-: Good evening.
Good evening, ladies and gentlemen.
My name is Abrio Coselli.
I am a current junior studying biology at Hillsdale,
and I have the distinct pleasure
of introducing our next speaker.
Gerald Posner is an author,
investigative journalist and former attorney.
He received a BA from the University of California Berkeley,
and a JD from the University of California
Hastings School of Law, where he was
the law review's Associate Executive Editor.
He was a Litigation Associate at the Wall Street law firm
of Cravath, Swaine and Moore
before leaving to co-found Posner and Ferrara,
a New York public interest law firm.
Several years of a pro bono legal representation on behalf
of survivors of Nazi experiments at Auschwitz led him
to co-author his first book, "Mengele: The Complete Story."
He subsequently left the legal practice to focus
on writing and investigative reporting.
Mr. Posner is the author of several books,
including "Case Closed: Lee Harvey Oswald,
"and the Assassination of JFK,"
which was a finalist for the Pulitzer Prize in History,
"Secrets of the Kingdom:
The Inside Story of the Secret Saudi-US Connection,"
and most recently "Pharma:
"Greed, Lies and the Poisoning of America."
Please join me in welcoming Mr. Posner to the stage.
(applause)
-: Thank you very much, Lee.
Thank you for the introduction, and thank you, Tricia,
my wife, who works with me and is also an author right here.
We know about Hillsdale, we've read about it,
we have followed, we've been online,
and over the years we've seen what this college does.
We understand that it's one of the last places
in America where you can get a classical education.
What we didn't appreciate is how vibrant this community
was and this college is until we actually got here.
So it is amazing.
I grew up on debate.
I was on debate in high school and in college.
It's what I always engaged in.
It's what I thought you had a bad idea from somebody
and you got rid of the idea
by engaging it in the public square
and showing why it was wrong.
And we have trouble doing that nowadays
in this country, and so it's fantastic to be here.
I thank everybody at Hillsdale who's made it possible,
and I thank you for being here.
(applause)
So, yes, this is some of the "Pharma's" not here,
but don't worry, we're talking about "Pharma."
These are books Tricia and I have done
over a period of time.
I'm particularly proud of "Why America Slept" because it was
the story that showed how the CIA and the FBI missed all
of the warnings for 9/11
and why 9/11 didn't have to happen.
And you knew that you hit a nerve when it was published
and they started to come after you as they do,
and said, no, that's all wrong.
The Saudi book, "Secrets of the Kingdom" we're proud of
because we both got banned from entering the kingdom.
So that was good.
That was a good reason not to go there,
and "God's Bankers", I was, I'm raised Catholic.
I went to Sisters of Charity for grammar school
and Jesuits for high school.
And this is the story of 200 year history of the Vatican,
and the Pope cannot tell us in enough ways no,
when we try to get access to the secret archives.
So we are still failing to do that,
but we have a lot of fun.
We like to pick topics that we think
there's something new on.
So when I went to my publisher and said what about
a history of the American pharmaceutical industry?
They said, you're crazy.
And then I said, no, I think I can do it.
And five years later we turned in a manuscript,
and it was interesting to do.
What I'm gonna talk about tonight is in part the opioid
crisis, but to get to the opioid crisis,
you need a little bit of background
in history about what I call the DNA of Pharma.
What makes the American pharmaceutical industry different
than just about anybody, anything else that you have.
One of the things, by the way, on "Pharma,"
when it was finally reviewed on different journals,
you'll notice a word came up that my publisher hated
because they say nobody buys an encyclopedia.
People buy a page turner, but reviews would say
an encyclopedic book and they would just say,
oh no, why did we publish this book?
But actually for a writer,
that's always a good thing to see.
The, now one of the things about the American drug industry,
it doesn't start, we think of it today as this
industry that's so large that it's always been like this,
but it actually starts in the middle of the 19th century
around the time of the Civil War, and why?
Because there's a tremendous demand for morphine.
Morphine's one of the few things that people
know works and it ends up working
to stop pain and there's a need for it.
So some people decide to get into the business.
So there are these two German cousins.
They are Charles Erhart and Charles Pfizer.
They have $2,500 in savings and $1,000 dollars loan
and a year into the Civil War,
they establish a plant in New York and they are
manufacturing just high quality morphine.
And that's enough business to start Pfizer
and its growth to what it is today.
Edward Robinson Squibb, he was a naval wartime surgeon.
He threw adulterated morphine overboard when it arrived
that was bad when he was actually in the Civil War,
and later knew the demand for quality morphine
and ended up creating that company
together with his two sons.
Some of you might be familiar with two pharmacist brothers
in Philadelphia, John and Frank Wyeth, same thing.
Civil War, Morphine is their first initial product
that they're putting out.
About 70% of their sales end up coming from that drug alone.
The, a chemist and a Union Army Colonel, Eli Lilly,
he missed, he knew the importance of morphine
and good quality drugs because he served in the Civil War.
He tried to open his company, Eli Lilly,
a year left on the Civil War, but he didn't make it.
He opened up just at the end.
Still it was a painkiller that was his seller
for the first 10 years that Lilly was up and running.
Bristol Myers, same thing.
John Myers and William Bristol,
two investors who put up $5,000 each to buy a drug firm.
They renamed as their own.
They did also have a good seller.
They had a mineral salt that was supposedly a pain reliever,
but morphine was still their number one seller.
And if you think it's not just all the names,
Harvey Park was a minor turned investor.
George Davis was a 27 year old salesman.
Their big hit, morphine carried them
for about three decades.
In 1900, they patented a drug called adrenaline,
and it's an actual part of our body.
And other companies said, oh, by the way,
you can't patent that, and they won a court case.
So every other company that has an adrenaline
product has to call it epinephrine.
So only Parke-Davis could call it
actually at that time Adrenaline.
And the last ones are Silas Burrows,
a pharmacist and Henry Welcome.
He was a promoter who claimed to have
invented invisible ink.
It was just actually a formula of lemon juice
that disappeared slowly.
It wasn't very good,
but they did much better with their firm.
You look at these names, it's quite interesting
'cause these aren't just names that we have forgotten about.
These are the names that existed and have grown over
the time to be in the top 10 of the pharmaceutical industry.
They started in a business at a time
with an addictive product, granted,
but one of the few that worked,
and why do I say one of the few that worked?
This time, doctors knew very, there wasn't even an AMA.
Doctors knew very little about what
caused disease, illnesses, infections.
