Who's afraid of The Real Anthony Fauci?

Who’s afraid of The Real Anthony Fauci? comments.bmartin.cc/2022/05/08/whos-afraid-of-the-real-anthony-fauci Brian Martin May 8, 2022 Robert F. Kennedy Jr.’s book The Real Anthony Fauci has sold over a million copies and was on best-seller lists for weeks. Yet, apparently, it has not been reviewed in the US mainstream media. This intrigued me. Since the beginning of the pandemic, I’ve been following arguments from a range of perspectives: the Covid orthodoxy — which keeps changing — and a diversity of critics. It was hard to avoid hearing about Kennedy’s book, published in November 2021, but I thought it probably addressed issues regularly canvassed among sceptics about Covid orthodoxy. I read about attacks on Kennedy and his book published in the New York Times and elsewhere, attacks that did not address the contents of the book (Brown, 2022). Still, that wasn’t enough to get me to read it. Then I read a commentary by Phillip Adams (2022), a prominent progressive voice who has a column in The Australian, otherwise a bastion of conservative opinion. Disappointingly, Adams disparaged Kennedy, calling him a “full-time conspiracy theorist,” and dismissed his book as “a long diatribe that would appeal to anti-vaxxers” without saying anything about the book’s contents. That did it: I resolved to read the book myself. 1/23 Robert F Kennedy Jr. The Real Anthony Fauci is about Fauci, to be sure, but in a wider sense it is about the pharmaceutical industry and its hold over the US and global health system. Fauci is the hook for a more wide-ranging examination. I am a social scientist, not a physician or medical researcher, and have not attempted to get to the bottom of claims and counter-claims about Covid and health matters more generally, for example studies of hydroxychloroquine or adverse reactions to vaccines. But based on a long study of the politics of health, it is possible to make some judgements about whether Kennedy’s analysis is compatible with scholarly treatments. The Real Anthony Fauci is a lengthy tome, massively referenced. Kennedy acknowledges a “team of researchers and fact checkers who sourced, cited, and factchecked this manuscript” (p. xii), and indeed there are lots of “facts” in the book, more than a single investigator might expect to verify in a few years. The book is available in electronic form and in print which, due to the small font and narrow margins, is not appealing to the eye. Even so, I preferred to read the print version. There is no index. Another issue is the organisation of material. For the most part, the chapters are coherently written, but occasionally there are digressions, some of them reprising themes covered elsewhere. In other words, the book is not as tightly constructed as it might be. On the other hand, it is quite up to date, suggesting it might have been rushed to publication. In the following, I look in most detail at Kennedy’s treatment of Covid issues, and then turn to some other parts of The Real Anthony Fauci. 2/23 Pandemic matters Many readers will be most interested in chapter 1, “Mismanaging a pandemic,” a lengthy and up-to-date treatment. Much of the chapter is on treatments for Covid, specifically hydroxychloroquine, ivermectin and remdesivir. Kennedy’s argument is that US health authorities and media followers tried to discredit cheap, safe and effective treatments, meanwhile promoting expensive, dangerous, less effective and inadequately studied responses. Here’s the story in brief, as presented by Kennedy. Hydroxychloroquine and ivermectin have been used for decades for a variety of health problems and have wellresearched safety profiles. Some doctors and researchers thought they looked promising as treatments for Covid, tried them on patients and obtained positive results, often in protocols also involving zinc, vitamin C, vitamin D, quercetin and other supplements and medications. The US medical establishment, in which Fauci played a key role, did not initiate a massive research effort to see whether these protocols were effective. Instead, they poured money into a patented treatment drug, remdesivir, and into the development of vaccines. Then, when some doctors and researchers championed hydroxychloroquine and ivermectin, Fauci et al. mounted an attack on these two drugs and tried to deregister or discredit their supporters. You might have heard ivermectin referred to as a “horse dewormer,” making it seem ill-advised for human use. Media coverage with this sort of depiction seldom mentions that doctors regularly prescribe drugs “off-label.” Calling ivermectin a horse dewormer reminded me of antifluoridationists who call fluoride “rat poison.” Sodium fluoride is indeed used as rat poison but only in doses far greater than can be obtained from the fluoride added to public water supplies to reduce tooth decay. Similarly, that ivermectin is used as a horse dewormer should not automatically discredit its use, in much smaller doses, as a preventive or early treatment drug for Covid. 