by Cephas Alain
As interest has increased in the lab leak hypothesis for the origin of the SARS-CoV-2 pandemic it has cast the spotlight upon the behaviours of parts of the scientific community, including the role of peer review, conflicts of interest and the ownership and funding of professional journals. In turn, this can all be considered within national and international political and organisational contexts. ‘Big Pharma’ is also under scrutiny. This article seeks to explain the general nature of the potential threat posed by Big Pharma. It is not a new story. Indeed, it can be usefully discussed with the help of a 60 year-old Presidential address.
On September 5th, 2021, LBC radio host and commentator Maajid Nawaz drew an analogy from Dwight D. Eisenhower’s Farewell Address to the nation as 34th President of the United States on January 17th, 1961. Maajid Nawaz suggested that the threat to democratic society described by President Eisenhower of the ‘Military-Industrial Complex’ has, at least to some degree, been supplanted by a ‘Big Pharma Industrial Complex’. He also suggested that the behaviours of governments in pursuing Covid related policies, such as the vaccination of 12-15 year-olds and vaccine passports (hot topics across the U.K. over the weekend), could only be properly understood by, as he put it, “joining the dots”. He also noted the existence of a “revolving door” of former Government Ministers, MPs and unelected senior officials exiting public office into highly paid commercial positions with large pharmaceutical and similar companies. He suggested that there is, therefore, enormous scope for conflicts of interest to shape public policy in ways that are not to the advantage of the general population.
Maajid Nawaz is correct. It is often worth considering the perspective of a former U.S. President. Their unique position at the apex of both power and information can sometimes result in statements of timeless wisdom and insight. That is irrespective of their party and how we might personally feel about them and their record. President Eisenhower’s Farewell Address has stood the test of time more than most and it deserves attention now. It should be noted that Eisenhower’s Address was made only 16 years after the end of World War Two, at the height of the Cold War with the Soviet Union. It was not an easy time to be president. Despite 60 years having passed the Address still has the ability to send a shiver down the spine. If there was a modern political ‘prophecy’ we would not have wanted to come to pass it was Eisenhower’s. That it did not come true precisely in the manner feared by Eisenhower is ‘good’ but the way it has come true in the last 18 months is probably at least as bad.
The President declared:
Crises there will continue to be. In meeting them, whether foreign or domestic, great or small, there is a recurring temptation to feel that some spectacular and costly action could become the miraculous solution to all current difficulties.
In the context of the SARS-CoV-2 pandemic, the “miraculous solution” was ‘Lockdowns and Vaccines’. Eisenhower continued:
A huge increase in newer elements of our defense; development of unrealistic programs to cure every ill in agriculture; a dramatic expansion in basic and applied research – these and many other possibilities, each possibly promising in itself, may be suggested as the only way to the road we wish to travel.
Eisenhower’s experience as both Supreme Commander of Allied Forces in Europe and as President suggested that mono-solutions were typically hubristic and wrong. There are invariably several roads to choose from. It is for scientists to advise on the possible routes, but it is for politicians to ask questions and to choose the route – to decide what should be done. These are two entirely different things. Eisenhower clearly understood this.
Each proposal must be weighed in the light of a broader consideration: the need to maintain balance in and among national programs – balance between the private and the public economy, balance between cost and hoped for advantage – balance between the clearly necessary and the comfortably desirable; balance between our essential requirements as a nation and the duties imposed by the nation upon the individual; balance between actions of the moment and the national welfare of the future. Good judgment seeks balance and progress; lack of it eventually finds imbalance and frustration.
This could easily have been a useful script for rational governmening during the pandemic. In practice, it was not adopted. The Westminster Government and many others became focussed upon a single dominating issue which, in the absence of balance, let alone a costs-benefits analysis, distorted every element of the political, economic, cultural, health and educational well-being of the nation. No balance. No costs-benefits analysis. Whither “the national welfare of the future”?
Eisenhower was no slouch. As such he considered that the U.S. had hitherto “stood the test” but: “[…] Threats, new in kind or degree, constantly arise. I mention two only.” His “two” were that of the military-industrial complex and the less well known, but similarly important, long term observation that we “cannot mortgage the material assets of our grandchildren without risking the loss also of their political and spiritual heritage”.
