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“We'll drink a drink, a drink
To Lily the Pink, the Pink, the Pink
The saviour of the human race
For she invented medicinal compounds
Most efficacious in every case
Mr. Freers, had sticky out ears
And it made him awfully shy
So they gave him medicinal compounds
Now he's learning how to fly”
Lily the Pink by The Scaffold
In this column we try to avoid the issues of personality that seem to bedevil even the most rational of commentators. We don't hate Mr Trump, Mr Biden, Mr Sunak or whatever-his-predecessor's-name-was – or anyone else for that matter. Maybe if we knew any of these people personally ...
Our focus here is the environment in which such people operate and how our proposed panocracy would avoid the same fate: falling under the control of the unelected, incompetent, voracious, ideological, narcissistic, sociopathic or psychopathic. It's not a list I would want to be on but many in public life seem to delight in being thought of this way. Indeed public life nowadays seems to be mainly about the interplay between these types.
I've been reading Robert F Kennedy Jr.'s book The Real Anthony Fauci. RFK's detailed and damning dissection of Dr. F.'s career reveals the kind of personality we have come to see heading up our major institutions and exerting huge influence over the running of our governments.
Having been inoculated against the horrors of Big Pharma malpractice by Ben Goldacre's mighty tome, Bad Pharma, I was largely prepared for the mischief that RFK Jr. reports.
See, all ye doubters, deniers and heretics - vaccination works!
Dr Anthony Fauci
Your attitude to Dr. F. depends partly on your attitude to drugs in general, partly on how you feel about the medical-industrial complex, and partly on your views on state agencies and institutions.
At one extreme, if you think that (prescription) drugs are the saviour of mankind then you're likely to believe that there should be a 'medicinal compound for every malady' and that Big Pharma is an efficient means to that end. Maybe you also think its acceptable, if undesirable, that there are casualties along the way to this noble end.
On the other hand you may have witnessed the adverse effects of pharmaceutical products on those you know and used to know, love and respect. This may have tempered your faith in the therapeutic efficacy of drugs and their pushers.
Whatever your views, you will have noticed that vast profits have been gleaned by certain big companies following the mass rollout of experimental medicinal compounds across the world under 'emergency authorisation'.
RFK's book examines the mechanisms by which such outcomes have become possible and at the heart of public health administration in the USA sits Dr. F.
After reading this, I confess a sneaking respect for Dr. F. If only a fraction of what RFK says about him is true then Dr. F. should have had his head impaled on a spike outside the Capitol long ago. The fact that he's still in post after all these years is testament to his machiavellian skill in manipulating people and situations.
He is of course not unique in this respect. I want to use Dr. F's example to illustrate what kind of pressures our institutions have been under, how they have in consequence failed us - and a few ways we might avoid this in future.
Relevance and Ritual Resignation
So let's examine a few of the ways people and institutions have been hoodwinked by this veritable NIAID Napoleon and bear in mind that this kind of thing goes on all the time not just in public health but in all public and corporate realms including the formerly venerable agencies and institutions of state.
As with all religious and quasi-religious institutions, public health has its high priests and each country has its own health supremo, archbishops, bishops, lay preachers and laity who are more or less committed to the cause. Thus the holy health emperor can pronounce upon elements of faith and be confident that his underlings and footsoldiers will do the right thing. In authentic religions, such encyclicals are considered by the faithful to be inspired by God; in other organisations, they are usually justified by appeals to 'scientific authority' or some similar quasi-religious artefact such as the NHS.
RFK characterises the National Institute of Allergy and Infectious Diseases (NIAID) as a 'sleepy, irrelevant agency' back in the 1970s at the time Dr. F. assumed control. The problem for NIAID was that it was essentially redundant. By the middle of the 20th century, infectious disease had been clobbered by the provision of efficient public services and social improvements. Clean water, efficient sewerage and nutritional improvements had improved life expectancy for white males in the US from 47 in 1900 to 68 (45%) in 1970 with even better improvements in other demographics.
The agency should have been disbanded or repurposed when it ran out of things to do, but it wasn't. Had NIAID been a commercial concern, it would have gone out of business.
So its first problem was long-term relevance.
NIAID initially addressed this by creating a solution to a problem that turned out not to be there. Perhaps unsurprisingly, it was a vaccine against 'swine flu'.
It was an early attempt to restore the agency's fading star by scaring the public and then racing in to save the day, like Mr Incredible.
President Ford himself was pictured in the Oval Office being vaccinated (we assume!).
Trouble was that the vaccine was a crock. It didn't confer long-term immunity and the inoculated suffered a high incidence of the neuropathic condition Guillain-Barre syndrome. And 'swine flu' turned out to be a damp squib anyway.
Does this ring any bells?
Almost no one died of the disease but plenty of folks succumbed to the cure. The agency itself survived when its director Dr Krause fell on his sword following this very public failure.
