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Written for South Front by Daniel Edgar
The confirmation hearings in the US Senate for the newly inaugurated president’s nominee for Secretary of Health and Human Services (Robert Kennedy) have been scheduled for the 29th of January (at 10am local time). While it is of course most likely that the hearings will turn out to be just another succession of Big Pharma representatives and associates (in the guise of senators in this instance) lining up to condemn, discredit and disqualify Kennedy as quickly as possible (after the pharmaceutical industry’s first tactic – disqualification by mass media character assassination – was not successful), the hearings could be a rare opportunity for other experts and social sectors to ‘meddle’ in the country’s health policies – if Kennedy has an opportunity to present his case and introduce expert testimony and witnesses, or if public interest groups are able to mount an effective political and media campaign to confront and contest the prepackaged narrative orchestrated by the pharmaceutical industry’s media blitzkrieg campaign and extensive lobbying apparatus.
The stage is set for another carefully scripted tent show performance in the US Congress. In this instance the paramount objective will be to ensure that the coveted cabinet post of Secretary of Health and Human Resources remains in the hands of a reliable and obedient pharmaceutical industry/ medical Establishment apparatchik. In this latter-day ‘David & Goliath’ showdown, Kennedy will have a few hours to persuade the Senate that he is a worthy candidate for the post, while the pharmaceutical industry can count on ready access to most senators at any time through personal contacts as well as via a large lobbying apparatus that is permanently stationed in the national capital. Meanwhile, the largest shareholders of almost all of the major pharmaceutical companies also have enormous influence over the mainstream media, politicians and the medical Establishment more generally.
Nonetheless, the hearings could yet turn out to be a rare opportunity for non-industry health experts, civil society organizations and social sectors to ‘meddle’ in health policy – if they can mobilize and join forces to develop a proactive lobbying effort, so that Robert Kennedy has an opportunity to present his case and introduce expert testimony and witnesses to counter the media barrage with detailed evidence and arguments.
A Brief Overview of the Pharmaceutical Industry’s Structural Power
From a broader institutional, economic and social perspective, it is important to recognize the multi-faceted and mutually reinforcing economic, political, administrative, scientific and technological sources of structural power wielded by the largest pharmaceutical and agribusiness corporations. There are many distinct institutional focal points and settings where the companies and their industry associations can directly or indirectly exert disproportionate influence over the elaboration and implementation of relevant government policies, programs and legislation.
Their immense structural power is also evident in terms of the ability of the largest companies to influence the research, development, production and supply of health products and services. This is often the case both in government agencies (for example, in the approval and regulation of scientific and commercial R&D programs and products), as well as in terms of their control over specific market sectors and commercial production. The cumulative impact of these three distinct but nonetheless highly synchronized and mutually reinforcing dimensions of structural power (legal/ political/ administrative/ regulatory, financial/ economic, and technological/ scientific) must be taken into account together to appreciate their full scope and effect.
State Institutions, Public Powers and Government Policies
The immense political power and influence of the pharmaceutical lobby has many dimensions. For one thing, many if not most of the members of Congress are on the Big Pharma payroll one way or another (whether in the Senate or the House of Representatives, Republican or Democrat – there are still just over zero representatives of ‘third parties’ and ‘independents’ in the US Congress). The main forms of political leverage identified by one study include large political campaign contributions to preferred political parties and individual candidates (with payments often being made to the candidates of both major parties, virtually guaranteeing a sympathetic attitude from the Congress and relevant congressional committees no matter which party has a formal majority – heads we win, tails you lose). (OCM, 2020)
Such incentives and fringe benefits typically include hefty campaign contributions and favourable media coverage for their preferred political candidates (from the pre-selection phase of each political party to the holding of federal and state elections), as well as the prospect of preferential treatment for their electoral districts in the location of pharmaceutical R&D or production facilities. A considerable number of industry and Establishment-backed politicians are also shareholders in and have other longstanding ties to (or simply an inherent affinity of interests with) the pharmaceutical industry.
