as autism (possibly even addiction).” Remarkably, this research finding emerged from an extensive, multicenter collaboration to compare the brains across several species. These researchers examined 247 specimens of neural tissue from six humans, five chimpanzees, and five macaque monkeys. Moreover, these investigators analyzed which genes were turned on or off in 16 regions of the brain. While the differences among species were subtle, there was a remarkable contrast in the neocortices, specifically in an area of the brain that is much more developed in humans than in chimpanzees. In fact, these researchers found that a gene called tyrosine hydroxylase (TH) for the enzyme, responsible for the production of dopamine, was expressed in the neocortex of humans, but not chimpanzees. As discussed earlier, dopamine is best known for its essential role within the brain’s reward system; the very system that responds to everything from sex, to gambling, to food, and to addictive drugs. However, dopamine also assists in regulating emotional responses, memory, and movement. Notably, abnormal dopamine levels have been linked to disorders including Parkinson’s, schizophrenia and spectrum disorders such as autism and addiction or RDS. Nora Volkow, the director of NIDA, pointed out that one alluring possibility is that the neurotransmitter dopamine plays a substantial role in humans’ ability to pursue various rewards that are perhaps months or even years away in the future. This same idea has been suggested by Dr. Robert Sapolsky, a professor of biology and neurology at Stanford University. Dr. Sapolsky cited evidence that dopamine levels rise dramatically in humans when we anticipate potential rewards that are uncertain and even far off in our futures, such as retirement or even the possible alterlife. This may explain what often motivates people to work for things that have no apparent short-term benefit 51. In similar work, Volkow and Bale 52 proposed a model in which dopamine can favor NOW processes through phasic signaling in reward circuits or LATER processes through tonic signaling in control circuits. Specifically, they suggest that through its modulation of the orbitofrontal cortex, which processes salience attribution, dopamine also enables shilting from NOW to LATER, while its modulation of the insula, which processes interoceptive information, influences the probability of selecting NOW versus LATER actions based on an individual’s physiological state. This hypothesis further supports the concept that disruptions along these circuits contribute to diverse pathologies, including obesity and addiction or RDS.
9/12/21
SeptOct - CP - Advantage vs Butler
Tournament: Grapevine | Round: 5 | Opponent: Marcus JR | Judge: Grant Brown CP Text: The member nations of the World Trade organization should give everyone adequate health care. Solves the first contention – ww is blue 1AC Forman 07 Trade Rules, Intellectual Property, and the Right to Health From: Ethics and International Affairs By: Lisa Forman Fall 2007 Given the adverse health impacts of the intellectual property protections contained in these free-trade agreements, why do countries consent to entering them at all? On the one hand, it is not surprising that governments may favor economic growth over critical health investments, especially considering how routinely health systems are underfinanced and how access to health care for marginalized and poor populations is so often neglected in both rich and poor countries.30 Governments may also assume that the aggregate economic benefits of these trade agreements outweigh and indeed justify any restrictions in access to medicines that they may cause. At the same time, trade negotiators may simply lack knowledge of the health implications of higher levels of intellectual property protection. There is, however, a degree of coercion that may accompany the finalization of these agreements. Peter Drahos suggests that developing countries have little room to refuse bilateral agreements, as trade negotiations take place alongside actual or threatened unilateral trade sanctions.32 Debates about the economic benefits of trade aside, from a human rights perspective sacrificing access to essential medicines for the poorest (those who most assuredly will be affected) in the service of broader economic growth is not an acceptable trade-off. Nor should it be a necessary trade-off. In Peru recently, largely due to the advocacy of Paul Hunt, the UN Special Rapporteur on Health, the government conducted an assessment of the potential impact of a free-trade agreement being negotiated with the United States. The assessment indicated that the agreement would limit access to medicines for approximately 700,000 people, and the government accordingly recommended implementing a fund from industries that would profit from the agreement to supplement this shortfall.33 While the Peruvian experience suggests that governments can mitigate the restrictive impact of trade rules on medicines access at the domestic level, impact assessments cannot directly challenge the injustices inherent in the current trade regime on medicines. Free-trade agreements and corporate and governmental challenges effectively turn TRIPS rights into powerful corporate entitlements that can be only rarely limited. This not only perpetuates the inaccessibility of present medicines but excludes poor people from accessing new therapeutic advances. INTERNATIONAL HUMAN RIGHTS ON HEALTH Since the global imposition and enforcement of stringent patent rights play a direct role in the high loss of life due to inaccessible medicines, such a system should be justifiable not simply from the perspective of intellectual property rights but from the perspective of human rights law. Access to essential medicines is a fundamental human rights claim under the rights to health and life.34 In accordance with international human rights law, it should therefore be seen as a core human rights entitlement to receive minimally adequate health care. Under these rights, governments have a range of duties with regard to medicines, which include, inter alia, ensuring the affordability of essential medicines and preventing restrictions on access. In this light, government use of TRIPS flexibilities to provide access to lifesaving medicines should be seen as necessary to fulfill their duties under rights to health and life. In cases where the adoption of patent provisions in TRIPS-plus free-trade agreements will result in the loss of life due to limited access to lifesaving drugs, this action should be seen as a violation of these duties. Support for the idea that the enforcement of trade-related intellectual property rights may violate human rights is found in the work of Thomas Pogge. Pogge argues that those who uphold social rules, such as trade and economic policies, can violate human rights when these rules 'Joreseeably and avoidably deprive human beings of secure access to the objects of their human rights."35 Pogge argues that the present international patent system fulfils these conditions. Solves 2nd contention – ww is blue 1AC Baker 13 AFRICAN HUMAN RIGHTS LAW JOURNAL * BA (UDW), BProc (UNISA), LLM (UDW), LLD (UKZN); vawday@ukzn.ac.za BA (Harvard), JD (Northeastern); b.baker@neu.edu (2013) 13 AHRLJ 55-81 Achieving social justice in the human rights/intellectual property debate: Realising the goal of access to medicines Yousuf A Vawda* Associate Professor of Law, University of KwaZulu-Natal, South Africa Brook K Baker Professor of Law, Northeastern University, Boston MA, USA; Honorary Research Fellow, University of KwaZulu-Natal, South Africa The increasing privatisation of knowledge and the products of knowledge have been a significant feature of the capitalist system from its earliest phases. It was typified by the ‘enclosure movement’,106 the design to fence off public spaces and bring them under private ownership and control. This culminated in according proprietary status to the products of the intellect – the recognition of intellectual property rights. In more recent times, the harmonisation and integration of intellectual property rights, through institutions such as the WIPO and WTO, signify a new wave of the enclosure movement, with intellectual property right protection now having a global reach. Protagonists of this approach have argued that the new property regime has given rise to ‘unparalleled expansion of productive possibilities’.107 But for whose benefit? Life-saving medicines and medical devices, critical to the health and well-being of individuals and societies alike, have not escaped appropriation as private assets. Medicines are thus often viewed as private commodities because of various factors, including, amongst others: • Reigning bioethical models with their focus on patient autonomy have emphasised individual aspects of health care, reinforced by the fact that medicines are privately consumed.108 • The market pre-selects consumers of highly-priced medicines, by excluding those individuals who cannot afford them. But medicines are – at least partially – public goods in the sense that they have significant implications for public health, are also global in their development and impact, and are prone to regulation in their development, manufacture, allocation and use.109 The public dimensions of medicines are well known, directly from their role in public health vaccination measures, as well as in the treatment of epidemic and endemic diseases. The public dimension also entails the public consequences emanating from choices made in research and development of new medicines, and the profiteering surrounding lifestyle drugs which draws resources away from research into socalled ‘neglected’ diseases. In contrast to private goods, ‘public goods’ are goods that are essentially social in character, even though (like medicines) they may be intended for private consumption.110 Public goods also often have positive externalities, meaning that their broad accessibility and use benefit the public at large, not just those who use them. This public benefit is most obvious in the instance of vaccination, where herd immunity develops because of wide diffusion. However, the same dynamic can be seen with respect to the prevention and treatment of infectious diseases. Indeed, because healthier populations have increased capacity in the economic, cultural, political and self actualising sphere, there are positive externalities for treating chronic and even temporary disease conditions. Medicines, therefore, cannot merely be regarded as private goods. Drug development itself has assumed a global character. It may be true that most innovation in this area emanates from laboratories in developed countries. However, developing countries make a significant contribution to the development of medicines in several ways, including sharing knowledge of indigenous plants and their properties, and controversially, being involved as research participants in clinical trials for medicines, from which they sometimes may not themselves benefit.111 A major change in the recent discourse on global health concerns the ‘framing, norms, and policy approaches to addressing the problem of globally inequitable access to drugs, diagnostics, vaccines and other health technologies’.112 This development is due, in no small part, to the global political and social mobilisation on the issue of access to affordable anti-retrovirals, which has fomented a re-think of the traditional approaches to understanding medicines as private goods, has focused attention on the global demand for access to health technologies for all (as opposed to merely ‘neglected’ diseases), and has highlighted the need for new, more inclusive governance mechanisms to manage pharmaceutical and related innovation.113
