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COVID-19 Planning: Is It Time to Nationalize Big Pharma?

Photograph by Nathaniel St. Clair

Pharmaceutical corporations make billions providing drugs to help improve some people’s lives, in much the same way that privately-run hospitals provide care to those who can afford to pay. But Big Pharma is not a caring industry. Big Pharma has done some truly despicable things over the past hundred years or so. This is why Big Pharma and the management of our health should not remain in the hands of huge corporations. It is high time that we bring vital private health industries under democratic public ownership. This is the only way to remove the perverse financial incentives that places profit before human need.

Of course, Big Pharma and their political enablers would like us all to believe that they should have even more power over our health services. This essay therefore aims to put the lie to this self-serving propaganda. It will do so by initially bursting the bubble on the ways that Big Pharma PR to deflect attention away from its profiteering through propaganda work. It will debunk some of the nonsense surrounding the ostensibly humanitarian actions undertaken by two corporate giants meddling in the politics of global health: the first is the world’s largest vaccines company, GlaxoSmithKline (GSK), which happens to be the only pharmaceutical giant that has committed to making any COVID-19 vaccine that they develop “affordable” for all. The second is the Bill and Melinda Gates Foundation, a non-profit corporation which is controlled by Bill Gates — a philanthropist whose personal wealth has, with the help of tax loopholes, doubled over the past decade. By examining the activities of these two corporations in relation to health profiteering both before and during this ongoing pandemic, this essay will prove beyond all reasonable doubt that there is no reason to be optimistic that corporations can be trusted to promote the best interests of humanity.

Selling Big Pharma: The Good Ship “SS Hope”

Big Pharma’s flagrant disregard for human life has already been the subject of many exposés. Yet the only thing that really seems to improve is the industry’s ability to funnel record-breaking sums of money into the pockets of politicians, doctors, regulatory agencies, and journalists to help them flog their often dangerous and many times unnecessary pharmaceutical wares. To be generous to all involved, the unhealthy fixation with using propaganda to shield Big Pharma’s activities from democratic scrutiny rather than addressing inadequacies is hardly new. Take for example, the late 1950s when psychological warfare experts enlisted the support of Big Pharma and the weapons industry in donating medical supplies to the globe’s poor. Project HOPE was the name given to this enterprise and the bulk of their work was undertaken in public by Dr William Walsh, a medical doctor, but other better known voices involved included C.D. Jackson (an executive vice president at the Time-Life Corporation and a former psychological warfare advisor to President Eisenhower), Frank Pace, Jr., (the president of defense contractor General Dynamics), John T. Connor, (the president of pharmaceutical giant Merck & Company), and George Meany (the right-wing head of the AFL-CIO).

With Big Pharma stumping up medical supplies and much more beside, the long voyage of SS Hope – the converted war ship delivering all this aid for Project HOPE — was a propaganda coup par excellence for the US national security state. Moreover, its aid efforts were aimed not just at winning the hearts and minds of foreign subjects, but also the domestic audience too. The domestic element of this strategy eventually paid handsome dividends in projecting the pharmaceutical industry from the regulatory gaze of the state. In lieu of any meaningful democratic reform of the pharmaceutical industry, actual change has been supplanted by ‘hope’ for change. ‘Hope’ provides a critical weapon in the industries ongoing efforts to divert public attention their systemic profiteering. Thus, Project HOPE is still busily promoting their novel brand of medical diplomacy across the world; and even before the coronavirus pandemic burst forth from Wuhan they were proud of their longstanding humanitarian operations covering the world which even included their having a base in this fateful city. Although Project HOPE are controversially still funded by weapons manufacturers like General Dynamics, their board room now only has room for representatives of Big Pharma: current dignitaries serving in this capacity includes Merck’s current CEO (Richard Clark), the former CEO of GlaxoSmithKline (Charles Sanders), and two representatives from Quest Diagnostics – the company that was involved with the ongoing cervical smear scandal in Ireland.