3/23 Kennedy documents a massive campaign to discredit hydroxychloroquine and ivermectin. This campaign had a research dimension. Some studies of hydroxychloroquine used it only on seriously ill patients when, according to proponents, it is least effective. Kennedy says researchers set up their studies to show hydroxychloroquine didn’t work. Then there was a major paper published in the prestigious medical journal The Lancet based on nearly one hundred thousand patients in numerous hospitals, definitively showing hydroxychloroquine was ineffective. It seemed like the coup de grace until it was revealed that the data could not be verified. The company running the study apparently organised a giant fraud. The Lancet retracted the paper. Why should there be such a campaign against cheap drugs that showed promise in treating Covid? Kennedy gives an answer: the US Food & Drug Administration, by law, cannot approve a vaccine for emergency use if there is an available treatment. Pharmaceutical companies, then spending vast amounts of money developing Covid vaccines, would not have their vaccines approved quickly if hydroxychloroquine, ivermectin or other therapies were shown to be effective as treatments. Kennedy quotes supporters of these two drugs saying that if they had been widely available in the US, hundreds of thousands of lives could have been saved. Instead, according to Kennedy, the CDC (Centers for Disease Control and Prevention), in an unprecedented move, ordered doctors to stop prescribing ivermectin, bought up stocks so they would not be available for sale, and encouraged pharmacists to refuse to fill doctors’ prescriptions. Meanwhile, Fauci’s favoured treatment drug, remdesivir, was pushed through the approval process despite studies showing minimal benefits and a high-risk profile. According to critics quoted by Kennedy, the use of remdesivir contributed to the death toll from Covid in the US. 4/23 Then came the vaccines. Kennedy provides figures showing Covid vaccines are far less than fully effective and cause far more adverse reactions than officially reported. The underlying motive, or factor, is clear enough: pharmaceutical company interests. Hydroxychloroquine and ivermectin are not under patent, and a course of either one costs only a few dollars, so there is little money to be made from them. In contrast, remdesivir and Covid vaccines were financial bonanzas, offering profits of billions of dollars. This story is a damning indictment of the US medical establishment, basically saying that cheap and effective treatments were discredited and made hard to obtain so that proprietary drugs and vaccines, with dubious safety profiles, could become the preferred way to deal with Covid, all at the expense of large numbers of lives. This story is almost a reversal of the views presented by government officials and the mass media, in which hydroxychloroquine and ivermectin are suspect and vaccines the only long-term solution. Is Kennedy’s analysis of pandemic politics compatible with viewpoints expressed in the field of social analysis of health and illness? To address this question, I look in turn at four areas: undone science, analyses of big pharma, the role of Fauci, and suppression of dissent. Undone science David Hess, professor of sociology at Vanderbilt University and author of many works on science and health, developed the concept of “undone science” (Hess, 2016). It refers to research that could be undertaken, and is called for by civil-society groups, but is not pursued because the findings might be unwelcome to powerful groups. Undone science is most commonly found in the areas of environment and health. Hess focuses on undone science involving environmental risk, but the concept can also be applied to vaccination safety research. For many years, critics have called for comprehensive studies comparing the health of unvaccinated and fully vaccinated children (e.g., Golden, 2019), but governments have not funded any such studies. It could be that such studies would definitively show the 5/23 benefits of childhood vaccines but there is a risk they might show harms greater than publicly acknowledged. So this research remains undone except for relatively small studies not funded by governments or vaccine manufacturers. The concept of undone science sidesteps debates about the nature of knowledge, focusing instead on research agendas. It can be slightly broadened by referring to topics that companies or governments investigate but then do not publish their findings. Kennedy’s account of hydroxychloroquine and ivermectin fits perfectly in the model of undone science. Despite calls from doctors and patient groups for studies of these and other cheap and widely used drugs for Covid, pharmaceutical companies and governments did not urgently pour billions of dollars into studies. They basically ignored these calls, instead channelling their research dollars towards proprietary options. This does not prove that hydroxychloroquine and ivermectin are effective, but it does suggest that the way the medical establishment responded to calls for studying these drugs fits a well-established pattern. Big pharma It may seem shocking to imagine that companies making billions of dollars would compromise the health of populations just so they could make more billions. Is this plausible? In the 1960s, the German drug company Grünenthal marketed a morning sickness drug, promising wonderful effects. The company began receiving reports from doctors that their patients were suffering serious side effects from the drug, including peripheral neuropathy. Grünenthal ignored the reports and continued marketing the drug, and in some cases tried to discredit the doctors. This might have continued indefinitely, but then reports were published about pregnant women on the drug giving birth to children with serious deformities. This was enough to have the drug withdrawn from sale. Despite the damning evidence, Grünenthal denied responsibility and fought lengthy legal battles to avoid paying compensation (Insight Team, 1979). 