Spare the Rodrigo: Philippine elections

Hey, Ryan Reynolds here wishing you a very happy half off holiday because right now Mint Mobile is offering you the gift of 50% off unlimited. To be clear, that's half the price, not half the service. Mint is still premium unlimited wireless for a great price.

So that means a half day. Yeah.

Give it a try@mintmobile.com Switch upfront payment.

Of $45 for three month plan equivalent to $15 per month required new customer offer for first three months only. Speed slow 135 gigabytes of network busy. Taxes and fees extra. See mintmobile.com.

Hello and welcome to the Intelligence on Economist Radio. I'm your host, Jason Palmer. Every weekday we provide a fresh perspective on the events shaping your world. Overuse of antibiotics has driven the evolution of microbes that are resistant to them. So new drugs are constantly needed. But pharmaceutical companies lack the incentive to develop them. Market prices are dirt cheap and doctors are trying to prescribe them less. And the treasures of antiquity that are dotted around Greece are jealously protected by the state. That's why a new art exhibition on Delos, smack in the middle of the tiny island's ancient sites, is both surprising and intriguing. But first, Today, Philippine voters will head to the polls for midterm legislative elections. More than 18,000 government positions are up for grabs, including around 300 seats in the House of Representatives and 12 slots in the Senate. In a political system where personality trumps party, some see the ballot as a popularity test for the country's firebrand leader, Rodrigo Duterte. If his loyalists do well, the president will be able to consolidate his power. Mr. Duterte was elected in 2016.

I will suppress crime. Droga Nakayung, corruption.

An anti establishment populist, he promised hardline policies. Three years into his term, he's delivered. He launched a bloody war on drug crime.

Almost every day, dead bodies are being recovered from the streets in Manila and.

In one notorious speech, even likened himself to Hitler.

Hitler massacred 3 million Jews. Now there is 3 million. 3 million drug addicts. There are. I'd be happy to slaughter them. President Duterte is an abrasive character who's earned some international opprobrium for his campaign against drugs, which has turned into a rather murderous free for all that's killed thousands of people.

John McLean reports for the Economist from Manila.

He's less well known for determined efforts to pursue peace with Muslim separatists in the south and the Philippines, while at the same time being tough on those who get together with Islamic State and also for his efforts to dial down the confrontation with China over territory in the South China Sea.

And today Filipinos will go to vote in midterm elections. Why are those elections important for Mr. Duterte?

Mr. Duterte has three years left of his single six year term. And like all presidents, he needs the support of Congress to keep governing effectively. Now, he has been quite clever in his first three years in office in getting most of the legislation he needed done urgently. This tax reform program of infrastructure building, which will help keep the economy going fast. So he has less need of Congress in the second half of his term, but it's still useful to have to govern effectively.

Well, I mean, what sort of changes are in prospect for the second half of his term?

What he needs to do is have Congress pass the second half, have a tax reform measure which will do the economy a world of good. Congress's help is also needed in his project to alter the Constitution to replace the unitary state with a federal system.

Why did Mr. Duterte want to change the nature of governance?

Essentially, he wants to make sure that the peace plan for the Muslim areas of the Philippines will stand up to the scrutiny of the Supreme Court. Now, there is a chance the Supreme Court will declare that peace plan unconstitutional. The simple answer to that problem, of course, is to change the Constitution. That is the main reason for Mr. Duterte's eagerness for a federal system.

And how popular is he with his program of tax reform and infrastructure and an ambitious peace plan? How's he doing in the polls?

Mr. Duterte has had consistently high ratings in all kinds of England. Polls, satisfaction with his government popularity, everything. It is not so much his policies that make him popular, but his personality.

And I mean, the thing that we often hear most outside the Philippines is about this brutal crackdown on drug dealers and the like. Is that a popular policy? Is that contributing to his popular.

Well, there are certainly misgivings among many Filipinos about how this campaign is conducted. But in general, there's a perception that crime on the streets has fallen. So yes, his policy has public approval, but it's very qualified public approval.