 Putting GlaxoSmithKline on Trial

One key question that should be at the forefront of any discussion of the health outcomes promoted by GlaxoSmithKline (GSK) is whether they have been involved in any activities that may be construed as endangering public health. And on this issue you don’t have to look too far to find evidence of wrongdoing. Earlier this year it was reported that the European Court of Justice had decided to support a disputed decision made by the UK’s Competition and Markets Authority that fined the drug-maker £37.6 million. As the article in the Financial Times noted, the Court “found that the pay-for-delay deals had deprived the NHS of significant price reductions, after the average price of a GSK drug dropped by 70 per cent over two years after independent generics were introduced to the market.” (Pay-for-day referring to the practice of paying off rival companies to prevent them launching cheaper copycat versions of drugs after their patent expires.)

In other news, last year GSK was implicated in a tax scandal in the UK; while earlier in the year another article in the Financial Times pointed out how the UK Serious Fraud Office had “closed its investigations” into GSK which the paper observed only sought to highlight the Office’s inability (rather unwillingness) “to prosecute individuals whose companies have been linked to criminal activity.” This political decision to offer a reprieve to the company is a itself a crime as the Fraud Office had initially opened its criminal investigation into GSK shortly after the Chinese authorities had accused GSK of earning hundreds of millions of pounds “in ‘illegal revenues’ by bribing hospitals and officials to buy its medicines.” These criminal actions in China led to £300 million fine; while GSK’s CEO Sir Andrew Witty of six years standing was slapped on his wrists too and had “his total pay temporarily cut almost in half (to £3.89 million). Making matters worse instead of listening to their employee who blew the whistle about GSK’s involvement in bribery, the company’s immediate response was to attack the whistleblower and to dismiss the allegations as an unfounded “smear campaign.”

Crime seems to pay, or at best goes barely punished; and certainly few positive lessons were being learnt at GSK as, just two years prior to the Chinese scandal, GSK had to pay $3 billion “in fines for promoting its best-selling antidepressants for unapproved uses and failing to report safety data about a top diabetes drug”. This was, and still is, the largest fine of its kind in US history. As the New York Times states:

“Prosecutors said the company had tried to win over doctors by paying for trips to Jamaica and Bermuda, as well as spa treatments and hunting excursions. In the case of Paxil, prosecutors claim GlaxoSmithKline employed several tactics aimed at promoting the use of the drug in children, including helping to publish a medical journal article that misreported data from a clinical trial.

“A warning was later added to the drug that Paxil, like other antidepressants, might increase the risk of suicidal thoughts in teenagers. Prosecutors said the company had marketed Wellbutrin for conditions like weight loss and sexual dysfunction when it was approved only to treat major depressive disorder.

“They said that in the case of Avandia, whose use was severely restricted in 2010 after it was linked to heart risks, the company had failed to report data from studies detailing the safety risks to the F.D.A.”

As the press explained at the time, GSK chief executive Sir Andrew Witty desperately “sought to portray the illegal actions as part of the company’s past.” Reporters also noted that despite the size of the fine GSK would be unlikely to amend their ways because it was well understood that the billions in profits derived from their illegal activities far exceeded the size of their fine.

As another illustration of the way that GSK’s corporate executives who overeee such criminal activities seem to be rewarded not punished we might take the related example of Tachi Yamada, who between 1999 and 2006 served as the chairman of Research and Development at GSK. In 2006 Yamada then became a senior advisor to a private equity firm (Frazier Healthcare) and was headhunted to become the President of Global Health Programs for the Gates Foundation. But his past GSK misdemeanours followed Yamuda to the Gates Foundation and within a year of starting work at the philanthropic foundation a US Senate Report highlighted how the esteemed scientist had acted to silence a renowned diabetes researcher for daring to suggest that users of GSK’s highly profitable diabetes drug (Avandia) had a high risk of heart disease. Jacob Stegenga, the author of Medical Nihilism (Oxford University Press, 2018) summarises this sickening episode in this way:

“When secrecy of evidence about harms of medical interventions is threatened by vigilant researchers, manufacturers can respond belligerently. Rosiglitazone [trade name Avandia], again, provides a good illustration. John Buse, a diabetes researcher, gave two talks arguing that rosiglitazone may have cardiovascular risks. GlaxoSmithKline executed an orchestrated campaign to silence him. This plan appears to have been initiated by the company’s head of research [Tachi Yamada], and even the chief executive officer was aware of it. The company referred to Buse as the ‘Avandia Renegade,’ and in contact with Buse and his department chair there were threats of lawsuits. Buse responded to the company with a letter that asked them to ‘call off the dogs.’ Later Buse expressed embarrassment that he caved in to the pressure of GlaxoSmithKline. By 2007, the year that Nissen’s metaanalysis was published, the FDA [US Food and Drug Administration] estimated that rosiglitazone had caused about 83,000 heart attacks since coming on the market in 1999.” (p.149)