So it was a time that I call the cocaine cowboys day
of the American pharmaceutical industry.
There goes, I think the cover on the mic,
but it's still working.
Anything went.
You could have a, they were called patent drugs.
So morphine was available.
Opium was allowed, mixtures with alcohol.
The, a couple of these products,
these were the big sellers for a 30 and 40 year period.
Laudanum was marketed by a whole series of companies.
That was a tincture of opium, codeine and morphine.
Well, you think that, oh, by the way,
it's not enough to have opium?
We'll give 'em a little codeine as well.
They still don't look like they fell asleep.
How about morphine on top of that?
All three?
It's amazing, more people didn't die.
Dr. Seth Arnold's Cough Killer.
That's fantastic.
It was about 30% morphine.
That'll stop your cough.
Vin Mariani...
Thank you.
And mic.
Sorry about that noise. (microphone brushing)
Better?
All right, sorry.
Vin Mariani is a, was done by a French chemist.
It was a number one seller for a while in the 1870's.
It was restore energy and vitality.
It turned out that that was red wine
with 7.2 milligrams per ounce of cocaine.
(audience laughs)
I kid you not, this was the pharmaceutical industry.
Mrs. Winslow, 65 milligrams of morphine
in a fluid mixed with alcohol and a little bit
of ammonia water.
Now the biggest seller, this was the one that
everybody wanted to get, was Kopp's Baby's Friend.
This was what you gave to your child
so it wouldn't be colic.
It wouldn't cry at night.
It would just be a good baby.
It turns out that it,
and what they did, they were very, very smart.
They went ahead and checked the birth announcements
in newspapers to find out when mothers had new babies.
And then they sent them a sample and then they would
sell them the product.
In fact, it was opium.
It did cause deaths,
and eventually their business went down.
The middle is one of my personal favorites.
The Amazon of its day was of course,
the Sears Roebuck Catalog,
and they sold for a $1.50, a small vial of cocaine
and a hypodermic so that you could be able to buy that.
So it's pretty remarkable to me.
The now, my Tricia's personal favorite is Bayer.
The reason I say that is Bayer was
a real pharmaceutical company,
was selling more prescriptions and more drugs than anybody
else in the world, and over a five year period,
their scientists invented,
found four different class of drugs.
They found acetaminophen.
That was the first in 1897.
Pretty interesting, so Tylenol, and then they discovered
Bayer Aspirin a couple of years later, a true wonder drug.
Aspirin can be fantastic.
And then in 1900, they actually had discovered
before that, heroin, which they patented
after the German name heroisch for,
and they called it heroin.
And that's how it was sold in the US as,
can any of you guess?
A cure for morphine addiction.
(audience groans)
That's pretty good.
That's true, true, I kid you not.
And they invented an entire new class
of drugs with barbiturates.
Luminol was their first product.
And then when they marketed in the United States,
they marketed as phenobarbital,
all without prescriptions,
because you didn't need a prescription.
If you were 18 years of age,
you can walk into any pharmacy,
you could walk out with any of these drugs.
However, Bayer scientists
said one of these drugs is too dangerous to market.
We've done tests on animals of that,
and it looks like it has a high toxicity level.
So they didn't put one of them out.
You know which one?
Tylenol.
Acetaminophen was never marketed because they
thought that was too dangerous.
But no problem with the heroin and the barbiturates.
And this is a, just a quick side note.
Even Bayer, drug companies can sometimes
hide things they don't like.
Arthur Eichengrun, who's the top of the picture there.
He was the Chief of Pharmaceutical Science.
He was responsible for the discovery
of acetaminophen and aspirin.
47 patents to his credit.
Bayer did this massive 2000 page tome,
"The Official History of Bayer" in 1934,
a year after Hitler had become the chancellor in Germany,
and they had already aryanized their company
and kicked all the Jews out.
So they didn't give credit to Eichengrun.
They gave in instead to his assistant,
the man at the lower part, a good aryan, Dr. Hoffman.
Well, Eichengrun complained about that and said,
I was the person responsible
for discovering those two drugs.
And they sent him to a concentration camp.
He lived.
He got out in 1948, he died.
He got out in '45, but he died in '48.
It took until 1999 for a Scottish pharmacologist to actually
track down the story and be able to publish it
and give him the credit that he was
due after all those years.
It's a little side story that I happen to like.
Justice comes, but sometimes is delayed, you know?
Now these are the fellows.
The new sheriff is in town who start to change the way
things happen in the drug industry.
This is Harvey Washington Wiley
and his Bureau of Chemistry.
And Wiley is the person here.
If this works, you might see him,
if I can get this to work, possibly, right there.
That is Harvey Washington Wiley.
He's the son of an itinerant preacher.
He goes to Washington.
That is the entire 1900 Bureau of Chemistry.
Doesn't look like a typical government
bureaucracy we see today, huh?
(audience laughs) They,
and he was from the very beginning,
interested in going ahead and regulating additives to food.
There was no regulations on it.
He thought he could do something about it.
And he was also interested in what he might
be able to do on drugs, but food was his major design.
He has a thing, he calls for volunteers
and he sets up a group called the Poison Squad by the press.
And they are volunteers that dress up in evening wear.
And he cooks them dinners with his staff every night
in the basement of the chemistry,
the Department of Chemistry.
And he puts additives like boron and formaldehyde
and other things into the food.
And he sees how sick they get.
One of them eventually dies,
but he learns a lot in that process.
And he keeps going back to Congress
trying to get a bill passed.
And they say, no, no, no, no.
And everything, as you know, in Congress is a bit of timing.
And so finally, we actually in what
I call the progressive era.
In 1906, he gets his law,
and it's the Pure Food and Drug Act,
and that's Wiley's, he's the driving force on it.
Also helps by the way that at that point,
you had a book done in which for the first time,
you really understand in the jungle, you know,
how the meat packing was done in Chicago,
and how terrible it was.
People were outraged by that.
And it gave some impetus to finally
make the changes in Congress.
All the 1906 law did, first federal law
regarding food and drugs was to say that
you have to put on the label what's inside.
Doesn't have to be safe, doesn't have to be therapeutic,
doesn't have to cure anything, even if you claim it does.
But you have to tell us what's on the front.
And so the first major lawsuit that Wiley brings
after 1906 Act is against Coca-Cola, of all people.
He says, that's because you have caffeine in the drink
and you don't disclose that on the label,
and you don't have coca in the drink.
And you say, Coca-Cola.
The government lost that suit.
The, it wasn't his finest moment unfortunately.
