“Science knows no country, because knowledge belongs to humanity.” Louis Pasteur said that in 1876. Today it would be more accurate to say that science belongs to the corporations and investors that have the money, power, and savvy to secure patents and bring new developments to global markets, a change that threatens human and planetary health.
As illustrated by the pharmaceutical industry’s windfall profits despite its failure to date to get Covid-19 vaccines to the poorest nations and the poorest in wealthy nations, Pasteur’s observation that bringing science to the world is “the highest personification of the nation” now seems aspirational at best.
The pandemic and the cascade of other global public health crises, including the climate emergency, increasing deaths of despair, growing burdens of chronic diseases and mental health problems, and the increasing toll of occupational and environmental exposures, demand a new accounting of the costs of the corporate control of science and technology in the 21st century.
Here are just a few examples of how corporate control of scientific discoveries jeopardizes global health:
- The fossil fuel industry’s misrepresentations of its own research on the perils of increased fossil fuel use and its active disruption of global efforts to mitigate the climate emergency blocks approval of measures to reverse this threat to planetary and individual health.
- The food industry’s use of new technologies to make ultra-processed foods, along with its focus on products high in sugar, salt, fats, and a brew of chemicals, flavorings, and stabilizers, has created a default global diet that contributes to making diet-related disease the leading cause of premature death and preventable illness around the world. The food industry favors these highly processed products because they are more profitable than the healthier diets under which humans had evolved.
- Big pharmaceutical companies use new discoveries in biological and precision medicines to develop new drugs that generate huge profits even if they help only a small portion of those with cancer or other devastating diseases, and even if they divert scientific attention from developing drugs or vaccines that would benefit more people.
Unfortunately, other new technologies of the next few decades — artificial intelligence, precision agriculture, and the development of new medical devices and medical diagnostics — risk extending global health and social disasters if their deployment is controlled by corporations that value maximizing profit over promoting the public good.
The coronavirus pandemic, rising public concern about global warming, the defeat of Donald Trump, and growing support for more progressive national priorities open new opportunities for rethinking the public policies that have allowed corporations to capture the use of science and technology for private gains. While most elected officials will continue to focus on short-term changes that can become regulations or laws in the next two years, advocates for more public-controlled science and medicine have an important opportunity to articulate a longer-term vision and agenda. Such a platform might package several ideas that until now have been discussed separately:
Reforms of patent laws should strengthen the public’s right to benefit from taxpayer-funded science, limit sole proprietary control of life-saving discoveries, expand compulsory licensing of essential medicines, and restrict patenting of biological materials. Industry has consistently exaggerated the benefits of the current corporate control of patenting and minimized the costs to public health of its control of science. Growing public control of intellectual property can help translate Pasteur’s vision into practice.
New approaches to negotiating multilateral and bilateral trade treaties can limit corporate use of new knowledge for private gain. Increasingly, trade and investment treaties privilege investors over governments and enable international corporations to bypass scientific evidence and challenge public health policies enacted through national democratic processes. Limiting the use of secret corporate-controlled investor-state dispute settlement panels to resolve trade conflicts between governments and corporations that affect public health, ending the use of trade treaties that enable indefinite extensions of exclusionary rights on patented medical products (a practice known as evergreening), and barring the use of trade agreements to block nations from regulating foods and beverages that contribute to diet-related diseases could restore the capacity of national governments to use science to protect public health.
Another key goal is to de-normalize corporate misinformation and obfuscation campaigns. Following the playbook written by the fossil fuel and tobacco industries, behemoth food companies such as Coca Cola, PepsiCo, and others have funded research to downplay the role of sugary beverages in dietary diseases and promote physical activity instead. This misrepresentation has been used to defeat public health measures to reduce consumption of the products most associated with the global rise of obesity. By developing legal measures that make industries liable for the health costs of their disinformation campaigns and by encouraging socially responsible investors to disinvest from companies and industries that misinform the public, science and public health advocates can build support for higher degrees of corporate accountability.
Universities, scientific journals, and medical institutions can develop and enforce rules and organizational cultures that discourage financial conflicts of interest and sanction those who violate these norms. The Covid-19 pandemic has highlighted that public trust in and credibility of the scientific community form an essential foundation for effective public health programs. When researchers, clinicians, or public health agencies accept industry money to fund studies that corporate executives have designed, accept payments for prescribing certain products, or fail to disclose funding sources for their research, they diminish that trust and credibility, jeopardizing success in controlling future health crises.
