World's most effective lifesaver is the most beloved AND the cheapest

That's not at all like Big Pharma, the world's least beloved industry.

Usually their effective lifesavers cost a big fortune and their ineffective ones merely cost a small fortune.

By contrast, our beloved inexpensive penicillin G has seen wide use among the world's poorest patients and as a result  billions of us have had a 'free ride' :  a quasi-herd immunity to millennium old contagious bacterial infections like Rheumatic Fever.

High tech drugs uphold White Man's Burden (1940)

It is still not often recognized that by the late 1930s, particularly after the huge success of the totally-not-from-nature Sulfa drugs (because they were 100% artificial) , high tech pharmaceuticals had became the key pillar upholding "The White Man's Burden".

Firstly - but still relatively unimportant compared to today - the biggest high tech pharmaceutical nations intended to earn lots of  of export revenues, via exclusive sales of high tech drugs to their informal (Germany and America) or formal (Britain and France) empires.

To do so, they had to strongly imply that that the only really safe and effective drugs were made of pure chemical synthetics produced in the leading medical research and chemical industry nations - conveniently , themselves and themselves only.

But this claim has much bigger 'legs' .

Because high tech drugs could also be used as the best single way to defend an old and failing hegemonic trope : the so called "White Man's Burden".

In the recent past, Europeans and European Americans had justified invading and ruthlessly exploiting others' societies as part of a holy missionary drive to bring Christianity, peace and democracy to primitive or despotic cultures.

Doctors and nurses had always been a big part of that mission effort but only as clinicians : hands-on, bedside doctors and nurses.

This hands-on help was all part of the (now-fading) 19th century belief in empathy, charity and humanitarianism.

In the sparkling brand new Twentieth Century, cold hard rational Science was the new God.

Pharmaceutical research could be used to hold off the many new opponents Civilized European Man faced by the time of the Great Depression.

Let us imagine a drug company ad's illustration from circa 1940.

In one corner of the illustration : a white European-origined  man , well educated and upper middle class,  stern-faced  in a white lab coat in a gleaming porcelain white laboratory located in a big country's biggest city, staring thoughtfully at the synthetic contents of a beaker.

In the other corner : a dark-faced peasant woman, poor and uneducated, cooking up some foul-smelling 'healing' Nature-based brew in her rural hovel, somewhere in the dank Tropics.

Implied strongly in the text copy below was the claim that her mishmash of a folk remedy would only harm rather than help, while his 100% pure synthetic drug cured - completely, cheaply and safely.

No Oxford-educated-darkie  was going to be able to "outside agitate" his way around that winsome storyline.

Obviously ,no one expected an "inside agitator" would come along and betray both his race and his profession.

But that is exactly what New York's Columbia University based Henry Dawson did.

In 1941, in the august pages of the New York Times itself, house organ of modernity , he gave a loud defence of his life-saving "crude penicillin" as  home-brewed himself from foul-smelling natural mold slime.

No wonder his ultimately hugely successful efforts were so resisted while he was alive and so buried with him after his premature death......

WWII's sins of uncaring omission as War Crimes

Even animals would be discomforted at the audible and visual pain as millions of Indians starved to death during the Bengali Famine of 1943.

It is a pity that so many of us,supposedly more sophisticated, humans have been less discomforted about the event ever since.

Most of us - at least in the Allied West - would strongly reject the  idea that this totally unnecessary mass famine was a war crime and and a sin of uncaring omission.

To ease our own consciences, we much prefer to limit our definition of war crimes to sins of commission, done by obvious evil-doers : the direct shooting, gassing or bayoneting of civilians as at Nanking, the Katyn Forest or at Auschwitz.

But it is not enough to save "oops -sorry !" when bombs we intend for rail yards or oil refineries happen to fall upon 250,000 soon-to-be dead civilians in occupied countries - not if we also clearly know that most of our bombs always fall widely off target.

Claiming that anything and everything is justified if our intent (to defeat Hitler) is good is not a moral claim with legs.