6/23 This is the story of the drug thalidomide, which became a famous emblem of corporate culpability. Was Grünenthal’s behaviour an outlier or a sign of things to come? Consider the tactics used by Grünenthal: marketing a drug before it had been sufficiently tested, ignoring reports of adverse effects, attacking critics and undertaking protracted legal means to avoid paying compensation — and never admitting wrongdoing. For some, it may be hard to believe companies could act in such a way. After all, they present themselves as supplying valuable solutions to health problems. Could they really be corrupt, enriching the pockets of executives and shareholders at the expense of public health? According to a range of critics, the answer is yes. The story of thalidomide became notorious but the same pattern has been repeated many times, except with less adverse publicity: the companies have become more sophisticated in their efforts to make exceptional profits without accountability. Ben Goldacre is a doctor and science journalist who wrote a scathing attack on alternative medicine, Bad Medicine (Goldacre, 2008). Then a few years later, perhaps to emphasise he wasn’t playing favourites, he wrote Bad Pharma, an exposé of the pharmaceutical industry, giving example after example of how researchers studying drugs for companies fudge their results, for example by fixing endpoints, ignoring adverse effects and using physiologically active placebos. Bad Pharma provides revealing stories of what might be called systematic scientific fraud (Goldacre, 2012). 7/23 Sergio Sismondo is a prominent figure in the field of science and technology studies, among other things having been editor of the premier journal Social Studies of Science for many years. He undertook a detailed investigation of the publication and marketing practices of pharmaceutical companies, for example attending conferences for pharmaceutical company liaisons and sales representatives, who use various forms of persuasion to encourage doctors to prescribe favoured drugs. In his book Ghostmanaged Medicine, Sismondo (2018) documents the process by which company researchers produce papers for publication in top medical journals, finding academics who have had little or no involvement in the research to be the nominal authors, thereby giving the papers greater credibility. After publication, these papers are distributed to as many as hundreds of thousands of doctors as part of well-coordinated marketing efforts. In Sismondo’s picture, medical research is a just part of a marketing enterprise. Peter Gøtzsche is a medical researcher who helped set up the Cochrane Collaboration, a network of independent scientists who carry out assessments of drugs and other medical interventions. Gøtzsche himself is a highly energetic investigator and a fierce critic of shoddy research and corrupt practice. In his book Deadly Medicines and Organised Crime, Gøtzsche (2013) gives numerous examples of pharmaceutical 8/23 companies that market products they know are dangerous. He says the pharmaceutical industry is just like organised crime in knowingly harming people, the main difference being that the industry kills far more people than organised criminals. In addition to analyses by Goldacre, Sismondo and Gøtzsche, one can turn to indictments by former editors of major medical journals (Angell, 2005; Smith 2005). Then there are pharmaceutical company whistleblowers who have told about corrupt practices from an inside perspective, as well as about the reprisals they suffered for speaking out (Rost, 2006). In this context, Kennedy’s analysis of Covid politics is nothing surprising. It is plausible that companies would promote responses to the pandemic that serve their own interests, even at the potential cost of large numbers of lives. But how could scientists and executives do such a thing? For the scientists, it is straightforward: they are part of a larger system, and they can just focus on their own narrow tasks (Schmidt, 2000). For executives and others, belief systems are convenient. They can truly believe that they are serving the public interest — or they can adopt any of various justifications for their actions. It’s not necessary to imagine that those who promote medical interventions as the solution to the pandemic have some secret agenda, scheming to cull the population. There is a well-known precedent, after all: the tobacco industry, responsible