The membership and staff of the US Congress are also heavily targeted, cultivated and courted by one of the most well-funded and highly-organized business lobby groups on ‘The Hill’ (and in ‘The Swamp’), with hundreds of often very well-connected lobbyists permanently stationed in the nation’s capital to cultivate ties with and augment their influence over congressional members between elections, efforts which are intensified during key sessions and votes on relevant topics. The pharmaceutical industry has consistently been one of the largest sources of funding for political campaign contributions for many years, and it has also consistently had one of the largest and wee resourced lobbying groups attending the members of the national Congress on a full time basis:
“In 2000, the main pharmaceutical industry lobbying association in the USA (PhRMA) counted 297 professional lobbyists, that is, one lobbyist for every two members of Congress. This number – already vastly exceeding the number of any other lobby – has tripled in recent years. In 2002, PhRMA financed the work of 675 lobbyists, which means that in Washington in that year there were more people working to promote the interests of pharmaceutical companies than members of Congress.” (Forcades, 2005)
This collective effort is complemented by the also very substantial lobbying resources of individual companies. Moreover, beyond the already very substantial lobbying power of the largest individual pharmaceutical companies and their main business association in the US (the Pharmaceutical Research and Manufacturers of America – PhRMA), many of the major shareholders of the largest companies in the pharmaceutical industry are also extremely active in a wide range of lobbying campaigns and other activities used to capture, control and influence the legislative and executive branches of government, regulatory agencies and scientific research institutes, providing additional sources of structural power that can be leveraged to influence the development, implementation and enforcement of public policy and legislation. The multiplier effect generated by the immense resources and structural power wielded by the largest institutional investors can be even greater at the international level (for example in the negotiation and implementation of international standards and bilateral or multilateral trade and investment treaties).
Of the ten largest pharmaceutical companies in the world, the four largest are based in the United States: Pfizer (with total revenue in 2022 of just over $100bn), Merck & Co. ($59bn), Abbvie ($58bn) and Janssen (a subsidiary of Johnson & Johnson, $52.6bn).
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The three largest shareholders of each of these companies are Vanguard Group Inc. (with a shareholding of between 9 and 9.6%), Blackrock Inc. (whose stake in each company is between 7.7 and 8%), and State Street Corporation (ranging from 4.3 to 5.4%) – however, it is likely that their total stake is significantly greater in many instances through indirect or proxy holdings.
The fifth and sixth largest pharmaceutical companies are based in Switzerland (Novartis and Roche Pharmaceuticals with total revenue in 2022 of $50.5bn and $47.7bn respectively), both of which demonstrate greater diversity in their ownership (including major stakes that have been held by individual families for many years). The seventh largest company (Bristol Myers Squibb, total revenue in 2022 of $46.2bn) is also based in the United States and has a very similar shareholder profile to the four other US-based companies: the three largest are Vanguard (at least 9.4%), State Street (4.4%), and Blackrock (2.4%). The eighth, ninth and tenth largest pharmaceutical companies are based in France and the United Kingdom respectively: Sanofi (with total revenue in 2022 of $45.3bn), AstraZeneca ($44.4bn) and Glaxxo Smith Klein ($36.9bn). While their ownership structures appear to be more diverse, Vanguard, Blackrock, State Street Corporation and Capital Research & Management (another major US-based institutional investor) still have a significant stake in most cases.
These powerful institutional investors have enormous resources at their disposal that they can commit to their campaigns of lobbying and persuasion (campaigns which are also often actively supported and promoted by the numerous mainstream media companies and social media platforms that are owned by the same financial conglomerates). (Edgar, 2024b) Moreover, the ‘Revolving Doors’ that operate between State institutions and the financial giants of the ‘free market’ typically operate at an even higher and more powerful level than those that serve the largest companies of the pharmaceutical and agribusiness industries; for example, numerous commentators have noted how the White House and key government agencies are invariably saturated with personnel transferred from BlackRock, Goldman Sachs, Monsanto and other corporate giants with the swearing in of each new administration, no matter which political party wins.
Other Sources and Forms of Corporate Influence over the State
In the context of State institutions and the development and implementation of public policy more generally, companies and industry associations have developed an extensive set of strategies that they can draw upon to influence decision-making in the Legislative branch (in the exercise of powers related to the development of legislation, the approval of financial spending for specific programs and functions, and oversight of the Executive branch), with a complementary array of strategies that are used to influence those components of the Executive branch that are of most relevance and value to industry interests and objectives.