In 1914, not long after,
you know, another eight years later,
government passes the Harrison Act
and that bans all narcotics in the country.
So all of a sudden, the morphine,
the opium, the codeine, the heroin, the cannabis,
the cocaines used in thousands of patent drugs
are out the window.
And a couple of years later, of course, we start that great,
great experiment on no alcohol with Prohibition.
Now you've taken away alcohol,
you've taken away controlled substances,
and you have taken away Pharma's lifeline.
The drug companies went into a tailspin
because they didn't have products.
The one of the things that happens,
and I'll tell you how small this industry was.
In 1909 Moody's, who, you know,
that they rank industries year by year
in terms of their power and effect.
1909, they did their first rankings for American industries.
Where was Pharma?
It wasn't even listed.
That's because it was so tiny that it didn't
count as an industry by Moody's standards.
It wasn't until 1929 that Moody's even listed
the pharmaceutical industry as an industry.
We think of it as something that's been around forever.
The only thing Pharma had was in 1922,
they discovered insulin,
two Canadian researchers up in Canada.
Lilly got the rights to distribute that.
And they were very clever.
They kept those rights for 40 years by sort of getting
the patent extended, extended, extended.
That's a separate story,
but that was the big discovery.
And then what changes the business and makes
the modern American pharmaceutical companies
that we know of is penicillin.
These people right here are the ones that change it.
Meaning up in the upper left-hand corner,
you'll see Alexander Fleming.
He's the doctor, Scottish doctor
who walked back into his lab in 1928 after
being on a vacation and found that the staph bacteria
on the edge of his Petri dishes looked as though it
was being eaten up by some mold that had formed there,
and that was penicillin.
And then it took years later before,
because nobody could figure out how to do anything with it
that would be worthwhile until guys like this,
who is Howard Florey, he's a Rhode Scholar
and Edward Heatley and an immigrant who had fled
Nazi Germany right there, who's Ernest Chain.
They were the British researchers who came over
to the United States in 1938 and '39
and said, we need the funding.
We don't have it.
We're at war.
War started in 1939 when the Nazis invaded Poland.
England was immediately at war.
There's no funding for the penicillin project.
So it's up to the United States to do.
And it is that that revolutionizes
the business for the following reason.
The government, our government put in tens of millions
of dollars into the project to find penicillin
and then give these companies that
came forward to help process it,
the manufacturing capacity in these enormous
fermentation plants that were built for them
to turn out penicillin because we knew that
it would save lives on the battlefield.
That was the primary purpose.
It was actually the Penicillin Project, the number two top
most secret project during the war.
The number one was the Manhattan Project, the atomic bomb.
Number two, right behind it was penicillin.
We worked on that.
We flooded the companies.
We asked for volunteers.
And all the companies I gave you before from Pfizer,
they all came forward and said they would help out.
Government did something very interesting.
Think of COVID and the vaccine and the money that we gave,
the billions of dollars to drug companies.
In World War II, the Roosevelt administration said, okay,
we're gonna build these things for you.
You're gonna be able to process a ton of penicillin,
but nobody owns the patent.
Nobody has the intellectual property rights to the drug.
It's available for anyone who comes in
and wants to be able to make it.
They all said, fine, but you can use the plants
that we're building for you for other things.
Good they said.
As a result, the price of penicillin
after the war dropped precipitously.
And so much so that the companies all started
looking for their own version of an antibiotic.
The 1950's becomes the decade of antibiotics.
And there's a quick thing about this.
You know, the government spent a ton of effort.
They put up over a period of time,
they had public announcements in public affairs to be able
to push penicillin, much like you might see on the vaccine,
on what was happening on COVID.
This is the World War II version of that.
And eventually we do get to a state of antibiotic
resistance, but nobody knows it's coming there.
Here's the stat that's so fascinating to me.
In 1939, if you take a snapshot of the drug world,
one out of every two prescriptions or medications being sold
in the world are being sold by
German pharmaceutical companies.
They dominate the global trade, 50% of the market.
In 1945, the German pharmaceutical companies are decimated.
Most of them have been bombed out.
Their manufacturing facilities are finished.
The American firms now have new manufacturing capacity
available as a result of this massive penicillin project,
and they step into the gap.
By 1950 American pharmaceutical companies,
the top 10 sold 80% of all the drugs in the world
and had 90% of all the profits.
And that sounds like a template that they liked,
and they kept.
In 2005, 60 years later,
the same top 10 companies, the biggest drug companies,
and most successful were the same as those that have
participated in the penicillin project back here.
They sort of got sent out into
the private market with a rocket launch.
And they start to compete with each other
with different versions of antibiotics.
Everyone wants their own antibiotics,
streptomycin and other versions.
And here comes somebody that eventually is a name
you might end up knowing, the Sacklers.
Now you know the Sacklers from opioids.
So you think, okay, what did I do?
Just jump 50 years forward?
No, no, no, no.
The Sacklers had a role in the drug industry far before
anyone ever thought of OxyContin
or thought of marketing as a drug.
They're the three brothers.
They're psychiatrists brothers from the left.
It's Mortimer, Raymond's in the middle,
and Arthur's on the right.
Arthur's the eldest.
They're all the first generation children of Eastern
European immigrants who had moved to Brooklyn.
They were the first of the family to ever go to college.
They went to medical school, they became psychiatrists.
As a matter of fact, Arthur went to NYU.
The two younger brothers who followed
in his footsteps tried to go to NYU,
but NYU had already filled up its
Jewish quotas for the years, so they had to go to Glasgow.
The, and that is Arthur with his second wife,
who turns out to be a German who owns
a small pharmaceutical company in Germany.
The reason that Sackler is so critical
is he revolutionizes the way drugs are marketed.
He comes to an industry that is really, really
back in the 50 years earlier and in the 1900's.
You know what they did for pharmaceutical ads
when he came in?
He bought a small advertising firm.
They would run the insert on the drug as an ad
in the journal of the American Medical Association.
So you know, when you get an insert on the drug
and you look at it and it's four this long
and print this big and you can't even
make heads or tails of it.
That was their advertisement in a medical journal.
Sackler said to them, I can change all of this.
I can go ahead and I can do aggressive selling.
I can do the hard sell Madison Avenue
selling on this type of product.
So we'll do four color ads in everything we can.
We will send out sales reps.
He was the one who invented the idea of sales reps for drug
companies to go out and be able to call on doctors
and be able to push it.
