by Kristopher Kolta

Using drugs to treat and benefit humans is a concept which has existed since 2000 B.C. These drugs are almost always discovered through experimentation with natural materials. Modern medicine is dependent upon drugs derived from the life of this planet and continues to evolve with the discovery of new beneficial plants, animals, and microscopic life (Pfizer online, 1997). Logical medicine began with the use of natural materials to benefit humans and the further development of both the medical and pharmaceutical industries will be dependent on the availability and discovery of new, beneficial, naturally derived drugs (Cultural History of Medicine, 1984).

The Timeline

2000 B.C. -Chinese treat ulcers with mold. The mold kills off bacteria and settles acid inside the stomach. The Chinese discovered the first known drug.

1500 B.C. -Egyptians prescribe garlic for headaches, heart disease, and other ailments (Encarta, 1996). It is not until recently that we have rediscovered the possible benefits of garlic in preventing heart disease. Used tannic acid derived from the acadia nut to treat burns.

1400 B.C. -People of Southeast Asia used snakeroot to treat mental illness (Encarta 1996). This use has no scientific evidence to back up its effectiveness.

1300 B.C. -The ancient civilizations of the Americas use quinine, curare, and coca. Coca is the plant cocaine is derived from; the Incas used coca so they could work harder and longer with the energy the coca gave them. Quinine is used to treat malaria and reduce fevers (Encarta, 1996).

1200 B.C. -Opium is used in Asia to control pain Encarta, 1996).

1100 B.C. -Hemp is widely used to control pain (Encarta, 1996).

1000 B.C. -The active ingredient in hot peppers is used in the Americas for a variety of medicinal purposes (Encarta 1996).

600 B.C. -Greeks use the natural form of aspirin found in willow trees to fight pain and fevers (Encarta, 1996).

Before 500 B.C. -Although pharmaceutical discoveries are made, they are not understood. The drugs used are seen as magical or as a blessing from the gods. However, ancient medicine found surprisingly high numbers of plant extracts with medicinal properties. Over 50 of these ancient plant extracts are still utilized today (Encarta 1996).

Note: -Although pharmaceuticals are not directly linked to medical discovery and philosophy, medical discovery and attitude have shaped the need and experimentation which has defined the pharmaceutical field. Many of the following dates show the progression of the medical industry and not directly the progression of the pharmaceutical industry. Information through mid 1900's is from Cultural History of Medicine, 1984 unless otherwise noted.

5th century B.C. -Logical, scientific medicine started in Greece. Hippocrates drew the line between magic and medical science and became known as the father of medicine. Hippocrates fought the plague, discovered simple surgeries, and gained an understanding of bodily fluids. The tools and drugs which would later simplify these surgeries would later increase the need for pharmaceuticals.

4th century B.C. -Diocles studies anatomy to understand medicine. Understands importance of healthy diet and lifestyle. Aristotle theorizes evolution and tries to explain the nervous and cardiovascular systems. Specialized fields of medical science develop and the brain is thought to be the center of the body. Understanding a healthy diet and lifestyle and bodily systems would lead to demand for the pharmaceutical industry. The understanding of a healthy diet later develops into a need for vitamins and other natural medicines.

3rd century B.C.-4th century A.D. -Medical slump, Romans suspect germs. The suspicion of germs would later lead to tremendous development in pharmaceuticals.

410 A.D.-570 A.D. -Medical magic makes a comeback. Religious healing dominates. This period reverses the understanding of medicine and limits the development of pharmaceuticals.

570 A.D. -Arabian chemistry makes breakthroughs in medical knowledge. Medical knowledge of Greeks and Romans is collected in a huge library. Chemistry would later lead to the synthesizing of many naturally occurring drugs.

1037 -A complete system of medical science is developed. This understanding of the human system was a huge step towards pharmaceutical development.

1200's -Complexity of eye is understood and religion regains power. Pharmaceutical development stops.

early 1300's -Leprosy epidemic leads to isolation of the sick.

1347 -The plague strikes, killing millions.

1100-1500 -Small pox epidemic.

1400's -Sweating sickness kills thousands, but disappears from existence.

