This is one of several movie suggestions written by students in the Chinese-Language Cinemas class of Winter 2019 (CHIN 3050/FILM 3350). For this “Playlist Project,” students looked for a film of interest not seen in class, watched and researched it, and wrote up their recommendation. More viewing suggestions will be posted each day leading up to the beginning of the new term.
Review written by Julia Walker
我不是药神, set in Shanghai, is a 2018 film from mainland China that translates directly to I am not a Medicine God. However, the film is commonly known in English as Dying to Survive. This was the debut feature film for Wen Muye, who co-wrote the screenplay and directed the film. Dying to Survive was inspired by a real life story of a store merchant who helped illegally smuggle Indian-made generic cancer drugs into China to help people who were suffering from leukemia who could not afford the real patented medication. A misfit group of five individuals make up the members of the smuggling team. Together, their personalities and actions bring comedy to a heavy topic movie. The film won multiple “Best Feature Film” titles worldwide from various international and domestic film festivals (CGTN, 2018). Through the comedic and melancholy tones, Dying to Survive shows themes of struggle and resilience of people fighting to stay alive. Although it deviates slightly from the true story, the film highlights the state of the current medical system in China by showing how affected individuals struggle to survive.
This is an important film because it highlights real issues that are affecting populations in China. Although the film has a comedic tone, it does emphasise the reality that many Chinese people face when they are suffering with diseases that they cannot afford medication for. Some argue that the current film industry, especially films made in Hollywood, lack social realism (CGTN, 2018). One definition of social realism in film is the realistic cinematic portrayal of the lower classes in society, often representing this group’s fears or concerns (Konsinska, 2011). This genre shines through the film as it is lower class people who cannot afford the medication and who beg the merchant to smuggle drugs for them. This shows their desperation to live, which reflects the real life struggles that people face in China. This realistic approach allowed the film to captivate audiences in China and across the world as it is seen to be fresh in comparison to unrealistic superficial films that have been recently released.
In addition to the realism of the film, it can be argued that the film is a social criticism on China’s medical system (CGTN, 2018). Although China has a national healthcare system, not all medications are covered by the medical insurance (Chen et al., 2016). Moreover, the government encourages its people to purchase expensive commercial insurance instead for if they need extended coverage (Chen et al., 2016). This problem is criticized by the film as the protagonist smuggles an equally effective cancer drug from India in order for patients to have more affordable access to the medication. This levels the charge that there is a flaw in the medical care system as it cannot support individuals’ recoveries by providing affordable medications. Thus, lower income citizens are forced to search for illegal alternatives just to be able to survive. The criticism of the medical system, however, is subtle enough for the film not to be censored when shown in China. Films have to be reviewed by the censorship board in order to be approved to be made in China. Some might be surprised that this film got approved since it is commenting on a government supplied medical system. However, this film has the correct balance of criticism without exceeding the limits in order to pass the censorship review board (Shepherd & Li, 2018). This could be because the film highlights the issues in the system without outright blaming the government for the outcomes.
Another reason this film is important and should be watched is because it addresses the moral dilemma between following the rule of law and or breaking it to save a life. One reason for medications to have high costs in China is there are few domestic pharmaceutical companies (CGTN, 2019). Therefore, almost all drugs are manufactured and imported from international locations, thus increasing the costs of the drugs. One suggestion is for China to start a nationalized pharmaceutical company to produce domestic drugs in order to lower the costs of the medications (CGTN, 2019). Gleevec, a Swiss-made patented cancer drug imported to China, has been continuously prescribed to individuals suffering from chronic myeloid leukemia (CML) (Lucas, 2019). The patented version of the drug was costing Chinese patients around the equivalent to $USD 3777 per month to purchase (Lucas, 2019). This was causing many individuals who suffer from CML to either not get treatment or go into debt attempting to do so. The Indian-made generic drug would cost the equivalent of $USD 436 per month; however, this is when the drug is illegally distributed (Lucas, 2019). Although this is still expensive, the illegal importation of the Indian drug made the medication slightly more affordable than the patented legal version. However, the hidden cost of obtaining the Indian generic drug is the fact that it is illegal to buy and sell unregulated drugs in China, therefore it is risky for the distributor and the consumer to seek the illegal alternative (Hunwick, 2014). Although the individuals involved could have faced prison time, the real life smuggler, Lu, “would do the same thing if [he] could go back” (Hunwick, 2014). This shows that Lu believed helping sick people was worth the risk of possible prison time. The film’s version of the smuggler originally sought only profit from the drug deal. However, once he saw the impact he was making by saving lives he saw the greater good to the operation even though, ultimately, what he is doing was illegal. This is a moral dilemma that causes audiences to have to think about the situation when they watch the film. Therefore, this film is significant because it tackles issues that are complex and thought provoking for the audience.
Although the direct link between Dying to Survive and government policy change cannot be proven, some see the film as a call to action to the Chinese government to look into changing the medical system to make medications like Gleevec fall under medical insurance (CGTN, 2019). For example, following the film, 36 new drugs were added to the Chinese national drug reimbursement list, including Gleevec (Lucas, 2019). Thus, supporting the claim that the film might have had an impact on the system. Ultimately, through realism and comedy, this film has served as a way for the world to see the realities of the hardships that Chinese citizens face when attempting to fight a disease and not being able to afford the medication.
CGTN (2018). ‘Dying to Survive’ hits nerve on costly cancer drugs. [Video File]. Retrieved from https://www.youtube.com/watch?v=-uXbkiaEvuA
Chen, Y., Xu, X., Liu, G., & Xiang, P. (2016). Brief Introduction of Medical Insurance System in China. Asia-Pacific Journal of Oncology Nursing, 3(1), 51-53. doi 10.4103/2347-5625.178172
Hunwick, R. (2014). Chinese ‘Dallas Buyers Club’ founder charged with fraud. The Telegraph. Retrieved from https://www.telegraph.co.uk/news/worldnews/asia/china/11308250/Chinese-Dallas-Buyers-Club-founder-charged-with-fraud.html
Konsinska, K. (2011). Style and attitude: Social(ist) realism in the Polish Black series and British free cinema. Studies in Eastern European Cinema, 2(1), 193-209. Retrieved from https://www-tandfonline-com.ezproxy.library.dal.ca/doi/pdf/10.1386/seec.2.2.193_1?needAccess=true
Lucas, C. (2019). Dying to Survive and cancer care in China. The Lancet: Oncology, 20(1) 30. Retrieved from https://ac-els-cdn com.ezproxy.library.dal.ca/S1470204518309215/1-s2.0-S1470204518309215-main.pdf?_tid=d5ea03e7-bda9-4db6-b2fa-bde79642f8dc&acdnat=1553133127_e751718d76a9f97eb135851993c83d6d
Shepherd, C., & Li, P. (2018). Cancer drug movie strikes nerve in China, becomes box-office hit. Reuters. Retrieved from https://mobile.reuters.com/article/amp/idUSKBN1K80TH
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