Thankfully Buse’s scientific career was not entirely derailed by this smear campaign, and in 2008 he was elected to serve as the President of the American Diabetes Association. Justice however was still some way off, and it would not be until July 2010 that an FDA advisory committee to finally take concrete action based upon Buse’s early warnings wherein they recommended “a recall” of Avandia and placed severe restrictions on its availability.

Just a few months later GSK made the news again (for all the wrong reasons) when it had to pay the US government $750 million “to settle civil and criminal charges that it manufactured and sold adulterated drug products.” Afterwards, in another case revolving around an issue first raised in 2012, in 2016 a former GSK biostatistics manager took the decision to file a whistleblower lawsuit “accusing the drug maker of firing him for alleging dodgy study data was used to tout the effectiveness of a smoking-cessation product.” While in 2018 it was reported that a former GSK sales representative in India had initiated legal action against the company after being sacked for trying to expose the culture of bullying and bribery. Therefore, considering all the problems that GSK has encountered with following any form of regulatory guidance, they were probably relieved when Dr Jesse Goodman, the former Chief Scientist for the US Food and Drug Administration (2009-2014) resigned from his position of authority at the FDA so he could join GSK’s illustrious board of directors.

 Pharma Philanthropy?

In the turbulent world of Big Pharma, chief executives are changed as often as corporations face public crises of democratic accountability. But the one thing that always remains the same is their relentless pursuit of profits. In 2017 Sir Andrew Witty vacated his position at the head of GSK after nine years’ service (at the time drawing an annual salary £6.7 million) to be replaced by Emma Walmsley, who only last December joined the board of directors of the Microsoft Corporation. Witty was subsequently shunted sideways into another industry, which runs parallel to Big Pharma, private health. Witty became the President of America’s largest health insurer, UnitedHealth Group. This gargantuan insurer is the former employer of Britain’s arch-health privatiser-in-chief Simon Stevens — the current CEO of the National Health Service (NHS). With the pandemic now upon us, last month Witty was granted a leave of absence from UnitedHealth so he could join the World Health Organization’s (WHO) ongoing efforts to develop a vaccine for COVID-19.

While it is true that the largely US-funded WHO always had the potential to help coordinate an international response to this deadly pandemic, Witty’s secondment to their ranks merely emphasizes the organizations increasing reliance on Big Pharma. One of the most notable individuals steering the agenda of the WHO in recent years has been Bill Gates — a man who first linked up with Witty and Tachi Yamada in 2008-09 to combat neglected tropical diseases in the poorest parts of the world. Yet as the poor already know, humanitarian efforts, when driven by the pay checks of the tax-avoiding super-rich like Gates rarely end up serving the interests of the working-class.

The collaboration between the Gates Foundation and Big Pharma was initiated in 2009 when the foundation organized a project to “study the cost and feasibility of incorporating HPV vaccines, produced by Merck and GlaxoSmithKline, into India’s public sector immunisation programme.” However, the trial which set about vaccinating 14,000 adolescent girls from poor families soon ran into trouble when seven of the girls died shortly after receiving the vaccine. In all likelihood the vaccine was not the cause of these deaths, but the ensuing public anger led to a formal investigation which did reveal a rather dark side to the whole affair. In 2013 the Financial Times reported:

“In August, an Indian parliamentary committee set up to probe the issue concluded the PATH [Program for Appropriate Technology in Health] project was a clinical trial in all but name and that the organization had used ‘subterfuge’ to avoid the ‘arduous and strictly regulated process’ of such a trial.

“The committee report said many of the girls’ consent forms had apparently been signed by school principals and hostel wardens, and expressed scepticism that the girls’ parents were fully briefed on the pros and cons.

“The committee also found there was no rigorous process to track adverse events, leading to ‘gross underreporting’. It came down hard on Indian government agencies for alleged dereliction of duty.”