Is there truth to that? Is crime genuinely down? Or is it the sort of very public, very visible nature of this crackdown, kind of contributing to the sense that crime is down?

Well, crime figures in the Philippines are like crime figures in many other parts of the world. They say what the police want them to say. It is a perception that the streets are safer. But on the other hand, the campaign against drugs is a very bloody affair in itself. It is not so much A case of police versus the criminals, but it's more of a war among drug dealers and protectors of the drug dealers among the police. So it's a free for all where no one knows exactly where they stand.

And in the event that Mr. Duterte and his allies are triumphant in this election, will that get worse, do you think?

Certainly, there will be less effective criticism of the campaign against drugs, but it will carry on anyway.

And in that election, I mean, who are the credible threats then to Mr. Duterte and his allies?

Well, the opposition coalition has made the mistake of painting this election as a referendum on Mr. Duterte. Now, the opinion polls have shown that the President is popular, that only one of the senatorial candidates in the opposition is likely to win a seat. Bam Aquino, who belongs to the Aquino clan that has provided two presidents in the Philippines. Now, political dynasties are a big factor in Philippine politics. And another interesting character to watch will be Mr. Duterte's own daughter, who is the mayor of his hometown. She's almost certain to retain her post. But whether we're seeing here the start of a new political dynasty on the national stage remains to be seen. I think it's highly unlikely that Cello Duterte will step onto the national stage anytime soon.

So what do you think then will happen in this election? Will Mr. Duterte and his loyalists keep their majorities?

Yes. Mr. Duterte will retain a degree of control of Congress. How long that control will last, though, is another matter. All politics in the Philippines is transactional. The President is the fountain of all patronage. Congress gives the President support in return for government spending in their constituencies. That loyalty to the President can change quickly, certainly when the President tends to become a lame duck, as he does towards the end of his term.

But for now, you think that Mr.

Duterte is safe for the next year or two years? Yes, he's safe. Towards the end of his term, he will certainly become a lame die, as all Philippine presidents do.

John, thank you very much for joining us.

Not at all.

Antibiotics are so widely used that it's easy to forget what a miracle drug they seemed when they were new. Before penicillin, even simple wounds could result in fatal infections. During the Second World War, the production capacity for the drug was limited. It wasn't used much because a single shot could cost around $600 in today's money. But better manufacturing methods cut that price down to just 20 cents. To make the quantities needed, it was.

Decided to seek help in the United States. Here, scientists devised better ways of Culturing penicillin, which could give much bigger yields.

This film, produced by the British government in the 1960s, hinted at the extraordinary need the world would develop for the drugs.

Today. The penicillins are only one group of antibiotics among many. And in laboratories throughout the world, the search goes on for more.

Big pharma companies are finding it very hard to make money on these drugs because the margins have historically been very slim. They obviously have more lucrative opportunities, such as drugs for cancer, rare diseases.

Sloveya Chankova is the Economist's healthcare correspondent.

The development of antibiotics is an expensive business. Molecules are harder to discover. The development costs are quite high. It takes about 10 years or even more to bring a drug from the lab to the patient. It costs somewhere around a billion dollars. So obviously, if you target your research and development investment in a particular product, you want to pick one that can bring you money.

And I presume that the rise of antibiotic resistance and the sort of growing awareness of that also kind of puts pressure on people are actively trying to use fewer of these things.

Absolutely. That's the main problem with the business model for antibiotics. So antibiotic stewardship, which is the concept of doctors reserving the newest antibiotics as a last resort in order to preserve them, to make sure that resistance doesn't develop to them means that sales volumes are very small. So if you have a new antibiotic on the market, not only you can't get a lot of money for it, you can't sell much of it either.

And why is it so expensive to find, to make new ones?

