How Does Ethan Watters Use Cultural Imperialism

In Ethan Watters’ essay “Mega-Marketing of Depression,” Watters describes the process GlaxoSmithKline, a drug company, uses to change the way Japan views mental health, especially depression. The tactics GlaxoSmithKline uses in the essay show how they use cultural imperialism to influence scientific ideas in Japan. Cultural imperialism plays a significant role in the exchange of scientific ideas between cultures. It is a driving force in the evolution of changing technologies and medicines. It promotes the growth of technologies, but it should not force one nation's ideals onto another. A country should pursue their own technological and medicinal advances at their pace. Nations may be influenced by another nation’s progress to seek their own

advances, but when countries start to impose their cultures on others, even in the name of science, their actions can be described as unethical.

GlaxoSmithKline’s goal was to sell the antidepressant, Paxil, to a new market in Japan. They planned their moves strategically to profit from this untouched market. Many of the actions GlaxoSmithKline used to sell their drug were dishonest in nature, even if GlaxoSmithKline claimed to have good intentions. They monopolized on the blank slate that was the Japanese market. For Kalman Applbaum, a University of Wisconsin professor and anthropologist, “it became clear that they were intent on implementing a complex and multifaceted plan to, as he put it, 'alter the total environment in which these drugs are or may be used'” (Watters 524). GlaxoSmithKline’s “plan” to sell Paxil comprised of a complete overhaul in the Japanese mentality on mental illness and treatment.

The process for getting Paxil approved for market in Japan first required initial testing to prove the effectiveness of the drug. Here GlaxoSmithKline displays their first suspicious actions. In their testing, GlaxoSmithKline funded studies to confirm the link between depression and suicide. Watters writes about the results of these studies and reveals, “those studies that showed a connection were reprinted in pamphlet form and reported to national media outlets as breaking news. Studies that failed to show a connection could simply be ignored” (526). GlaxoSmithKline displayed notably unethical actions. The company disregarded important data and does not share all findings with the public. The public has a right to know everything there is to know about medicine, especially if they or someone they know will potentially be receiving this medication. The company behind Paxil markets in a way that makes them the single source of treatment for depression. They do this again when they misinform people about what Paxil can do. On their website, Paxil is described as being able to help maintain a balance of serotonin levels (529). The issue with this is that "there is no scientific consensus that depression is linked to serotonin deficiency or that SSRIs restore the brain's normal 'balance' of this neurotransmitter" (529). Paxil and other drugs that are serotonin based are medicines of past research. The scientific data behind serotonin leveling drugs is outdated, and the current scientific community does not have proof that these types of drugs are effective. GlaxoSmithKline was not just covering up data, but they actively promoted the wrong data. They want people to believe they have the only solution for fighting depression. GlaxoSmithKline does not offer the Japanese scientific community the chance to learn from the tests and data since they provided incorrect results and conceal others. This is considerably unethical as it does not promote the growth of Japanese scientific ideas. Sure GlaxoSmithKline was introducing a new drug, but they did it in a way that made Paxil seem to be the only solution to beating depression. GlaxoSmithKline uses this to their favor as they change the Japanese people's impressions of mental health. They hide scientific fact from the people and market in an underhanded way as well. They monopolize the market surrounding Japanese mental illness for their own personal gain. GlaxoSmithKline's actions may have been deemed more ethical if they instead revealed all the data they gathered to the Japanese people and made it a point that even if there was no data to back up the use of serotonin leveling antidepressants, these drugs have shown to be effective in some cases.