1500's -All of the plagues showed the need for drugs which could treat the diseases. Contagious diseases are understood through observation of the plagues, but drugs are not developed.

mid 1500's -Anatomy guides medicine. Drug-development slows.

late 1500's -Clinical observation gains importance. Pare becomes father of surgery. Comprehensive treatments become method of choice. The sick are dealt with as a whole rather than isolating the sick part of the body.

early 1600's -Pulmonary circulation understood. Relationship between blood and heart understood.

mid 1600's -Microscope invented; highly important to the development of germ-killing drugs.

late 1600's -Human brain and body temperature become better understood.

1600-1700 -Pathogens are understood. A huge step forward for pharmaceuticals.

1700's -Human egg is discovered. Electrical impulses are discovered and thought to be the missing secret of life. Sperm are finally linked to reproduction rather than semen. Germs are known to exist but cannot be proven, surgeries are being developed, and diseases are beginning to be understood by the public. Oxygen's importance to the respiratory and cardiovascular systems is understood. Effort to explain life begins.

late 1700's -Criminals are thought to simply be sick rather than at fault for their actions. The beginning of genetics.

1800 -Vaccine is developed for man pox and small pox. This vaccine is derived from a form of this disease present in animals which the human body could fight off and gain immunity from. This is the first successful vaccine against a disease.

early 1800's -Stethoscope is invented, diagnostics becomes an important field of medicine, body tissues are studied. Diagnostics lead to understanding of diseases.

mid 1800's -Plant cells lead to human cells and doctors study nuclei. Anesthetics are developed. Antiseptics become used. Bacteria is for the first time found and studied. Rabies vaccine is found. The method of injecting weakened virus is introduced.

1883 -Germany founds first national health service program and is followed by other European nations. Important to the distribution of pharmaceuticals.

1800's -Cells continue to be studied, genetics are theorized, immunity becomes fully understood. Bacteria is isolated and vaccines are worked on for anthrax, tuberculosis, and cholera. This was a time of rapid development for pharmaceuticals.

1900 -X-rays invented, vitamins importance studied, hormones are studied. These hormones and vitamins would later form a significant part of the pharmaceutical field.

early 1900's -Penicillin is invented. Mold is used to kill of bacteria and is synthesized. The process of synthesizing drugs would become highly important due to strains on the natural environment.

1948 -World Health Organization is founded. Important to the distribution of pharmaceuticals to Third-World countries (Encarta, 1996).

mid 1900's -Viruses are isolated and studied through new, more powerful microscopes. Reflexes understood, mental disorders understood. Psychoanalyses becomes new medical field. Neurosurgery, heart transplants, organ transplants. Viruses become the new aim of the pharmaceutical industry.

1971 -The bark of the Pacific Yew tree is found to contain Taxol which is the most important anti-cancer drug of the past 30 years (Encarta, 1996).

1970's -Ebola breakouts create the need for a drug or vaccine to fight Ebola.

1980's -AIDS breaks out, AIDS brings the issue of deadly diseases to the First-World's attention. AIDS would lead to the development of drugs designed to slow AIDS progression within the human body.

1987 -World Health Organization has 166 member countries (Encarta, 1996).

1990's -Genetic experimentation becomes used to predict diseases, search for cures, and manipulate life. Genetics become a new source of attention for the pharmaceutical field.

mid 1990's -Cloning is developed.

1950-present day -Scientists focus on synthesizing rather than new natural discoveries has lead to resistance of diseases and a lack of other options to treat most diseases (Various Pharmaceutical cites on the web).

Cultural and Economic Causes and Effects

I. Causes of the Lack of Access to Drugs in the Third-World -Although scarcity of currently used drugs is not a large problem, billions of people throughout the world lack access to beneficial drugs. Third-World poverty, the failure to recognize medicine as a basic human need and right, the high cost of medicine, and the need for an international or national supplier of basic medical needs are responsible for an unequal distribution of drugs throughout the world. I.A. Lack of a Supplier of Drugs in the Third-World As most pharmaceutical companies are privatized and therefore aimed at making a profit, the Third-World often is ignored. Even the impoverished in First-World countries often lack medicine because of the high price of medicine. In countries where the government does not provide for medical attention personal medical needs are left up to the people of that country. In the Third-World where the government and economy are unstable national programs for medicine do not exist.

