Thursday, September 14, 2023

NYRB Unreasonable Toims

 




Unreasonable Terms

Daniel J. Kevles

In Owning the Sun, Alexander Zaitchik shows how American drug companies have exploited government contracts to pursue profit over public interest.

October 5, 2023 issue



Juwon Jeong


Juwon Jeong: Morning Medicine, 2021


Reviewed:


Owning the Sun: A People’s History of Monopoly Medicine from Aspirin to Covid-19 Vaccines


by Alexander Zaitchik

Counterpoint, 285 pp., $26.00; $17.95 (paper)

One of the main corporate participants in Operation Warp Speed, the Trump administration’s multibillion-dollar crash program to create and produce a Covid-19 vaccine, was Moderna. The federal government gave Moderna, which in 2019 was a small, unprofitable pharmaceutical firm, some $2.48 billion for vaccine development and bought millions of doses at $26 each for essentially free distribution to US residents. Moderna’s profits soared to $21 billion over the course of the pandemic. In late 2022, when federal subsidies seemed on the verge of ending, the company announced that it would soon offer an updated version of its vaccine at as much as $130 per dose. Many Americans were outraged.


Moderna’s behavior will not surprise readers of the journalist Alexander Zaitchik’s Owning the Sun, an indictment of American drug companies and the federal government for all too often privileging profits over health, and of the research universities, medical professionals, and philanthropists who have been deeply complicit with them. Ranging for the most part from the early years of the United States to the Covid-19 pandemic, the book shows how the drug industry and its affiliates operated in a state of ethical grace through much of the nineteenth century and in the twentieth fell from it with accelerating speed.


Zaitchik relies heavily upon recent studies that have called the prescription drug industry and its allies to account, for example Paul Farmer’s Pathologies of Power: Health, Human Rights, and the New War on the Poor (2003) and Graham Dutfield’s That High Design of Purest Gold: A Critical History of the Pharmaceutical Industry, 1880–2020 (2020). What distinguishes Owning the Sun is its aim to be a “people’s history” that tells the interrelated stories of drug commerce and the patent system “from the perspective of the dissenters, critics, and antagonists.” In his treatment of monopoly medicine Zaitchik at times slips into mere muckraking, offers simplistic interpretations, and stumbles into errors. His book is largely inattentive to the process of scientific invention and to the types of licensing rights that bring new products into use. It is also sloppily referenced.



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More by Daniel J. Kevles


The Scandal of Our Drug SupplyJuly 23, 2020 issue

‘Bottle of Lies: The Inside Story of the Generic Drug Boom’ by Katherine Eban


July 23, 2020 issue


Why Is Medicine So Expensive?February 21, 2019 issue

The system of prescription drug pricing is a patchwork product of history, vulnerable to manipulation by the pharmaceutical industry.


February 21, 2019 issue


Remembering Bob SilversMarch 21, 2017

March 21, 2017


Daniel J. Kevles

Daniel J. Kevles is a Professor of History Emeritus at Yale and a visiting scholar at NYU Law School. His books include The Physicists, In the Name of Eugenics, The Baltimore Case, and, most recently, Heirloom Fruits of America: Selections from the USDA Pomological Watercolor Collection. He is writing a history of intellectual property protection in living organisms. (October 2023)