The parliamentary committee made the additional claim that GSK were lining their own corporate pockets with their so-called aid. They explained that the “sole aim” of the project had been “to promote the commercial interests of HPV vaccine manufacturers, who would have reaped windfall profits had PATH been successful in getting the HPV vaccine included” in India’s immunisation protocols. Linsey McGoey, author of No Such Thing as a Free Gift: The Gates Foundation and the Price of Philanthropy (Verso, 2015), argues that the “most alarming” aspect of this so-called trial was that the overseers’ of the Foundation project “did not implement any system for recording major adverse reactions to the vaccines,… something legally mandated for large-scale clinical trials.”

As this controversy was raging in India, local non-profits like the All India Drug Action Network made useful political interventions into the intense public debate. In 2010, the Network said that, in addition to the aforementioned ethical concerns, the one issue that was regularly ignored was the importance of promoting cervical cancer screening which “is almost non-existent in India.” To make matters worse, in 2018 the Network also explained that there is still “a lack of evidence” that the HPV vaccine “is effective and cost-efficient.” Yet despite that fact that the importance of screening is well understood, many health activists are concerned that there is a worrying decrease in its use (this includes in the UK). This needs to change, and even Dr Vivien Tsu, the Director of PATH’s controversial HPV vaccine project now emphasises the need for more screening. In fact only last year Dr Tse co-authored an academic paper (financed by the Gates Foundation) that determined “that immediate implementation of HPV testing has the potential to save the lives of hundreds of thousands of women in India who are beyond the target age of HPV vaccination”.

But even on the fairly uncontroversial issue of promoting cervical smears in India, US-based agencies (including the Gates Foundation) managed to undermine scientific protocols and public trust again. Thus, screening research undertaken in India between 1998 and 2015 resulted in the unnecessary sacrifice of 254 women’s lives because research agencies “exploited local regulatory weaknesses and economic and social inequities” in a process that has been referred to as “ethics dumping”. This meant that “effective methods of screening for cervical cancer were therefore withheld from 141,000 women in areas where it was known to be of high incidence and prevalence.” The sickening nature of this systemic exploitation are sadly nothing new. In her 2006 book The Body Hunters: Testing New Drugs on the World’s Poorest, Sonia Shah wrote that given all the incentives that the Indian government has made for foreign investors…

“…the potential for abuse of research subjects in India appears nearly unlimited. But if in the past government officials tolerated ethical lapses because most experimentation was oriented toward public health goals, no such trade-off exists today, for the modern body hunt in India proceeds by the logic not of public health but the profit-driven needs of distant drug companies.”

The ongoing HPV debacle in India is not the first time that corporate powerbrokers have tried to force their ‘help’ upon the poor, but it has had lasting effects upon many people’s faith in both Big Pharma and in vaccines more generally. In this regard, it is understandable that billions of people across the world have little trust in huge corporations to look after their health needs. This is why it is so vital that socialists continue to raise the popular demand that the powerful and largely unaccountable corporations that dominate our health landscape be nationalised and run under democratic control by the workers themselves. This is critically important because fear of vaccines is dangerous for us all, as vaccines represent a critical health intervention that, despite the rampant profiteering on the part of corrupt elites, continues to serve the needs of the majority of humanity. So, when Big Pharma persist in subverting democratic norms by failing to develop drugs in an open and transparent manner they are damaging trust in medicines. It is clear that we must take away their monopoly powers over the life-saving vaccines that we do need.

One of the most insightful writers on the philanthropic abuses of Bill Gates in India is the Mumbai-based journalist Sandhya Srinivasan. She has written eloquently about the Gates Foundations scandalous involvement in all manner of interventions from the HPV nightmare through to their Malthusian-inspired efforts to regulate the fertility of the poor. Writing in 2014 she states that the Gates Foundation’s aim in India is…

“…to install a public health model driven by private corporations, and revolving around the use of privately-owned technological interventions, a ‘magic bullet’ for each disease. While such a model is incapable of delivering public health, it is geared to deliver a private profit.”