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If his nomination is approved by the Senate, Kennedy will be responsible for numerous government agencies whose activities are of vital interest to the pharmaceutical industry. Among many other tasks and functions, the Department of Health and Human Services manages the Medicare program and has overall portfolio responsibility for the Food and Drug Administration, the National Institutes of Health and the Office of Technology Transfer.
Nonetheless, there are of course many other federal agencies that are routinely and systematically targeted by pharmaceutical and agribusiness companies (or that typically feature high rates of executive and employee turnover with many of the largest companies in those sectors), including: the United States Patent and Trademark Office; the Office of the US Trade Representative; the National Institute of Standards and Technology (within the Department of Commerce); the Department of Justice and the Federal Trade Commission.
The functions and powers of these federal agencies correspond to the main public policy issues that ‘Big Pharma’ directs most attention and resources towards influencing in their favour, such as: intellectual property; bilateral, regional and international trade agreements; anti-trust law; the elaboration and enforcement of standards by regulatory agencies; and the research priorities, programs and technology-licensing policies of public research institutes.
There are many detailed studies from the United States of America examining different aspects of the individual and collective influence of the pharmaceutical and agribusiness companies on the drafting and implementation of public policies and regulations (for example Huffman, 2017: Ndiaye & Iwayemi, 2021: OCM, 2020: Kloppenburg, 1988: Edgar, 2024a). Some of the most common elements that have been identified in terms of sources of corporate influence over the Executive branch include privileged opportunities for direct participation in policy development, as well as the ability to exercise disproportionate influence over the implementation (or non-implementation) and enforcement (or non-enforcement) of relevant public policies, laws and standards. Another study (Meghani & Kuzma, 2011) examines one of the most significant sources of indirect industry influence over and representation within State institutions and regulatory agencies in the US:
“There is a ‘revolving door’ between federal agencies and the industries regulated by them. Often, at the end of their industry tenure, key industry personnel seek employment in government regulatory entities and vice versa. The flow of workers between the two sectors could bring about good. Industry veterans might have specialized knowledge that could be useful to regulatory bodies and former government employees could help businesses become and remain compliant with regulations.
But the ‘revolving door’ also poses at least three ethical and policy challenges that have to do with public trust and fair representation. First, the presence of former key industry personnel on review boards could adversely impact the public’s confidence in regulatory decisions about new technology products, including agrifood biotechnologies. Second, the ‘revolving door’ may result in policy decisions about technologies that are biased in favor of industry interests. And third, the ‘revolving door’ virtually guarantees industry a voice in the policymaking process, even though other stakeholders have no assurance that their concerns will be addressed by regulatory agencies… (These) three problems indicate a failure of regulatory review for new technologies. The review process lacks credibility because, at the very least, it is procedurally biased in favor of industry interests.”
This is another topic that is of fundamental importance and deserves detailed analysis and public debate to consider the best ways to ensure that inherent (and endemic) conflicts of interest can be avoided in the future.
Systematic Abuse of Market Power and Other Illegal Practices
With respect to the systematic use and abuse of market power, Ndiaye and Iwayemi (2021) identify a wide range of common industry practices such as ‘product hopping’ or ‘evergreening’ (making minor changes to the formulation or production of drugs and products when the patent is due to expire in order to obtain a new patent), ‘pay-for-delay’ schemes (paying generic drug manufacturers to delay the production of drugs whose patents have expired), and offering physicians incentives and bonuses for prescribing their products. Similarly, Marcia Angell (2004) has stated of the exponential growth in civil lawsuits and criminal investigations over the last thirty years involving pharmaceutical industry (mal)practices:
“The litany of charges includes illegally overcharging Medicaid and Medicare, paying kickbacks to doctors, engaging in anticompetitive practices, colluding with generic companies to keep generic drugs off the market, illegally promoting drugs for unapproved uses, engaging in misleading direct-to-consumer advertising, and, of course, covering up evidence. Some of the settlements have been huge.”