After Paxil had been approved for the market, GlaxoSmithKline faced the challenge of actually selling the drug. Again, GlaxoSmithKline demonstrated underhanded techniques to sell Paxil. In Japan, the idea of depression and mental illness was a social stigma. For Paxil to be successful, GlaxoSmithKline would need to market not only their drug but also the idea of depression. Depression was literally a foreign term to the Japanese people. They did not have a concept of what depression is. GlaxoSmithKline's task was to educate the Japanese people about depression. Once more, questions about GlaxoSmithKline's motive arise. GlaxoSmithKline claimed they were teaching the Japanese populace because they wanted to bring real change to the world, but the deceptive nature of their actions speak of a monetary motive. The campaign GlaxoSmithKline used often came in disguised forms, such as patient advocacy groups that were actually created by the drug companies themselves. Websites like utu-net.com, appeared to be the coalition of depressed patients and their advocates, but they were actually founded by GlaxoSmithKline (525). Another way the Paxil manufacturers unethically promoted their drug was when it was confirmed that the Crown Princess Masako suffered from depression. Princess Masako's personal psychiatrist was Yutaka Ono, one of the field's leaders that GlaxoSmithKline had entertained at the Kyoto conference (526). The actions that GlaxoSmithKline perform are unethical because the company bypasses the Japanese law against selling directly to consumers by doing exactly that.

It may be reasonable to argue that GlaxoSmithKline was lucky in their marketing, but it is obvious they had a hand in directly influencing many of their “lucky breaks”. GlaxoSmithKline campaign involved workarounds to Japanese prohibitions on marketing prescription drugs directly to the consumer (524). They systematically used the internet and trusted sources to spread their information. They gained many buyers by using a workaround that can be considered dishonest on many levels. They created fake advocacy websites and pretended to be different companies that tested if a person had depression. Since, GlaxoSmithKline was the one running the tests, the results were probably skewed in their favor. GlaxoSmithKline also invited the psychiatrist in charge of this celebrity figure to a week of lavish pampering under the pretense of a scientific conference. "GlaxoSmithKline worked very hard to win over the most prominent medical researchers and psychiatrists in the country and keep them on message" (527). Like with the Princess' psychiatrist Ono, these conferences offered GlaxoSmithKline an opportunity to sway distinguished personal to endorse their product.

The deceptiveness in their actions puts doubt into some minds about the true intentions of GlaxoSmithKline.

The company assures the researchers it brings in, like Applebaum, that they want to "fight" depression, anxiety, and social phobia (527). It is almost their calling to bring light to these diseases, and they will use any means necessary. Applbaum says on this topic, "They seemed to believe their products were effective and they were baffled that anyone should question their value" (528). The way Applbaum describes this meeting with GlaxoSmithKline reveals some of their real intentions, making money. Applbaum says the company was "baffled" anyone would question their integrity. This is quite an exaggerated emotion. It seems like they were trying to hard to display good intentions and when were actually questioned, they were offended this exaggerated degree. They wanted to believe they were doing good and hid their real motives. They used "fighting depression" as a means to make money. If they were really in the market for the benefit of the Japanese people, they could have had a cleaner campaign. The only reason GlaxoSmithKline can say they are in the market for the sake of the Japanese people, is because their product has shown results. Pxil and other serotonin leveling drugs have worked in some cases, but Paxil is not the magic pill that can cure depression, GlaxoSmithKline is making only it seem like

that.

GlaxoSmithKline and their takeover of the Japanese market are unethical in their actions.

Paxil does not promote the Japanese scientific community to grow and expand on their own. Instead, the Japanese culture is diminished and changed for monetary gain. GlaxoSmithKline does not allow the Japanese market to grow on it's own and instead almost forces the Japanese market to accept their, and western, ideals. With the covering up of scientific results, bolstering of wrong data, and underhanded actions in marketing via the internet and bringing prominent figures, GlaxoSmithKline serious questionable actions. They could have helped the Japanese market to grow tremendously. Japanese scientists could have helped test new types of products to combat depression, had GlaxoSmithKline not covered up the results showing that Paxil did not work in some cases. GlaxoSmithKline could have worked together with the Japanese scientific community to produce a drug that could have been more efficient. With this, the Japanese people may have been more open to accepting Paxil because it would been recreated with the help of Japanese scientists. GlaxoSmithKline could have also marketed in a more honest way if they not marketed in a sneaky way. They could have capitalized on that there is currently no other drug that combats depression like Paxil. They also could have made it a point that they were working together with Japanese scientists to make Paxil

better.