The first threat arose because “we can no longer risk emergency improvisation of national defense; we have been compelled to create a permanent armaments industry of vast proportions”. As Maajid Nawaz implied by his reference to the Eisenhower Address, Big Pharma is similarly vast:
- “The global pharmaceuticals market is expected to grow from U.S. $1228.45 billion in 2020 to $1250.24 billion in 2021 at a compound annual growth rate (CAGR) of 1.8%.” Major companies include Pfizer, Hoffmann-La Roche; Johnson & Johnson, AstraZeneca, Novartis, GlaxoSmithKline, Bayer, Gilead, Merck and so on. “The market is expected to reach $1700.97 billion in 2025 at a CAGR of 8%.”(“Pharmaceuticals Global Market Report 2021: Covid Impact and Recovery to 2030” – ResearchAndMarkets.com – April 2021 cited here.) It is a large, fast growing sector.
- “[…] The global aerospace and defence market is estimated to be valued at U.S. $ 1,600 billion in the year 2025, growing at a CAGR of 3.5% in the period 2019 to 2025.” (“Global Aerospace & Defence Market [(By Region – North America (The U.S. and Mexico), Europe (The U.K., Germany and France) and Asia Pacific (Japan, China & India)] Outlook 2025” – ResearchAndMarkets.com – May 2020 cited here.) It is a large, but maybe not as fast growing, sector when compared to pharmaceuticals.
Just as Eisenhower could say back in 1961: “This conjunction of an immense military establishment and a large arms industry is new in the American experience.” We might say the same of Global Big Pharma. Eisenhower recognised the way in which the military-industrial complex operated: “The total influence – economic, political, even spiritual – is felt in every city, every State house, every office of the Federal government.” Lots of businesses, lots of employees, lots of shareholders (both individual and institutional), lots of lobbying and financing and funding makes influence inevitable. Eisenhower warned: “We recognise the imperative need for this development. Yet we must not fail to comprehend its grave implications. Our toil, resources and livelihood are all involved; so is the very structure of our society.” We should take careful note of his use of the word “grave”. That is this something that can place a nation in danger of serious harm. More specifically:
In the councils of government, we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military-industrial complex. The potential for the disastrous rise of misplaced power exists and will persist.
Once more we can see how this might easily occur in the context of Big Pharma, especially as the scientific and knowledge community is so clearly interlinked and operates both alongside and indeed within the responsibilities that modern Governments have taken on in the name of maintaining and improving public health – as broadly defined.
Eisenhower was clearly extremely concerned:
We must never let the weight of this combination endanger our liberties or democratic processes. We should take nothing for granted. Only an alert and knowledgeable citizenry can compel the proper meshing of the huge industrial and military machinery of defense with our peaceful methods and goals, so that security and liberty may prosper together.
We could easily rewrite this as a manifesto for a new movement or political manifesto in 2021:
We must never let the weight of this combination endanger our liberties or democratic processes. We should take nothing for granted. Only an alert and knowledgeable citizenry can compel the proper meshing of the huge Big Pharma machinery and Public Health with our democratic freedoms, so that health, security and liberty may prosper together.
In some ways we would appear to be “too late” given the expansion of overt and covert censorship (including self-censorship) which works against the development of a “knowledgeable citizenry”. And the Government already has a well-established, coercive and divisive, agenda relentlessly traveling towards its “miraculous solution”. But at least it provides a useful perspective. Optimistically: we might consider the miraculous solution (and the supposed end result of ‘safety’) to be a mirage which can ultimately be revealed as such – with the happy ending of ‘the Emperor has no clothes’. Pessimistically: the miraculous solution remains a mirage but compulsory travel towards it becomes, or is deliberately made, ever more difficult to resist. The Emperor does not need clothes – no small boys are allowed to attend the parade.