As history shows, pharmaceutical companies have a reputation for burying awkward results from clinical trials on drugs which show harm to human life. In a sane world clinical trials would be conducted by scientists who are financially independent from pharmaceutical corporations. This is rarely the case. Independent scientists of course continue to do their best at critically scrutinizing all available research (although much remains hidden by corporations) to make evidence-based recommendations as to the efficacy of various drugs and treatments. Often-times this leads to sharp disagreement and debates, and an important example of this is provided by recent meta-analyses of the health effects of the HPV vaccine.

On one side of this ongoing controversy are HPV vaccine advocates, many of whom work closely with the very corporations and foundations (GSK, Merck, and Gates) that seek to continue expanding the global use of the vaccine. While on the other side we have independent scientists, who have drawn attention to serious shortcomings in the manner in which the decision was made to roll-out HPV vaccines; and in doing so highlight the fact that their meta-analyses of HPV trials raise serious concerns about adverse health impacts associated with HPV vaccines. With billions of dollars of profits at stake, the unfortunate response to these reasonable if challenging questions about HPV vaccines has been to attack the messenger. This has involved launching a witch hunt against HPV critics which, amongst other things, has involved accusing critical scientists of being anti-vaxxers. Such smears are about as far from the truth as one can get. (For more on this read Peter Gøtzsche’s incisive book Vaccines: Truth, Lies and Controversy.)

 Viral Profiteering: How Disease Breeds Greed

Profiteering takes many forms but perhaps the most despicable of all is pandemic profiteering, and getting to the root of the history of this matter is more important than ever. In an opinion piece for the New York Times Gerald Posner, the author of Pharma: Greed, Lies and the Poisoning of America (Simon & Schuster, 2020), reminds us how profits trumped human need during the 1976 swine flu outbreak. He explains how for “several months, four drug firms — Merck’s Sharp & Dohme, Merrell, Wyeth, and Parke-Davis — refused to sell to the government the 100 million [vaccine] doses they had manufactured until they got full liability indemnity and a guaranteed profit.” This wouldn’t be the first or last time that profiteering obscured access to life-saving drugs.

The story of the anti-viral drug Oseltamivir (known as Tamiflu), a treatment that is still reaping millions for Big Pharma despite the fact that it was initially developed (as often is the case) by public researchers at the expense of ordinary taxpayers, is also revealing. Tamiflu profits keep flowing even though the considered evidence suggests that the anti-viral is next to useless. Tamiflu is the brand name drug produced by Roche and Gilead Sciences. The other related anti-viral that is manufactured by GSK to combat flu symptoms is Zanamirvir (brand name Relenza), and it too does next to nothing except make huge sales. The release of both drugs for sale is mired in controversy. As Sid Wolfe and his coauthors noted in their book Worst Pills, Best Pills: A Consumer’s Guide to Avoiding Drug-Induced Death or Illness (Pocket Books, 2005):

“Zanamirvir was reviewed by the FDA’s Antiviral Drug Advisory Committee on February 24, 1999. This committee of 17 outside experts was asked by the FDA: ‘Does the information presented by the applicant [Glaxo Wellcome] support the safety and effectiveness of zanamirvir for treatment of influenza?’ The committee voted 13 to 4 that it did not.” (p.755)

This democratic and evidence-based decision did not please GSK profit-makers who immediately dispatched a furious and threatening letter to the FDA, who then capitulated to the pharma bully and approved the useless drug. The seventeen-page letter that had such a dramatic impact upon the FDA was written by James Palmer (who after 2000 assumed the position of GSK’s second in charge of Research and Development working under Tachi Yamada). In his warning Palmer made it clear that refusal to approve zanamirvir would endanger global efforts to stockpile drugs needed to respond to a future pandemic. Thus, as a direct result of this letter the lead biostatistician who oversaw the FDA’s independent review, Michael Elashoff, was removed from his duties. Soon after this shameful episode the FDA decided to neglect organizing an independent scientific review of Tamiflu and simply approved it for use. Of course like zanamirvir there was never any “convincing evidence that Tamiflu prevents influenza complications or reduces the spread of influenza to other people.” On the contrary, as the Director of Emergency Care Research at the US National Institutes of Health states: “Tamiflu often gives you some of the very symptoms you are trying to relieve, and at best will shorten your misery from influenza by a day.” Little wonder that many people remain unconvinced by the sincerity of Big Pharma’s efforts to help those other than their shareholders, especially during times of global crisis. This dire situation is aptly summed up by Peter Gøtzsche who notes:

“During the ten years leading up to WHO’s pandemic declaration of 2009, scientists associated with the companies that were to profit from the WHO’s ‘pandemic preparedness’ programmes, including Roche and GlaxoSmithKline, were involved at virtually every stage of the development of those programs. Roy Anderson, a prominent British epidemiologist and adviser to both the WHO and the UK government, gravely warned a BBC radio audience [in May 2009] that only Relenza and Tamiflu would prevent a catastrophe on the scale of the 1918 influenza pandemic. At the time, Anderson was receiving £116,000 per year from GlaxoSmithKline, manufacturer of Relenza. By declaring a pandemic and linking the response to Tamiflu stockpiling, the WHO could not have done a better job of promoting Roche’s interests.”

In fact, Sir Roy Anderson had joined GSK board of directors in October 2007 and remained there until May 2018.

Pandemic UN-Preparation in the UK and US

When it comes to the huge pharmaceutical corporations that dominate the world of “Big Pharma organized crime” we should not be too surprised to find their dirty fingers dug deep within the public health sector. The British government’s Chief Scientific Adviser, Sir Patrick Vallance, who prior to taking up this prestigious appointment had been a President of Research and Development at GSK, is a case in point. Another high-profile individual overseeing the Tories pandemic ‘response’ is Jonathan Van-Tam who previously held senior positions at GSK, Roche, and Aventis Pasteur. Currently he is the UK’s Deputy Chief Medical Officer for England. This is the same individual who acted as the chair of the government’s New and Emerging Respiratory Virus Threat Advisory Group (NERVTAG) that oversaw “Exercise Cygnus” in late 2016. Exercise Cygnus was the pandemic-training exercise that demonstrated to the world that the NHS was totally unprepared for any future pandemic. As the Daily Telegraph revealed: “Minutes from a NERVTAG meeting held in the wake of Cygnus show that Dr Van Tam agreed to write to the Department of Health to repeat the committee’s concerns over the NHS stockpile of personal protective equipment.” But surprise, surprise, it turns out that this advice was never acted upon. In reality, Exercise Cygnus was undertaken specifically to demonstrate how well our health services “would cope with a major influenza outbreak with a maximum national death toll of 500,000.” This is exactly the situation we are facing today.

Ultimately, however, the underlying reason why the British government was so ill-prepared for this pandemic is because the Tories initial ‘response’ was to sacrifice hundreds of thousands of people’s lives through the so-called ‘herd immunity’ strategy. In many respects this implicit tolerance of mass mortalities is a central part of any privatised health care system: those who are wealthy enough and can afford treatment and those who can’t… well, they die. This was emphasised in an article published in the New Statesman which stated that the British government’s “planning documents – which date from 2005 to 2018 but are mainly based on the 2011 ‘Influenza Preparedness Strategy’ – suggest that Britain may in fact have been prepared, just for the wrong outcome.” That is, the Tories were wholly reliant on the initial plans first devised disgracefully by New Labour, plans which only ever planned to “mitigate rather than suppress” the impact of any pandemic.

Gates to the Rescue?

In contrast to almost all governments across the world, which failed to prepare for the type of pandemics they knew were just around the corner, in January 2017 a new group was formed in a last ditch attempt to overcome these serious problems. This was an initiative launched at an annual meeting of billionaires at the World Economic Forum in Davos which was called the Coalition for Epidemic Preparedness Innovations (CEPI). Early founders included the governments of Norway and India, the Gates Foundation and the Wellcome Trust. The billionaires present at Davos however weren’t so keen to part with their own wealth, and by December 2018 CEPI were still $250 million short of their initial $1 billion funding target. It seems unlikely that capitalists will ever act to protect the public good: with a pandemic now in full deadly affect CEPI is still short of money — although last month they received a $150 million boost from the Kingdom of Saudi Arabia, a country which is still pursuing a war on Yemen with the active support of the British government.