The repertoire of strategies and techniques that have been developed over time by the pharmaceutical industry cartel to increase their profits and eliminate competition is truly astonishing in its scope, ruthlessness and tenacity. For example, an abstract written by staff from the US Department of Justice describing the findings of a detailed study of such practices in the pharmaceutical industry in the 1980s (by Braithwaite, 1984) comments:
“Results are presented of interviews with 31 executives in the pharmaceutical industry; interviews were conducted in the United States, Australia, Mexico, Guatemala, and the United Kingdom. Questionable payments disclosed to the Securities and Exchange Commission in the 1970’s by US pharmaceutical companies – including American Home Products, Pfizer, Upjohn, Revlon, Dow, Syntex and Bristol Myer – are discussed.
Fraud in the testing of drugs and criminal negligence in the manufacture of drugs are addressed… The various ways that pharmaceutical transnational corporations defy the intent of laws regulating the safety of drugs by bribery, false advertising, fraud in the safety testing of drugs, unsafe manufacturing processes, smuggling and international law evasion strategies are explored.”
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The Pandemic Factor
There is however another particularly controversial aspect of the pending Senate hearings that has infuriated some of the most powerful Establishment figures and vested interest groups: for the last month the mainstream media has been unanimous in their denunciations of Robert Kennedy as a crackpot conspiracy theorist (or words to that effect) for his opinions and activities related to the Covid pandemic criticizing the imposition of mandatory injections on the entire population and questioning their safety and efficacy (among other concerns).
If I am not mistaken, every hypothesis and theory concerning the origin and nature of the Coronavirus remains in effect a ‘conspiracy theory’ of various degrees and persuasions, each of which depends above all on the opinions and interests of the experts and commentators discussing the topic at any particular moment (as well as the resources and structural power of their sponsors and benefactors).
Some scientists and health experts are convinced that it was all caused by an infected bat that emerged from some cave in China to wreak havoc on humanity (before disappearing without a trace). Although the theory has gained widespread acceptance in some quarters, as far as I am aware it has not been conclusively proven (for example, the identity of the species of bat and the location of its dwelling place, or follow up studies on the behaviour and characteristics of the virus in the host community and the multitude of other scientific variables and implications involved that could have contributed to international efforts to control the spread of the virus and develop effective treatments).
Meanwhile, every now and then some Chinese or Russian official blames the US for the virus, while US officials occasionally blame the Chinese (whether for malfeasance, secrecy, failing to cooperate with other countries and scientists, or simply for gross negligence and incompetence) – including the then (and current) US president, who not so scientifically or diplomatically took to calling it ‘the Chinese virus’ in his regular twitter tirades.
There have of course been many, many other claims and theories – including the possibility that the virus might have been produced in a laboratory and subsequently escaped (or was deliberately released) – all of which must be thoroughly investigated, cross-checked, verified or refuted if we are ever to have an accurate understanding of what happened and how future outbreaks can be prevented or mitigated. In this respect, it is submitted that all countries (or non-State actors) making allegations of malfeasance, negligence or incompetence must either be prepared to present all of the evidence and reasoning upon which their accusations are based for independent verification or shut up.
Consequently, some five years later it is still the case that nobody can say for sure whether the Coronavirus was a purely natural phenomenon and where it came from, or whether it may have been a laboratory invention that escaped or was deliberately released. In one South Front report published in mid-2020 I quoted an article written by Gilad Atzmon concerning rumours that the virus may not have originated in a natural setting in which he suggested that two distinct investigative processes were required, one scientific and the other to investigate the possibility of criminal culpability in the creation and spread of the virus:
“We have recently heard from frontline medical physicians that the current global health crisis is something they have not been trained to deal with nor do they fully understand the spectrum of symptoms they encounter in hospitals and emergency centres…
One would assume that if the virus at the centre of the current epidemic was an unsavoury present from ‘mother nature’ we would be able to trace its evolution. We likely would have seen the gradual appearance of some of the new symptoms that have caught our medical establishment unprepared. It doesn’t seem this happened. In the view of many medical practitioners the new disease is in a category of its own. It is a novelty.
This means that it is possible that the Corona virus wasn’t created by nature but by creatures who believe themselves to be greater than nature. Since we do not know its provenance, we should treat the current epidemic as a potentially criminal act as well as a medical event. We must begin the search for the perpetrators who may be at the centre of this possible crime of global genocidal proportions.
