There’s the harm: A faulty study by the now-disbarred doctor Andrew Wakefield (centre) claimed that the measles, mumps and rubella vaccine caused autism, contributing to “vaccine hesitancy” among parents, as well as several measles outbreaks. (Daniel Berehulak/Getty Images)
Propaganda is an attempt to influence the public away from the truth. It differs from spin in that the essence of it is untrue. Spin merely deflects from the less palatable parts of reality but is essentially true.
All forms of propaganda contain a kernel of truth — often something that at least hints at a real grievance. A skilled propagandist exploits this kernel of truth to create a web of lies and relies on the target audience to be trapped by a feeling that at last, the thing no one is talking about is exposed.
Propaganda historically has been carefully managed and required large budgets. The techniques go back a long way but were perfected by the Nazis.
Today, propaganda can take a more subtle form: the social media meme — an idea that propagates and evolves through internet-based social connections. A meme may grow out of something people are convinced is true but which has at best a loose connection with fact.
Some, like climate change denial, are deliberate campaigns seeded by powerful corporate interests. Climate change denial is part of a broader cottage industry in sowing doubts about science that is inconvenient for corporate interests and started with organised tobacco. This movement is well-documented; a good place to read about it is Naomi Oreskes and Erik Conway’s book Merchants of Doubt.
Others appear to have grown organically out of distrust of “the system”. Ironically, distrust of the “system” all too often turns into excessive trust of proselytisers, sometimes with agendas of their own.
The Aids denial movement did not appear to have anything behind it besides the egos of scientists who couldn’t admit they were wrong, yet it influenced health policy in this country against both prevention and affordable treatments, and still has a lot of adherents despite no evidence to back it.
Another example of this kind of organic meme is the anti-vax movement, which tracks back to the early days of vaccination, where the original smallpox vaccine was opposed by some. With the original smallpox vaccine becoming compulsory in the United Kingdom in the 1850s, the movement grew and eventually compulsory vaccination was abandoned — even though it was upheld by the United States Supreme Court in 1905.
After many battles over vaccines, with the disease usually the ultimate loser, the anti-vax movement took on a new lease of life with the publication of a paper by Andrew Wakefield in 1998 claiming a link between autism and the measles, mumps, and rubella vaccine.
This paper was thoroughly discredited. Wakefield had failed to declare a material conflict of interest where he was a paid consultant to lawyers suing the government over claims that the vaccine caused autism, and he was comprehensively exposed as a scientific fraud.
Subsequent studies showed no link between vaccination and autism. Even so, the myth grew on the wings of the internet and later social media.
Despite the fact that vaccines remain one of the most successful and cost-effective medical interventions, suspicions persist and potential Covid-19 vaccines have run into the same problem.
Like any propaganda campaign, there is a kernel of truth underlying the lies: a genuine reason to be suspicious of Big Pharma. But that does not mean we throw out all medical science.
Médecins Sans Frontières (MSF, Doctors Without Borders) is an NGO that works with the poorest of the poor. MSF lists six of Big Pharma’s dirty secrets.
Big Pharma exaggerates the cost of drug development. They feast off taxpayer-funded research and tax credits that reduce the risk of their business. They are not great innovators: about two-thirds of new drugs imitate existing remedies. They abuse the patent system to add small tweaks to existing patents to protect themselves against competition. They bully developing countries to accept trade regulation that favours Big Pharma, not the population’s health.
Finally, MSF accuses Big Pharma of using profits to do share buy-backs to boost stock prices rather than investing as they should in research and development.
To this litany I can add a few more.
Big Pharma aggressively markets prescription drugs, resulting in overmedicating. The most extreme example of this in recent times is the opioid epidemic in the US, causing 450 000 deaths between 1999 and 2018, according to the US Centers for Disease Control and Prevention.
Launching of so-called “me too” drugs exploits the fact that the test of drug efficacy is comparison with a placebo, not the best-known remedy. What makes this bad? Every drug has a risk of harmful effects that do not show up in testing so a new drug that’s no better than existing ones creates an unnecessary risk.
Lobbying governments to buy at inflated prices is particularly bad in the US, where public health, despite covering a relatively small fraction of the population, is among the most expensive per capita in the world.
No doubt there is more to add to the list.
The point? There is reason to be suspicious of Big Pharma, but vaccines are the wrong target. Numerous studies show that vaccines make manufacturers less money than remedies for the diseases they prevent. Chronic diseases with ongoing medication are much more profitable — most vaccines are a single dose or two doses and then you are done.
Provided testing is done correctly and manufacturing is to a high standard, vaccines are among the safest medications and are generally far safer than the disease they prevent (if they are not, they are pointless).
I will give MSF the last word. It repeatedly calls for vaccines to be affordable and accessible and for an end to profiteering and the use of patents to maintain monopolies. As an NGO that works for the poorest of the poor, MSF knows what is wrong with Big Pharma because it is at the receiving end.
The issue with Covid-19 vaccines is not opposing them, it’s equitable and affordable access.
The views expressed are those of the author and do not necessarily reflect the official policy or position of the Mail & Guardian.