Strengthening democracy and limiting the political influence of private interests creates a more level playing field for public debates on science and technology. Reversing Citizens United, the Supreme Court decision that expands constitutional protection of free speech to corporations, blocking the revolving door between government and industry, and limiting the power of corporate lobbyists to preempt state and local public health regulations on food, pharmaceuticals, and firearms can help create a more level political playing field in which public interests can compete fairly with private ones.
Are the public health crises of the last decade harbingers of a world doomed to declining human and planetary health or a wakeup call to act now to create a better future? By advancing a comprehensive vision of a society in which the science and technology produced by humanity serve the public good rather than private interests, health professionals, researchers, and scientific organizations can contribute to a healthier, more equitable, and sustainable future.
Nicholas Freudenberg is professor of public health at the City University of New York and the author of “At What Cost: Modern Capitalism and the Future of Health” (Oxford University Press, March 2021).
The author is dreaming of Valhalla. His ideals are lofty and worthy, but it will require some political volcanic eruptions, earthquakes and tsunamis to eliminate Lobbyists (vultures), vile profiteers (like Big Tobacco and Purdue), and foul politicians (with only self-interest, and no altruism for the greater good). Yet – even small changes towards that Valhalla goal would deliver noticeable improvements for public health and the population. I hope the author has friends in high places – these changes have to come from the top down.
In the run for an end to this pandemic : it IS valuable and necessary to vaccinate and ensure safety in “smart” countries first – then go full-tilt into the countries of lesser means. This concept already is used in every single airplane flight : adults put on their oxygen masks first, THEN they help their kids. If capables are not kept alive, both capables and lesser-capables succumb. What good does that do? No good. Thus similarly it is crucial to keep those capable of helping indeed capable of helping. Otherwise everyone loses out. To vaccinate a bit here and a bit there (as would happen due to logical vaccine supply limits) is too scattered and diluted to have any real pandemic-stopping effect anywhere. First vaccinate and keep alive those populations that can invent and make vaccines, and then vaccinate those who are perpetual recipients of global assistance – and could not sustain themselves without help from the capables. It is unfortunate and feels un-fair, but global equality is un-attainable, and so is vaccination equality.
so I am a post transplant and come from a family all with advanced degrees both from ivies and Cambridge university ( 2 members ) ; so I obviously take a tremendous amounts in drugs on a daily basis called immunosuppressants to avoid rejection ; most of my drugs are generic and they do not change except in milligrams however the copays go up every year but I am fortunate to be able to afford them but many on medicare can not ; we all know why too
1) Government is capable of doing exactly what efficiently?- see DMV.
2) Public schools are fully in government (owned by teacher’s unions) control. How’s that going?
3) “Evil” capitalism created a Covid Vaccine in months. Government’s been handling distribution. How’s that going?
4) Tossing in tobacco, fossil fuels etc. is obfuscation.
I suggest that the author get a real education by taking a break from academia and the NY Times by putting some of his own money at risk to create a job or product.
1) Efficiency is less important than equity and promoting the health of all. Efficiency has no per se value, lives do. With fair tax structures and an empowered IRS we could actually adequately fund DMVs and many other government services. We can cherry pick many examples of industry inefficiency as well.
2) Either the schools are in government control, or teacher union control, make up your mind. Ask parents of kids in well funded public schools with well-paid teachers what they think about public schools. Teachers unions routinely go to bat for improving student services (see Chicago). Improving funding is imperative.
3) Capitalism as a whole doesn’t get to take credit for the timely success of a technology years in the making. Besides, China and even Cuba have shown dramatic progress in vaccines without supporting capitalism (theoretically). Capitalism can take credit if you also recognize that the dramatic disparate racial and class impact of covid deaths in the US is also due to capitalism tying wealth with access to adequate care including preventative care.
4) If tobacco used a playbook that PepsiCo then uses, that’s not obfuscation, that’s history. There’s a tendency to make oil and tobacco bad apples, but they’re all from the same seed.
Criticism of government is often misplaced and should be criticism of chronic underfunding, privatization of core functions, and de-skilling.
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