II. Effects of Lack of Access to Drugs in the Third-World -As many people around the world can only provide for needs such as food, clothing, and shelter, they are denied the benefits of modern medicine. Benefits as intangible as a longer life, better health, and an equal chance at life that the financially well-off have. The lack of drugs not only takes away from the impoverished lives, it hurts us as a planet. Without birth control, Third-World poverty continues to limit international economic and environmental success, without immunization and disease treatment, we may never rid ourselves of diseases which, although currently treatable, could become the killers of tomorrow, and without health care or medical supplies, Third-World poverty will continue to make our planet an unstable place.

III. The Failure to Recognize Basic Health Care as a Right rather than a Business -The current privatization of the pharmaceutical industry has made a business out of a human necessity. Under privatization, pharmaceutical companies are out to make a profit and cut as many corners as they can. Short-cuts taken by the industry give the poor little chance of receiving drugs and care. Only under universal health care systems are entire populations receiving drugs. In England such a system exists and all Englanders receive basic health care and beneficial drugs. England is one of the few countries where basic health care is a right rather than a business (Cultural History of Medicine, 1984).

IV. Cause: The High Cost of Drugs; Effect: The Poor Lack Drugs and Countries are Reluctant to Adopt Universal Health Care Systems -The high cost of pharmaceuticals is also one of the reasons that the poor don't get care. Obviously, the poor cannot afford the high cost of modern-day drugs, and because of the high cost, governments of poor or even rich countries cannot afford to provide universal care and make access to drugs a right. Even in the U.S., universal health care was turned down many times in the thirties and forties and universal coverage was even turned down in 1993 (Encarta, 1996). This failure to provide universal care by one of the world's wealthiest countries shows how the incredibly high cost of health care and pharmaceuticals can pressure countries into not offering such beneficial programs. The high cost of drugs is making health care a royalty rather than a right.

V. Cause: Poor Funding of International Health Organizations; Effect: Limited Effectiveness of International Drug Providers such as the WHO -Another cause in the pharmaceutical industry is the low budget of international health organizations. These programs have lofty goals but little financial support behind them. The WHO has 166 member countries but lacks the resources to have any strong international effect (Encarta, 1996). International health organizations were created to help humanity on a global level, but due to low levels of financial support, such groups have taken on small projects and avoided putting money into larger efforts. An example is the U.N.'s effort to wipe out small pox. Rather than aiming to improve the health of the entire world in a general attempt, the U.N. specified itself and only helped in the limited area of small pox. Instead of trying to help out our planet as a whole through providing a varied supply of medicines, the U.N. limited itself through providing only one type of pharmaceutical, the small pox vaccine.

VI. Cause: First World Demand; Effect: High Prices which Prevent the Distribution of Drugs in the Third-World -There are many causes in the cultural and economic environment, but, overall, it is the high price of pharmaceuticals caused by the privatization of the pharmaceutical industry. Despite competition within the international pharmaceutical industry, the price of pharmaceuticals continues to rise due to high demand in the First World. Although companies create high quantities of their synthesized drugs, they are only considering the consumers within the limited First-World population. Although much of the population lives in Third-World, they are not considered or targeted by pharmaceutical companies because most Third-World residents cannot afford their products. Although Third-World health would allow for faster development and long-term economic benefits, pharmaceutical companies are not willing or lack the resources to supply non-paying residents. The high cost of pharmaceuticals would lead most countries to take a loss if they funded Third-World medicinal demand. It is the high demand in the First-World that keeps the price of pharmaceuticals beyond the Third-World's budget, individual or governmental. Because pharmaceuticals are seen as a necessity in the First-World and viewed as vital to a long, healthy life, consumers are willing to pay high prices for drugs. In the Third-World drugs are not accessible and therefore not seen as a necessity.

Causes in The Natural Environment

I. Scarcity of naturally-derived drugs -As most drugs are derived from life in the natural environment, the issue of environmental scarcity and depletion are huge problems for the pharmaceutical industry. In the past scarcity of natural substances due to overuse and abuse have lead to problems in the supply of drugs. An example is quinine, a treatment for malaria. Quinine was derived from the bark of the cinchona tree, and after centuries of overuse, the trees, naturally found in South America, were nearly extinct. The need for quinine became desperate and the trees were finally successfully transplanted to Indonesia where the supply of quinine was renewed. During WWII the problem of scarcity was again encountered when Japan cut off the supply from Indonesia. In 1944, quinine was finally synthesized, but natural quinine is still in demand because some forms of malaria have become resistant to the synthetic (Encarta, 1996).