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Friday, September 1, 2023

Allende NYRB

Defending Allende Ariel Dorfman The question of where Chile’s true identity lies becomes ever more pressing as the fiftieth anniversary of Pinochet’s coup approaches. September 21, 2023 issue Salvador Allende campaigning before Chile’s parliamentary elections STF/AFP/Getty Images Salvador Allende campaigning before Chile’s parliamentary elections, Santiago, February 1973 On September 4, 1973, an enormous multitude of Chileans—I was one of them—poured into the streets of Santiago to back the besieged government of Salvador Allende. Ever since he had won the presidency three years earlier with 36.6 percent of the vote in a three-way race, forces from inside and outside the country had been conspiring to destroy his attempt—the first in world history—to build a socialist state through nonviolent, democratic means. One shout from a chorus of voices echoed through the air: “Allende, Allende, el pueblo te defiende,” emphasizing the need to defend the president. After one thousand days of unrelenting opposition, his enemies seemed close to orchestrating a coup d’état that would wipe “the Marxist cancer” from Chilean society forever. Allende felt cornered. I knew this because, though only thirty-one at the time, I had been working for the previous two months at the presidential palace of La Moneda as a cultural and press adviser to Fernando Flores, Allende’s chief of staff, and our reports indicated that many admirals and generals were openly plotting against him. Allende nevertheless remained hopeful. Unlike that of so many Latin American nations, Chile’s military had a lengthy tradition of respect for constitutional rule, with smooth transitions between presidencies guaranteed by its strict nonintervention in political affairs. Thus far the army, at least, had continued to profess loyalty to the government. I remember Flores telling me with glee that General Augusto Pinochet, the head of the army, was in his pocket, nicely tied up: “Este Pinoccho! Lo tengo en este bolsillo, bien amarrado.” Allende also believed this was the case, but he placed his real faith in the mobilization of el pueblo (a term that encompasses several meanings in Spanish: the people, the masses, the poor, the great unwashed). And the Chilean pueblo had many reasons to support the Allende experiment. His cabinet—the first to include a peasant and an industrial worker as ministers—had undertaken a series of reforms, the most impressive of which was the nationalization of the enormous copper mines, until then owned by predatory US corporations. It had also nationalized the mining of minerals like nitrate and iron, as well as many banks and large factories, a number of which were being administered by those who worked in them. An ambitious agrarian reform had been handing over latifundios—large rural estates—to the peasants who had toiled on them from time immemorial; by 1973 almost 60 percent of Chile’s arable land had been expropriated. Though some of these initiatives (and blunders by the relatively dysfunctional government of the Unidad Popular, the alliance of left-wing parties that had supported Allende for president) caused economic and financial disruptions, there had been a remarkable redistribution of income and services to the most underserved members of society. Other measures revealed Allende’s priorities: a half-liter of milk daily for every child; cabins erected by the ocean so workers could vacation with their families (most had never seen the Pacific before); the acknowledgment of indigenous identities and languages; the publication of millions of inexpensive books that were sold at newspaper kiosks; and major advances in health, affordable public housing, education, and child care. All this was accompanied by a blossoming of culture, particularly in music, mural painting, and documentary film. But perhaps more important than these material advantages was the dignity felt by so many disadvantaged citizens, their sense that they were now the central characters of their nation’s history. I had one of the most moving epiphanies of my life on the night of Allende’s election on September 4, 1970. After listening to him promise a delirious crowd that he would be el compañero presidente when he entered La Moneda in two months’ time, I wandered along the streets of Santiago with my wife and friends and witnessed the wonder, pride, and determination on the faces of workers and their families as they walked through the center of the city. Unsurprisingly, then, in April 1971 the Unidad Popular parties received nearly 50 percent of the vote—a plurality—in municipal elections, which was interpreted by The New York Times as “a popular mandate to push ahead with [Allende’s] revolutionary Socialist program.” Momentum seemed to be with us, but formidable barriers remained. Months before Allende’s victory, on June 27, 1970, Henry Kissinger, President Nixon’s national security adviser, indicated what American policy would be regarding the Chilean road to socialism: “I don’t see why we need to stand by and watch a country go communist due to the irresponsibility of its people. The issues are much too important for the Chilean voters to be left to decide for themselves.” Once Allende won—in spite of an American-funded campaign of misinformation that depicted him, a man of impeccable democratic credentials, as a Communist stooge—the next step was to try to stop his inauguration. A CIA-financed terrorist group killed General René Schneider, the commander in chief of the army, who was committed to the rule of law. When Allende was nonetheless sworn in on November 3, covert operations were launched to “make the economy scream,” per Nixon’s instructions. Advertisement Over the following years, an international credit squeeze of both private and public funds strangled Chile. Efforts to renegotiate the foreign debt were hampered, copper exports were stalled in reprisal for nationalization, technological expertise was denied, and essential imports (including parts needed to repair machinery and trucks) were prevented from reaching the country. In December 1972 at the UN General Assembly, Allende declared, “before the conscience of the world,” that his country was being subjected to an invisible blockade from abroad that was meant to create chaos and foment a coup. Such chaos could not prosper without allies in Chile. The US funneled funds to bolster the right-wing Partido Nacional and to persuade the centrist Christian Democratic Party to oppose