We'll have seminars given, we'll have lecture agencies,
we'll pay doctors to be consultants to our drug company,
and how did he prove it?
He went around to different companies and he said,
I can make your antibiotic into the number one best seller
in the country, and most people say, oh, get outta here.
You know, you're crazy.
That's not gonna work.
We're not interested in spending
a lot of money on advertising.
We have to convince doctors to prescribe the drug.
We're not advertising to the end user, the consumer.
It's a strange business.
Doctors won't listen to advertisements.
But one guy listened to him, Jack McCain.
He was the CEO of Pfizer,
and Pfizer had a drug at the time called Terramycin.
It was their antibiotic.
They had a patent on it.
Now, what was so great about Terramycin?
Nothing.
It was one atom of difference
from a competitor's antibiotic.
The drug that we were competing with was
called Aureomycin by Lederle.
And Pfizer's internal documents already had recognized that
there was no therapeutic and no benefit to their new drug.
Sackler said, if you give me a 10 million budget,
I'll make that the number one drug in America.
And they took a flyer on him, and Arthur Sackler
sent out an army of people when that drug was launched.
And six months later, Terramycin was the number one
selling antibiotic in the country.
And every other drug company started to follow the Sackler
route 'cause they realized that the line that Jack McCain
later gave to shareholders was with Arthur Sackler.
I can't even make a mediocre drug into the best drug around
in terms of the bottom line.
And that was an unfortunate change
because it changes the business dramatically.
Medicine Avenue is one of the things that Arthur coins.
He gets a lifetime achievement award as he deserved.
And one of the things I uncovered,
so you know what, I do book research.
I try to go to Washington to get into National Archives,
to look for old files.
One of the things I like about being
an author is you can't do it all online,
which is fantastic because if we could do it all online,
then I would have no advantage at all to doing my research.
Sometimes you have to go out, we have to pull the boxes,
we have to put on gloves so we don't ruin the documents.
And you have to go through them to find out what's there.
So one of the things that we ended up discovering on this
was when Estes Kefauver had his hearing on the drug industry
in the early 1960's, one of his chief investigator
had come up with a file and a conclusion
that nobody had seen before that says,
during the course of this investigation,
I've heard rumors about the Sackler brothers
or a Sackler empire.
At first I had been under the impression
that this was something of a fringe operation,
but I'd been forced to modify this impression.
And he talks about the number of companies
that they control through subterfuge.
The number of companies in which they have interest
in all areas of the pharmaceutical.
This is 1962.
It happens to be 44 years
before OxyContin ever goes on the market.
It gets lost because the committee has so much else to do.
They call Arthur Sackler to testify.
And it's a great piece.
I covered in the book about how he obfuscates,
and how he dodges the questions.
And he gets away with it.
He pulls it off.
One of the things I found, we got documents finding
from the FBI and one of the most interesting things,
when I published "Pharma,"
I thought this was going to be the big news,
but nobody seemed to care.
Yes, there's a typical FBI document, of course.
Very good.
I enjoy those all the time.
The little bit of redaction,
is that Arthur Sackler and his brothers,
the men that we think of as the epitome
of capitalism in the drug industry,
were card carrying members of the American Communist Party
at a time when it was quite dangerous to be
a card carrying member of the American Communist Party.
The late 1940's into the 1950's.
The, and the FBI investigated them for nearly
a 20 year period at one point for espionage
because of this case of two who had left the country,
and they were friends with them.
They never were able to build a case.
And Arthur of all people,
the Brian Kennedy, where are you?
Oh, there you are.
You'll like this because it relates to you in an odd way.
The Arthur's hero, his moral compass was
another doctor called Norman Bethune,
who was a Canadian communist who had gone to fight first
for the communist in Spain and then went to China
to fight at the front lines with Mao Zedong.
And Arthur thought this was the greatest thing.
This was a person that you could admire,
a doctor who was fighting on the front lines
in the communist revolution.
And then Bethune gets killed.
And Arthur's heartbroken for it.
Mao gives him a special warning.
Arthur later becomes, by the way, the largest collector
in the western world of Chinese fine art.
Many of his institutions are named after him,
collecting the art at a time when it was difficult to get
a visa to do anything in communist China.
But Arthur was not only able to get there,
but get some of the best art out at a very interesting time.
So this was how the brothers were.
And as a matter of fact,
they all worked at a place called Creedmoor,
the Creedmoor Institute for the Insane in New York.
Two of the brothers, the two younger ones had
to leave because they wouldn't sign a loyalty oath.
Because, so the background, the family's fantastic.
When the book came out, I said to Tricia,
always predicting this wrong.
I said, oh my God, it's gonna be big news
that the Sacklers were communists and nobody seemed to care.
Amazing.
I would tell the different reporters and newspapers.
They'd say, oh, that's interesting.
What are they doing today?
The, and we would track the Sackler companies.
I have a whiteboard in the house that I would go ahead,
I literally would put it all together
and figure out where they were.
We found dozens of companies.
They made a mistake.
They used the same telephone number
for some of the companies, the same address.
The same brownstone in New York would have
10 different companies.
Now, we don't realize by looking at that
as that Tricia's kind enough to let me
actually use a a wall of our,
sometimes I have to, I wish I was taller.
If I was an NBA player, I'd be fine.
I could just get up and do that without the ladder.
But sometimes, and then I using that.
So, and you should just note very quickly as I wrap up
on this part of Sackler, his partners
Ludwig Wolfgang Frohlich,
he comes into the US in 1935, leaving Nazi Germany.
And he sets up an advertising firm
at Arthur's sort of encouragement.
Arthur helps finance it and nobody knows about his past.
It's, there's a rumor he could be a Nazi.
He joins Manhattan's University Club,
which had no Jews until 1962.
He joined the tennis club in Palm Beach
is notoriously anti-Semitic.
So they said, oh, he must be a Nazi that guy.
He had a townhouse on off of Fifth Avenue.
Turns out he was actually hiding something.
He was both Jewish and gay.
The, and Arthur was the only one that knew those secrets.
Never used it as blackmail against him.
But at a time when he was keeping it secret and he,
together with Arthur, established a company called IMS,
which today is worth about 20 billion.
But they had sold it long before that to,
they knew then these guys in the early sixties.
We have to figure out who the high prescribers are,
who the big prescribing doctors are.
If we send out sales reps, we don't wanna send sales reps
to some doctor who's gonna sit there
and just give two or three prescriptions.
Let's send it out to the doctor who's gonna
write them from morning to night.