for the premature death of tens of millions of people (Proctor, 2012). We don’t need to think big tobacco is run by homicidal maniacs with a secret agenda. Well, they do have secrets, but for the purpose of maintaining and expanding markets for their products and making more money. The role of Fauci Kennedy’s book is titled The Real Anthony Fauci so it is hardly surprising that Fauci plays the lead role in Kennedy’s account of responses to Covid. Kennedy says relatively little about the politics of treatments and vaccines outside the US, except in as much as they 9/23 support his argument. Is it reasonable to blame Fauci personally for so much of Covid policy? Anthony Fauci One alternative is to use a structural analysis, standard in social science, that focuses on institutions and processes and sees individuals as epiphenomena. In this sort of picture, the drivers of the responses to the pandemic include the pharmaceutical industry which created the basis for a Covid paradigm — a hegemonic way of understanding Covid and what to do about it — that serves to support the industry’s interests. Responses to the pandemic were also influenced by political leaders who gained support by implementing tough policies, from the mass and social media that gave saturation coverage of the Covid threat without much historical or social context, and audiences frightened by a Covid hysteria and who looked to authorities for protection. Using this sort of structural analysis puts Fauci in a different light. He may have had an outsized influence on developments, but if someone else had been in his position, the outcome may not have been all that different. How to assess the value of a Faucicentred analysis as compared with a structure-centred analysis is not straightforward. One way to proceed might be to undertake a comparative analysis of Covid responses in different parts of the world, looking at the roles of key individuals and policy decisions. For example, has the Swedish policy, widely seen as a contrast with policies in other European countries, better explained by Swedish history and institutions or by the influence of key individuals, or some combination? Kennedy’s focus on Fauci can also be understood as a narrative device, as a way of creating interest in the story. Readers may be more attracted by a story of a scheming individual than by the operations of faceless organisations and sets of ideas. You are reading Kennedy’s story about Fauci, the master manipulator at the centre of a web of influence, and learning about drugs, policies and much else along the way, without having to plough through the sort of prose found in a sociology monograph. Suppression of dissent 10/23 In a revealing passage (pp. 142–143), Kennedy tells how for years he was able to have articles published in major newspapers and was widely sought after as a speaker on environmental issues. Then in 2005 he wrote an article about corruption in CDC’s vaccine branch, published in both Salon and Rolling Stone — and everything changed. His articles were removed, newspapers henceforth refused to publish his articles, and speaking engagements dried up due to complaints to venues or hosts. Throughout The Real Anthony Fauci, Kennedy describes how critics of orthodoxy have been suppressed, including losing their funding, being deregistered and being subject to derogatory misrepresentations. For example, in the 1970s, distinguished scientist J. Anthony Morris questioned the promotion of a flu vaccine. Kennedy describes the methods used against Morris: “… enforced isolation, disgrace, prohibiting him from publishing papers, presenting at conferences, or talking to the press, changing his laboratory locks to prevent further research …” (p. 360). I had read about this case earlier (Boffey, 1976). Based on my studies of “suppression of dissent” (Martin, 1999, 2015), this aspect of Kennedy’s account is completely believable. What he describes accords with experiences reported by hundreds of other scientists and campaigners. Pandemic matters: summary Kennedy provides a hard-hitting critique of US pandemic policy. Contrary to the official narrative that vaccines are the salvation and that hydroxychloroquine and ivermectin are kooky or dangerous, Kennedy argues that these two generic drugs, if used appropriately, are potent treatments for Covid. If they had been recognised and widely used, they might have reduced the US Covid death toll by hundreds of thousands. Accepting them as valid treatments, though, would have meant that Covid vaccines should not have received emergency use authorisations, and the proprietary drug remdesivir would not have been favoured. Behind this scandal, Kennedy says, is Anthony Fauci, the Covid-response 11/23 kingpin whose actions faithfully served the pharmaceutical industry at the expense of public health. If Kennedy’s account is accepted, it points to one of the greatest scandals in the history of US public health. As a way of reflecting on Kennedy’s claims, I asked myself whether his analysis is compatible with analyses in the sociology of health and illness. Overall, it is. It is well documented that the pharmaceutical industry often has pursued