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West Wing Reflections: The American health care system was as broken in Aaron Sorkin’s script as it is now

(Courtesy of Warner Bros. Television)

By Alex Driscoll

Oct. 20, 2020 8:20 p.m.

Garnering 95 Emmy nominations and 26 wins in its seven seasons, “The West Wing” is an NBC television drama that depicts an era in which the president of the United States is a Catholic Democrat and Twitter does not yet exist. Though it premiered back in 1999 and ran until 2006, columnist Alex Driscoll dives into various episodes of the series, putting a twist on a typical review with analysis on how the show reflects today’s political climate.

(Emily Dembinski/Illustrations director)

In the world of “The West Wing,” the concept of cooperation feels about as common as a three-term President.

Back in the 1990s when the AIDS epidemic was still raging worldwide, “The West Wing” writers reflected on the debilitating discourse between American pharmaceutical companies and developing nations. The resulting episode educates viewers on the nearly impossible feat of finding the middle ground between the powerful drug companies and the individuals whose lives are dependent on their products. Titled “In This White House,” the second season’s fourth episode is evocative of how marginalized communities are often shut out of America’s healthcare system today, particularly in the wake of COVID-19.

At the height of the episode’s tumultuous negotiation, White House staffers were seeking a compromise that can save the AIDS victims of Kundu — a fictionalized West African nation — while also minimizing the financial risks that free drugs pose to its manufacturers. But the ongoing dispute between Big Pharma and President Nimbala (Zakes Mokae) sits at a standstill because of accusations of misconduct from both sides of the table.

As President Nimbala pleads with the drug companies to help save his country, the executives point out that Kundu’s health crisis is compounded by government corruption and a lack of education among its people. Nimbala’s requests are met with ambivalence as the pharmaceutical representatives remain hesitant to take on an investment that could damage their revenue stream.

[Related: West Wing Reflections: Themes of racial discrimination echo from Bartlet’s administration to today]

However, Mokae’s performance in this scene discards any notion of racial or wealth stereotypes commonly seen in the depiction of West African countries in modern media. In a study published only two years prior to the episode’s airing on NBC, researchers found that 84% of New York Times articles written about African nations portrayed them in a negative and demeaning light. Yet the sincerity in Mokae’s characterization of President Nimbala leaves a lasting impression on those who sympathize with the plight of his country.

Over the course of the episode, the writers also effortlessly weave in one-liners on the exploitative nature of American pharmaceutical companies. During attempts to negotiate on behalf of both parties, Deputy Chief of Staff Josh Lyman (Bradley Whitford) and Communications Director Toby Ziegler (Richard Schiff) explain Nimbala’s concern over allocating money toward nonessential commercial drugs rather than vital AIDS research to the executives.

Even with “The West Wing’s” hypercritical dialogue, Big Pharma conglomerates are no stranger to prioritizing profits over humanitarian ethics. In the past decade, Pfizer — one of the largest pharmaceutical companies in the world — spent $139 billion on share buybacks and dividends in order to increase its profitability on the stock market and only $82 billion on research and development. Coupled with an exponential increase in drug prices since 2010, pharmaceutical companies have maintained a longstanding reputation of exploiting the public in exchange for wider profit margins.

According to the Campaign for Sustainable Rx Pricing, the typical American spends $1,200 out of pocket on prescription medications each year, allowing the top 10 largest pharmaceutical companies to rake in more than $200 billion in revenue alone. It is no longer a question of whether or not Big Pharma is taking advantage of lower-income Americans. The real debate lies in just how far Big Pharma is willing to go in order to carve out a monopoly on life-saving drugs.

[Related: Movie review: ‘Totally Under Contro’ offers chilling picture of US’ failed COVID-19 response]

Second-year human biology and society and political science student, Olivia Bielskis, said large pharmaceutical companies in the U.S. have a historically unethical relationship with how they treat clinical trials of new drugs in foreign countries. Because regulations in places like Argentina are few and far between, companies can exploit the uneducated and underpaid populations by serving them confusing contracts for risky clinical experiments, only to be left behind if the drug proves to be successful.

“We try to think that Western countries have so many better regulations,” Bielskis said. “But when it comes to the motivation of profit in an industry that is so intertwined with people’s livelihoods and well-being, we do very little to prevent pharmaceutical companies from a variety of nefarious business practices.”

“The West Wing” communicates these ethical conundrums by depicting Big Pharma in its truest form — a business. With executives unwilling to commit to a cause that could save millions of lives, the script reflects the reality of many Americans who are backed into a corner by price gouging and corporate manipulation. President Nimbala leaves the White House in disappointment, a sentiment shared by the one in four Americans who still cannot afford their own medications today.

“To say that Big Pharma is only slightly flawed is an understatement; they represent an entire system fueled by greed and corruption,” Bielskis said.

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