Due to scarcity of the natural sources necessary for many drugs, synthesizing natural substances which have benefits to humans has become essential to the supply of nearly all different types of drugs. Almost every natural substance with medicinal effects has been synthesized (Encarta, 1996), and, therefore, the supply of most drugs is not a problem. However, as in the case of quinine, scarcity of natural products can potentially create a problem.

II. Loss of Biodiversity and Deforestation -The scarcity of natural sources for known drugs pales at the possibility for finding new drugs from natural sources which are disappearing or extinct. With the loss of biodiversity and rainforests goes the possibility of hundreds of new drugs in the future. Today's plant- based prescription medicines come from only 95 different plant species of the known 250,000, and it is possible that up to 750,000 plant species exist (Pfizer online, 1997). That means that currently we are using about one ten-thousandth of our plant species for medicine. With the loss of biodiversity, we risk loosing thousands of opportunities for new drugs.

III. The Evolution of Pathogens -Another cause in the natural environment is evolution. As we treat diseases with drugs, they evolve in order to continue their existence. This evolution leads to resistance to existing drugs; antibiotics are an example of how decades of using a drug can result in the evolution of bacteria. This resistance fuels a constant demand for new drugs for diseases and creates a never-ending battle for research facilities against organisms which were previously thought to have become harmless.

IV. Overpopulation -Overpopulation causes a huge problem for the pharmaceutical industry. This problem is the tremendous expense of supplying over 2 billion impoverished people around the world with free drugs. As the Third-World population continues to grow, the cost of supplying the drugs steadily increases. If an international distribution program were started it would cost trillions. The high cost of drugs coupled with a growing population causes a huge problem in the area of funding an international drug distribution program.

Environmental Effects

I. Effects of the Loss of Biodiversity and Deforestation -The effects of deforestation and loss of biodiversity on the pharmaceutical industry are highly unknown. It is the naturally-derived drugs of the future rather than the synthetics of today. Diseases such as Ebola, AIDS, cancers, and drug-resistant bacteria may have cures just waiting to be found deep inside a South American rainforest, but if those natural cures become extinct through deforestation before they are found, millions of lives could be lost in the future without cures to those deadly diseases. Currently the threat of losing possibly existing natural cures has lead to the rapid testing of natural products. Pharmaceutical companies currently realize the risk of losing not only life-saving drugs but huge profits through the extinction of species around the world. The prospect of finding a cure to currently deadly diseases has lead pharmaceutical companies to test daily shipments of natural products from around the world.

This testing usually has specific perameters which are designed to protect biodiversity because of the companies' understanding of the endless possibilities for finding new drugs and the chance that a cure could be lost in the scavenging process. Once a natural product is found chances are that it can be synthesized, but testing is a detailed and time- consuming process. If natural products exist which will cure our planet's worst diseases, it is a race against time to find the products and synthesize them.

II. The Effects of Scarcity and the Evolution of Pathogens -The effects of not finding successful drugs and being forced to prescribe already overused drugs which diseases are gaining a resistance to are millions of deaths a year and the potential for future epidemics which could kill billions. The risks of untreatable diseases provide fear and motivation for pharmaceutical companies to develop new drugs.

III. The Effects of Overpopulation -Due to overpopulation, the cost of providing drugs to the Third-World is out of reach for individual organizations. The effect of overpopulation is the lack of a successful international health care program which results in millions of deaths from curable diseases in the Third-World. The effect of overpopulation on the cost of providing drugs to the Third-World has limited the effectiveness of past efforts and will be an obstacle which future efforts will have to overcome.

Solutions in the Cultural and Economic Environment

I. The Complexity of a Successful Solution -Solutions to an industry which provides a basic, yet expensive, human need are complex and costly. Successful solutions on the international level would be most effective through governmental programs which work with pharmaceutical companies to provide drugs to the less fortunate.

II. What past Solutions have Taught Us -Attempts by both governmental organizations and private companies show the possibility for providing drugs to the Third-World, but they also show the difficulty and high cost of providing such a service. Both governmental and private companies have shown that they cannot implement a complete solution alone, and therefore, for a solution to be long-term and successful it would have to incorporate both the private and governmental efforts.