Eisenhower also noted in his Address that:
Research has become central; it also becomes more formalised, complex, and costly. A steadily increasing share is conducted for, by, or at the direction of, the Federal Government. Today, the solitary inventor, tinkering in his shop, has been overshadowed by task forces of scientists in laboratories and testing fields. In the same fashion, the free university, historically the fountainhead of free ideas and scientific discovery, has experienced a revolution in the conduct of research. Partly because of the huge costs involved, a government contract becomes virtually a substitute for intellectual curiosity. For every old blackboard, there are now hundreds of new electronic computers.
While there are exceptions, this observation can be summed up in practical terms as ‘funding is crucial’. Compromises will inevitably take place to obtain it and retain it. Just as the U.S. Government might always seek to fund a ‘defence application’ as opposed to a peaceful application of new technology in Eisenhower’s day, Big Pharma also has an agenda.
Maajid Nawaz referred to an interesting, and rather damning, piece of research in 2018 by Professor Mariana Mazzucato, Director of the UCL Institute for Innovation and Public Purpose. It was entitled “The People’s Prescription: Re-imagining health innovation to deliver public value“. That report found the process of developing drugs incentivised high prices and the delivery of short-term returns to shareholders. It did not, as a matter of course, adopt higher-risk long-term research into therapeutic advances into diseases such as tuberculosis. In fact, over half of recently (to 2018) approved drugs had little or no extra health care advantage. A cynic would suggest they were tweaks to create new drugs for wealthier markets. A cure for tuberculosis would probably not be particularly remunerative as the market would be far from wealthy. In short, the research suggested that Big Pharma had little genuine interest in improving public health in accordance with actual needs. They do however like to sell lots of drugs to people in rich countries. We should not forget that singular intent.
Pulling the strands of the story together, one comes to the most ominous and portentous part of Eisenhower’s speech:
The prospect of domination of the nation’s scholars by Federal employment, project allocations, and the power of money is ever-present and is gravely to be regarded. Yet, in holding scientific research and discovery in respect, as we should, we must also be alert to the equal and opposite danger that public policy could itself become the captive of a scientific-technological elite.
Anyone who has ‘joined the dots’, as Maajid Nawaz suggests we should, from the NIH under Dr. Fauci, allegedly helping to facilitate funding for ‘gain of function’ research on bat coronaviruses at the Wuhan Institute of Virology (making them more transmissible to and between humans) to the labelling of the lab leak hypothesis as a “conspiracy theory” in the Lancet, by a not entirely non-conflicted group of scientists, can see how dangerous this can be to freedom of thought. But as to our “public policy could itself become the captive of a scientific-technological elite”: surely not… our politicians make the public policy decisions so that could never happen… But given all the talk by them of ‘following the Science’ during the pandemic, it apparently has de facto captured public policy. However, this is an illusion as ‘the Science’ is always a bundle of debate. So actually, it appears to be rather more mutually convenient than just a win for the technocrats and Big Pharma. That is especially if we remind ourselves of that revolving door of job opportunities and of what happens when independent science heads in one direction only to meet a politically driven policy miracle heading in the other. The side-lining of the, previously followed, advice from the Joint Commission on Vaccination and Immunisation not to vaccinate 12-15 year-olds in England is a good case in point.
Eisenhower reminds us of something else the pandemic experience has illuminated:
It is the task of statesmanship to mold, to balance, and to integrate these and other forces, new and old, within the principles of our democratic system – ever aiming toward the supreme goals of our free society.
This our politicians, at least in the U.K., have arguably rather failed to do. If there are any statesmen or women in the room please can they make themselves known? It would be good if they could do it quickly. Our free society is being undermined daily, nudge by nudge, new restriction by new restriction, micro-pressure by micro-pressure – albeit naturally for our own safety. And as for our taking out a “mortgage [over] the material assets of our grandchildren” the Westminster Government has truly excelled: “U.K. general Government gross debt was £2,224.5 billion at the end of financial year ending March 2021, equivalent to 106.0% of gross domestic product.” The origin of the word ‘mortgage’ imports debt being likened to ‘the grip of death’. Leaving the last word to Eisenhower: “We want democracy to survive for all generations to come, not to become the insolvent phantom of tomorrow.”
Cephas Alain is the pseudonym of a retired lawyer.