9/12/21
SeptOct - CP - Advantage vs Vaccines
Tournament: Grapevine | Round: 2 | Opponent: Lexington BF | Judge: Samantha Mclaughlin The United States should: - substantially increase production and global distribution of the COVID-19 Vaccine - cooperate with allies to achieve increased production and global distribution of the COVID-19 Vaccine. Solves heg – us intervenes in vaccine diplomacy better than the aff bc it looks like follow on w the other wto countries Solves developing econs – gives them vaccines Solves credibility – resolves covid which the wto is struggling with That solves better – IP rights don’t hinder vaccine cooperation, but manufacturing capacity is the current constraint. Hans Sauer 6-17 (Deputy General Counsel, Biotechnology Industry Organization.) “Web event — Confronting Joe Biden’s proposed TRIPS waiver for COVID-19 vaccines and treatments” https://www.aei.org/wp-content/uploads/2021/06/210617-Confronting-Joe-Bidens-proposed-TRIPS-waiver.pdf?x91208andx91208 TDI But contrary to what Lori said, there are genuine real problems in the supply chain that are not caused by patents, that are simply caused by the unavailability and the constraints on existing capacity. There is in this world such a thing as maxed-out capacity that just can’t be increased on a dime. It’s not all due to intellectual property. This is true for existing vaccines as well as for vaccine raw materials. There are trade barriers. There are export restrictions that we should all be aware of and that we need to work on. And there are very real political, I think, interests in finding an explanation for how we got to this place that absolve governments around the world from their own policy decisions that they made in the past. In the United States, again, it was the declared policy of the previous administration, as well as this one, that we would vaccinate healthy college kids and go all down the line and offer a vaccine to everybody who wants it before we start sharing any with grandmothers in Burkina Faso. That was the policy. You can agree with it or disagree with it, but that was policy. We had export restrictions in place before a lot of other countries did. And that, too, contributed to unequal access of vaccines around the world. Another thing that was predictable was that politicians and governments around the world who want to be seen as proactive, on the ball, in control, for a long time were actually very indecisive, very unsure about how to address the COVID problem, which has so many dimensions. Vaccines are only one of those. But with respect to vaccines, not many governments took decisive action, put money on the table, put bets on multiple horses, before we knew whether these vaccines would work, would be approved. And it was governments in middle-income countries who now, I think, justifiably are concerned that they’re not getting fast enough access, who didn’t have the means and who didn’t have the decision-making structure to place the same bets on multiple horses, if you will, that were placed in the relatively more wealthy, global North and global West. But there is, I think, a really good and, with hindsight, predictable explanation of how we got to this place, and I think it teaches us something about how to fix the problem going forward. So why will the waiver not work? Well, first of all, with complex technology like vaccines, Lori touched on it, reverse engineering, like you would for a small molecule drug, is much more difficult if not impossible. But it depends very much more than small molecule drugs on cooperation, on voluntary transfer of technology, and on mutual assistance. We have seen as part of the pandemic response an unprecedented level of collaborations and cooperation and no indication that IP has stood in the way of the pandemic response. The waiver proponents have found zero credible examples of where IP has actually been an obstacle, where somebody has tried to block somebody else from developing a COVID vaccine or other COVID countermeasure, right? It’s not there. Second, the myth of this vast global capacity to manufacture COVID vaccines that somehow exists out there is unsubstantiated and frankly, in my opinion, untrue. But there is no such thing as vast untapped, idle capacity that could be turned around on a dime to start making COVID vaccines within weeks or even months. This capacity needs to be built; it needs to be established. And at a time when time is of the essence to beat this pandemic, starting capacity-building discussions is helpful, but it won’t be the answer to beat this pandemic. It will be the answer if we do everything right to beating the next pandemic. And if we learn any lesson of this, and then I will stop, is that the COVID waiver as well as the situation in which we find ourselves — if anything, it’s a reminder that we definitely have to take global capacity-building more seriously than we did in the past. That is true for the global North, as well as for middle-income countries — all of whom have to dedicate themselves much more determinedly to pandemic preparedness. And there’s a need to invest both in preparedness and in public health systems that hasn’t happened in the wake of past pandemic threats. This is what we will need to do. We will need to reduce export restrictions, and we will need to rededicate ourselves to preparing for the next pandemic. As far as this pandemic goes, there are 11 vaccines around the world that are already being shot into arms, only four of which come from the global North. How many more vaccines do we want? I don’t know, maybe 11 is enough if we start making more of them. But there are manufacturers around the world who know how to do this — including in China, including in India, and including in Russia. All developed their homegrown vaccines, apparently without interference by IP rights, right? So let’s make more of those. I think that’s going to be the more practical and realistic answer to solving the problem. And we need to lean on governments to stop export controls and to dedicate themselves to more global equity. Unilateral US action is necessary to combat Chinese and Russian vaccine diplomacy – they’re establishing spheres of influence because of few vaccines in developing countries – collapses the LIO. Carman and Carl 21. (Ezequiel Carman is an Argentine lawyer and global health and trade policy consultant. Previously, he served as a legal advisor to the Ministry of Justice of Buenos Aires, an assistant professor of international public law at the Universidad Católica Argentina, and a research assistant at the O’Neill Institute for National and Global Health Law. Joseph Carl is a graduate of Liberty University, where he studied international relations and strategic international studies. He has worked for the U.S. Department of State and the Heritage Foundation) “A U.S. vaccine diplomacy strategy for Latin America and the Caribbean,” The Global Americans, June 15, 2021. https://theglobalamericans.org/2021/06/a-u-s-vaccine-diplomacy-strategy-for-latin-america-and-the-caribbean/ TDI Once again, history seems to be repeating itself. The United States, along with the world’s other rich and mostly Western countries, continue to be accused of hoarding medical supplies, having purchased one billion surplus vaccine doses (more than is required to vaccinate their citizens). In their absence, China—and, to a lesser extent, Russia—have rushed to take advantage of the vaccine gap in the Global South, particularly in Latin America and the Caribbean. A lack of leadership from Washington in sharing vaccines and their intellectual property (IP) earlier in the pandemic has allowed its geopolitical competitors to take advantage of Latin America’s desperate need to acquire scarce vaccines. Although the region represents only eight percent of the global population, it has experienced nearly one-third of all COVID-19 deaths. Historical precedent demonstrates this is not the first time that Washington’s international moral standing has been damaged during a global health crisis, due to the lack of political will to share lifesaving drugs and other vital resources. However, this time around, unlike in such past episodes, there will be concrete geopolitical consequences to Washington’s inaction. In recent years, the U.S. has lost significant political and economic influence among its southern neighbors; without swift remedial action, its geopolitical rivals may cement such losses through their campaigns of vaccine diplomacy. To rebuild its influence in the region, Washington will need to muster the political will to increase Latin America and the Caribbean’s access to vaccines and develop a sound strategy for its own vaccine diplomacy. Already, some countries in the region have been sufficiently strong-armed by other global powers, the implications of which could be damaging for U.S. interests. As the world transitions into the next stage of the pandemic, those nations that continue to be most ravaged by COVID-19 will likely continue to remember which countries provided them with aid and succor in their time of need. History