When I was here six months ago, Health Minister Siti Fadillah Supari stomped on American scientists who’ve been trying for decades to help Indonesian colleagues build world-class research skills. The move played well to the growing Xenophobia of a minority of the population. But as rallies of flag-waving campaign louts brought Jakarta’s slothful traffic to an absolute standstill last week, she went one better. She worried aloud that foreign pharmaceutical firms were using Indonesian children as testing grounds for dodgy vaccines. Sadly, the vaccines she called into question were some of the most effective on offer: hepatitis B, chicken pox, rubella and typhoid. While Indonesian paediatricians fumed, nationalists rallied around the ambitious minister, saying a review of foreign vaccines is long overdue. Supardi’s own staff have been desperately backpedalling, basically admiting (“without elaborating” that the comments were little but political votemongering.

I’m not one to be too upset about being critical of Big Pharma when it’s warranted, but in this case it’s clearly not. The gossip in Jakarta is that Supardi is not anti Big Pharma, in any case. She justs thinks Indonesian businesswomen (and men) rather than foreigners should profit from the drugs the government buys. Shutting out foreign vaccines creates a market, in theory at least, for Indonesian firms such as Kalbe Farma, whose “Indonesia can do it too” press conferences are graced by the Minister.

I find it mildly ironic that Supardi gets such a good ride out of her anti-foreign demagoguery. Other members of her party think that pro- foreign sells better with the electorate than anti-foreign: they’re surfing the Obama wave in search of votes.

Thanks to Astry for this poster. There’s a fantastic collection of election posters on Astry’s blog, If you think Obama is kitsch, check out the candiadates who pose with David Beckham and Che Guevarra…

Activists have done a spectacular job in slapping down the price of antiretroviral drugs in the last five years. They’ve rallied big names like Bill Clinton and marshalled huge funders like the Global Fund. Even US-funded PEPFAR, once laughingly known as Purchasing Expensive Pharmaceuticals from American Retailers, is spending money on cheap generic drugs. All the while, Big Pharma has warned that eroding profit margins by pushing prices too low will discourage new investment in research.

Roche has been careful not to make a direct connection between low prices for HIV-related drugs and their decision to stop research in the area, even off the record. And there are good reasons for the decision — they were not a huge player in HIV in the first place; less that 5% o HIV related drug sales are from Roche. Many of their drugs are designed to help people only after other, more common treatments fail. And one of their most effective products is unpopular because it has to be injected rather than swallowed.

Is Roche’s announcement a shot across the bows of advocacy for cheaper drugs? “Stop eroding the profits we want, or we’ll stop inventing the drugs you need?” It’s hard to say, but I am amazed that the question is not ringing loudly around the blogosphere. I support the achievements of groups that have fought to bring down drug prices with every fibre of my body. And I certainly find it hard to feel sorry for an industry that spends far more on marketing than it does on research, and that consistently makes its shareholders richer. But is there a point when we have to start discussing how much is enough when we press commercial firms to lower prices?

One solution to the return-on-investment dilemma of is of course to provide more public funding for the development of drugs that meet the needs of poor people and poor countries. There’s been a fair bit of progress in finding public funding for vaccine research, so it’s especially depressing that yet another vaccine trial has been canceled because researchers think it’s unlikely to produce good news.