As it turns out CEPI’s founders were fully aware of the difficulties of getting capitalists to plan to prevent mass fatalities, and at its launch, Sir Jeremy Farrar (the head of the Wellcome Trust)[19] stated that

“…there has not been until CEPI came along, not been an ability to take those things forward when there’s no commercial drive, when there’s no market incentives, when there is no way of selling that, of making a profit. And the Coalition is determined to change that, to make sure that we have vaccines for everything that we are going to need.”

Three years later, on March 30, 2020, leading members of CEPI published a report in the New England Journal of Medicine concluding that: “A global financing system [that CEPI aims to be] that supports end-to-end development and large-scale manufacturing and deployment, ensures fair allocation, and protects private-sector partners from significant financial losses will be a critical component of future pandemic preparedness.” The stand-out part of this statement emphasized the protection of corporations from financial losses. This is a fitting priority given that the lead author of this article (Nicole Lurie) is married to the former FDA boss turned current GSK board member Jesse Goodman. Thus, considering CEPI’s professed ambitions it is appropriate that GSK’s former President of Global Vaccines is a Strategic Advisor to CEPI’s CEO. Further illustrating the pernicious way in which Big Pharma’s interests weigh heavily upon CEPI’s potentially useful activities, in late 2018 Medecins Sans Frontieres pulled out of the Coalition citing concerns that it’s revised policy “no longer guarantees that the vaccines CEPI funds will be made available at an affordable price.”

In the US context, pandemic preparedness has, like in Britain, a nearly non-existent priority in government circles. “Crimson Contagion” was the code-name for President Trump’s pandemic preparation project which was carried last year and was overseen by longstanding corporate lobbyist Robert Kadlec, an individual who presently serves as the US Assistant Secretary for Preparedness and Response. Like in Britain the results of this secretive training exercise “drove home just how underfunded, underprepared and uncoordinated the federal government would be for a life-or-death battle with a virus for which no treatment existed.” Unsurprisingly, nothing was done to address this problem. Kadlec once worked closely with current CEPI board member Rajeev Venkayya in drafting the government’s 2006 Pandemic and All-Hazards Preparedness Act – a relationship that developed while Kadlec was serving as the Director for biodefense on the Homeland Security Council.

Like other Big Pharma executives, Rajeev Venkayya is well immersed in the controversies swirling around powerful vaccine manufacturers. Thus, after working on biodefense issues for the US government he became the head of vaccine delivery projects at the Gates Foundation (where he worked under Tachi Yamada), and then moved on to employment at Takeda Pharmaceutical – Japan’s largest drug manufacturer. Takeda has not been immune from the lurid crime of health profiteering. In April 2014 they made international headlines when a $9 billion fine for punitive damages was levied against Takeda and Eli Lilly “for concealing possible health risks linked to their blockbuster diabetes drug Actos.” So, when Christophe Weber, Takeda’s new CEO arrived in post at exactly this moment of global notoriety, he drew upon his years of experience in leading executive positions at GSK. Later that same year celebrated his first success when it was announced that the proposed $9 billion fine had been reduced to a paltry $36.8 million!

That profit-seeking individuals like Venkayya can flit so easily between the shadowy world of the national security state, foundations, and Big Pharma is disturbing, but especially so for conservative conspiracy theorists. But there is no conspiracy at work, as in each instance we should appreciate that such revolving doorways exist precisely because their abiding interests remain the same. All are united in their promotion of capitalist interests at the expense of human life. This helps explain why President Obama’s chose Sylvia Mathews Burwell, a former President of the Gates Foundation’s Global Development Program to serve as the US Secretary of Health and Human Services. Burwell is a millionaire, who after her tenure in this high-ranking government position then joined the board room of one of America’s leading health insurers (GuideWell Mutual Holding Corporation) where she remains to this day.