repeats itself In 1981, the first cases of acquired immunodeficiency syndrome (AIDS) were reported; the following decade was defined by a devastating global AIDS epidemic (which would eventually be recognized as a pandemic). Analogous to how Latin America and the Caribbean have borne disproportionately the burden of COVID-19, Africa was hit hardest by the AIDS epidemic. Many parallels can be drawn between the international handlings of both the COVID-19 and AIDS pandemics. By the late 1980s, once antiretroviral therapies (ARV) were approved by the U.S. Food and Drug Administration (FDA), AIDS deaths in the U.S. began to decline immediately. Nevertheless, high levels of AIDS-related deaths in Africa continued for another decade. Africa’s enduring fight against AIDS was largely due to the cost of ARVs, which, at the time, were priced at USD $10,000 per person annually—completely out of reach for most developing countries. Pharmaceutical companies argued that the drug’s high selling price was necessary to procure a return on its investment in the research and development (RandD) of the ARV, and that pricing the drugs at a marginal cost would maximize consumer surplus while also halting future development in the industry. When pricing a drug, a pharmaceutical company needs to factor-in several costs: 1) the cost of RandD for drugs that never enter the market; 2) clinical trials necessary to comply with regulatory requirements; 3) and the marketing cost of promoting the new drug. While the original price of the patented ARV was USD $10,000 per patient per year, the price of the generic version, manufactured by the Indian pharmaceutical company Cipla, was only USD $1.00 per day. During the AIDS pandemic, since many developing countries were members of the World Trade Organization (WTO), they were forbidden from importing generic pharmaceutical products because in order to maintain compliance with regulations imposed by the Trade Related Aspects of Intellectual Property (TRIPS) agreement. Western pharmaceutical companies—the owners of the IP rights for the medications—blocked access to generic ARV drugs out of fear that the importation of these generic alternatives would ultimately threaten their net profitization. Despite the protests of the pharmaceutical industry, India and South Africa continued to compete with and defy the U.S. and the WTO (a body in which powerful industrialized economies—those of the U.S., Europe, and Japan—wield disproportionate influence). Drug companies eventually sued to keep lifesaving therapies out of the hands of dying AIDS-sufferers in Africa, a state of affairs that engendered a forceful reaction from international activists. After years of political pressure, Washington was forced to yield, eventually pushing for the relaxation of stringent IP protections for ARVs, making generic versions of the drugs more accessible and affordable. Despite its eventual concession, the perception that the U.S. had fought bitterly to prioritize pharmaceutical company profits over human lives in the Global South only helped bolster negative narratives surrounding the Western superpower. However, unlike the unipolarity that characterized the 1990s and early 2000s, the U.S. is no longer the only global superpower, and the humanitarian decisions it makes now—during a new global health crisis—have the potential to be hugely consequential for the country’s influence and image. Similar to its trajectory at the height of the AIDS crisis, Washington only recently voiced its desire to back the WTO patent waiver proposal, having come under tremendous international pressure. Granted, the U.S. backed a patent waiver for COVID-19 vaccines much faster than it did for ARVs in the 1980s. However, having been presented with a rare opportunity to make amends for past moral missteps—by eliminating vaccine IP protections to ensure that affordable, generic versions of COVID-19 vaccines could be manufactured en masse around the world—the U.S. once again hesitated, limiting opportunities for developing nations to recover from the pandemic and again amplifying criticisms of the United States. Backed by over 100 developing countries, India and South Africa are once again leading the current fight to eliminate IP protections. India and South Africa filed a waiver with the WTO requesting a temporary suspension of patent obligations under TRIPS (Sections 1, 4, 5, and 7 of Part II) so that developing countries can access vaccines in a timely manner. The intent of this effort is to boost domestic manufacturing capacity by facilitating the widespread production of generic versions of COVID-19 vaccines, evening the odds with respect to global vaccine procurement and accessibility. The waiver would also allow developing countries to procure vaccines more expeditiously, either by producing them themselves or by streamlining the cumbersome institutional and legal requirements of importing pharmaceutical products from other countries that possess the necessary manufacturing capacity. After months of pushback from activists and political leaders, the U.S. finally expressed its support for patent waivers, with several key Western powers (notably France and the European Union (EU)) following suit. However, Germany—a major political player in the patent waiver debate due to its powerful pharmaceutical sector—continues to oppose the move. Other European countries remain similarly split on the patent waiver proposal, reflecting the fact that any patent waiver proposal will still requires extensive negotiation (in order for it to be accepted, there must be unanimous consent among WTO members). Political leaders and activists continue to call on the West to support the waiving of IP protections, noting that current projections anticipate that wealthy countries will be able to immunize their entire populations by the end of 2021, while developing countries will only see the same results in the next three to four years. Unlike the AIDS pandemic, COVID-19 has generated not only massive medical concerns, but also a global economic crisis: vaccination campaigns in richer countries have already allowed them to begin to rebuild their economies, while mass unemployment and lockdowns continue to strangle the economies of many developing nations. Increasing the supply and accessibility of vaccines in the developing world will undoubtedly facilitate a faster, and more equal, economic recovery. Continuing to allow the virus to spread unencumbered throughout the Global South, however, will only increase the likelihood of further viral mutations, possibly jeopardizing the efficacy of existing vaccines and further perpetuating already grave economic and medical concerns. Washington’s initial unwillingness to cross the pharmaceutical industry has undeniably damaged the moral standing of the United States. Moreover, this decision also created a humanitarian void eagerly filled by Beijing and Moscow, as they actively seek to position themselves as the benefactors of the most COVID-19-stricken region of the world: Latin America and the Caribbean. To date, Russian and Chinese vaccine diplomacy have already led to economic, diplomatic, and political losses being felt by Washington; this trend, if allowed to continue, will only further limit U.S. regional influence with its neighbors to the south. A lack of strategy and political will In the absence of an effective vaccine diplomacy strategy from Washington, and with the perpetuation of its current nationalistic vaccine policy, some of the pharmaceutical companies that the U.S. so readily protects have pushed countries throughout Latin America and the Caribbean into the waiting arms of Beijing and Moscow. While some Latin American countries have received a few vaccines from Western companies, most nations in the region continue to struggle to obtain doses. Pfizer, a U.S. pharmaceutical company, was accused of bullying Latin American countries during vaccine procurement negotiations, using its own leverage to attempt to force desperate nations to offer sovereign assets—such as their embassies—as collateral. Pfizer’s efforts resulted in a lost deal with Argentina, which has continued to grow increasingly closer to China. While the U.S. possesses a surplus of COVID-19 vaccines, it has failed to develop an effective, far-reaching donation strategy. Only recently did the Biden administration announce its plans to ship 80 million vaccines—a small portion of its surplus supply—abroad. Of the initial 25 million doses destined to be distributed internationally, 19 million will be donated to the largely mismanaged UN-backed COVAX program, with only six million of these COVAX doses designated for Latin America and the Caribbean. In comparison, China alone has donated or sold over 165 million vaccines to Latin America, with countries like Chile and Uruguay having vaccinated 80 and 63 percent of their populations, respectively, with Chinese vaccines. The administration of U.S. President Joe Biden previously donated a total of 4.2 million AstraZeneca vaccines to Canada and Mexico, the first vaccines that the U.S. had sent abroad. Still, this relatively modest donation was preceded by repeated calls from prominent Latin American leaders for President Biden to donate vaccines to U.S. allies in Latin America. Mexican President Andrés Manuel López Obrador (AMLO) was notably rebuffed in his request for shipments of U.S. vaccines, being told by the Biden administration that it was prioritizing the vaccination of the American public (despite the fact that Washington had already bought enough vaccines to inoculate the entire U.S. population several times over). Colombia President Iván Duque of Colombia, a country that is a key regional ally, has also called for the Biden administration to aid countries in the Western Hemisphere that are struggling to procure vaccines. By contrast, some Latin American officials have described easier negotiations, cheaper prices, and overall better terms in their successful agreements with Russia and China. Last year, for example, Beijing offered a USD $1 billion loan to Latin American nations to help finance their purchasing of Chinese-made vaccines—an offer that was well-received by recipient countries. Due to a lack of vaccine support and assurance from Washington, countries are growing closer to Beijing and Moscow, succumbing to rival geopolitical powers that do not align with the diplomatic and economic interests of the United States.