The, and that fellow to the right is Felix Marti-Ibanez,
who is a polyglot who came from Spain.
He fled Franco and he was also a psychiatrist
and becomes the third wheel in this group.
Now, what does Sackler and his friends do?
And now you understand a little bit of how
they eventually market opioid or OxyContin.
The Army never wanted to be behind the eight ball.
The Army does experiments in the 1940's and into the fifties
called the Executive Monkey Experiments.
They would take two monkeys.
They did this hundreds of times.
They would strap them both into, it sounds terrible
until this like contraption where they couldn't move
just their feet a little bit.
And then on one of the monkeys, as you could see,
they put a small box, then they would give
electric jolts to the two monkeys.
And the box in front of the one monkey,
if the monkey started, operated,
would stop the electricity coming to both of them.
And monkeys are pretty smart.
And it would end up learning how to do that.
They would do that until the monkeys eventually died.
Then they would do autopsies on them.
And what they found is that the so-called executive monkey,
as they called it, the one operating the box,
that was a monkey that ended up having ulcers
and heart disease and all types of arterial cirrhosis
and problems when they did the autopsy.
The non-executive monkey didn't seem to have much of that.
Arthur Sackler took that information and said,
oh, that's brilliant.
That's how we're gonna market drugs in the 1960's.
Because the executive monkey, that's a man, those are men.
They're under the stress of going off and earning a income
and having to be tough to the world.
And that's why they always have ulcers and they die of heart
disease, and the other monkey, that's the woman.
They stay at home and they're raising children.
Now let's figure out how we can make
a lot of money for drug companies.
And so what comes is, first there's the pill,
which they're, which is a lifestyle drug.
Then they're marketing Ritalin.
So you can be better with your baby and you know, clearly.
Then there's Milprin, by the way, for menopause.
Don't forget to take antidepressants
if you're going through menopause.
Oh, wanna be slim, amphetamines.
That's always a good product.
You know, we can, that was being sold.
Dexamol, don't forget about that.
It's another stimulant so you can do more housework.
Arthur's always figuring out how to do it.
And then this was his hit ad.
His hit ad was an ad for Valium,
which was sort of the drug in many ways.
And he ran a lot of ads.
But this one ran everywhere.
35, single and psycho neurotic.
And so it starts off with pictures.
It's a fictional girl who goes through all these years
and she turns out next to be 35 years old
and she can't find somebody to marry her.
And she's so distraught over that.
The only answer is Valium.
The Arthur Sackler was chosen by Hoffmann-LaRoche
to market Librium and Valium.
Librium came out first.
Number one drug in the world, Librium for three years.
What knocked it off the top?
Valium.
Valium was the number one drug in the world for 15 years.
It's an unrivaled, unrivaled sales numbers.
And that was Sacklers handiwork,
time and time again being able to do it.
He also had his hand involved with a doctor
in New York, Dr. Robert Wilson,
a star gynecologist who writes a book
called Feminine Forever.
What that says is, by the way,
when you get near menopause,
if you don't take Wyatt's Prempro,
you're gonna end up being just miserable.
You're gonna just shrivel up.
You're gonna end up, your life is over.
You'll lose your femininity.
It wasn't until 10 years later that we found out that that
book and that doctor was subsidized by Wyatt to write
the book, and of course that drug, which they first put out,
had levels of estrogen that were so high that when
the reports started to come back into the company
of blood clots and uterine cancer,
instead of sending them onto the FDA,
they would shove them in the back room.
It took nearly 15 years for that story to come out.
One of the war stories in the Pharma history,
the, but Arthur did succeed on Valium was his big mark.
This is the New York Times talking about Valium Mania.
And this story is coming out in '75.
"Valley of the Dolls,"
one of the most popular books and TVs at the time.
The Rolling Stones had a song, "Mother's Little Helper."
It is about that little blue pill.
That is about Valium.
He made it part of the, what I call
modern culture in some ways.
I used to care, but now I take a pill for that, a um, a uh.
(audience laughs)
All right.
And just as a quick sidelight to show you
how smart the Sacklers were,
Apollo 11 is being taking off in 1969,
and this fellow you may have heard
of called Michael Crichton,
writes a book called "The Andromeda Strain" about a,
you know, this plague coming down
from another world, a microbe.
And suddenly NASA is worried about, oh my God,
what if we bring a microbe down that's
gonna infect the rest of the world?
Arthur hears about that and he goes to them and says,
oh, we have a product called Hibiclens.
It's Betadine.
Betadine is the predecessor.
We have Betadine.
All you have to do is go ahead and use it,
we'll give it to you.
And NASA says, fine.
The astronauts land, they rub it on their suits
and they rub it on the little rubber part there.
And then Arthur, literally, they made nearly $40 million
in the next few months by being able to advertise it.
They were the product that saved the Earth
from the great microbe.
So how do we get to OxyContin?
The woman who's leaning over there is, loves,
I don't have the time to tell you,
but just rest assured that Cicely Saunders
is a British nurse turned doctor,
is one of the greatest stories
because she was a nurse and she said,
I want to create something called hospice.
I'm sick of seeing patients who are dying of cancer
or can't go home 'cause they need pain treatment.
And a British doctor said to her,
no one's gonna listen to you.
You're only a nurse.
They only listen in this country to doctors.
She said, fine.
She went off and became a doctor.
They and she came back with the same idea,
but she was stopped from one thing.
She needed a long acting pain killer 'cause they were giving
the equivalent of morphine in three to four hour drips.
And who came up with the eventual pain killer is a company
in England called Napp Pharmaceuticals, and who owns it?
The Sackler brothers.
They came up with a little invisible polymer wrap that
meant you received the pain every 12 hours
and it was morphine inside.
And she established the first hospice based on that in 1966,
a drug was called MS Continuous.
And then OxyContin is the same 12 hour delivery system.
But this time it's oxycodone.
That comes out in 1996.
Now why do I see the FDA?
You cannot...
How does an end of life drug for terminal pain
turn out to be one of the most popular drugs in America?
Only when the approval is given at the FDA
in 1995, comes out in '96 to say that,
well we think because it's a 12 hour relief,
it's probably not subject to such abuse as regular pills.
All you had to do was crush the pill.
All you had to do was break it and release
all of the amount of oxycodone inside.
But for some reason they didn't think of that.
It turned out to be just as addictive.
They thought the addiction rates were lower.
