How medicine became the world’s most profitable promise — and the patient its most expendable asset.
By Prof. MarkAnthony Nze
The Price of Survival
The modern hospital looks nothing like a factory, but it functions like one. From the gleam of the surgical theater to the hum of the billing department, every breath, every test, every tablet has a price. What once stood as a sanctuary for the sick has become the engine room of a trillion-dollar enterprise, a marketplace where recovery is purchased in installments, and health is the currency most people can no longer afford.
In 2025, the world spent over seventeen trillion dollars on healthcare — more than double the annual global defense budget and nearly a fifth of total world GDP (World Bank, 2023). Yet more than two billion people still lack access to basic medical services (World Health Organization [WHO], 2024). This paradox is not a flaw in the system; it is the system. Medicine, once a moral endeavor, has been remodeled into an economy of perpetual demand.
The Invisible Industry of the Ill
The profit motive in health is older than modern capitalism, but never has it been so precisely engineered. Pharmaceutical conglomerates now report margins higher than those of oil or technology firms. The world’s ten largest drug manufacturers collectively earned over 180 billion dollars in net profit in 2024, a 40 percent rise since the COVID-19 pandemic (OECD, 2022). These gains are not driven by breakthroughs alone but by strategy — pricing, patents, and the perpetual management of chronic illness.
Take insulin. Invented more than a century ago and sold for a dollar in its first patent transfer, it now retails at up to 100 times its production cost in some markets (Baker & Faden, 2020). For the three major companies that dominate insulin supply, this is not cruelty; it is compliance with shareholder obligation. The longer a patient depends on their product, the more predictable the quarterly projection. The cure is profitable only when it never ends.
“Health has become a subscription model,” says a Lagos-based public health economist. “You don’t buy recovery — you rent it.”
When Care Becomes Currency
In theory, healthcare operates on solidarity: the healthy subsidize the sick, the rich the poor, the present the future. In practice, it operates on scarcity. Insurance, the financial buffer meant to democratize access, has become another gatekeeper. Across developed economies, premiums have risen faster than wages for twelve consecutive years (OECD, 2022). In the United States, the average family premium crossed $22,000 per year; in emerging economies, private coverage remains a luxury for less than 10 percent of the population.
Read also: Diseases That Pay: The Global Health Economy—Intro
The arithmetic is global and brutal. The WHO (2024) estimates that about 490 million people fall into poverty annually because of medical expenses. The same nations that host the largest pharmaceutical supply chains — Nigeria, India, Brazil, Indonesia — also record the highest rates of catastrophic health spending.
Economists at the United Nations Development Programme (2023) call it “the poverty prescription”: a feedback loop in which sickness leads to debt, debt restricts access, and restricted access sustains sickness. Health is not the equalizer; it is the amplifier of inequality.
The Machinery Behind the Mask
Behind every medical breakthrough lies a labyrinth of contracts, incentives, and intellectual property filings. Patents, intended to reward innovation, now extend monopolies far beyond their ethical lifespan. Between 2018 and 2023, over 78 percent of new drug patents were not for new molecules but for minor modifications of existing ones — “evergreening,” the industry term for legal immortality (Phelan & Gostin, 2019).
The effect is simple: delay generic competition, inflate prices, and transform lifesaving medication into lifetime revenue streams. A cancer patient in Nairobi pays roughly five times more for a branded chemotherapy drug than the same medicine costs in Mumbai, because licensing agreements prohibit parallel importation.
This asymmetry is sustained not by science but by diplomacy. Trade treaties, often negotiated in private, include clauses that enforce pharmaceutical protections as conditions for market access. As Moon and Kickbusch (2022) note, “global health governance has evolved from humanitarian coordination into corporate negotiation.”
The Cost of Compassion
To understand the price of survival, one must follow the money through the hospital corridors. Each consultation, laboratory test, or MRI scan is a transaction nested in another — a medical hierarchy of billing codes and insurance authorizations. The administrative cost of this machinery now consumes nearly 15 percent of global health expenditure (WHO, 2024). In some private systems, administrative overheads exceed the total spent on preventive care.