9/13/21
SeptOct - DA - Infrastructure
Tournament: Grapevine | Round: 2 | Opponent: Lexington BF | Judge: Samantha Mclaughlin Infrastructure passes now with limited corporation support, but increased big Pharma backlash causes it to fail Waldman 8/31 Paul, opinion writer for the Plum Line blog. Before joining The Post, he worked at an advocacy group, edited an online magazine, taught at university and worked on political campaigns. He has authored or co-authored four books on media and politics, and his work has appeared in dozens of newspapers and magazines. He is also a senior writer at the American Prospect, “Opinion: Democrats, don’t knuckle under to corporations on the reconciliation bill”, 08-31-2021, Washington Post, https://www.washingtonpost.com/opinions/2021/08/31/democrats-dont-knuckle-under-corporations-reconciliation-bill///pranav The infrastructure bill that passed the Senate and awaits action in the House was in some ways a model of bipartisanship, supported by some Republicans as well as all the chamber’s Democrats, and given a boost from traditionally Republican business groups. That wasn’t a surprise; big corporations need infrastructure to do business. If the government pays for better roads, a more resilient electrical grid and wider availability of broadband, it’ll probably help the bottom line. But what happens when the government suggests addressing Americans’ needs and asks those corporations to help pay for it? This is what happens: A torrent of political groups representing some of the country’s most influential corporations — including ExxonMobil, Pfizer, and the Walt Disney Company — is laying the groundwork for a massive lobbying blitz to stop Congress from enacting significant swaths of President Biden’s $3.5 trillion economic agenda. The emerging opposition appears to be vast, spanning drug manufacturers, big banks, tech titans, major retailers and oil-and-gas giants. In recent weeks, top Washington organizations representing these and other industries have started strategizing behind the scenes, seeking to battle back key elements in Democrats proposed overhaul to federal health care, education and safety net programs. This campaign will have lots of behind-the-scenes pressure: Together, these companies employ a group of lobbyists that are approximately equal in number to China’s People’s Liberation Army — as well as online and TV ads coming to a screen near you. So Democrats should now ask themselves: What are we doing here? As in, why did we decide to run for Congress? Because there are some moments that test your resolve, in which you have to ask what the purpose of public service is, and whether it’s more than just staying in your job for as long as possible. There are disagreements among Democrats about what should be in the final bill, and it’s almost certain that these corporations will have some success in stripping away some provisions they find threatening. There’s an increase in the corporate tax rate (though under every proposal, it would still be less than before the 2017 Republican tax cut). There’s money to boost Internal Revenue Service enforcement of existing tax laws, which the people who run corporations don’t like; an overstretched, overworked IRS that can’t manage to audit the super-rich is just how CEOs like things. Perhaps most threatening is the proposal to allow Medicare to negotiate prices for prescription drugs, as they are currently barred by law from doing. Democrats insist that change would pay for much of the trillions of dollars in new and beefed-up social programs this bill creates. Big Pharma hates the plan – empirics – err neg our ev literally cites their press releases PhRMA ’21 The Pharmaceutical Research and Manufacturers of America (PhRMA) represents the country’s leading innovative biopharmaceutical research companies, which are devoted to discovering and developing medicines that enable patients to live longer, healthier and more productive lives. Since 2000, PhRMA member companies have invested nearly $1 trillion in the search for new treatments and cures, including an estimated $83 billion in 2019 alone, “PhRMA Statement on WTO TRIPS Intellectual Property Waiver”, 05-05-2021, https://www.phrma.org/coronavirus/phrma-statement-on-wto-trips-intellectual-property-waiver//pranav WASHINGTON, D.C. (May 5, 2021) – Pharmaceutical Research and Manufacturers of America (PhRMA) president and CEO Stephen J. Ubl made the following statement after the United States Trade Representative expressed support for a proposal to waive patent protections for COVID-19 medicines: “In the midst of a deadly pandemic, the Biden Administration has taken an unprecedented step that will undermine our global response to the pandemic and compromise safety. This decision will sow confusion between public and private partners, further weaken already strained supply chains and foster the proliferation of counterfeit vaccines. “This change in longstanding American policy will not save lives. It also flies in the face of President Biden’s stated policy of building up American infrastructure and creating jobs by handing over American innovations to countries looking to undermine our leadership in biomedical discovery. This decision does nothing to address the real challenges to getting more shots in arms, including last-mile distribution and limited availability of raw materials. These are the real challenges we face that this empty promise ignores. “In the past few days alone, we’ve seen more American vaccine exports, increased production targets from manufacturers, new commitments to COVAX and unprecedented aid for India during its devastating COVID-19 surge. Biopharmaceutical manufacturers are fully committed to providing global access to COVID-19 vaccines, and they are collaborating at a scale that was previously unimaginable, including more than 200 manufacturing and other partnerships to date. The biopharmaceutical industry shares the goal to get as many people vaccinated as quickly as possible, and we hope we can all re-focus on that shared objective.” They lash out against infra and use COVID clout to kill it – they have public support, and a win now postpones reform indefinitely which turns case Fuchs et al. 09/02 Hailey Fuchs attended Yale University and was an inaugural Bradlee Fellow for The Washington Post, where she reported on national politics, Alice Ollstein is a health care reporter for POLITICO Pro, covering the Capitol Hill beat. Prior to joining POLITICO, she covered federal policy and politics for Talking Points Memo, Megan Wilson is a health care and influence reporter at POLITICO, “Drug industry banks on its Covid clout to halt Dems’ push on prices”, 09-02-2021, https://www.politico.com/news/2021/09/02/drug-prices-democrats-lobbying-508127//pranav As Democrats prepare a massive overhaul of prescription drug policy, major pharmaceutical companies are mounting a lobbying campaign against it, arguing that the effort could undermine a Covid fight likely to last far longer than originally expected. In meetings with lawmakers, lobbyists for the pharmaceutical industry have issued warnings about the reconciliation package now moving through both chambers of Congress that is set to include language allowing Medicare to negotiate the price of some drugs, which could generate billions of dollars in savings. In those conversations, K Street insiders say, lobbyists have explicitly mentioned that the fight against the coronavirus will almost certainly extend beyond the current surge of the Delta variant. And they’re arguing that now isn’t the time to hit the industry with new regulations or taxes, particularly in light of its successful efforts to swiftly develop vaccines for the virus. “For years, politicians have been saying that the federal government can interfere in the price of medicines and patients won’t suffer any harm,” said Brian Newell, a spokesperson for the Pharmaceutical Research and Manufacturers of America, or PhRMA, in a statement. “But in countries where this already happens, people experience fewer choices and less access to prescription medicines. Patients know if something sounds too good to be true, then it usually is.” The escalating warnings from the pharmaceutical industry are part of what is expected to be one of the more dramatic and expensive lobbying fights in recent memory, and a heightened repeat of the industry’s pushback to actions by former President Donald Trump to target drug prices. The proposal now under consideration in Democrats’ reconciliation package could save the federal government hundreds of billions of dollars by leveraging its ability to purchase prescription drugs, according to a report from the Congressional Budget Office. Without those funds, Democrats won’t be able to pay for the rest of the health care agenda they’ve promised to voters, including expansions of Medicare, Medicaid and Obamacare. But the plan has political power as more than a revenue raiser. Party leaders — from President Joe Biden to Senate Budget Chair Bernie Sanders (I-Vt.) — are touting it as one of the most important components of the $3.5 trillion package, with the potential to lower out-of-pocket health spending for tens if not hundreds of millions of people. Outside advocates have also zeroed in on it as the most consequential policy fight on the horizon. “This is the best chance that we have seen in a couple of decades to enact meaningful reforms to drug pricing policy in the United States that will lower the prices of prescription drugs, and it’s very clear that the drug companies are going all out to stop it,” said David Mitchell, founder of Patients for Affordable