It puts one to mind of the claims of George W Bush that he just had to suspend civil liberties in America ----- in order to bring them instead to the oppressed of the Middle East !

We must always demonstrate extremely due care when we kill some in an effort to save others : clearly seeking to see if there are not other ways to defeat evil without killing so many of the innocent.

Famine , fortunately, was not general throughout the Allied and Neutral world, between 1939-1945.

But many (powerless) people needlessly went more hungry than they had to , in many of the Allied-controlled colonies.

But if Allied famine had been widespread and prolonged - caused perhaps by normally reoccurring weather disasters adding to uncaring imperial government mis-management - would it have been moral to continue to treat DDT as a war secret and deny its use to civilians, to reduce additional loss of food to insect pests ?

The militarizing of wartime DDT thus escaped - just - being another war crime of uncaring omission.

But there are more uncaring crimes of omission in the Allied closet.

In 1940-1941, several years into WWII, the new class of sulfa drugs which had emerged only 5 years earlier, seemed a gift that just kept on giving.

Today when the doctor comes in with the test results and says "I'm very afraid it appears that the cancer has metastasized" , the room gets very still as patient, family and nursing personnel absorb the grim news.

In the years before sulfa and antibiotics, people rarely lived to an age where they could learn that their original primary (localized) cancer tumour had spread throughout their body and that their chances of survival were now slim.

Instead what they feared was something not un-similiar happening with an infection that had originally been localized to one lesion , something most bodies, and good nursing care, could eventually fight off on its own.

Now in came the doctor with the blood tests (indicating colonies of bacteria were thick throughout the entire blood supply) and the room would go similarly silent.

Septicemia (Sepsis) was what the doctor would call it, but laypeople  would whisper to friends "blood-poisoning" , just we tend today to whisper "the doctor says the cancer is all through the body".

While we are correct to say that cancer spreading throughout the body (ie a systemic cancer rather than a localized tumour) is deadly and will directly kill us, our concept of what blood poisoning actually means is only half accurate at best.

It is correct that a bacteria infection flourishing in the blood will spread through out the body (is now a systemic disease) but the bacteria will not directly kill us - not by their "poisons" or their physical actions.

Rather it is that our body overreacts to any massive (systemic) assault upon it - not just to systemic bacterial infections - and it is the body's immune defenses' overreaction that kills us in sepsis.

The 1930s - modernist - mindset thought everything humans did - including our immune system - was marvellous beyond words and simply much preferred to blame those nasty little devils, the bacteria.

Until Sulfa drugs came along, nothing but God's will and dumb luck could prevent sepsis from ending in death.

The arrival of the sulfa drugs had meant all sides in WWII went to war a bit more confident that infection deaths would be much reduced on and off the battlefield.

So, despite the war between them, both the Allies and the Axis went on investigating tens of thousands of sulfa drugs, publicly* patented thousands of them and seriously trying hundreds of them on animals and humans.

*Yes, even in wartime - on both sides ! A notable contrast with the Allied secrecy on DDT and penicillin.

The new sulfa drugs of 1940-1941 tended to be less toxic and more effective than the slightly older ones - some even treated diseases originally thought beyond the reach of sulfa.

How could life ever get much better than this ?

But a year is a very long time in infectious disease treatment when practised massively and on a global basis.

By late1942, the sulfas were in a dire crisis.

Two American chemists, Roblin and Bell- who had helped invent the latest in the sulfa wonder drugs - had just published a convincing chemical explanation for their claim that the sulfa molecule (whatever its other medical uses) would no longer produce any new antibacterial drugs.

Seventy five years on, their claim has stood the test of time.

Typically the popular media (Newsweek, September 21st 1942, for example) played Roblin and Bell's research as a good news story - saying that now chemists could tell if a drug would work, before actually assembling it in the test tube.

But frontline chemists in the sulfa-synthesizing business could not help but hear it as a death knell.

The sulfas had other problems.

