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Dr Mike Yeadon's avatar

Dear Ben, you’re absolutely correct. Like you, I observed what I called The Dirty Snowball gobble up larger and larger pharmaceutical companies through the first two thirds of my career (late 1980s to mid noughties) to the point that few, very large corporations dominated the world.

We joked that it was one of the many industries in which you could work for four different companies without leaving your office.

Size was always the ostensible motive, because R&D was becoming more and more expensive as well as *less successful. Almost everything failed to reach market or to be profitable because of poor efficacy or unacceptable side effects.

I expected the industry to all but vanish during my working life. They should have vanished. They’ve stopped producing anything useful.

What must have happened in parallel with consolidation was regulatory capture. I’ve no doubt that there has always been sporadic corruption. I remember an FDA Advisory Committee (AdCom) for a drug that was in our view hopeless which then was approved by a unanimous vote. This was around 1990. It was a market failure.

But while we slept, big pharma board rooms and the seniormost leaders of FDA merged, probably catalysed by back room conversations at Davos.

While many of us can see this expression of centralisation so clearly and can even paint the steps leading to it in this specific & highly relevant example, Ben has become aware of this kind of phenomenon much more broadly.

We’ve been gulled into accepting the inevitability of globalisation. We’re told that it’s “progress” & you can’t prevent it. It’s at minimum an organic process though obviously it can also be steered.

The dirty secret is that those who were in corporate early on, and were talented enough not to have been fired eariy in this journey of consolidation, did well financially out of globalization. Such people were paid generously to assist in merging all these functions (“building the prison camps”).

They were then advised to sock away large, tax-relieved sums into their private pensions and then to invest those savings into the shares of those companies who were busy ensuring that their profits grew, corruptly if need be, yielding astonishing returns.

Guilty as charged. I never once thought of the wider implications of what I could see happening in my own sector when applied to the wider economy.

It’s everywhere. Virtually nothing has escaped the clutches of globalization and more specifically centralisation.

The result is that a handful of people can affect substantial parts of the lives of most people on earth. This is without precedent in human history.

Swimming against the tide might seem impossible, but it really isn’t. If you want no more than to turn your back on corporate life in all its many forms and to connect with people locally for as many of your needs as possible, you absolutely can.

Only in this way do we stand a chance of creating a network of people which is resistant to the baleful and totalitarian practices of globalization.

*there is an important silver lining to this cloud. Pharma hasn’t got worse at inventing the rare, genuinely useful drug. What’s happened is that the very patent system which grants the innovator a limited duration of commercial exclusivity has created a deep thicket of off patent, low cost drugs. They don’t go away when the patent expires. The existence of the blockbuster drugs of the past inevitably formed a portfolio of affordable medicines. Most aren’t particularly safe and effective, but some are.

I vote that we create the draft shortlist of generic drugs we should have access to.

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LionTL's avatar

Ben, this is brilliant! The ecosystem we have all become accustomed to existing in is becoming obsolete in the lives of those whose human instincts are drawn by other, more local and human friendly endeavours. I see it everywhere, you capture the hope so well, thank you

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