Drugs. “This is Armageddon for pharma.” Progressive Democrats and their outside allies believe they’re closer than they’ve been in decades to imposing some price controls, and worry that failure to do so this year will delay progress indefinitely given the possibility of the party losing one or more chambers of Congress in the 2022 midterms. In April, the House passed a fairly aggressive version — H.R. 3 (117) — though a handful of moderate Democrats friendly to the industry have threatened to block it when it comes back to the floor for a vote later this fall. Leadership has largely shrugged off this threat, banking on the fact that the most vulnerable frontline Democrats are vocally in favor of the policy, while most of the dissenters sit in safe blue districts. The Senate is designing its own version, outlined by Sen. Ron Wyden (D-Ore.) in June, as a middle ground between HR3 and the more narrow, bipartisan bill he and Sen. Chuck Grassley (R-Iowa) put forward last Congress. A senior Senate Democratic aide confirmed to POLITICO that the bill is nearly complete and that they’re in the process of shopping it around to undecided senators to make sure it has enough support to move forward in the 50-50 upper chamber. “It makes sense to get buy-in before releasing it rather than releasing it with fingers crossed and then tweaking it once members complain,” the aide said. But the reform push is coming at a time when the pharmaceutical industry is working hand-in-hand with government officials to combat the pandemic and enjoying a boost in public opinion as a result, even as drug costs continue to rise. The companies claim that fundamental changes to their bottom line — in addition to the Medicare provision, the reconciliation bill will likely raise corporate tax rate significantly, as high as 28 percent (a jump of 7 percentage points) — will threaten its current investments in research and development at a historically critical juncture. With the final draft of the bill expected in the coming weeks, the Pharmaceutical Research and Manufacturers of America, the lobbying arm of the pharmaceutical industry, is taking its case public. The group has recently spent at least seven figures on ads pressuring Congress not to change Medicare drug policy. Big pharma always wins – independently kills aff solvency bc it causes the plan to be watered down so much that de facto monopolies can survive Florko and Facher ‘19 Nicholas Florko is a Stat News Washington correspondent and Lev Facher is Stat News health and life sciences writer, “How pharma, under attack from all sides, keeps winning in Washington”, 07-16-2019, Stat News, https://www.statnews.com/2019/07/16/pharma-still-winning///pranav It does not seem to matter how angrily President Trump tweets, how pointedly House Speaker Nancy Pelosi lobs a critique, or how shrewdly health secretary Alex Azar drafts a regulatory change. The pharmaceutical industry is still winning in Washington. In the past month alone, drug makers and the army of lobbyists they employ pressured a Republican senator not to push forward a bill that would have limited some of their intellectual property rights, according to lobbyists and industry representatives. They managed to water down another before it was added to a legislative package aimed at lowering health care costs. Lobbyists also convinced yet another GOP lawmaker — once bombastically opposed to the industry’s patent tactics — to publicly commit to softening his own legislation on the topic, as STAT reported last month. Even off Capitol Hill, they found a way to block perhaps the Trump administration’s most substantial anti-industry accomplishment in the past two years: a rule that would have required drug companies to list their prices in television ads. To pick their way through the policy minefield, drug makers have successfully deployed dozens of lobbyists and devoted record-breaking sums to their federal advocacy efforts. But there is also a seemingly new strategy in play: industry CEOs have targeted their campaign donations this year on a pair of vulnerable Republican lawmakers — and then called on them not to upend the industry’s business model. In more than a dozen interviews by STAT with an array of industry employees, Capitol Hill staff, lobbyists, policy analysts, and advocates for lower drug prices, however, an unmistakable disconnect emerges. Even though Washington has stepped up its rhetorical attacks on the industry, and focused its policymaking efforts on reining in high drug prices, the pharmaceutical industry’s time-honored lobbying and advocacy strategies have kept both lawmakers and the Trump administration from landing any of their prescription-drug punches. “Big Pharma has replaced Big Tobacco as the most powerful brute in the ranks of Washington power brokers,” Sen. Dick Durbin (D-Ill.) said in a statement to STAT. Durbin, who recently saw the industry successfully oppose his proposal to curtail some of the industry’s patent maneuvering, added that, “Pharma’s billions allow them to continue to rip off American families and taxpayers.” The industry doesn’t get all the credit; it has also benefited from a fractured Congress and discord between President Trump’s most senior health care advisers. PhRMA, the drug industry’s largest lobbying group here, declined to comment for this article. But industry leaders have broadly argued against efforts to rein in the industry’s practices in terms of price hikes and patents, making the case that that could irreparably stifle medical innovation. The battle is far from over, and industry representatives and lobbyists are quick to hypothesize that the worst, for them, is yet to come. They point to several ongoing legislative initiatives, including in the Senate Finance Committee, that could take more concerted direct aim at their pricing strategies in Medicare. They’re waiting, too, to see if House Democrats can cut a drug pricing deal with the White House to empower Medicare to negotiate at least some drug prices. Another pending regulation, loathed by drug makers, might tie their pricing decisions in Medicare to an index of international prices. They’ve also bemoaned the Trump administration’s decision last week to abandon a policy change that would have ended drug rebates — which, the pharmaceutical industry has said, could have given drug makers more space to lower their prices voluntarily. “We’re getting killed!” one pharma lobbyist told STAT. Of course, the Trump administration’s supposedly devastating decision to abandon that proposal simply maintains the status quo. “Big Pharma has replaced Big Tobacco as the most powerful brute in the ranks of Washington power brokers.” n Valentine’s Day, Sen. Thom Tillis (R-N.C.) enjoyed a showering of love that is familiar in Washington: a flood of campaign contributions, many at the federal limit of $2,800 for a candidate or $5,000 for an affiliated political committee. One donation came from Pfizer’s CEO, Albert Bourla, who donated $5,000 to Tillis and another $10,000 to Sen. John Cornyn (R-Texas) and associated campaign committees. Another came from Kenneth Frazier, the top executive at Merck. The Tillis campaign committee eventually cashed checks from CEOs and other high-ranking executives at those companies as well as Amgen, Eli Lilly, Sanofi, and Bristol Myers-Squibb, plus two high-ranking officials at the advocacy group PhRMA. Six lobbyists at one firm that works with PhRMA, BGR, also combined to contribute $100,000 to a bevy of Republican lawmakers and the party’s campaign arms. Tillis raised an additional $64,500 from drug industry political action committees in the past quarter, according to disclosures released on Monday. A Pfizer spokeswoman declined to comment about Bourla’s contributions, and representatives for the other companies did not respond to STAT’s request for comment. Tills was one of few individual lawmakers — in many cases, the only one — to whom the executives had written personal checks during the current election cycle. While drug industry CEOs frequently contribute to political committees for congressional leadership, the breadth of executives who donated Tillis specifically is notable, particularly considering his outspoken role on pharmaceutical industry issues. While lobbyists pushed back on the notion that campaign contributions directly influence votes, the donations targeted so specifically to a particular candidate could be seen as a prime example of Washington’s system for rewarding loyalty and how industries protect their interests. The same PhRMA PAC that donated to Tillis has given generously in recent years: nearly $200,000 in the 2018 campaign cycle, roughly 58 of which was targeted toward Republicans. Drug industry PACs donated $10.3 million in total in that cycle, according to the Center for Responsive Politics. The figure two years before was even higher: a total of $12.2 million from industry-aligned PACs alone. It is no accident that the pharmaceutical industry has maintained its reputation among the nation’s most powerful lobbies, said Sheila Krumholz, the executive director of the Center for Responsive Politics, an organization that tracks political influence. “Their access and influence goes beyond this Congress or even the administration,” Krumholz said in an interview, adding that she “was struggling to think of evidence” it had waned. Pharma has a reputation here for winning on policy — often thanks to the lawmakers who are among the biggest recipients of the millions that drug corporations, employees, and the industry political arms donate each year. Even as the rhetoric has escalated, the industry has