profits over patient health, has silenced, discredited and suppressed those who challenge its agendas, and has colonised the medical profession to serve its own ends. Sociologists would probably not place so much importance on a single person, Fauci in this case, as being responsible for abuses, but instead would point to institutional and systemic processes, but this does not change the basic compatibility of Kennedy’s account with scholarly perspectives. This does not mean Kennedy’s account is right, just that it should not be ruled out as implausible. If it is considered a conspiracy theory, it might well be about a real conspiracy. I now turn to some other parts of The Real Anthony Fauci. AIDS Kennedy, after looking at Covid, turns to earlier stages in Fauci’s career, especially concerning AIDS. From the 1980s, Fauci was involved in the US response to AIDS, which was first diagnosed in 1981. For treating AIDS, Fauci championed the drug AZT, which turned out to be highly toxic. Kennedy, to show Fauci’s intolerance of contrary views, gives extensive commentary on the view that HIV is not responsible for AIDS, or not fully responsible. Starting in the late 1980s, this HIV-AIDS heresy was championed by Peter Duesberg, a highly prominent virologist. Previously he had received generous, prestigious funding for his research; after questioning HIV-AIDS, he was vilified and all his grant applications failed. He had difficulty publishing scientific papers, even in venues where normally he had guaranteed access. I have long been aware of HIV-AIDS dissent and the treatment of Duesberg, even citing it as an example of heresy in medicine. However, I never delved into the issue deeply, in large part due to my involvement in another AIDS debate, specifically the theory that AIDS developed from contaminated polio vaccines used in central Africa in the 12/23 late 1950s. In 1991, I arranged for the publication of a working paper about this view (Pascal, 1991), which led to close contact with several of the key figures in the debate over the origin of AIDS, including the indefatigable investigator Edward Hooper (2000). Not long after the discovery of HIV, the human immunodeficiency virus, in 1983, a related virus was discovered in monkeys, simian immunodeficiency virus, SIV. Immediately, scientists speculated that SIV — of which there are many variants — had somehow gotten into humans and become transmissible. The question was how. One suggestion was that it was from people eating monkey meat. Another was that a hunter, in butchering a monkey, got monkey blood in a cut. This view can be called the cut-hunter theory or the bushmeat theory. Then there was the polio-vaccine theory. Polio research pioneer Hilary Koprowski ran trials involving polio vaccines that were administered orally to up to a million people in central Africa. These vaccines were cultured on monkey kidneys, offering a pathway for contamination by SIVs. Many scientists intensely disliked this theory. Naturally, the polio pioneers accused of accidentally causing AIDS were strong opponents, and a number of others joined them. I had a front-row seat in seeing the underhanded techniques used to censor and discredit the polio-vaccine theory, including blocking publications, suing for defamation, manipulating a scientific conference and making false claims (Martin, 2010). 13/23 Hilary Koprowski With this experience, it is easy to say that Kennedy’s treatment of Duesberg and HIV-AIDS dissent fits a pattern of suppressing dissent from AIDS orthodoxy. The question that came to my mind was, why did Kennedy give so much attention to the HIV-AIDS dissent and not even mention the origin-of-AIDS controversy? An obvious factor is that Fauci was centrally involved in the response to Duesberg and his allies but played no role in the response to the polio-vaccine theory. Kennedy states that “From the outset, I want to make clear that I take no position on the relationship between HIV and AIDS.” (p. 178). Nevertheless, in writing about HIVAIDS, he gives extensive explanations of the viewpoint of Duesberg and other dissidents, focusing almost entirely on AIDS in the US. In this perspective, early US AIDS cases were attributable to poppers and other drugs used widely in the gay community, and later cases were due to AZT, the drug widely used to treat AIDS, with toxic consequences. This is a cogent account of the case that HIV is not responsible for AIDS. But it is onesided. Nowhere does Kennedy mention evidence that might be difficult for Duesberg to explain. Why, for example, are the earliest cases of HIV-positive blood traced to central Africa from 1959 and after? Why did Ugandans recognise Slim, the local name for AIDS, as a new disease at the start of the 1980s, just as HIV appeared there? (Hooper, 2000, pp. 168–169). If HIV is simply a passenger virus, as Duesberg argues, why did it seem to emerge about the same time as the earliest cases of AIDS, and in the same location? I’m aware that Duesberg and his supporters can come up with explanations for anomalies like this. My point is that Kennedy has given only the information that HIV-AIDS dissidents can more easily explain. A fatal