Allende. Equally consequential was substantial support for the media hostile to the socialist project, particularly El Mercurio, Chile’s main newspaper. All these actions influenced public opinion as well as Congress, where the Unidad Popular was a minority. A coup always seemed a possibility. But Allende’s enemies in Chile hoped to oust him through legal means by winning a majority in the March 1973 parliamentary elections, which would allow them to impeach him and remove him from office. The economic situation was dire as those elections approached. Galloping inflation, a thriving black market, and critical shortages of food and staples seemed to be eroding the government’s popularity. The uncertainty was enhanced by insurrectionary strikes by right-wing entrepreneurs, miners, and truck drivers that dealt severe blows to production and distribution. And extensive sabotage and terrorist acts were being carried out by fascist militias flaunting Nazi paraphernalia. Not all of Allende’s problems came from the foes to his right. Even before his victory in 1970, many left-wing militants had viewed with suspicion his confidence that he could use the bourgeois legal system to achieve radical change. That was only possible, they claimed, if total power was in the hands of the working class and its revolutionary vanguard, which would mean an inevitable confrontation with the military. This thesis was supported by many within Allende’s Socialist Party but mainly by the Movimiento de Izquierda Revolucionaria (MIR, the Revolutionary Left Movement), which, like so many groups of my generation in Latin America, was inspired to embrace armed struggle by the example of Fidel Castro and Cuba. As soon as Allende was elected, the MIR incessantly pressed the government to go beyond the limits of its own program. Certain that Allende, no matter how “reformist” he might be, would not repress them (they were right), the MIR encouraged workers to occupy factories that were supposed to remain in the private sector and incited peasants in the countryside and the homeless poor in the major cities to seize land that had not been targeted for expropriation. This situation—ominously amplified by the media being subsidized by the CIA—gave the impression that the president had lost control of his own partisans and would, therefore, be unable (or perhaps unwilling) to honor his vow to remain within the legal system. This eroded the trust of those citizens—mostly from the middle classes (small entrepreneurs and shopkeepers, professionals, technicians), but also workers and shantytown dwellers who were anti-Marxist and also patriotic and antioligarchic—whose support was essential, at least in theory, for the Unidad Popular to win a majority in parliament. The insecurity created by the actions of the extreme left, which were tolerated by the government, fed into the wariness that many Chileans already harbored about an administration brimming with Communists who owed allegiance to Moscow and socialists enamored of Che Guevara. And yet, despite all these difficulties, Allende’s coalition gained seats in Congress in May 1973 with 44.23 percent of the vote, down from nearly 50 percent two years earlier but up eight percentage points from Allende’s showing in the 1970 presidential election. Having failed to achieve a veto-proof majority, the opposition, instead of waiting for the 1976 presidential election to defeat the Unidad Popular, now concentrated on creating the conditions for a military pronunciamiento, as a putsch is often called in Spain and Latin America, where armed forces traditionally speak out before deposing a government, pronouncing words to indicate their motives. But the people could also speak out. That show of popular support for Allende on the third anniversary of his September 4 victory marked one last occasion for a mobilized populace to send a message of strength and defiance to the armed forces, warning them not to destroy the democracy they had sworn to uphold. Advertisement Although during the day I worked at La Moneda, that night I joined a vociferous group of compañeros and militants who marched down the Alameda, the central avenue of the capital, waiting for hours to pass by the presidential palace and catch a glimpse of our leader. As soon as we saw him next to his wife, Tencha, waving a handkerchief from a balcony that overlooked the Plaza de la Constitución, we intensified our chant, our vow that the pueblo would defend Allende. We kept roaring that oath, even after we turned the corner and left him behind, and then we did something that I still recall, fifty years later, with a tide of nostalgia and emotion. We went around the block and smuggled ourselves into the next colossal contingent of militants so we could pass by the same spot again, as if we wanted to make sure he was still there—though also as if we were saying good-bye to our president. We did not know—or did we have an inkling?—that we were also saying good-bye to ourselves, to who we had been and what we had aspired to, good-bye to a way of life and dreams, good-bye to the country that would soon change. We may have had an intuition that the battle for memory—a battle that has continued to this day—was already beginning. We were trying to fix that moment so that it would not be forgotten, so that when the story was told that Allende had been alone as the coup materialized and nobody came to the rescue, we could point to that march and to so many actions during those years in defense of what he stood for, use that memory to deny the lies of his enemies and the erosion of time. We would have to defend him when he was gone. Maybe that was what, in retrospect, we were really doing: envisaging a future with and without him. Maybe we already knew that we were going to lose. One week later, on September 11, 1973, a military junta, headed by our supposed man-in-the-pocket, Augusto Pinochet, and representing the full fury of the army, navy, air force, and carabineros (national police), made its pronunciamiento, which turned out to be considerably stronger than the words shouted to the wind by our scattered throats: Allende had been deposed and the junta would rule “only for as long as circumstances demand.” When the president refused to resign, the military shelled the palace from the air and the ground. After many hours of combat during which Allende, along with a handful of bodyguards, functionaries, and close friends, engaged in armed resistance, La Moneda lay in smoldering ruins and the president was dead. It was not until the next day, after