quietly worked to insulate itself from any major legislative changes. Take, for example, a recent about-face from Cornyn, the Texas Republican who took in some campaign cash alongside Tillis. As recently as February, Cornyn seemed to be positioning himself as a rare Republican figurehead for anti-pharma congressional wrath. At a widely publicized hearing before the Senate Finance Committee, he went head-to-head with AbbVie CEO Richard Gonzalez, pressing him to explain why the company had filed more than 100 patents on its blockbuster arthritis drug Humira. Cornyn introduced legislation soon after the skirmish to crack down on patent “thicketing,” a term for a drug company tactic to accumulate tens, if not hundreds, of patents to shield a drug from potential generic competition. Pharma sprung into action. They recruited congressional allies, including Tillis, to pressure Cornyn to significantly rework the bill, and they succeeded. The version of the bill that eventually cleared the Senate Judiciary Committee was stripped of language that would have empowered the Federal Trade Commission to go after patent thicketing. Instead, the bill limited how many patents a drug maker could assert in a patent lawsuit. The new version of the bill lost “a lot of teeth” and “solves a narrower problem in a narrow way,” advocates told STAT when the change was first introduced. It is far from the only example of the industry’s aggressive interventions to water down legislation. “In lots of ways they’re like the National Rifle Association, because they have an incredible power to squash out any negative opinion, nor to feel any of the ill effects of those things,” said Pallavi Damani Kumar, an American University crisis communications professor who once worked in media relations for drug manufacturers. “It just speaks to how incredibly savvy they are.” Pharmaceutical industry lobbyists also successfully fought to keep another anti-drug industry patent proposal from Sen. Bill Cassidy (R-La.) and Dick Durbin (D-Ill.) out of a bipartisan drug pricing package moving through the Senate HELP Committee. The legislation would have allowed the FDA to approve cheaper versions of drugs, even when the more expensive product was protected by certain patents. Cassidy’s proposal never even made it into the HELP package. As the lobbyist who bemoaned the withdrawal of the rebate rule put it, Cassidy “simmered down” in the face of industry pressure. In recent weeks, the industry had targeted Cassidy in particular, in recent weeks, for fear he would break with many of his GOP colleagues to support a cap on some price hikes for drugs purchased under Medicare, a proposal so far pushed only by Democrats. “Sen. Cassidy doesn’t care what lobbyists think — he is going to do what’s best for patients,” said Ty Bofferding, a Cassidy spokesman. “Sen. Cassidy fought for the committee to include the REMEDY Act in the package, despite strong opposition from the pharmaceutical industry.” The committee eventually included half the bill’s provisions, he added, as well as four other pieces of legislation meant to prevent the industry from taking advantage of the patent system. The drug industry also notched a win by watering down another proposal in that package from Sen. Susan Collins (R-Maine) that would have blocked drug makers from suing over patents they didn’t disclose to the FDA. The version of the bill that actually made it into the package doesn’t block drug makers from suing, but instead directs the FDA to create a public list of companies that fail to disclose their patents. “This change is a big win for drug makers,” Michael Carrier, a Rutgers University professor and expert on patent gaming, told STAT. “Shaming is something drug makers don’t seem worried about.” Matthew Lane, the executive director of the Coalition Against Patent Abuse, likewise added that the altered bill “doesn’t seem to be doing much anymore.” Not all of the pharma-endorsed changes, however, are self-serving. Patent experts and federal regulators too had raised concerns with some of the bill being proposed. Cornyn’s patent bill was particularly controversial. “These provisions encourage ‘fishing expeditions’ by zealous bureaucrats, politically motivated by the popularity of efforts to reduce drug prices and garner the political benefits of being seen to be pursuing these ends,” Kevin Noonan, a patent lawyer at McDonnell Boehnen Hulbert and Berghoff wrote in a recent blog post, referring to the original Cornyn bill. Drug-pricing advocates said lobbyists have even managed to convince lawmakers to introduce some legislation they say has explicitly favored the drug industry, including intellectual property-focused legislation that would allow drug makers to patent human genes. That particular bill would “undo the bipartisan effort underway to fix pharma’s exploitation of the patent system,” said the Coalition Against Patent Abuse. And they were far from the only group raising concerns. The American Civil Liberties Union and more than 150 other groups wrote to lawmakers last month opposing the bill. Pharma’s list of policy victories goes on: Drug companies and allied patient groups forced the Trump administration to back off a proposal to make relatively minor changes to Medicare’s so-called protected classes policy. Currently, Medicare is required to cover all drugs for certain conditions, including depression and HIV. The Trump administration proposed in November that private Medicare plans should be able to remove certain drugs in those classes from their formularies, if the drugs were just new formulations of a cheaper, older version of the same drug, or when a drug spiked in price. But drug industry opposition helped convince the administration to spike that effort. A week ago, the industry struck its biggest blow yet. Three of the country’s largest pharmaceutical companies —Amgen, Eli Lilly, and Merck — prevailed in a lawsuit to strike down a Trump administration requirement that they disclose list prices in television advertisements. The lack of congressional action — despite the Democratic enthusiasm and bipartisan appetite — is still further evidence of industry’s ability to stave off defeat. As the dozens of Democrats running for president ramp up their anti-pharma rhetoric, both Trump and progressives have begun to fret that Washington’s efforts have proven to be all bark and no bite. With two weeks remaining before the August recess and an escalating 2020 campaign, some advocates fear that the window for bold action is closing quickly. “It’s appalling that we are six months into this Congress and we haven’t seen meaningful legislation passed on American’s number one issue for this congress,” said Peter Maybarduk, who leads drug-pricing initiatives for the advocacy group Public Citizen. “Congress needs to get its act together.” Infra’s k2 stopping existential climate change – warming is incremental and every change in temperature is vital Higgins 8/16 Trevor, Senior Director, Domestic Climate and Energy, “Budget Reconciliation Is the Key to Stopping Climate Change”, 08-16-2021, https://www.americanprogress.org/issues/green/news/2021/08/16/502681/budget-reconciliation-key-stopping-climate-change///pranav The United States is suffering acutely from the chaotic changes in climate that scientists now directly attribute to the burning of fossil fuels and other human activity. The drought, fires, extreme heat, and floods that have already killed hundreds this summer across the continent and around the world are a tragedy—and a warning of worsening instability yet to come. However, this week, the Senate initiated an extraordinary legislative response that would set the world on a different path. Enacting the full scope of President Joe Biden’s Build Back Better agenda would put the American economy to work leading a global transition to clean energy and stabilizing the climate. A look at what’s coming next through the budget reconciliation process reveals a ray of hope that is easy to miss amid the fitful negotiations of recent months: At long last, Congress is on the verge of major legislation that would build a more equitable, just, and inclusive clean energy economy. This is our shot to stop climate change. Building a clean energy future must start now Until the global economy stops polluting the air and instead starts to draw down the emissions of years past, the world will continue to heat up, blundering past perilous tipping points that threaten irreversible and catastrophic consequences. Stemming the extent of warming at 1.5 degrees Celsius rather 2 degrees or worse will reduce the risk of crossing such tipping points or otherwise exceeding the adaptive capacity of human society. Every degree matters. Stabilizing global warming at 1.5 degrees Celsius starts with cutting annual greenhouse gas emissions in the United States to half of peak levels by 2030. This isn’t about temporary offsets or incremental gains in efficiency—it’s about the rapid adoption of scalable solutions that will work throughout the world to eliminate global net emissions by 2050 and sustain net-negative emissions thereafter. Building this better future will tackle climate change, deliver on environmental justice, and create good jobs. It will give us a shot to stop the planet from continuously warming. It will alleviate the concentrated burdens of fossil fuel pollution, which are concentrated in systemically disadvantaged, often majority Black and brown communities. It will empower American workers to compete in the global clean energy economy of the 21st century. There is no time to lose in the work of building a clean energy future.
