The ancient prophet Jeremiah once lamented, “Is there no balm in Gilead? Is there no physician there?” His cry was a plea for healing, for relief from the suffering of his people. In the modern age, we might ask a similar question of the pharmaceutical industry, an enterprise ostensibly dedicated to alleviating human affliction. Drugs don’t offer healing. Yet, as we survey the landscape of modern medicine, a troubling pattern emerges: drug companies, despite their vast resources and scientific prowess, seem perpetually unable—or unwilling—to deliver cures. Instead, they offer a steady stream of treatments that manage symptoms, prolong conditions, and ensure a lifetime of dependency. Is there no balm in Gilead, indeed?
At first glance, the pharmaceutical industry appears to be a beacon of progress. Billions of dollars are poured into research and development each year, and the fruits of this labor are evident in the form of sleek advertisements, glossy brochures, and a pharmacopeia brimming with new medications. We are told that these drugs represent the cutting edge of science, the result of tireless innovation. But a closer examination reveals a stark truth: for all their ingenuity, drug companies rarely, if ever, produce anything that eradicates disease at its root. Instead, they specialize in palliatives—temporary salves that soothe but do not heal.
Consider the case of chronic illnesses like diabetes, hypertension, or rheumatoid arthritis. These conditions affect millions worldwide, and the drugs designed to treat them—insulin analogs, ACE inhibitors, biologics—are marvels of modern chemistry. They keep patients alive and functional, no small feat. Yet none of these medications cures the underlying disease. Type 2 diabetes remains a lifelong sentence, hypertension a persistent shadow, arthritis an unrelenting foe. The patient is tethered to a regimen of pills or injections, often for decades, while the root causes fester unchecked. Why is this the case? Why, with all our technological might, do we not see cures for these pervasive ailments? Because drugs don’t offer healing.
The answer lies not in science alone but in economics. Pharmaceutical companies are not altruistic entities; they are businesses, beholden to shareholders and driven by profit. A cure, by its very nature, is a one-time transaction—a patient is healed, and the need for medication vanishes. A treatment, however, is a gift that keeps on giving. A diabetic patient who requires daily insulin or a hypertensive patient who pops a pill each morning represents a steady revenue stream, often spanning a lifetime. To cure these patients would be to cut off that flow, a prospect no profit-minded corporation would willingly entertain.
This perverse incentive is not mere speculation; it is borne out by the industry’s own behavior. Take, for instance, the development of antibiotics. In the mid-20th century, antibiotics were hailed as miracle drugs, capable of curing bacterial infections that once spelled certain death. Penicillin, streptomycin, and their successors saved countless lives and remain one of the few examples of true cures in modern medicine. Yet, today, the pipeline for new antibiotics has all but dried up. Why? Because antibiotics, when effective, are used briefly and then discarded. They do not engender dependency, and thus they are less lucrative than drugs for chronic conditions. Meanwhile, antibiotic resistance grows, a crisis that could return us to the dark ages of medicine, yet drug companies show little urgency to address it. The balm, it seems, is not worth the bother.
Contrast this with the explosion of research into so-called “blockbuster drugs”—medications that treat widespread, ongoing conditions and generate billions in annual sales. Statins for cholesterol, SSRIs for depression, proton pump inhibitors for acid reflux: these are the darlings of the industry, prescribed to millions and taken indefinitely. They are not cures but maintenance tools, designed to keep symptoms at bay while leaving the patient tethered to the pharmacy counter. The message is clear: the industry thrives not on healing but on perpetuation.
This dynamic is perhaps most glaring in the realm of cancer, a disease that inspires both dread and hope. Oncology has seen remarkable advances in recent decades—immunotherapies, targeted therapies, and precision medicine have extended lives and improved outcomes. Yet, even here, the language of “cure” is conspicuously absent. Patients are deemed “in remission,” a fragile state that often requires ongoing treatment to prevent recurrence. Drugs like Keytruda or Imbruvica, hailed as breakthroughs, are administered over months or years, costing tens of thousands of dollars annually. They are miracles of survival, yes, but not of eradication. The cancer may retreat, but it is rarely vanquished outright. And so the patient remains a customer, the disease a lingering specter.
This is not to say that pharmaceutical companies are devoid of merit. Their drugs have undeniably saved lives, eased suffering, and pushed the boundaries of what medicine can achieve. A world without their contributions would be a bleaker one. But the question remains: why, with all their power, do they stop short of the finish line? Why do they offer balms but not cures?
Some point to regulatory hurdles or the complexity of human biology as excuses. The U.S. Food and Drug Administration (FDA), for instance, demands rigorous evidence of safety and efficacy, a process that can take years and cost hundreds of millions. A cure, with its promise of permanence, might face even higher scrutiny than a treatment. Yet this argument rings hollow when we consider that the industry navigates these hurdles adeptly for profitable chronic therapies. If the will existed, the way could be found.
Others suggest that cures are simply unfeasible for most diseases—that we are destined to manage rather than eliminate them. But history belies this pessimism. Smallpox, once a scourge that killed millions, was eradicated through vaccination, a triumph of medical science. Polio, too, has been nearly wiped out. These victories required not just ingenuity but a collective commitment to healing over profit—a commitment that today’s drug companies seem reluctant to embrace.
What, then, is the path forward? If the pharmaceutical industry will not deliver the balm we seek, must we look elsewhere? One possibility lies in public investment. Government-funded research has historically driven some of medicine’s greatest leaps—penicillin, the polio vaccine, even the foundational science behind mRNA vaccines emerged from public institutions. Unlike corporations, governments and nonprofits are not beholden to quarterly earnings; they can prioritize cures over cash flow. Yet public funding alone is no panacea; it lacks the scale and agility of private industry.
Ultimately, the question “Is there no balm in Gilead?” is not just a critique of drug companies but a challenge to us all. We live in an age of unprecedented scientific potential, yet we settle for half-measures. The pharmaceutical industry, for all its brilliance, has chosen a path of maintenance over mastery, of salves over solutions. Until that changes—until we demand and deliver true healing—the balm will remain elusive, and the suffering will endure. Jeremiah’s lament echoes still, unanswered.