“Kennedy and Trump are taking a wrecking ball to probably the most important thing we have done consistently better than the rest of the world over the last eighty years, and I don’t get it.” — Barry Werth
Last week on the show, the San Francisco based AI mogul and Eureka Machine author Richard Socher promised a scientific renaissance in which AI will cure everything. Socher’s eureka moment, however, may have already occurred. Not with AI, but with big pharma. At least according to Barry Werth who has spent the last thirty-five years writing about American pharma. Indeed, his new book The Age of Cures: How American Scientists Saved Your Life, a twentieth century history of big pharma, completes a trilogy that began with The Billion-Dollar Molecule in 1994.
When it comes to medical breakthroughs, Barry Werth isn’t particularly optimistic on the AI front. It will add more data to preexisting mountains of data, he warns. And Werth reports that many leading scientific designers of drugs don’t think it will change much. Given, however, the hundreds of billions of dollars now being poured into its ecosystem, what today’s AI revolution does instead is remind you what a real scientific breakthrough costs, both politically and economically.
Thus the significance of The Age of Cures, which The New York Times is already recommending. In his new history, Werth reminds us that ninety years ago there were almost no drugs for anything. Penicillin was discovered by accident in 1928, and by 1941 there was only enough of it to treat a single London policeman — who began to recover, then died when the supply ran out.
Cutting edge technology plus state investment changed everything. The engineer and scientific mandarin Vannevar Bush (the guy who also first imagined the internet) persuaded FDR to fund science publicly without conscripting the scientists. And Bush’s Office of Scientific Research and Development, the same state institution that fathered the Manhattan Project, made penicillin for D-Day its number one priority. Bush then ensured the arrangement continued in peacetime, which it did, for eighty years.
According to Werth, both big pharma’s idealism and its now much derided financial ambition were real. George Merck’s famous line about medicine being for people, not for profits, is true — as long as we remember that those profits will follow from life-saving drugs. What broke this virtuous cycle, Werth argues, was the Wall Street short-termism of the greed-is-good Eighties that focused only on quarterly profits. So today, the term Big Pharma is mostly used as an insult. Big Tech moguls like Richard Socher should thus read Barry Werth’s The Age of Cures with particular care.
Five Takeaways
• Before the Cures. Ninety years ago there were almost no drugs for anything. In 1941 the world’s entire penicillin supply went to one London policeman — who recovered, then died when it ran out.
• Vannevar Bush’s Machine. An electrical engineer persuaded Roosevelt to fund science publicly without conscripting the scientists. The result delivered penicillin for D-Day — and eighty years of American advantage.
• Medicine Is for People. Merck’s famous line is always quoted by half: if we remember that, the profits will follow, and the better we remember it, the bigger they will be.
• What Wall Street Changed. Antibiotics came from sifting dirt and wastewater. Then biotech arrived, the quarter became the unit of measurement, and the model became marketing something marginally better.
• The Wrecking Ball — and the Answer to AI. Operation Warp Speed took nine months; the previous record was four years. As for AI curing cancer: hits are only the beginning of a very long process.
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Chapters:
00:00:31 Introduction: after the Eureka Machine
00:02:33 Why we forget how recent all this is
00:03:33 The trilogy, and how it fits together
00:07:26 Were the drug companies the OpenAIs of their day?
00:08:03 Penicillin, and the London policeman
00:10:12 Vannevar Bush goes to Roosevelt
00:13:00 Is the book a polemic?
00:15:42 Did neoliberalism break it?
00:20:13 George Merck: medicine is for people
00:23:02 The consumer is not the customer
00:25:03 From saving lives to selling lifestyles
00:27:56 How big is biotech, really?
00:28:59 Drug prices and the dysfunctional system
00:31:45 America, Switzerland and Denmark
00:33:59 RFK Jr. and the attack on the foundations
00:34:22 Operation Warp Speed
00:37:19 Is there a threat from the left too?
00:40:52 Losing money on Vertex
00:41:59 Are the smartest kids going into AI instead?
00:43:31 Can AI cure cancer?
00:46:22 Patience, and a thirty-year trilogy