So the second problem is that the incompetence of a state department or agency can never be admitted. The solution is usually the public humiliation of the top bod by resignation or retirement. It's a kind of ritual atonement and for some reason, we always seem to be satisfied even though it does nothing to cure the systemic problems or redress the wrongs.
New Broom, New Threats
Following this debacle Dr. F. assumed control of NIAID. It could be said that Dr F. rescued NIAID. He certainly wasn't about to go the way of Dr Krause and, as Krause's sidekick, he'd learned a lot about how and how not to handle institutional failure. His Jesuit education had provided him with an arsenal of analytic tools which could serve his ambition, and a religious zeal for getting his own way. His religious principle appears to be 'a pill for every ill' so Big Pharma companies are his natural allies.
He also understood that Krause's invention of ramping up fear over a novel virus, although inspired, was just the foundation. In addition, you had to be able to manage the image of the agency you headed up so that it looked like it was doing a great job even when it was failing dismally. This was Dr. F.'s innovation and he worked the system relentlessly.
Dr F. well understood the rationale that new threats need to be invented to keep the show going. A menagerie of new viruses surfaced following his appointment, a new one every few years: AIDS, SARS, Bird Flu, MERS, Swine Flu (again), Dengue, Ebola, Zika and COVID-19.
Dr F. astutely manouvered his agency into the position of approving funding for AIDS research and this gave him enormous power over what was and wasn't done. AZT was a ‘wonder drug’ that had been abandoned by its discoverers for being too toxic. Its big advantages were (i) that it killed HIV virus in vitro and (ii) it was in patent (hence highly profitable). At that time, many practising doctors had evolved treatments for AIDS but alternative therapies were blocked by Dr. F.
The excuse was that no clinical trials had been done. What wasn't so clear was that Dr. F's agency had refused to fund clinical trials on anything except his pricey drug. After all, there can be only one explanation and treatment for any disease which is that it's due to a microbe which we experts in the medical-industrial complex will identify and exterminate. And what wouldn’t you pay for being disease free?
Bio-scientists dependent on public and big pharma funding watched this unfold and took notes for their future funding prospects.
Eventually, Dr F. got pally with Bill Gates the well known philanthropist and quite coincidentally Mr Gates' subsequent investments in vaccine companies paid off handsomely. Gates also provided funding for (the right kind of) research via the Bill and Melinda Gates Foundation – a charitable trust.
Now as the COVID-19 debacle unravels we can see again the tricks that have been refined over the years, and a few new ones that have been brought to bear. The capture of public research establishments and what science they undertake by selective funding, the capture of the media by advertising revenue, the capture of the political system by self-declared authority, the selective cancellation of those who question the 'scientific consensus' aka 'the science'.
The take-home message from the repetition of these drug disasters is that they're going to happen again and again.
Doctors bury their mistakes, as the saying goes, and no doctor is better at that than Dr. F.
How can we finally bury Caesar?
History is very much concerned with the ambitious psychopath: the individual who acquires and hangs on to power and influence by any means. Even though they always declare themselves to be benign, a war has raged forever amongst such people with the man in the street being cannon fodder for their campaigns.
We don't have politicians in our panocracy so that will eliminate one important source of chicanery, incompetence and hubris. We do expect still to have institutions and many of them will have similar roles to those we have now. Even given our rules how do we avoid capture of our future institutions by ambitious demagogues like Dr F.?
We have few tools at our disposal - like the requirement for agency openness. If the details of Dr F's cosy relationship with Mr Gates or his machinations over AZT were open to searching and continuous inspection as they would be under a panocracy, where agency and institutional employees are required to make public their communications and outside interests, then much of what has happened would have been exposed before millions lost their health, their livelihoods, their homes or even their lives.
It's hard to imagine that someone as clever as Dr F. wouldn't find a way round the legal procedures and sanctions so we must think of how to organise things so he wouldn't even try.
Unfortunately, the kind of individual that our cultural ecosystem has come to value is the two-faced, avaricious, attention-seeking, manipulative technocrat typified by Dr. F. We dote on such people and our media are full of them. We look to them as natural leaders and they're more than happy to accept the accolades.
The elephant in the room is of course money and power (it has two heads). If an ambitious young sociopath saw that it wasn't worth his while working in public service then he'd go elsewhere. In a panocracy, the voters, and not some malleable Minister of State, have control over the budgets and so we might expect the purse strings to be under continuous and intense scrutiny. A fledgling technocrat probably couldn't see any opportunities for world domination there.
Aha! I hear you say, won't that mean that our institutions will be staffed with the dimwitted and the unambitious and thus be ineffective? Well, they'll be ineffective at controlling us. That's a different thing from being ineffective at whatever function they are tasked with. The rules and regulations they will follow will need dogged persistence rather than novel political contrivances. There are plenty of effective people out there who never had an original thought in their lives.
I suggest that some dogged dimwittedness in the right places would be better for us all.