Allende’s body had been buried in an unmarked grave in a seaside cemetery in Viña del Mar, that the junta declared he had committed suicide, a claim that was, for many years, repudiated by his family and followers as well as by public opinion worldwide. Gradually the elite of the left in Chile, including Allende’s widow, began to accept that he had taken his own life, though many doubts still remain, and most Chileans of all ideological stripes whom I have consulted over the years insist that he was murdered, something that most people abroad also believe. Whatever the cause, Allende’s death was the first of many to come. The military had not hesitated to raze the lovely neoclassical building that since 1845 had been the seat of the nation’s government and that had served as Chile’s mint in colonial times (hence its name, La Moneda), and it was certainly not reluctant to punish and persecute Allende’s supporters. Due to a chain of fortunate accidents, I survived the coup, but most of those who served with me as advisers at La Moneda were executed almost immediately, while Allende’s prominent ministers and closest friends were flown to a concentration camp on a freezing, windswept island in Patagonia. Books were burned publicly, shantytowns raided, students and professors expelled from schools and universities. Detention centers in which prisoners were tortured and executed sprang up all over the country. (In Santiago the National Stadium was converted into one.) Freedom of the press and assembly were abrogated; Congress was dissolved, as were all political parties, trade unions, and nongovernmental organizations. The only institution left in place was the judiciary, which had opposed Allende’s measures and soon showed its subservience to the new masters of Chile: when family members petitioned the courts to learn the whereabouts of their missing relatives, no habeas corpus was issued. Indeed, there were occasions when the judges mocked the wives, suggesting they were so ugly that it was no wonder their husbands had run off. Disappearance became the regime’s iconic form of repression. It allowed the authorities to eliminate troublemakers without being held accountable, leaving families and friends in the inferno of never knowing if the loved one was dead or still alive and being endlessly tormented. There was no burial site or mourning, only the inchoate fear that this sort of retribution could be doled out to anyone exhibiting the slightest sign of dissidence. Besides being a way of spreading grief and terror, disappearances laid bare what the dictatorship, counseled by archconservative civilians, intended to inflict on Chile itself: to disappear its past, to systematically demolish all vestiges of the welfare state, an array of civil rights that generations had fought for, and a communal notion of a country that took care of its own. In its place, Chile became a laboratory for Milton Friedman’s neoliberalism. The new regime applied the pain of “shock therapy” to a captive land. Instead of a shining example of a country that could peacefully aspire to a radically just social order, we were turned into a model of extreme free market economics that was imitated around the world. Any challenge to the new rulers or their “reconstruction” of Chile to serve the interests of foreign corporations and local monopolies was met with maximum violence. Behind such brutality lurked a fear—perhaps a certainty—that those millions of Allendistas would not be easily deterred, that they would resist, that our president was still alive in the utopia of our hearts, that we would emerge from the shadows. Those who betrayed and overthrew Allende may have been haunted, as we were, by his last words from La Moneda that day, just before the last loyalist radio was silenced: “El metal tranquilo de mi voz ya no llegará a ustedes” (You will no longer hear the serene metal of my voice). In that speech, Allende excoriates the military and promises that they will receive some form of punishment, even if only a moral one, in the future. He tells his followers not to let themselves be humiliated but also to avoid confronting the soldiers patrolling the city and countryside—advice that saved thousands of lives. But what has resonated most, the words that adorn hundreds of monuments erected in plazas, streets, and playgrounds across the world, is his prophecy that someday the grandes alamedas, the great avenues lined with trees, would open for the free people of tomorrow to walk through. He was right to give us hope, to offer that prophecy during his final farewell. But once he was dead, it was up to the mourners he left behind to figure out how to survive and resist and forge an alliance that would defeat the dictatorship and perhaps make those luminous words about the grandes alamedas come true. On September 4, 1990, Allende finally received the triumphant funeral his enemies had denied him. Despite a concerted effort to denigrate him from the day of his death (it was said that he was a corrupt, cowardly drunkard, a sexual deviant who had orgies with nubile girls, a traitor who had secret plans to assassinate the officers of the armed forces and their families and to turn the country into a second Cuba), his mythical stature had only grown over the years, culminating in this public homage. It was orchestrated by the government of the Christian Democrat president Patricio Aylwin, who had taken over from a reluctant and embattled Pinochet when democracy was restored in March 1990. The date of the funeral was carefully chosen to coincide with the twentieth anniversary of Allende’s victory in the 1970 elections. As I waded through the gigantic, seething, raucous crowd that had gathered in the Plaza de Armas in hopes of catching a glimpse of the dead president’s coffin as it left the cathedral, where a mass was being celebrated in his honor, for a moment I harbored the illusion that time had stood still. The chant of Allende, Allende, el pueblo te defiende transported me back to that march seventeen years earlier in front of La Moneda, and here again was that pueblo, battered and bruised and persecuted; here were these men and women and their progeny who had resisted with enormous sacrifices and courage and cunning the onslaught of the dictatorship and made this day possible by refusing to forget their dead leader. The illusion could not last. Too much had changed. Those crowds were being tightly controlled, kept away from the official ceremonies—both at the cathedral and at the cemetery where the remains were deposited in a specia