Doesn't help the public perception that Dr. Curtis Wright,
who was the doctor who was involved at the FDA to approve
the labeling that was really unprecedented
about how it could be applied,
later went to Purdue two years later to work for a job,
10 times the salary that he was getting at the FDA.
And then over a period of time the FDA failed.
OxyContin comes out in 1996.
There's problems from the very beginning, but by 2000
and 2001 there were reports in the New York Times
and other publications about
diversion and cases of addiction.
So the DEA says, okay, let's look into this.
They get a panel of 10 experts together,
and the experts come back and they say, no, it's fine.
It should continue to be used for chronic pain,
not just end of life pain.
Eight of those experts had worked for drug companies,
half of them had worked for Purdue
or had were working for Purdue.
But that wasn't a conflict of interest that
the FDA was worried about the, unfortunately.
So what happens with the Sacklers?
They're one hit wonder.
Arthur's dead at this point.
The brothers have a company called Purdue
and they have one drug, that's it.
And it's OxyContin.
And what does it end up doing for them?
It ends up putting the brothers
onto the Forbes list in 2015
as one of the America's richest families
worth then an estimated 15 billion.
And they start to put their names, as you know,
the Sackler School of Medicine in Tel Aviv,
Sackler School of Medicine and Biomedicine at Tufts.
You had the Sackler Institute at Yale.
It's a Sackler Museum at Harvard,
the Institute for Development Psychobiology at Columbia,
the Arthur Sackler Gallery with his
Chinese collection at the Smithsonian,
the Sackler Wing of Oriental Antiquities at the Louvre.
It went across the world.
These brothers had become famous and they had become
billionaires off of a drug that was leaving a trail of death
and destruction across the US.
And there's a pushback that starts.
That lady up in the left,
she is the person at the heart of a chapter
I have called "You Messed With the Wrong Mom."
Her daughter Jill died of OxyContin.
She'd gone to see a local doctor for back pain,
prescribed OxyContin and died of an overdose.
And Marianne Skolek said, I'm a registered nurse.
What are they giving her that for?
As a matter of fact, that's a drug that you
should be getting only in the worst possible situation.
And she became a one person power horse
against the Sacklers.
I have met since the book, parents who have lost children
on Fentanyl and others, Ed Bishop and others,
they have remained activists
in trying to go after the Sacklers.
Finally, the public pressure worked, took a long time,
but the names started to come down.
And what's the result of all of this pushback on OxyContin,
the overuse of what's taken place in opioids
and how freely they were marketed and given away?
I did three op-eds by the way on this over
in a period of a year in the Los Angeles Times,
how to hold Purdue accountable for its role.
I wrote two pieces in the New York Times,
believe it or not, with with bankruptcy professors,
one the Sacklers could get away with it.
And then about the last poison pill they had.
And guess what?
They did get away with it, despite all of this.
Meaning that they got to pay money.
This is what happens in the pharmaceutical industry.
You do something wrong, lives are lost sometimes,
outrageous behavior,
but you don't have to worry about going to jail.
You end up paying a fine.
So you put a lot of money up,
you've made more money than that before.
And that's what happens here.
They pay six billion.
It's amazing, but they still have billions left.
So they walk out of bankruptcy for their company
without any problem.
And what's happened overall?
All of the distributors, all of the companies involved,
and we're talking Walgreens now, the big chains,
the distributors like Amerisource Bergen and others,
Johnson and Johnson, for drug companies,
Cardinal Health, they've all contributed over 50 billion.
It's actually $54 billion.
And how much of it goes to the real victims?
Pennies, pennies.
It ends up going to the states for the most part
to do harm reduction for the future,
for the next crisis that we have
with fentanyl or whatever else.
Fantastic, it's being used for something,
but it's not being used in terms of the victims,
unfortunately here at all.
The, if you think, by the way, as I wrap up here,
that COVID was a scare and a half,
and the government got used to exercising control.
The penultimate chapter in my book
is called "The Coming Pandemic," but doesn't mention COVID
because I published in March of 2020.
In two days it'll be March 10th, it'll be three years.
This is a pandemic that was told to us by the doctors
we interviewed who are infectious disease doctors who said,
oh, you want to, next pandemic is going to be the worst.
And that's gonna be a bacterial infection, a superbug.
Well COVID was only a virus, so they're still waiting
for the superbug to come out.
When that comes out, they'll already be doing it.
But the one thing I know is that no matter what comes next,
I'm prepared, Tricia and I are ready.
And we also have even, you know, our book can be ready
for the next pandemic because "It's Masked Up", the...
(audience laughs)
And all I can say to you is there is some hope.
I do think you can't regulate your way
out of the pharmaceutical industry.
It's a strange business.
It's at the crossroads of public health.
We are the last country, good for capitalism, to allow them
to set their own price so they get
to set whatever price they want.
It's also why we have the highest drug prices in the world.
And it's a tough situation to balance,
but as long as you have companies that have to meet
quarterly numbers on Wall Street and serve the bottom line,
it's never gonna be the best
for serving medicine and patients.
Thank you very much for all your time.
(applause)
-: Woo! (applause continues)
-: Thank you.
Mr. Posner has agreed to sign copies of his book
"Pharma: Greed, Lies and the Poisoning of America,"
following the lecture in the Sur Lobby.
We now have time for Q&A.
If you have a question,
please make your way down to a microphone.
Student questions will be given preference.
-: Yes, thank you.
So what about the responsibility of the prescribing doctors?
I mean, it's not just,
you have to have a prescription to get this right?
That's question number one,
and then isn't there also responsibility of the people who
are taking the drugs, right?
I mean it's a voluntary act, you know,
so is it all on the pharmaceutical companies?
-: No, good questions.
First, there were some doctors right before OxyContin came
out who were pain doctors up at Memorial Sloan Kettering,
the big cancer hospital who thought that
opioids had been tarnished too long.
They weren't that addictive and they led sort of a revival
of the idea that you might be able to take opioids
and not get addicted.
So that was, some doctors were sincere about that.
The other, the problem though of the over-prescribing
doctors is that some set up the equivalent
of what I call pill mill, in which they would operate
all the time writing as many prescriptions as they could.
Some have gone to jail, some lost their licenses.
So those doctors existed.
The problem is the manufacturer knew,
as I point out in the book, which doctors were operating
essentially as a legal drug clinic
and kept flooding them with more
prescriptions than you could imagine.
So little town in Kentucky gets five million prescriptions
for a town of 3,800 people.
You have to know something's going wrong,
and they're diverting it into the illegal market.
So that was part of the problem.