flaw? One-sidedness is a feature throughout The Real Anthony Fauci. Earlier I described Kennedy’s writing about Covid, specifically about hydroxychloroquine, ivermectin, remdesivir and vaccines. In relation to hydroxychloroquine and ivermectin, Kennedy 14/23 writes like a lawyer for the defence; in relation to remdesivir and vaccines, he writes like a prosecutor. Is this a fatal flaw in his arguments? If it is, the same fatal flaw is present in most of the writing giving the standard, official views about Covid, which offer no acknowledgement of any contrary evidence. For example, official pronouncements about hydroxychloroquine never cite the many studies showing its effectiveness against Covid. In this context, Kennedy is presenting views to counter a one-sided orthodoxy. Furthermore, he is confronting an establishment committed to censorship and suppression. He has taken his opportunity to present a challenging view in as strong terms as he can manage. Nearly all of his readers will be fully aware of the orthodox view, which is dominant in mainstream sources and which shapes policy. So, in a sense, Kennedy might be excused for being one-sided. It’s useful to remember that The Real Anthony Fauci has been a bestseller that has received no reviews in mainstream media, only attacks. If Kennedy’s arguments are so dangerous, why not respond to them in a careful manner rather than trying to censor the message and discredit the messenger? One consequence of official intolerance of dissent is that some of those with reservations about the official line will find a welldocumented presentation of contrary views persuasive. They might feel their only choices are orthodoxy or a Kennedy-informed heterodoxy. Gates The subtitle of Kennedy’s book is Bill Gates, Big Pharma, and the Global War on Democracy and Public Health. Bill Gates, the co-founder of Microsoft, is well known as one of the world’s richest people. He and his former wife set up the Bill and Melinda Gates Foundation which has dispensed billions of dollars for the cause of public health. At the same time, many commentators in the Covid-critical community see Gates as an evil manipulator, one who might even have depopulation as part of a sinister agenda. 15/23 Bill Gates Kennedy quotes critics of Gates’ so-called “philanthrocapitalism” who point out that the Gates Foundation, while giving away large amounts of money, is becoming even wealthier, as indeed has Gates himself. The explanation is Gates’ investments in pharmaceutical companies and the Gates Foundation’s focus on vaccination as the solution to the world’s health problems, especially those in Africa. According to Kennedy, the Gates Foundation, by making generous donations, has colonised international bodies like the World Health Organization, major research bodies and the mass media. In Africa, Gates promotes vaccines while long-time development experts say primary health care is more important. The money poured into vaccines has meant neglect of the basics, including adequate food and clean water. In other words, Kennedy says, Gates’ prioritising of vaccines is serving the interests of pharmaceutical companies rather than those of people in need. Throughout his book, Kennedy makes the point that Fauci, Gates and those in their thrall put disproportionate emphasis on vaccines and drugs while neglecting efforts to build people’s immune systems through better nutrition and hygiene. In summary: “… global public health advocates accuse Bill Gates and Dr. Fauci of hijacking WHO’s public health agenda away from the projects that are proven to curb infectious diseases (clean water, hygiene, nutrition, and economic development) and diverting international aid to wedge open emerging markets for their multinational partners and to serve their personal vaccine fetish.” (p. 323) Does this sound conspiratorial? It might, but there is no need to invoke conscious scheming. As studies of paradigms suggest, it is quite possible for Gates to be serving his own interests while sincerely believing that he is playing a life-saving role for hundreds of millions of people. Intellectual property A revealing indication of priorities is the role of intellectual property (IP) in public health. The rationale for IP, which includes copyright and patents, is to stimulate the production of new ideas and products by giving a temporary monopoly to the creator. I am one of many critics of IP, on several grounds (Martin, 1995). At the simplest level, the length of copyright terms, now standing at 70 years after an author’s death, is vastly longer than 16/23 needed to stimulate more creative works. More generally, IP primarily benefits big companies in software, publishing, genetically modified foods, Hollywood entertainment — and pharmaceuticals. Intellectual property is a restraint on innovation justified by the need to stimulate more innovation, but big companies regularly use their controls to stymie competitors. This process is institutionalised in global agreements, most famously TRIPS (TradeRelated Aspects of Intellectual Property Rights). The US government has been the most aggressive in pushing to include stronger IP controls in trade