While medical diagnosis is defined by: (1) a determination of the nature of the cause of a disease; (2) a concise technical description of the cause, nature, and/or manifestations of the symptoms. Criminal investigations are primarily engaged with the human element. The criminal investigator seeks to ascertain the methods, motives, and identities of criminals, the identity of victims and may also search for and interrogate witnesses to the crime. Treating the Corona virus as a crime would mean searching for possible offenders: individuals, institutions, or states that may have created the lethal virus as part of a research program or more directly, as an agent of biological warfare.
Law enforcement agencies often allocate dozens of investigators, officers, detectives and agents to untangle a single homicide. One would expect that following the deaths of tens of thousands around the globe, every police force, government and intelligence agency would join forces in the attempt to identify the possible culprit(s) at the root of the coronavirus crisis. We may be dealing with a negligent or criminal event on a massive scale…
A number of scientists have commented that laboratories and research centres have been engaged in the study of corona viruses and experimented with models that resemble the current virus. Specifically, some have pointed to a North Carolina laboratory that experimented with the viruses extracted from bats in 2015… In 2014 the US National Institute of Health removed its funding of gain-of-function (GOF) experiments involving the influenza, SARS, and MERS viruses… Treating the Corona virus outbreak as a crime ought to include a visit by the FBI to the office of the National Institute of Health and a careful review of all the files related to American laboratories conducting GOF experiments with Coronavirus. This investigative procedure must be exercised in every region and country in the world that has engaged in GOF experiments.
As soon as the Corona virus became the new disaster, Dany Shoham, a former Israeli military intelligence officer, was quick to point to China’s biowarfare program as a possible originator of the virus. By now, with the exception of President Trump and his Pompeo character, not many are convinced that Covid-19 is a Chinese Virus (as Trump refers to it when he wants to annoy progressives). A criminal investigation would have to examine Chinese as well as Russian, British, French, German, etc. laboratories and their safety records. It should also verify whether Dany Shoham had any evidence for his assertion regarding China or whether he was attempting to divert attention from another possible suspect in this Corona affair. Israel, with its extensive biological warfare laboratories and WMD facilities must also be subject to thorough scrutiny.”
Unfortunately, there was never much interest in the initiation of an authoritative and collective international investigation; for example, the 73rd annual session of the World Health Assembly in Geneva urged member States to participate in an ‘impartial, independent and comprehensive evaluation’ of each country’s response to the pandemic. However, according to a Reuters report at the time, only 116 of the 194 member States were in favour of the resolution and the proposal languished.
In this broader context, the Senate hearings could be an opportunity to reinvigorate longstanding calls for a thorough international investigation in order to identify the source and nature of the virus once and for all, and to conduct a detailed comparative analysis of the effectiveness of the measures taken by each country to contain it. Ideally, all formal and documented claims and accusations would be thoroughly and transparently investigated by some type of international commission, with all countries and scientific organizations being invited to contribute their most experienced and qualified scientific, medical and forensic experts. All research and information would be subject to peer review as well as full and informed public analysis and debate – the world cannot afford any more of the elitist and condescending ‘national security’, ‘Security Council veto’, ‘diplomatic immunities and privileges’, ‘commercial confidentiality’, or ‘it’s too complicated for the plebs to understand’ bullshit.
Moreover, it is not just the scientific institutes and research programs controlled by Nation-States that must be investigated. It would be of paramount importance to include private sector scientific facilities and research programs (such as major biochemical and pharmaceutical conglomerates, as well as other research and development foundations or institutes with significant R&D capabilities in related fields). Some of these vast corporate scientific-industrial complexes are probably the only institutions in the world that are even close to matching the capacity of the US military to outsource, offshore and camouflage programs and installations for the research, development and production of materials related to viruses and biological weapons.
A Final Note
At first I didn’t pay much attention to reports about the virus. However, after it arrived to the region where I was living at the time (Tumaco, on Colombia’s west coast), I began to hear reports about a medicinal plant that people were using as a treatment and I eventually wrote a series of reports (during the second half of 2021), in the first of which I wrote:
I had heard about the use of ‘matarratón’ by people in Tumaco to cure COVID since shortly after the virus arrived in the region… The anecdotes I was hearing about the use of Gliricidia leaves to cure COVID were reinforced when I was informed of a medical practitioner from the region, Dr Jesús Rosero Ruano, who had conducted an interview with local media speaking about the plant’s medicinal properties for the treatment of Dengue fever and more recently for treating COVID…
I later reviewed the news reports in the national (Colombian) mass media that followed the announcement that it appears there is a natural and low risk cure for COVID that people on the Pacific coast are using. The reaction from the main national media agencies was astonishing (though not particularly surprising). A good part of the full weight of the Colombian ‘medical’ and ‘scientific’ Establishment rubbished the claim and dismissed Mr Rosero’s efforts and conclusions as unsubstantiated.