And I do think there is a, the patients on the other hand,
they often were put on a drug that they didn't know
because they were told by doctors the chance of addiction
is very, very low, could then become addictive.
And so I have a lot of sympathy for the patients after
having dealt with so many of the families
if that makes sense.
-: Hi, thank you for speaking tonight.
I am Dr. Toula Berti.
And I have a question regarding cannabis.
I believe that it is being sold to our youth
and almost like the new snake oil that a cure for,
there's a cure for everything
if you take a cannabinoid or a cannabis.
What do you have to say about that,
or do you think it is pharma's next big project?
-: Well, I'm surprised that pharmaceutical companies are not
yet into the cannabis business in terms of marketing.
And we're going to find out in the next five,
10 years or sooner, what cannabis can do medicinally,
no question.
What I'm not a fan of, and I know I sound antiquated
when I say this, not a fan.
I know the state has recreational cannabis.
I just think that that's ahead of the game.
We're sort of a, we are a living experiment.
We are the sort of, you know, ongoing test to find out
what the long-term effects of regular
recreational strong THC cannabis will do.
So I'm not sure how you divide those two,
but I think we will find out.
The minute you start to hear that Pharma companies are
buying cannabis farms and companies, then, you know,
they're about to turn out a patent,
a product that has a patent on it that they can hold.
Thank you.
-: Thank you for your lecture Mr. Posner.
I had a question about the argument over government
intervention when it comes to drugs and how do you respond
to the people that say that the huge change in the way that
Oxys were used when they started to prescribe them for more
than just, you know, when, when you were on death's door,
but for just chronic pain and things like that.
What do you say to the people that that argue that it was
capitalism's fault, that those lines were drawn back.
It was an interest in profits
rather than the general welfare.
And that the result of that is we need to have more
government intervention to limit the uses?
-: Yeah, so I mean it, OxyContin was a problem
in European countries, but not nearly
the problem was in the United States
because the control of the supply of drugs is tighter.
You have national sort of medical boards
that set the pricing for the drugs.
The doctors are monitored a little bit more,
but that's the price we pay sometimes
for what I call unfettered capitalism.
There are still tools that could
have stopped this even with the drive for money,
as was the case here.
The FDA could have come in early on and said, guess what?
You can't get a refill on this prescription.
You can't do a prescription of more than 14 days.
You have to come up with a special reason.
Instead, they had no limits at all for nearly 14 years.
There were things we could have done separate
from the money that might have had some better control here.
I'm not sure if we ever learned because the same thing,
sorry, the same thing happened on Valium
and all the benzodiazepines.
They were over-prescribed, took years.
And then the next big thing after that was Prozac
from Prozac Nation and it was over-prescribed,
and then we went through the OxyContin.
So what will be the next one?
There's always something that Pharma gets into that
can be abused that has a slightly dependent nature to it.
And then they overzealously market it, sell it,
and then we learn the lesson again for another generation.
I don't think it's necessarily capitalism's fault as much
as it is just a lack of common sense
sometimes in terms of controls.
-: Hello Mr. Posner.
Thank you for speaking tonight.
So I was just wondering after, you know,
sitting through the talk here, I kind of was getting some,
I guess I was kind of hearing both ways.
So on the one hand, you know, the start of Pharma
as a major industry was largely because there was, you know,
all this government involvement in it and then, you know,
there were problems from there.
But then on the other hand, I'm hearing this story more of,
you know, maybe there're ought to be government controls.
So is the, so like are we talking, you know,
which direction are we talking about going with government?
And then, you know, I know our government is one of the few
that allows direct to end consumer
advertising of of drugs.
So I was just curious if how far you think changing that,
those rules would go to solving some of these problems?
-: Yeah, yeah.
I look, I tonight I gave you a presentation
of Pharma that was pretty bad,
you know, bad Pharma as I call it.
But also in the book there's good Pharma
and they have come up, there are scientists
and researchers working in the lab to come up with cures.
They are making breakthroughs on some childhood cancers
and genetic cancers that are great.
They, you know, penicillin was a fantastic thing and they,
the polio vaccine turned out to be
pretty good for an entire generation.
So it's not all bad, but at the same time,
you just said direct to consumer
advertising is a perfect example.
We passed that in 1997.
The FDA gave it a green light.
You know how many other countries have it?
One, New Zealand.
That's all.
For some reason those are the only two countries
on the planet that think it's a good idea
to go ahead and allow drug companies to spend billions
of dollars to target us, the consumer,
because we can't write the prescription.
We need doctors to do it.
And I heard Brian earlier say that that buys some control
for the companies over the networks.
That's true.
But let me tell you, it also is a big return
for them because they know,
and Sackler was the first one to say this,
but they all believe this to be the case now,
that you can drive consumer demand,
not withstanding all the things that we heard before about
the list of side effects that you'll see
at the end of an advertisement.
Somebody who has diabetes or heart condition
or whatever else will say on a new drug.
It's got some bad side effects, but you know what,
I'm gonna go and ask my doctor about that.
That's what they want.
They want to drive demand from the patients to the doctors
to prescribe the newest and latest and greatest.
So it's an industry that I think,
I don't like a lot of government regulation,
I don't like government, you know,
then saying we're gonna to monitor that we're gonna,
you know, have a national health system
like Tricia's England has.
We see all the problems with that.
So I prefer the free market system working.
But I do think you have to be careful
'cause you're working on a strange business.
It is public health.
Look on COVID last thing, I'm sorry.
We gave, at first Donald Trump was
President, Democratic Congress.
The first tranche of money that went out was eight billion
to when COVID first started.
In that $8 billion, three billion went to drug companies.
The first draft of the bill said, by the way,
nobody can own the intellectual property rights
to any vaccines that come up.
A week later when that money went out, it was out.
Pharma buys influence on both sides of the aisle.
They're very smart.
It's not just one party.
They can have somebody on each side,
and they were able to do it then.
So instead of having the vaccines freely available,
although they were free, but governments paid for them,
but companies got to own the rights,
patent them and make $50 billion in the case of Pfizer.
-: With the way that pharmaceutical companies
are beholden to profits and shareholders,
isn't there a conflict of interest somewhat for punitive
measures given to those companies
in regards to public health?
'Cause as you said, no one had went to jail
for the large scale advertising and resulting
over prescription of OxyContin and even prior drugs.
-: Yeah, I mean it's very interesting question
because punitive damages almost never
get applied to them here.
And there is a question,
people don't want to hurt the public companies.