III. Examples of Specified but Successful Solutions in the Past and Present -There have been many efforts which have been successful, but these efforts specified on providing either one kind of drug or helped one group of people. Examples of such successes come from both governmental and private efforts. The U.N. specifically targeted small pox and eliminated it, Glaxo Wellcome, an international pharmaceutical company, invented and donated an anti-malaria drug which is currently saving millions of lives (Glaxo Wellcome online, 1997), and religious foundations funded by individuals in the U.S. provide drugs and medical care which save millions of lives in the Third-World.

IV. The Coordination Necessary for a Successful, Permanent, Wide-Spread Solution -Although all these types of organizations do help, it will take the coordination of individuals, government, and pharmaceutical companies to implement a solution. While previous efforts have been forced to specify due to financial limitations, a group funded by individuals and government with the products of pharmaceutical companies could provide medical and pharmaceutical service to the poor. Currently the WHO is the closest thing to an effective international medical-supply program. The WHO has been limited by poor financial support, but if the governments of the 166 member countries were to set aside a fund for the WHO, the WHO could provide doctors and other staff for Third-World countries. Individuals could also help fund this international project. Those who donate to relief organizations often have their money's effectiveness limited by the many changes of hands their money goes through before it reaches their target, but if they had an effective organization like the WHO working for them, their money would be spent much more effectively. The pharmaceutical industry could work into the project by supplying drugs and medical equipment to the improved WHO. The drugs are not usually expensive for the companies to make. It is the high demand in the First-World and actually administering the drugs which currently limits pharmaceutical efforts. If the companies had an honest organization which would do all the labor and distribution of the drugs for them, the companies wouldn't lose that much money funding impoverished people. If the WHO guaranteed not to distribute the drugs in high demand countries which already are paying high prices for drugs, the companies would not be forced to lower prices in their profitable markets such as the U.S.

V. Advantages of such a Program -Through such a program, conditions in the Third-World countries would improve and lead to economic development, possibly creating new paying consumers for the pharmaceutical industry in the future and fueling international trade.

VI. The Need for a more Coordinated International Program -The current system of specified targeting of relief projects by the U.N., the WHO, individuals, and pharmaceutical countries is an uncoordinated effort that shows the potential for a collaboration of existing groups into a new, improved WHO. Billions of dollars are spent annually but not fully utilized through separate efforts by many organizations. The support from government is the most critical piece to this program because it would be the main contributor, but if the 166 member countries would donate now with the prospect of a short term loss, they could create a more profitable and more stable international economy in the future. It is probable that companies are already putting enough money out to fund such a project with individual countries such as Glaxo putting out over 30 million dollars a year for relief efforts (Glaxo Wellcome online, 1997). If labor and administration of the drugs and services were covered, that much money from each international company could fund the materials needed for an effective WHO of the future. An uncoordinated effort will continue to limit the effectiveness of relief efforts, but through a coordinated effort in the future, the pharmaceutical needs of everyone around the world could be met.

Solutions in the Natural Environment

I. The Problems in the Natural Environment -As most of the problems within the natural environment are already widely recognized as they are currently some of our most pressing environmental problems, solutions in the natural environment for pharmaceutical companies would mainly augment existing environmental efforts. Problems which the pharmaceutical industry faces are loss of biodiversity, deforestation, evolution of diseases, and overpopulation.

II. Protecting Biodiversity and Forests -The loss of biodiversity and deforestation are already recognized by the pharmaceutical industry. Current practices in research involve strict guidelines to protect biodiversity and forests when taking natural sample from the environment. Companies, the government, grass roots organizations, and individuals must continue their efforts to protect the biodiversity and forests which researchers are dependent upon to find new cures.

III. Finding new Drugs to Fight newly Evolved Diseases and Publicizing the Effects of the Loss of Biodiversity on the Pharmaceutical Industry -The evolution of diseases is a problem which is more unique to the pharmaceutical industry. The only real way to solve this problem is to find new antibiotic sources and develop new synthetics by altering existing drugs. Pfizer has recently developed a new synthetic antibiotic, CP-99,219, which will fill in some of the gaps in the effectiveness of antibiotics (Pfizer online, 1997). The most promising source of new antibiotics is the natural environment which goes back to efforts to protect the environment by existing groups. It would help if pharmaceutical industries publicized the potential loss of human life caused by species' extinctions. By informing the public of possible cures we are loosing to potential epidemics of the future, companies may be able to give individuals one more reason to donate to environmental groups.