9/13/21
SeptOct - DA - Modi Adventurism
Tournament: Grapevine | Round: 2 | Opponent: Lexington BF | Judge: Samantha Mclaughlin India’s COVID crisis has killed Modi’s appetite for international adventurism, but increasing vaccine production reverses the trend. Singh ’21 (Sushant; senior fellow with the Centre for Policy Research in India; 5-3-2021; “The End of Modi’s Global Dreams”; Foreign Policy; https://foreignpolicy.com/2021/05/03/india-vishwaguru-modi-second-wave-soft-power-self-sufficiency/; Accessed: 8-27-2021) India’s prime minister advanced a muscular foreign policy, but his mishandling of the pandemic is an embarrassing step back. In December 2004, when an earthquake and tsunami struck Asia, then-Indian Prime Minister Manmohan Singh decided it was high time for India to stop accepting aid from other countries to deal with disasters and rely on itself instead. “We feel that we can cope with the situation on our own,” he said, “and we will take their help if needed.” It was a pointed political statement about India’s growing economic heft, and it wasn’t the last. Singh’s government offered aid to the United States in the wake of Hurricane Katrina in 2005 and to China after the 2008 Sichuan earthquake. Seen as a matter of national pride, an indicator of self-sufficiency, and a snub to nosy aid givers, the practice continued under Indian Prime Minister Narendra Modi despite pressure to change course during floods in the southern state of Kerala in 2018. Modi, who has consistently campaigned on virulent nationalism captured by the slogan “Atmanirbhar Bharat” (or self-reliant India), has been forced to abruptly change policy. Last week, with images of people dying on roads without oxygen and crematoriums for pet dogs being used for humans’ last rites as the second wave of the COVID-19 pandemic overwhelmed the country, his government accepted offers of help from nearly 40 other nations. Its diplomats have lobbied with foreign governments for oxygen plants and tankers, the arrival of medicines, and other supplies hailed on social media. “We have given assistance; we are getting assistance,” said Harsh Vardhan Shringla, the country’s top diplomat, to justify the embarrassing U-turn. “It shows an interdependent world. It shows a world that is working with each other.” The world may be working with each other, but it is not working for Modi in the realm of foreign policy. Rather, this is a moment of reckoning, triggered by the rampaging coronavirus. After seven years as prime minister, Modi’s hyper-nationalistic domestic agenda—including his ambition of making the country a “Vishwaguru” (or master to the world)—now lies in tatters. India, which has been envisaged since former U.S. President Donald Trump’s administration became the Quadrilateral Security Dialogue’s lynchpin and focused other efforts in the Indo-Pacific strategy to counter China, will have to work harder to justify that role. Meanwhile, China has redoubled its efforts in India’s neighborhood since the second wave began, strengthening its existing ties with South Asian countries and contrasting its strength and reliability with India’s limitations. No doubt, New Delhi will be able to regain a certain sense of normalcy in a few months, but the mishandling of the pandemic has dealt it a weaker hand in ongoing backchannel talks with Islamabad and border negotiations with Beijing. But even longer-lasting damage has been done to India’s soft power, which was already dented under Modi’s authoritarian regime. This is a big problem for the government as it was soft power that allowed New Delhi to assert itself for a seat at the global high table to begin with. Front page images and video clips of constantly burning pyres and dying patients may recede from the foreground with time, but rebuilding India’s diplomatic heft and geopolitical prominence will need more than the passage of months and years. It will take a concerted effort, and S. Jaishankar, Modi’s chosen man to be India’s foreign minister, has so far appeared unequal to the task. In March, when the second wave of the pandemic started unfolding in India, Jaishankar’s ministry was busy issuing official statements and organizing social media storms against popstar Rihanna and climate change activist Greta Thunberg. On Thursday, at the peak of the health crisis, Jaishankar’s focus in a meeting with all the Indian ambassadors to various global capitals was on countering the so-called “one-sided” narrative in international media, which said Modi’s government had failed the country by its “incompetent” handling of the second pandemic wave. Until recently, Jaishankar was also the most enthusiastic promoter of the government’s Vaccine Maitri (or “Vaccine Friendship”) program, under which New Delhi supplied around 66.4 million doses of the India-made AstraZeneca vaccine to 95 countries in packing boxes marked prominently with large pictures of Modi. These vaccines were either commercially contracted, given as bilateral grants, or transferred under the World Health Organization’s COVID-19 Vaccines Global Access (COVAX) scheme for poorer countries. Meanwhile, India’s own vaccination rollout has been dismal. Around 2 percent of Indians have been fully vaccinated, despite the country being the world’s biggest vaccine manufacturer—a misstep that has emerged as one of the key culprits for India’s uncontrolled second wave. Having exported doses in a quest for personal glory, Modi is now awaiting 20 million doses of AstraZeneca vaccines from the United States after abruptly reversing 16 years of policy, as indicated in its disaster management documents, against accepting bilateral aid. It is bad enough that India is getting help from traditional partners like the United States and Russia, but it is also accepting supplies coming from China, with which India’s relationship has been increasingly strained under Modi. And it must have been particularly galling to the prime minister that even Pakistan made an offer to help with medical supplies and equipment. So woeful is India’s situation that it has started importing 88,000 pounds of medical oxygen daily from the tiny Himalayan kingdom of Bhutan. Most Indians acknowledge their country was in an economic recession last year, and accepting bilateral aid is more of a compulsion than a choice. But how will they reconcile that with the fact that work on a $2 billion project to reconstruct a government office complex in the national capital, including building a new residence for Modi, continues unabated as an “essential service” during the pandemic? Modi boasted of having made India a Vishwaguru and personally enhancing national prestige through his numerous global trips. His ultranationalist supporters had started assuming India was already a global power in the same league as the United States and China. This feeling tied in with his domestic political positioning. Hindutva, or homogenized Hindu nationalism, was offered as the ideology that had made this supremacy possible. But now Modi’s supporters find their dreams of a global power shattered. They must instead confront the harsh reality of being citizens of a so-called “third world country,” which is dependent once again on the largesse of others. As the Indian economy continues to be hammered by the pandemic, there is little Modi can offer economically to his base. The edifice of nationalist pride, prestige, and global respect built by Modi on his so-called foreign-policy prowess has been demolished by the pandemic. The pandemic has hurt India in other ways too. Australia, a member of the Quadrilateral Security Dialogue (or Quad), has imposed a ban on its citizens from returning home, threatening five-year prison sentences, if they have spent time in India. In its first leaders’ summit in March, the grouping decided to provide a billion doses of the COVID-19 vaccine to the Indo-Pacific region by 2022. The vaccines were to be produced in India, funded by the United States and Japan, and distributed by Australia, in what was seen as the showpiece initiative to move the Quad away from its security-centric approach and soften its reputation as an anti-China grouping. With India struggling to produce vaccines for its own citizens hit by the pandemic, it is unlikely the Quad will be able to keep its scheme on schedule. In the bargain, New Delhi’s position as the lynchpin of the Quad stands considerably diminished. If India stumbles, the American dream of the Quad can never become a reality. Beijing has already moved in to take advantage of India’s misfortune to strengthen its ties with other South Asian countries. Last Tuesday, the Chinese foreign minister held a meeting with his counterparts from Afghanistan, Bangladesh, Nepal, Pakistan, and Sri Lanka for cooperation against COVID-19. India was absent from the meeting. And although Afghanistan, Bangladesh, Nepal, and Sri Lanka have received some vaccine supplies from India and expect more, these countries are now looking toward Beijing for doses after New Delhi failed to keep up its commercial and COVAX commitments. In the race between the two Asian giants to be an attractive and reliable partner in South Asia, India seems to have finished behind China. China has also pressed its advantage along its restive border with India. After an initial disengagement in Ladakh, India, China refused to pull back any further from other Indian-held territories it had moved into last summer. It stonewalled Indian attempts to discuss these areas in the last round of talks between the two sides, and it has constructed permanent military infrastructure and deployed troops close to the disputed border. If there were ever a time for India to demonstrate its strength, it would be now. But the second wave of COVID-19 has forced the opposite. A similar impact will be felt during New Delhi’s ongoing backchannel talks with Islamabad, where Pakistan will likely try to take full advantage of any chinks in India’s armor. India cannot afford to walk away from those talks as it has already been forced to engage with Islamabad due to its own inability to handle a two-front threat from China and Pakistan. An economy and a country ravaged by the pandemic makes the dual threat an even more challenging proposition for India—and hands Pakistan an unexpected advantage in the talks.
