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Focus Films co-president James Schamus began his remarks Monday night at the New York premiere of Fernando Meirelles’s fantastic new film, The Constant Gardener, by quoting that “great American philosopher and epistemologist Donald Rumsfeld,” who, in March, 2003, assessed the limits of our knowledge of the situation in Iraq.

“There are known knowns,” Rumsfeld said back then. “These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. There are things we don’t know we don’t know.”

Schamus then went on to quote the Slovenian philosopher Slavoj Zizek, who discussed Rumsfeld’s comments in an essay appearing in In These Times entitled “What Rumsfeld Doesn’t Know That He Knows about Abu Ghraib” and which I excerpt from below:

“What [Rumsfeld] forgot to add was the crucial fourth term: the ‘unknown knowns,’ the things we don’t know that we know — which is precisely, the Freudian unconscious, the ‘knowledge which doesn’t know itself,’ as Lacan used to say.

“If Rumsfeld thinks that the main dangers in the confrontation with Iraq were the ‘unknown unknowns,’ that is, the threats from Saddam whose nature we cannot even suspect, then the Abu Ghraib scandal shows that the main dangers lie in the ‘unknown knowns’ — the disavowed beliefs, suppositions and obscene practices we pretend not to know about, even though they form the background of our public values.”

Among the “unknown knowns” which lie not so deeply within the American political unconscious is “Big Pharma in Africa,” which forms the truly chilling backdrop to Meirelles’s exciting and unexpectedly moving conspiracy thriller/love story adapted from John LeCarre’s 2000 novel.

In The Constant Gardener, Ralph Fiennes plays a British diplomat whose activist wife, played by Rachel Weisz, is killed in what he begins to suspect is a conspiracy to suppress information she’s uncovered about unsafe drug testing by First World multinationals in the poor African continent.

At the film’s end, a statement by Le Carre appeared on screen: “Nobody in this story, and no outfit or corporation, thank God, is based upon an actual person or outfit in the real world. But I can tell you this; as my journey through the pharmaceutical jungle progressed, I came to realize that, by comparison with the reality, my story was as tame as a holiday postcard.”

Here, in an excerpt from an essay originally appearing in The Nation, Le Carre elaborates on this statement and spells out the point-of-view of Meirelles’s uncommonly tough-minded thriller:

“…And of all these crimes of unbridled capitalism, it seemed to me, as I began to cast round for a story to illustrate this argument in my most recent novel, that the pharmaceutical industry offered me the most eloquent example…. The multinational pharmaceutical world, once I entered it, got me by the throat and wouldn’t let me go. Big Pharma, as it is known, offered everything: the hopes and dreams we have of it; its vast, partly realized potential for good; and its pitch-dark underside, sustained by huge wealth, pathological secrecy, corruption and greed.

“I learned, for instance, of how Big Pharma in the United States had persuaded the State Department to threaten poor countries’ governments with trade sanctions in order to prevent them from making their own cheap forms of the patented lifesaving drugs that could ease the agony of 35 million men, women and children in the Third World who are HIV-positive, 80 percent of them in sub-Saharan Africa. In pharma jargon, these patent-free copycat drugs are called generic. Big Pharma likes to trash them, insisting they are unsafe and carelessly administered. Practice shows that they are neither. They simply save the same lives that Big Pharma could save, but at a fraction of the cost.

“Big Pharma did not invent these lifesaving drugs that they have patented and arbitrarily overpriced, incidentally. Anti-retrovirals were for the most part discovered by publicly funded US research projects into other diseases, and only later entrusted to pharmaceutical companies for marketing and exploitation. Once the pharmas had the patent, they charged whatever they thought an AIDS-desperate Western market would stand: $12,000 to $15,000 a year for compounds that cost a few hundred to run up. Thus a price tag was attached, and the Western world, by and large, fell for it. Nobody said it was a massive confidence trick. Nobody remarked that, while Africa has 80 percent of the world’s AIDS patients, it comprises 1 percent of Big Pharma’s market…

“I was also told about the dumping of inappropriate or out-of-date medicines by means of ‘charitable donations’ in order to get rid of unsalable stock, avoid destruction costs and earn a tax break. And about the deliberate widening of a drug’s specifications in order to broaden its sales base in the Third World. Thus, for instance, a drug that in Western Europe or the States would be licensed only for extreme cancer pain might be sold in Nairobi as a simple headache cure-and at several times the cost of buying it in Paris or New York. And in all probability no contraindications would be provided.”

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