Transparency International (2021) describes corruption in healthcare as “the ignored pandemic.” From procurement kickbacks to inflated equipment contracts, the disease of mismanagement siphons billions each year — funds that could have vaccinated, treated, or fed millions. When governance fails, disease prospers.
For patients, this reality translates into despair disguised as dignity. A mother in Owerri sells her last parcel of land to pay for dialysis. A young man in Manila crowdfunding for cancer treatment posts updates like diary entries, turning survival into spectacle. Each donation buys another day; each delay, another debt.
The Politics of Pain
No nation is innocent. Governments court pharmaceutical investment as eagerly as they court technology or mining firms. Health budgets are crafted to attract donors and debt relief, not necessarily to heal citizens. The World Bank’s 2023 Global Health Expenditure Database shows that while donor funding for health projects reached record highs, local government spending as a percentage of GDP fell in twenty-three African countries.
The message is unambiguous: health is good politics but bad business unless privatized. Ministers speak of universal coverage while signing public-private partnerships that hand hospitals to corporations for decades. In effect, taxpayers finance the infrastructure, and patients finance the profits.
A World Built on the Edge of the Bed
By the time the average person reaches sixty, they will have spent about eight years of their life in hospitals, clinics, or pharmacies (Global Burden of Disease Collaborative Network, 2024). Those years are now someone’s business model.
The great irony is that modern medicine has never been more capable — or more captive. It can sequence genomes, print organs, and reverse blindness, but it cannot break free of the profit imperative that defines its existence. The survival of the patient and the survival of the industry are no longer perfectly aligned.
What began as the triumph of science has become the triumph of finance.
Conclusion: The Price of Being Human
Health has become the final luxury of modern existence — not because medicine is rare, but because mercy has been priced. In a world where survival generates profit, life itself has become the ultimate transaction. Gold no longer defines wealth; longevity does. Each diagnosis is a negotiation, each prescription a billable act of hope.
The global health economy endures on one certainty: everyone, eventually, becomes its customer. It thrives not on cures, but on continuity — an industry built to manage, not to end, suffering. Few comprehend its machinery; fewer dare to question it.
What began as the noblest expression of science has been remade into a market of necessity, where compassion competes with capital. The arithmetic is cruel but precise: in this century, the cost of living has become indistinguishable from the price of being alive.
Bibliographies
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Global Burden of Disease Collaborative Network. (2024). Global burden of disease study 2024 results. Seattle, WA: Institute for Health Metrics and Evaluation (IHME). http://www.healthdata.org
Moon, S., & Kickbusch, I. (2022). Global health diplomacy and governance in the age of corporate influence. The Lancet Global Health, 10(8), e1064–e1070. https://doi.org/10.1016/S2214-109X(22)00177-3
Organisation for Economic Co-operation and Development. (2022). Health at a glance 2022: OECD indicators. Paris: OECD Publishing. https://doi.org/10.1787/4dd50c09-en
Phelan, A. L., & Gostin, L. O. (2019). Trade, patents, and public health: The WHO–WTO–WIPO trilateral relationship. Journal of Global Health, 9(2), 020303. https://doi.org/10.7189/jogh.09.020303
Transparency International. (2021). The ignored pandemic: How corruption in healthcare is costing lives. London: Transparency International.
United Nations Development Programme. (2023). Human development report 2023/2024: Breaking the gridlock – Reimagining cooperation in a polarized world. New York: UNDP.
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Professor MarkAnthony Ujunwa Nze is an internationally acclaimed investigative journalist, public intellectual, and global governance analyst whose work shapes contemporary thinking at the intersection of health and social care management, media, law, and policy. Renowned for his incisive commentary and structural insight, he brings rigorous scholarship to questions of justice, power, and institutional integrity.
Based in New York, he serves as a full tenured professor and Academic Director at the New York Center for Advanced Research (NYCAR), where he leads high-impact research in governance innovation, strategic leadership, and geopolitical risk. He also oversees NYCAR’s free Health & Social Care professional certification programs, accessible worldwide at:
👉 https://www.newyorkresearch.org/professional-certification/
Professor Nze remains a defining voice in advancing ethical leadership and democratic accountability across global systems.