Almost all major media agencies that covered the announcement that ‘matarratón’ appears to be an effective treatment for COVID denounced it as ‘fake news’, citing a variety of medical and scientific ‘experts’ saying that there is no evidence that the leaves of the plant can cure COVID, that the World Health Organization (WHO) has not announced that the plant is an effective form of treatment for COVID, etc. For example, an article published by El Espectador (on the 20th of August 2020) pronounced:
“Once again, disinformation is circulating promoting matarratón as a ‘cure’ against COVID-19. This time it arose in Tumaco, Nariño, where the tree is being promoted by the former governor of Nariño, the doctor Jesús Rosero Ruano, who assures us that the plant (Gliricidia Sepium) is effective against this viral disease and that its use is recommended at the onset of symptoms. However, and as we have already said, the World Health Organization has repeatedly stated throughout the pandemic that although some natural remedies of Western or traditional medicine or home remedies can be comforting and alleviate the mildest symptoms of COVID-19, so far no drug has been shown to prevent or cure the disease.”
None of the ‘experts’ consulted mentioned that there also is no evidence that the plant is NOT effective against COVID (as no official studies have been done), and none of them showed the slightest interest in investigating the possibility through a series of formal exploratory studies and clinical trials…
I have since realized that there is not even one well-established natural medicine institute or faculty in Colombia, the country with according to some estimates the second highest level of plant diversity in the world.
Indeed, rather than initiating a research project to investigate the claims, at one point the mayor of Tumaco started sending out teams of contractors to cut down all matarraton trees located on public land (she subsequently had to rescind the order and seek refuge in the local military garrison for a while after one of the illegal armed groups in the region threatened to kill her if she didn’t stop cutting the trees down).
There was another medicinal plant in Colombia (commonly known as Moringa) that was widely reported to have produced promising results as a treatment for the virus after it was used by prison authorities throughout the country (this was before the ‘vaccines’ had become available). The series of reports also noted similar developments in Thailand, where a widely used local traditional medicinal plant had shown positive results (in this instance also, one of the first to try the medicinal plant on the Coronavirus were prison authorities), but again there was strong institutional resistance and pressure from some quarters against recognizing and investigating the possible effectiveness of the treatment.
Select Bibliography
Angell, M, 2004, “The Truth About Drug Companies: How they deceive us and what to do about it”, Random House
Braithwaite, J, 1984, “Corporate Crime in the Pharmaceutical Industry”, Routledge, Boston
Buesing, S, 2022, “The Revolving Door between the pharmaceutical industry and the FDA”, Buesing Naturopathic
Edgar, D, 2024a, “Intercultural Health, Traditional Medicine and Cultural Heritage in Latin America”, Independent Academia
Edgar, D, 2024b, “Focal Points and Extended Networks of Corporate Ownership and Control: An overview of the centralization and projection of financial power”, Independent Academia
Forcades, T, 2005, “Crimes and abuses of the Pharmaceutical Industry”, CJ Booklets
Huffman, A, Maxwell, J, Salerno, A, 2017, “Consolidation, Globalization and the American Family Farm”, Organization for Competitive Markets
Kloppenburg, 1988, “First the seed: the political economy of plant biotechnology, 1492-2000”, Cambridge University Press
Meghani, Z, Kuzma, J, 2011, “The ‘Revolving Door’ between Regulatory Agencies and Industry: A problem that requires reconceptualizing objectivity”, Journal of Agriculture and Environmental Ethics Vol. 24, pp.575-599
Ndiaye, F, Iwayemi, T, 2021, “The Industry Agenda: Big Pharma”, The Revolving Door Project
OCM, 2020, “Captured: How Agribusiness controls regulatory agencies and harms producers and consumers”, Organization for Competitive Markets
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