agreements, even though for practical purposes IP restrains trade. Sometimes IP comes in direct conflict with public health. After AIDS drugs were developed, pharmaceutical companies charged exorbitant prices for them. Governments in low-income countries argued that these drugs should be compulsorily licensed so they could be made available at close to production costs and thereby be used to treat millions of AIDS patients who otherwise would not be able to afford them. The companies, backed by Gates and his entities, vigorously opposed this relaxation of tight IP controls. Gates, in software and drugs, put IP-derived profits above public health. Then came Covid and the same scenario, this time with vaccines and public health. The pandemic was proclaimed to be a public health emergency that warranted the most urgent efforts to develop vaccines that would be rolled out for the world’s entire population. But when governments asked for compulsory licensing so manufacturers of generics could provide otherwise unaffordable vaccines, the companies and Gates resisted. The willingness of big pharma and its government allies to fight against making their products available at low cost to fight pandemics — AIDS and Covid — is a damning indictment, yet it has received little media attention. Kennedy recounts how the Gates Foundation has made significant donations to media organisations, most of which muzzled themselves when it comes to any questioning of orthodoxy even when, as with licensing of drugs and vaccines, the realities of IP protection clash with public health priorities. Depopulation? Perhaps the most outlandish-seeming claims about Fauci and Gates are that they have a depopulation agenda. Kennedy addresses several versions, inadvertent and intentional. 17/23 Inadvertently, some vaccine promotion efforts may lead to higher death rates. Scientist Peter Aaby and colleagues have studied the mortality of children in GuineaBissau following various vaccines (Aaby et al., 2018; Kristensen, 2000). The measles vaccine reduces mortality significantly but the DTP triple vaccine (diphtheria, tetanus and pertussis) increases mortality, quite dramatically for young girls. Years ago, the whole-cell pertussis component of DTP was found to be dangerous, so in the West it was replaced by an acellular version, with the resulting triple vaccine denoted as DTaP. However, as Kennedy reports, WHO, supported by Gates, continued to promote the more dangerous DTP version in Africa. This might be called an inadvertent depopulation process. Then there is the way vaccine promotion in low-income countries actually hurts population health by diverting money from basic measures such as providing clean water. Kennedy gives the example of the hepatitis B vaccine, promoted in India despite the disease it targets, hepatocellular carcinoma, not being a significant health problem in the country. Furthermore, according to Kennedy, Gates’ entities and allies pushed the WHO to include the hepatitis B vaccine in the mandated list of vaccines worldwide, irrespective of whether it addressed a significant problem. This meant governments paid large amounts to pharmaceutical companies for the vaccines; Gates has large holdings in these companies, so by giving money away he increases his fortune. By diverting scarce funds from more important health problems, this vaccine-promotion agenda could be said to be an inadvertent depopulation process. Then there are overt measures to control populations: promotion of anti-fertility drugs. Kennedy presents evidence suggesting that some vaccination programmes in lowincome countries were covers for administering anti-fertility drugs, notably one called Depo-Provera. He cites writers who note that the schedule for giving the vaccines was one injection every six months for several years, rather than the usual pattern for the tetanus vaccine. Kennedy also refers to Gates’ longstanding interest in population control. 18/23 The administration of anti-fertility drugs under the guise of vaccination, without proper consent, is obviously scandalous. However, even if true, it is not necessarily evidence of an intent to kill vast numbers of people, as might be suggested by the term “depopulation.” If Kennedy’s claims are correct, they are compatible with Gates sincerely seeking to address the problem of overpopulation, albeit sometimes with unethical means. Conclusion The Real Anthony Fauci is an impressive book, covering a wide range of important topics with extensive referencing. There is much more in the book that I have not discussed, including chapters on declaring pandemics and on biological warfare. I have not tried to pass judgement on Kennedy’s claims but rather to comment on whether his general perspective is compatible with some of the analyses by scientists and social scientists who have studied the same issues. For the most part, it is. The Real Anthony Fauci is, in parts, far more strident than typical scholarly treatments. In places, it reads like a diatribe, especially against Fauci and Gates. For example, Kennedy writes, “Blind faith in Saint Anthony Fauci may go down in history as the fatal flaw of contemporary liberalism and the destructive force that subverted American democracy, our constitutional government, and global leadership.” (p. 231). Many scholars would look less at the role of individuals and more at social structures, in particular at social systems that allow certain individuals to have an inordinate role in decision-making. A serious criticism of The Real Anthony Fauci is that it is one-sided. It presents lots of damning information but seldom attempts to present the other side, except to attack it. Discerning readers need to be aware that this is a critique of Covid orthodoxy and of the actions of the pharmaceutical industry and its most powerful supporters in government, science and philanthropy. 