Whether Democrats or Republicans the one thing that unites them is the profit motive, and so on the other end of the corporate political spectrum we might look at one of Burwell’s Republican forerunners, Tommy Thompson, who served as the US Secretary of Health and Human Services (holding this post between 2001 and 2005) under President George W. Bush’s administration. A focus upon Thompson is interesting in the context of the current crisis because when he retired he freely admitted that what worried him most was the threat posed by a human flu pandemic which, as he put it, could take the lives of up to 70 million people. “This is a really huge bomb that could adversely impact on the health of the world,” he said at the time. Yet on his watch, which overlapped and oversaw the biodefense efforts undertaken by Venkayya and Kadlec, his department…

“…and the Pentagon spent $14.5 billion to safeguard national security against largely hypothetical biological threats like smallpox and anthrax, even as they pursued a penny-pinching strategy to deal with the most dangerous and likely ‘bioterrorist’: avian influenza. The administration’s lackadaisical response to the pandemic threat (despite Secretary Thompson’s personal anxiety) is only the tip of the iceberg. Over the last generation, writes Lancet editor Richard Horton, ‘The U.S. public-health system has been slowly and quietly falling apart.’”

This was the opinion of socialist historian Mike Davis, author of The Monster at Our Door: The Global Threat of Avian Flu (The New Press, 2005), who went on to add:

“Under Democrats as well as Republicans, Washington has looked the other way as local health departments have lost funding and crucial hospital surge capacity has been eroded in the wake of the HMO [Health Maintenance Organization] revolution. (A sobering 2004 Government Accounting Office [GAO] report confirmed that “no state is fully prepared to respond to a major public-health threat.”) The federal government also has refused to address the growing lack of new vaccines and antibiotics caused by the pharmaceutical industry’s withdrawal from sectors judged to be insufficiently profitable; moreover, revolutionary breakthroughs in vaccine design and manufacturing technology have languished due to lack of sponsorship by either the government or the drug industry.”

So, the current healthcare problems facing the world were hardly unexpected; instead they were planned for by a dangerous economic system that is only programmed to care for its own profits.

 Pandemic Self-Care and the Fight for Democracy

Although this essay has only touched upon the full extent of the criminal corporate profiteering that takes place under the guise of delivering health care for all, what should be apparent is that this cannot be allowed to continue. Time and time again corporations have been found guilty of the most heinous of crimes, and capitalist politicians of all flavours have been sedated by their gifts and soothing assurances that they have amended their bad old ways. Big Pharma have had their chances to change and they have failed.

In the early 1980s, John Braithwaite undertook the task of interviewing scores of the most powerful executives in the pharmaceutical industry and therein gave the world a horrifying insider’s view of the world of Big Pharma. This exhaustive research led to a book titled Corporate Crime in the Pharmaceutical Industry, which documented the “abominable harm which group decision-making in the pharmaceutical industry has caused on many occasions.” Yet although it is enlightening to explore the specific wrongdoings of corporate leaders it is vital that we delve below the level of such superficial symptoms so we can understand the underlying causes of such destructive practices. Braithwaite therefore observes that…

“… most corporate crimes in the pharmaceutical industry cannot be explained by the perverse personalities of their perpetrators. One must question the proclivity in an individualistic culture to locate the source of evil deeds in evil people. Instead we should ‘pay attention to the factors that lead ordinary men to do extraordinary things’. Rather than think of corporate actors as individual personalities, they should be viewed as actors who assume certain roles. The requirements of these roles are defined by the organization, not by the actor’s personality.” (p.2)

The required cure which flows from such a systemic view of corporate crime is that the political and economic system itself must be changed, although it wouldn’t hurt if a few of the worst perpetrators of the pharmaceutical atrocities against humanity were punished too. Ultimately this must involve eradicating capitalism (to use a medical term) and replacing it with a democratic and socialist alternative.

But in order to prepare the way for achieving such revolutionary goals we must demand immediate reforms that can inoculate our body politic from the draining depredations of Big Pharma. A pandemic continues to wreak havoc across our planet, and under no circumstances can the proponents of Big Pharma be allowed to continue with business-as-usual. We urgently need a health system that can meet the needs of the global working-class and that cannot be delivered by the status quo. This means we must organize to seize control of Big Pharma’s assets so that their potentially life-enhancing knowledge and resources can be turned to the immediate goal of serving real human needs. Corporations must be democratically run by workers for workers, a process which will need to expend to other industries too. This will be a difficult task and in many situations will require the construction of new and democratic mass organizations of the working-class, but if we are to learn anything from this pandemic then it must be that the only people who are capable and willing of steering us through this current crises will be ourselves, the global working-class.

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Michael Barker is the author of Under the Mask of Philanthropy (2017).

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