One of the things about the Sacklers and Purdue
is they were a privately family held company.
There are very few of those,
so it was possible to go after them.
But what was interesting, the most punitive action to take
against any of them, including the public companies,
would be in a case in which they hid
the evidence about the side effects the,
and it was later shown to be lethal and they kept
on the market longer than it should have been.
I always wonder why there aren't criminal indictments.
And I've called for at least a criminal investigation
on some of the Sacklers who controlled the board for years.
Evidently nobody in the Department of Justice is listening
and none of the state attorney generals are interested
but until there are criminal probes
on some of the most egregious examples,
you're not gonna scare these executives.
They pay the fine, they still get to go to the country club.
They still get to be accepted
for the most part in their society.
Maybe the Sacklers are a little taboo now because they were
too public for too long, but it doesn't really hurt them.
And that is the problem.
You talk about, you know, when you say punitive,
I think of it as a lawyer, the punitive damages.
But there has to be punitive action taken when people's
lives have been cost for the purpose of the bottom line.
Thank you, oh sorry.
-: Hi there.
Thank you so much for your talk.
So you mentioned Sacklers involvement in Pharma
and Mr. Kennedy gave a speech earlier
about the Communist Party and the involvement in big Pharma
and its communist party involvement
in American pharmaceuticals has
undoubtedly only grown since Sackler.
I was wondering if you found anything related to that
in your research, or if you have a hunch of any kind?
-: Yeah, something very interesting.
So, Brian Kennedy was right, 90% of that,
some antibiotics go through China in terms of the supplies
that we need and the way that
the active ingredients are put together.
But guess what?
Take the top 10 most expensive drugs in the world.
They're all what are called orphan drugs.
I have a chapter called "Billion Dollar Orphans."
You'll wonder what that is.
But the Pharma companies game that very, very well.
Those drugs, guess what they're manufactured?
Here or in Europe.
We don't send those abroad.
So the expensive ones, the ones that are 200,000 a year,
they're for special cases.
The ones that make the real bottom line profits.
Here we're sending out antibiotics
because nobody's interested
'cause it's $4 at Walgreens for a weak supply.
We shouldn't be having any of that, I agree.
But it's interesting that when you look
at the real proprietary things,
the things that they make the most profit on,
they're keeping control of.
We don't make much here, but to the extent we make it,
it's the big money drugs.
-: Tag, I'm it.
All right, my life, I'll have to send you my CV
because you're not gonna believe
how much I have seen of what
you've spoken of through my career.
But I will tell you that in the mid 2000's
in my neurosurgery practice,
I had a nurse practitioner join me who'd actually
been a nurse and a medic, a nursing student
in my practice before that.
And the nursing schools had a shift
from the time he was in his bachelor's
to his master's degree
about this pain being a fourth vital sign.
And the push of these pain scores
in to clinical practice was almost overwhelming.
And I'm here, you know, I'd been in practice
for a decade already going and with my pharmacy
and medicine background,
we were extremely conservative of narcotics.
And he was coming to me going, but this, and you know,
the nurses were all upset about pain scales.
And I said, look, this stuff's addicting.
You can't keep people on it.
It's bad.
I don't care what form it's in, it's gonna cause problems.
And that came in through the schools
of nursing and schools of medicine.
And because of that, people were misled
as with the more recent issues with COVID
and vaccines, bad data, bad,
and it was partly marketing.
It was a lot of pressure, a lot of funding
from pharmaceutical companies to medical schools
and nursing schools to give people a bad clinical protocol.
There's, yeah, the question is this, okay,
so with that as a background, I think my question is,
can you please emphasize how important individual
discernment is when new information is presented?
And these people
coming at you with an air of authority
have to be questioned.
They have to substantiate their recommendations
and these trends.
These are trends that come across
and they come from the top down.
And we've heard about that all week long.
And then lastly, I'll just, I wanna list three drugs
and see if you have any impressions on them?
Darvocet, demerol, and I forgot the last one anyway,
I'll think of it and I'll bark it out at you.
Thank you.
-: The, just very quickly, it was right before OxyContin
came out that there was a push to get,
as she said, pain is the fifth vital sign.
So you would go to the doctor before that
and they would say, well you should take your blood pressure
and your pulse and your temperature.
Then you would go afterwards, they'd have a little scale.
The first agency that accepted that idea
was the Veterans Affairs Association.
So the government said yes, and then everyone followed.
So now you go and they say,
what's your level of pain on a scale of one to 10?
And then they try to treat that.
I think that part of the problem here,
and you see it very, very well,
is that it's not just Pharma, it's the medical associations
that work together with Pharma will
sometimes enable and empower Pharma.
So what happens?
The pain scale helped the drug companies a lot.
So did the fact that it used to be that 130 over 80
or 130 over 90 in Britain was a fair blood pressure.
Now it's 120 over 70.
I got it very few people have that.
Once they changed that they added nearly 15 million people
to the new prescription medication.
What about sugar?
Oh, if your sugar's 110, that's normal.
How about making it a hundred?
Which they did.
They added six million people to the number
of people took prescriptions.
So they have to have their partners sometimes in the medical
associations to make the numbers a little stricter
and to be able to push it along.
And I see that partnership play out because they both feed
each other at times on those critical things.
One last thing and then we'll leave.
One of the things I've been trying to research
and write about a little bit is Lupron, AbbVie's product.
AbbVie makes a lot of money.
Lupron is used for chemical castration of sex offenders
and it's used in prostate cancer
because it lowers the testosterone level.
So it's one of the treatments given,
and it's also used in gender dysphoria as a gender blocker,
hormone blocker for adolescents who are considering changing
their gender and doctors are allowed to prescribe off-label.
It's one of the benefits they're given.
They're, because they're physicians,
they can take a drug and not prescribe it
for what it was tested for.
And AbbVie knows this is how the drug is being used
and knows it's the major use of the drug
and knows it's the most profitable use of the drug.
But of course doesn't have to do anything
because that's the way we've created the rules.
That's something we could change.
But that's a discussion for another time.
-: (mumbles) ivermectin.
-: Yes. -: Yes.
-: And so with Ivermectin, which is astonishing to me,
and you all know this, what infuriated me about Ivermectin
is they didn't allow the debate.
That's what was amazing.
Scientists and doctors and researchers do
what they should do, have the debate,
and instead of you suggested that you were banned,
you were cast aside, you were considered a quack.
That shutdown, that type of censorship
is exactly what we should be worried
about and I am worried about.
All right, thank you.
(applause)