Some researchers say that the low hanging fruit has been picked. Traditionally, the way antibiotics have been discovered has been to literally just dig in the samples of soil brought from anywhere in the world and try to find a compound that works on certain. So that model is getting more difficult because resistance is so widespread now with overuse of antibiotics all over the world, on the other hand, developing new drugs is as expensive as ever. Bringing them from the lab to the patient requires expensive clinical trials. And in the case of antibiotics for new superbugs, it's particularly difficult because the number of patients who need them is quite small. Resistance develops over time, so the number of these patients will grow. But at the beginning, there are so few of them that for clinical trials, it's a lot of work to find these patients and run the trial, which makes it very expensive and difficult to do it in reasonable time.

And so these drugs then look kind of like a bad bet for pharmaceutical companies to pursue.

Yes, that's right. And that's why? Big pharma companies have largely left this line of business. Only three of them still have antibiotics in clinical research. So the pipeline of new antibiotics has really dried up.

So kind of across the board, the incentives to develop these things have been reduced. Is there any way to address that or to bring down development costs or raise the incentives in some other way?

Bringing down development costs is really not an option because you do need to run the clinical trials. The development costs are what they are. It's difficult to bring them down. On the other hand, paying for drugs could be changed. At the moment, antibiotics in America are paid for as part of bundles for hospitalized patients, which means that companies can't charge a lot of money for them. So changing how antibiotics are reimbursed could make a difference. There are some interesting models that are being considered. The British government, for example, is trying out a model whereby they pay for antibiotics in bulk. So it's sort of a subscription fee to have access to a certain antibiotic regardless of how much they use. If that subscription fee is large enough, that could make business sense for some new antibiotics.

And is anybody sort of stepping into the breach?

Yes, there are small biotechnology companies which in the last five to ten years have tried to fill in this gap. Some of them have come up with antibiotics for some of the really scary superbugs that kill half of the patients that they infect. However, as they are bringing their products to market, they are running into the same problem of not being able to make money at the beginning when there are so few patients around for that drug. And another interesting idea that has been discussed quite a bit is giving an award to someone who develops an antibiotic for a particularly scary superbug. And the amount that has been discussed is about a billion dollars, which is the development costs for a new drug. That seems like a lot of money, but by some estimates, antibiotic resistance cost the world a lot more. By 2050. The World bank estimates that the cost of antimicrobial resistance could rival that of the 2007 financial crisis.

But given the mechanism that's brought us to this point, with the growing resistance then and the need to find new drugs, I mean, isn't this a problem that will kind of continue and indeed magnify if it's so hard to find new drugs?

Oh, absolutely. We've been able to keep infections under control. Exactly. Because there have been new antibiotics being developed to replace those to which microbes have become resistan, that this process is slowing down, we are in real danger of being unable to fight common infections. If there are no new antibiotics to replace those that are rapidly becoming useless.

Is there a chance that we'll reach a stage where there are simply no more molecules to be found to do this job?

I don't know anyone knows the answer to that question. Molecules are still being found, which means they're out there. It may be more difficult to discover them, but the real problem is really once a molecule is discovered, how it will be brought to a drug that goes on the market and is commercially sustainable.

And so it's all about getting the incentives right at this stage.

Yes, that's right.

Slavaja, thank you very much for your time.

Thank you, Jason.

And if you'd like to hear more on antimicrobial resistance, you can listen to the Economist's podcast, the World Ahead. When the drugs don't work, we speak to Maren McKenna, the author of the new book Plucked. She reveals just how much antibiotics are overused in the agricultural industry.

We are spraying streptomycin and oxytetracycline, hundreds of thousands of kilograms on citrus grows, to save the orange industry of Florida and California. No matter how we have misused antibiotics in all of these settings, the central problem is that we are not using them for the. The thing that they were invented for, which is to cure infections.

Every summer, tourists flock to the Mediterranean and board ferries to the Greek islands. In between, basking in the sun and eating moussaka, many visit the ruins of ancient Greek civilization, imagining an era when people worshiped a pantheon of gods and fought terrible wars, but also nurtured early democracy, science, drama and architecture.

