The problem with what we see going on in the African clinics in The Constant Gardener is the lack of consent by the test subjects, but objections to the pharmaceuticals arise from their profits. In his 24 December 2000 Sunday Times (London) commentary upon the publication of le Carré's book, Andrew Sullivan wrote, "The fact that Big Pharma doesn't give away the products of its research for free, or without profit, is [taken by its critics to be] the ultimate sign of its evil. And the profit motive, according le Carré, has all but corrupted the very basic principles of medical practice across the globe." (One irony, according to Ronald Bailey's defense of the pharmaceutical industry in the April 2001 issue of ReasonOnline: in 1999 drug companies spent $13.9 billion on advertising and promotion, half of which was for drug samples that doctors gave to patients for free. In this article from the 16 December 2004 San Diego Union-Tribune Doug Bandow puts samples as 2/3 of marketing expenses.)

As one character says in the movie, the drug companies never do anything except for profit, which is indisputable, but what the critics of the industry don't understand is that if the drug companies ignore profits, by permitting generic copies of their drugs before the expiration of their patents, or by selling their drugs at cost, they will not be able to finance the research and development necessary to produce the drugs that they're supposed to be giving away. As the Tax Court laid out the economics in its opinion in Eli Lilly & Co. v. Comm'r, 84 T.C. 996, 1160-61 (1985), "Pharmaceutical companies rely for their long-range survival on the research and development of new chemical products as well as on the maintenance and upgrading of their existing patents. The time and cost of inventing and developing new drugs and testing them in order to receive FDA approval to market them is a complex, risky, and expensive process. A pharmaceutical company must fund that process through the revenues of its successfully marketed products." And we want a constant flow of new drugs, which tend to be better than older ones. According to Bandow in this 8 May 2003 Policy Analysis (No. 475), Columbia University economist Frank Lichtenberg concluded in National Bureau of Economic Research Working Paper No. 8147 (March 2001) "that replacing 1,000 prescriptions for older drugs with 1,000 prescriptions for newer drugs would increase drug costs by $18,000 but slash hospital costs by at least $44,000."

In his review in the 17 September 2005 New Republic Online, that eternal numbnuts Stanley Kauffmann connects the dots: he reports that before the release of The Constant Gardener a pharmaceutical industry representative sent movie reviewers an e-mail saying, among other things, that "from 1998 to 2003, the pharmaceutical industry donated $4.1 billion ... to improve global health," to which Kauffmann retorts, "The email says nothing about the prices of drugs that made those billions available." Kauffmann is perhaps one of the "many people" who, in Bandow's words, "appear to believe that pharmaceuticals fall from the sky rather like manna from heaven. In their view, employees of the evil drug companies got up before anyone else and grabbed the manna, and then sold it at outrageous prices."