A few strains of bacteria had always and instantly shown a resistance to their bacterial action. But now the numbers of strains so displaying resistance had exploded in numbers and their resistance was more potent.

The first human response was to up the dosages to overcome the resistance.

The sulfa drugs had always been moderately toxic even at low dosages and required attention to detail in monitoring their use.

But now heavy dosages and careless doctor and nursing care was leading to needless deaths from the drug itself.

More thoughtful doctors faced a horrible choice : too big and too long a sulfa treatment might kill or permanently damage the patient, but without it , the patient was almost certain to die from sepsis.

They jungled frantically, trying different sulfas as well as backing them off for a while and then returning to them.

This disaster in the sulfa treatment of systemic infections was effecting military hospitals as least as hard as civilian hospitals.

The dirty little secret of war wound medicine is that soldiers rarely die from localized infections, anymore than they do in civilian life.

Soldiers die all the time from massive wounds - as do civilians - but rarely is the fact that the wound is also locally infected the critical factor in their death.

But if any sized wound permits the infection to spread to the blood - then soldiers do die from the indirect result of a wound that was originally just locally infected.

Just as well then that the local curing of local wounds was largely irrelevant to life survival.

Because the sulfas were proving to be totally useless in curing local wound infections. In 1940, two British researchers, Fildes and Woods, had offered up an explanation for how sulfa works (that it is mistaken for a vital food bacteria needs) that has also stood the test of time for 75 years.

Their research also explained why sulfa sometimes didn't work even if the bacterial strain wasn't resistant to it.

If bacterial lesion had lots of the real food around, enough bacteria ate it, instead of the useless sulfa lookalike, to keep the infection going.

Wounds - badly tended war wounds in particular - had lots of that food provided by dead and dying flesh.

So no new sulfas on the way - ever , the ones now in use were proving to be either useless, toxic or increasingly resisted by more and more bacteria.

Today,at any one time, we prefer to use about a dozen different drugs to fight serious infections.

But also we have about one hundred we could use - including the sulfas - if the current dozen all suddenly proved useless.

More importantly, these one hundred represent many different classes of drugs - never is any one bacteria infection resistant to all of them.

These discarded drugs are both more toxic or less effective than those in preferred use, but if death by sepsis is the alternative, even a highly toxic drug is the better - more moral - choice.

But the sulfas were the one and only class of drugs in use in 1942 against systemic life threatening infection ; they all shared the same good and bad features, all shared the same fate.

So it appeared that inevitable death by blood poisoning , for both military personnel and civilians, was on its way back.

Unless .......penicillin was put into serious mass production.

But in 1942, both the British and American medical elites had already decided that penicillin was to be kept as secret as possible and used only as a weapon of war - used only to cure our side's wounded on the QT,  so no one else would pick up on it.

Letting civilians have it and above all letting civilian newspapers chatter on about miracle cures would only alter the enemy into making their own penicillin and the Allied military advantage would be gone.

Powerful figures in Britain and America decided that wasn't about to happen.

But in the Fall of 1942, one man realized that if penicillin was now the only thing between blood poisoning death and a nice long life, he would have to up his own ante in this relentless game of chicken.

So that Fall, Dr Henry Dawson stole his first supply of government-issued penicillin and put it to work saving lives from systemic SBE disease , again against strict government orders to let the SBE patients die.

By his reckoning, if the Allies could militarize penicillin, there seemed no reason why one - dying - doctor couldn't un-militarize it back again......

AZT, Penicillin,Sulfa : Mr Romney, 47% of life-saving drugs were once written off as "useless"

Romney "latinoing-up" for votes

Asking who invented AZT, like asking who invented Penicillin or Sulfa drugs, is entirely missing the really important point : which is "who exactly first discovered their life saving qualities?"

The people who first discovered Penicillin and AZT and Sulfa (and Carbolic Acid et al) did not in fact discover and prove-up their uniquely tremendous life-saving qualities : that credit belongs to other people.

