Rage and Love
The Constant Gardener (2005) leaves us no doubt about the villains. Based on the “angriest story” that John le Carré ever told, the film paints an unsparing portrait of the predatory instincts of pharmaceutical companies that test experimental drugs on Africa’s unsuspecting poor. Hoping to sidestep the regulations of their own government, the Western drug makers in the film ignore ethical protocols by experimenting on the Kenyan people. But the real Machiavellians are the Western bureaucrats who turn a blind eye to their drug makers’ abuses. As Peter Bradshaw writes in The Guardian, The Constant Gardener is “an intricate, despairing meditation on the shabby compromises involved in maintaining Britain’s interests and waning foreign prestige.”
But the film, told through flashbacks, leaves us guessing about its heroine, Tessa Quayle. Her husband Justin, a low-level British diplomat, is the constant gardener, a quiet, decent man more alert to the health of his plants than to the moral state of the world. As the film opens he is tending his potted plants when he learns that his wife, a young, fiery social activist, has died in a crash along the rust-colored sands of a remote Kenyan lake. Amidst rumors of Tessa’s infidelity, Justin has long worked in his wife’s shadow, never fully confident of her affection or aware of her activist schemes. Bewildered and grieved, he sets out to discover the truth about Tessa’s death and the political conspiracy she suspected, although he will never learn her full secrets. Director Fernando Meirelles weaves both threads—the furor over drug testing and the story of lost love—into a taut, impressionistic film, at once a fierce exposé and a romantic mystery.
Nevirapine and Drug Tests
As a novel and a film, The Constant Gardener clearly hit a nerve: it has won acclaim for its prescience and courage and prompted rebuttals. Both before and after Le Carré’s book appeared in 2001, lawsuits over drug experimentation in Africa reached headlines. In 2002 the Associated Press disputed the National Institute of Health’s report on the Ugandan trial of nevirapine—an anti-AIDS drug mentioned often in the film. Edmund Tramont, the chief AIDS researcher for the NIH, now concedes that he rewrote the report, suppressing his own staff’s conclusions that nevirapine suffered from “inadequate safety” testing. Government claims that nevirapine reduced the transmission of AIDS from mother to infant by 41% are also now suspect. Tramont defended his action by claiming that Africans need leniency: the continent cannot wait to meet American safety standards if it is going to make immediate headway against the AIDS crisis. The NIH came under further attack when it did not disclose the dangers of nevirapine to the White House, even as George Bush announced plans to spread nevirapine through Africa. Ironically, the film shows a well-meaning doctor freely distributing nevirapine, even though the NIH now fears that this prescription may actually build long-term resistance to AIDS drugs.
In addition to the uproar over nevirapine, there are now plenty of documented cases of exploitive drug experiments in the two-thirds world. In 1996 the drug giant Pfizer tested the antibiotic Trovan on uninformed children in Nigeria. The FDA ignored standards for experimenting with tenofovir, an HIV medication, on people in Cambodia and Cameroon. Johnson & Johnson had to stop some Latin American tests on one of its respiratory drugs when it was revealed that they selected some patients to receive placebos, a clear violation of American medical ethics. As the AP reports, there is now a “mounting body of evidence pointing to systemic corruption within the academic medical research community—including the FDA and NIH. A cascade of alarming evidence comes from highly credible sources—including company documents obtained through court procedures, eyewitness reports by courageous whistleblowers in academia, government agencies, and the pharmaceutical industry.” Although describing a fictional case, The Constant Gardener captures the moral dilemmas of those suddenly capable of blowing the whistle. What makes the moral choice difficult is that exposing the fraud and wrongdoing among medical researchers and government agencies usually leads to a moratorium on the drug, a practice that may well increase death rates and deny the infected Africans access to experimental remedies.
The film does have its critics, on both the left and the right. Anthony Kaufman laments that the movie serves up another “little white romance.” The “white liberal guilt genre,” he complains, “has a palliative effect on the wounded left,” but this tale of British lovers treats the Kenyan poor and their shantytowns as merely an exotic backdrop to a story of European heartache. The film does, however, endeavor to expose the European bias against African doctors. That theme surfaced lately in a lawsuit by Kenyan researchers against eight scholars from Oxford University. The Kenyans claim that their “intellectual work” was ignored and wrongly excluded from the patent for an AIDS vaccine, developed from the study of Kenyan prostitutes. Some reviewers moan that the film is a leftist, one-dimensional diatribe, but many of the critiques are subtler, praising the film’s courage but modifying some claims. In The Nation, Sonia Shaw writes that challenging drug experimentation “is not nearly as black-and-white as this film would have it. . . . Most of the time new drugs aren’t uniformly deadly, rendering unequivocal data showcasing their killer properties.” We need to be careful, she claims, not to “jump to the conclusion that any experiment that rendered any deaths is irredeemable, no matter the condition of the patients, the purpose of the trial or the rates of death from traditional therapies or no therapy.” In Shaw’s view, the real problem may be Western reluctance to accept the “risks of drug development” at home. Americans want the benefits of the experiments but not the risks, and that may be “the single biggest reason” why scientists and governments have chosen to “shift the burden of experimentation away from Western consumers and onto the world’s poor.”
John le Carré and Fernando Meirelles
John le Carré is the most literate of spy novelists; his best work probes the psychological costs and moral ambiguities of espionage during the Cold War. Although Le Carré’s novels have often been filmed by the BBC or Hollywood, the choice of the Brazilian Meirelles as the director brought an edginess into Le Carré’s urbane style. As Bradshaw claims, instead of the “torpid melancholy and disillusion that tend to creep into screen versions of Le Carré, Meirelles gives us something gutsier and less English. We get rage, relentless curiosity, agonized self-reproach and whole landscapes lit up with lightning flashes of paranoia.” Born in São Paulo City, Meirelles made commercials and directed a popular TV show for children before turning to feature films. In 2002, in only his third feature, he delved into the violent corridors of Brazilian drug culture and urban poverty by bringing Paulo Lins’s novel City of God to the screen. The fearless realism of those Rio scenes—lurid colors, handheld camerawork, brisk editing, and nonprofessional actors—is also evident in Meirelles’s filming of the Kenyan slums in The Constant Gardener.