IV. Solving the Problem of Overpopulation -Overpopulation within the Third-World is a serious problem in that it raises the costs of providing drugs to everyone. A possible solution to this is denying families with more than one child access to the improved WHO's relief efforts. When the program is implemented it couldn't punish the already large families, but it could punish families which continue to have too many kids after its implementation. The WHO could make birth control the primary drug of their effort and lower the cost of their program in the long- term through a reduction in population.

The Implementation of Pharmaceutical Industry Solutions

I. Reason for Coordination and Assigning Responsibilities -Overall, it will be coordination of efforts and funds which bring success to relief efforts. Until this coordination is started, relief efforts will continue to be limited and no perameters for wide-spread, permanent relief will be set. Without such coordination a permanent, effective solution will not be reached. In order to reach this coordinated solution, the responsibilities of individuals, grass-roots groups, companies, and the government must be laid out.

II. Individual Responsibilities to a Successful Solution -Individuals, mainly in the First-World, must pressure their governments to reorganize the WHO and U.N. health efforts and to increase funding to these organizations. Residents of First-World countries must demand a more effective program than religious foundations and poorly funded international health organizations. Residents must tell their representatives in their Congress or Parliament that they demand change and that they support higher levels of funding to the WHO, but that they will not support the new program if it does not involve pharmaceutical companies, the government, and individuals. The best way to lobby government for such a change is to form grass roots organizations which will promise funding, but only after reform.

III. Grass Roots' Responsibilities -Individuals must form grass roots organizations to lobby government for change. These groups must focus first on raising money which will be their main bargaining chip when dealing with the government. Once a large fund is established through individuals' donations, the grass roots groups can unite and put the pressure on government. The best way to insure multi-national support for the coordinated international health care system they demand is through an international organization of grass roots groups. These groups will promise their raised funds to the WHO if a revolutionized WHO is created and supported by the major governments and pharmaceutical companies of the world.

IV. Governments' Responsibilities -The governments of the world must work towards an improved WHO. Although it will most likely require the pressure of highly organized grass roots groups to change the governments' funding and organization of the WHO, the government should also be looking at ways to boost funding because of the inhumanity of allowing Third-World people to needlessly die from common, curable ailments. If the government will not change without pressure, it must at least listen to the demands of grass roots groups. If these groups dangle billions of dollars in the face of government, the government will change and conform to grass roots demands. It will be the job of the government to make sure the pharmaceutical industry joins in the effort to provide drugs to the Third-World. The governments of the world should be able to give companies which donate drug products and other pharmaceutical equipment enough of a tax break to cut most of their losses. This governmental help in the coordination of the WHO will be crucial to a successful solution. The government must put human life in the Third-World above revenue gained through the taxing of pharmaceutical companies.

V. The Pharmaceutical Industry's Responsibilities -The Pharmaceutical Industry will either make or break the new WHO through its contributions of medical supples. The companies must have foresight into the benefits of such a program. In the long-term, companies can hope to gain a new market through the development of Third-World companies. Their contribution of supplies will allow the Third-World to have a better chance at economic development and insure more paying customers in the future. Further incentives for the companies, if needed, could be free access to natural products for drug testing which exist in the Third-World. The pharmaceutical companies must also prioritize their practices; the companies must choose between human life and profit.

VI. Overall Policies and Effects of such an Organization -The new WHO would have a huge bargaining chip in the solving many of the problems of the pharmaceutical industry around the world. The WHO could slow the overpopulation problem through denying coverage to large families and providing birth control. The WHO could demand the protection of the biodiversity and forests in return for their service. The WHO could make problems of scarcity less unpredictable by denying coverage to countries which block the exportation of natural substances needed for drugs. Overall, if the responsibilities of each group were followed, a successful solution could be reached which would save millions of lives, help develop Third-World countries, solve problems within the pharmaceutical industry, help the economy of the world as a whole, and finally put human life ahead of pharmaceutical and governmental profits.

Works Cite

1. Encarta Cd-Rom, Microsoft, 1996.

2. Pfizer online, www.pfizer.com, 1997

3. Glaxo Wellcome online, www.glaxowellcome.co.uk, 1997

4. Cultural History of Medicine, 1984

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