Many famous drugs once part of Romney's "unfit" 47%

And there is a current lesson here : not a medical one - but a political one - because this ties in very closely indeed to the 2012 American Presidential election.

Many famous drugs, as well as many unfortunate American citizens, can fit---temporarily --- into Mitt Romney's 47%.

One minute a drug is down and not paying any federal income tax (and so is written off for all time by Romney and Ryan) ---- the next minute it is up --- up in the lineup to get a Nobel from the King of Sweden and wondering how it is going to tax-shelter all the billions it is making.

Some very famous drugs were discovered twice : once as a useless chemical and only later as a marvellous life saver.

Fairness demands (even if  if the black and white simplicity of contemporary journalism does not) that the credit for them be shared.

Shared between those who discovered or invented the original substance and with those who (much) later decided to try it out to save lives in unexpected applications - often against the opposition of their more cautious colleagues.

Pause from thinking of Romney's strange new Latino tan - please - to honor the memory of Jerome Horwitz who died, unnoticed and unhonored, on September 6th of this year.

In 1964, Horwitz came up with a promising theory of drug therapy that he thought might help conquer cancer. He and his colleagues synthesized "almost but not quite perfect" analogues of a common building block used by life in creating DNA.

Horwitz hoped these drugs (AZT being by far the best known) would act as a Trojan horse and confuse cancer cells into using it to try and build new DNA.

The effort would falter and then the cancer cells would cease to multiply - effectively halting the cancer growth in its tracks.

Unfortunately AZT failed to work - in cancer cells - and Horwitz put it on the shelves - unpatented.

But not before publishing his FAILURE in the open public literature.

In the success-oriented world of Science (rather like the stock market) it takes courage for a scientist to admit failure and for a journal editor to publish that admission of failure : kudos to both for doing so.

Cut to 20 years later, AIDS is in full blown attack and every smart pharma company is in hot pursuit of finding a cure.

A traditional and time tested method is "brute force science" : mindlessly try every known chemical against the HIV virus, on the off chance that one will work, despite roomfuls of Nobel Prize winners standing around whining "that it won't work /don't bother".

Ten thousand (relatively un-expensive, very unimaginative) experiments later, sometimes something totally unexpected and totally wonderful happens.

As it did for Burroughs Wellcome . They patented AZT when the results showed it slowed HIV , AIDS was seemingly repelled - at least among those who could afford their patented marvel - and they made billions in profits.

Horwitz got none of that money and little of the acclaim that AZT garnered.

But he will get someday get wide acclaim - sadly only now that he is dead - because his line of research is indeed working on a broad front against many viruses, not just against HIV.

And successes against viruses (outside of vaccines and Mom's advice of lots of bed rest and lots of fluids)  are rare enough to cheer to the rafters.

So why is Horwitz ,the discoverer that AZT doesn't cure cancer, ignored and why is Michael Heidelberger, the discoverer that Sulfa don't save lives, also ignored? When Fleming ,the discoverer that penicillin won't save lives, is among the best known, best loved scientists of all time.

Why mostly because popular journalism is not in fact Rocket Science or Brain Surgery. It is not particularly rational or scientific or sophisticated: its priority is to tell uncomplicated - simple - compelling stories while remaining willing to use the facts ----- but only if they fit that simple narrative.

Alexander Fleming, Paul Gelmo, Jerome Horwitz do all deserve some fame for penicillin, Sulfa drugs and AZT : but so do Martin Henry Dawson, Gerhard Domagk and the nameless boffins at Burroughs Wellcome ---- the guys who first used those useless inventions to save useful lives.

Naturally, as a patient and not a chemist, I am profoundly biased : I honor much more those who save lives then those who merely invent or discover chemicals.

Don't you wish your average journalist started thinking more like a patient and less like a chemist when they appropriate honor ?

After all their readers are almost certainly likely to be patients sometimes in their lives but very few will ever be chemists.

And don't you wish Mitt Romney and Paul Ryan would ponder the "down and then up" life stories of Sulfa, penicillin and AZT before they write off the human 47% for all time ?