Delos is an island in the middle of the Aegean, a small little rock surrounded by many other larger ones.

Amaryllis Kripari is a tour guide who shows people around the tiny place with its huge ancient city.

I believe that one of the most beautiful sides of Delos is that by passing the sea to get there, you are literally having a catharsis of our times. And you travel back into time with a boat and you get the opportunity to walk through history with no traffic, no buses, no shops. Not much reminding us of our times. But it's just yourself, history, nature and the surrounding light.

She's worked for years on the island, showing people round the site where pilgrims once came to worship Artemis and Apollo and to trade. But like most ancient sites in Greece, the authorities have never allowed anything modern on the ruins until now.

Now, these sculptures, they're made of iron. They're obviously contemporary sculptures, and they make an extraordinary impression in this very antique and Beautiful landscape.

Bruce Clark writes about faith for the Economist and visited Delos earlier this month.

You've got a small and very numinous Greek island with a low hill at the top with a lovely carpet of flowers and grass because it's springtime and we've had lots of rain and so. So the injection of these sculptures into the landscape is something very powerful. It really catches the eye.

So, Bruce, what's going on? Who made these sculptures and what are they doing on the island?

Well, these sculptures were made by one of Britain's most popular public artists, Sir Anthony Gormley. Now, he's famous in England for placing sculptures in important public places. And the common theme of all his sculptures is that they explore the relationship of the human being with his environment. And they were brought to Greece at the initiative of a private artistic foundation by the name of Neon, and they were working in close collaboration with the Greek Ministry of Culture.

And did you get a chance to ask Sir Anthony about why he chose this site?

Well, after seeing the exhibition, I had the chance to sit down with Sir Anthony Gormley in a hotel and talk to him about the show. It's difficult not to kind of go into magical thinking or mysticism in saying the qualities of Delos are extraordinary. But it is something to do with the. With the. In a way, the smallness of the island. It's, it's. It's rockiness and its light, its lack of water, and yet this feeling of somehow, in spite of the smallness of the island, somehow being extended into space at large. I mean, he's spent the last several months fine tuning the installation of his sculptures in this landscape. It's been a very complex operation putting the sculptures in place. Some of them had to be dropped in by helicopter.

Well, quite. With helicopters and everything. I mean, it's not common for Greece to allow this kind of. Of intrusion into ancient sites. Right. Why did they permit this one?

Well, to start with the first point, it's certainly true that the Greek authorities are very sensitive to anything that seems to disturb the integrity of an ancient site. Now, I think what was special in this case is that there was already a very powerful bond of collaboration between the private sector and the public sector, as it were, the private Foundation Neon and the Greek Ministry of Culture, and they jointly made the application to the Greek Archaeological Council to use the landscape of Delos. And on certain conditions, it was accepted.

And so what did you make of it? Did you like it?

Well, certainly the ones that were placed with the sea in the background, I found extraordinarily moving. I mean, it is just a stunning landscape anyway. And the sight of these sculptures, again, the scudding waves, is very, very powerful and moving. The ones that are extremely abstract will appeal to some people, not to others. To me, it was almost provocative that they put a rather solid, heavy piece of iron in the middle of the ancient theater, which is a place that would have hosted lovely, flexible, nimble movements in olden times. So there was a great contrast between the heaviness and the solidity of the this piece of iron with the kind of performance that once would have been seen in this lovely environment. But it was, let's say, a provocation, almost a playful statement which I found acceptable and didn't ruin the environment. For me, that's the main thing. The environment is so powerful that it really can't be overshadowed by anything.

Bruce, thank you very much for your time.

Thank you.

That's all for this episode of the Intelligence. If you like us, give us a rating on Apple podcasts and you can subscribe to the economist@exterator.com radio. Offer 12 issues for $12 or 12 pounds. See you back here tomorrow. It.