Modi’s domestic support sets the course for his international policies – trust in his administration directly translates into Indian adventurism. Mishra et al. ’16 (Atul; contributor to the Norwegian Peacebuilding Resource Centre; January 2016; “The evolving domestic drivers of Indian foregin policy”; Norwegian Peacebuilding Resource Centre; https://www.files.ethz.ch/isn/195766/f9f6e4b3e8a2c703364e7fb102dbf413.pdf; Accessed: 8-28-2021) To inform answers to these questions, five broad categories of domestic influence that currently influence evolving Indian foreign policy decision-making processes are explored below: simple majority politics, the symbolism of Indian aspirations, the factor of Modi’s personality, regional states’ influence and business interests. Firstly and most simplistically, the BJP’s simple majority means a government that in theory is less constrained by regional political forces or alliance partners that can bring coalition politics to a grinding halt. Policy is then by definition allowed to be more rational and predictable in both the domestic and international environments. A related factor is that few in the BJP are seen to be able to challenge either Modi or BJP president Amit Shah. Like a other party in India, the BJP has disgruntled elements, but they are unlikely to cause serious foreign policy disruptions in the short term.8 As a result, the party’s projection of corporate unity and its marginalising of rebellious leaders can be expected to continue, especially given India’s need for sustained economic growth and social development. This basic current political reality has set the stage for confronting the issues that the Modi government was elected to deal with. Secondly, the symbolism of aspiration has acquired great substance through Modi. There has been a long-standing practice of paying occasional lip service to traditional Indian principles of foreign policy such as non-alignment, morality and human rights. But under Modi the hesitancy about India projecting itself as an aspirational and even aggressive international power is disappearing. For example, the BJP has sought to replace the five traditional international principles of panchsheel (a term associated with Buddhism) with the five new pillars of panchamrit or “five nectars” (a term unambiguously associated with Hinduism). These are: dignity, dialogue, security, shared prosperity and culture.9 While panchsheel sought to combine and balance the values of India and those of the West, panchamrit calls to mind the emphasis on non-West- ern, “Asian values” that do not necessarily fit well with the values of open, searching and public criticism, social equality, and radical dissent in politics. Further, Modi promises that India will now be guided by the “Three Cs” in its international relations: culture, commerce and connec- tivity (Economic Times, 2014). This is typified by the govern- ment’s unapologetic use of its religious and cultural resources – primarily Hinduism – as elements of soft power on the international stage.10 The declaration that June 21st would be International Yoga Day and Modi’s numerous religious/cultural gestures during his overseas visits support this perspective. Thirdly, the personality factor has returned to the centre of Indian diplomacy. Modi has recast Indian foreign policy in a vigorous and purposive – and above all personal – light. His image is that of a simple and hardworking man who is clearheaded, decisive, and incorruptible. Like neoliberal leaders of China (primarily the late Deng Xiaoping) and Singapore (the late Lee Kuan Yew), he has been described as a pragmatist. Although the term is ephemeral and something of a misfit (principally because Modi is economi- cally and politically ideological), it has been used to positively describe his business-like attitude to foreign affairs. He lends a personal touch to relations with powers greater than India, as was evident in the way India hosted U.S. president Barack Obama and Chinese president Xi Jinping,11 giving the impression that all the parties involved are at the same level and thus hiding power disparities. Modi breaks protocol, becomes informal when the occasion demands, and ably sells India as an investment and cultural destination. Although previous Indian leaders have historically promoted business with “strong” leaders whose democratic credentials are suspected by the international community, Modi has prioritised economic interests rather than democratic ideals and is at ease with such leaders. Finally, unlike other Indian leaders who conducted themselves in deference to established Indian traditions on international conduct built over decades, Modi comes across as unburdened by this legacy. He is neither understated nor regards himself as the leader of a post- colonial country who is conscious of his country’s lack of international clout. He has positioned himself as the leader of a young, aspiring country that has much to offer in terms of culture and human potential.
9/13/21
SeptOct - T - Vaccines
Tournament: Grapevine | Round: 2 | Opponent: Lexington BF | Judge: Samantha Mclaughlin Interp – “medicines” treat or cure, whereas vaccines prevent – o/w on specificity since it’s about the COVID vaccine Vecchio 7/22 (Christopher Vecchio, CFA, Senior Strategist 7-22-2021, “Delta Variant Concerns Won't Cripple Markets, US Economy“, DailyFX, accessed: 8-9-2021, https://www.dailyfx.com/forex/video/daily_news_report/2021/07/22/market-minutes-delta-variant-concerns-wont-cripple-markets-us-economy.html) ajs Let’s stick to the facts. The COVID-19 vaccines are not medicines, which by definition “treat or cure diseases.” Vaccines “help prevent diseases,” an important distinction. Why does this matter? Because data coming out of some of the world’s developed economies with high adult vaccination rates suggest that the vaccines are working as intended: tail-risks have been reduced, with hospitalizations and deaths falling relative to the recent spike in infections (which have been occurring primarily among the unvaccinated at this point). Put another way, vaccines are like a Kevlar vest for the immune system; while they don’t make you bulletproof, they dramatically increase the odds of surviving an adverse event.s Violation – their advantage area is about vaccines which means either a. they solve nothing and vote neg on presumption because vaccines aren’t “COVID-19 medicines” or b. they violate
Negate – 1 Limits – expanding the topic to preventative treatment or medical interventions allows anything from surgery to medical devices to education strategies or mosquito repellent to prevent malaria. Destroys core generics like innovation which are exclusive to disease curing – core of the topic is about proprietary information.
Voters: Drop the debater – they have a 7-6 rebuttal advantage and the 2ar to make args I can’t respond to, Use competing interps reasonability invites arbitrary judge intervention since we don’t know your bs meter, No RVIs –illogical – you shouldn’t win for being fair – it’s a litmus test for engaging in substance, Evaluate T before 1AR theory – norms – we only have a couple months to set T norms but can set 1AR theory norms anytime,
9/13/21
SeptOct - Theory - Cant specify medicines
Tournament: Grapevine | Round: 2 | Opponent: Lexington BF | Judge: Samantha Mclaughlin Interpretation: The aff may not defend WTO member nations reducing intellectual property protections for a subset of medicines.
Violation – they only defend COVID-19 medicines
Vote neg: 1 Limits – you can pick anything from COVID vaccines to marijuana to random biotech to insulin treatments and there’s no universal disad since each one has a different function and implication for health, tech, and relations – explodes neg prep and leads to random medicine of the week affs which makes cutting stable neg links impossible. PICs don’t solve – it’s absurd to say neg potential abuse justifies the aff being flat out not T, which leads to a race towards abuse. Limits key to reciprocal engagement since they create a caselist for neg prep. 2 TVA – read the aff as an advantage to a whole rez aff.