19/23 The one-sidedness of the book might be considered, in context, a counter to the one-sidedness of the orthodox position concerning the pharmaceutical industry, Covid and vaccination. There is a certain symmetry here: both defenders and critics of orthodoxy give insufficient recognition to the other side. But there is a big difference. The defenders of Covid and pharmaceutical orthodoxy are backed by vast wealth and power, including the power to censor critics. The New York Times published attacks on Kennedy, meanwhile refusing to run an advertisement for his book (Lyons, 2022). There is one other difference between The Real Anthony Fauci and the many scholarly critiques that raise similar concerns: Kennedy’s book has sold over a million copies. In the age of Covid, it testifies to a widespread interest in seeing a welldocumented perspective that questions the official line. That mainstream media decline to review the book or to address its claims shows the importance of a critique that reaches a wide audience. Acknowledgements For valuable comments on drafts, I thank Kevin Dew, Bob Dildine, Kurtis Hagen, Ed Hooper, Olga Kuchinskaya, Susan Maret and Sergio Sismondo. None of them necessarily agrees with Kennedy’s views or my own. References Aaby, Peter, Søren Wengel Mogensen, Amabella Rodrigues and Christine S. Benn. 2018. “Evidence of increase in mortality after the introduction of diphtheria-tetanus-pertussis vaccine to children aged 6–35 months in Guinea-Bissau: a time for reflection?” Frontiers in Public Health 6(79), 1–10. Adams, Phillip. 2022. “Conspiracy of fools,” Weekend Australian Magazine, 19 February, 42. 20/23 Angell, Marcia. 2005. The Truth about the Drug Companies: How They Deceive Us and What to Do about It. New York: Random House. Boffey, Philip M. 1976. “Vaccine imbroglio: the rise and fall of a scientist-critic.” Science 194 (December 3), 1021–1024. Brown, Steve. 2022. “RFK, Jr.’s ‘The Real Anthony Fauci’ is a record-smashing bestseller — but mainstream media pretends it doesn’t exist.” Children’s Health Defense, February 17. https://childrenshealthdefense.org/defender/rfk-jr-the-real-anthony-fauci-recordsmashing-bestseller/ Goldacre, Ben. 2008. Bad Science. London: Fourth Estate. Goldacre, Ben. 2012. Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients. London: Fourth Estate. Golden, I. 2019. “Reluctance to vaccinate: reasons and solutions.” Journal of Translational Science 5, 1–6. Gøtzsche, Peter C. 2013. Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. London: Radcliffe. Hess, David J. 2016. Undone Science: Social Movements, Mobilized Publics, and Industrial Transitions. Cambridge, MA: MIT Press. Hooper, Edward. 2000. The River: A Journey to the Source of HIV and AIDS. Boston: Little, Brown. http://www.aidsorigins.com/the-river-a-journey-to-the-source-of-hiv-andaids-2021-edition-by-edward-hooper/#more-3529 Insight Team of The Sunday Times (Phillip Knightley, Harold Evans, Elaine Potter and Marjorie Wallace). 1979. Suffer the Children: The Story of Thalidomide. London: André Deutsch. 21/23 Kennedy, Robert F., Jr. 2021. The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health. New York: Skyhorse. Kristensen, Ines, Peter Aaby and Henrik Jensen. 2000. “Routine vaccinations and child survival: follow up study in Guinea-Bissau, West Africa.” BMJ 321 (December 9), 1–8. Lyons, Tony. 2022. “We tried to run an ad for ‘The Real Anthony Fauci’ in The New York Times. Here’s what happened.” Children’s Health Defense, March 13. https://childrenshealthdefense.org/defender/ad-the-real-anthony-fauci-the-new-york-times Martin, Brian. 1995. “Against intellectual property.” Philosophy and Social Action 21(3), 7– 22. https://www.bmartin.cc/pubs/95psa.html Martin, Brian. 1999. “Suppression of dissent in science.” Research in Social Problems and Public Policy 7, 105–135. https://www.bmartin.cc/pubs/99rsppp.html Martin, Brian. 2010. “How to attack a scientific theory and get away with it (usually): the attempt to destroy an origin-of-AIDS hypothesis.” Science as Culture 19(2): 215–239. https://www.bmartin.cc/pubs/10sac.html Martin, Brian. 2015. “On the suppression of vaccination dissent.” Science and Engineering Ethics 21(1), 143–157. https://www.bmartin.cc/pubs/15see.html Pascal, Louis. 1991. What Happens When Science Goes Bad. The Corruption of Science and the Origin of AIDS: A Study in Spontaneous Generation. Working Paper No. 9, Science and Technology Studies, University of Wollongong, Australia. https://www.bmartin.cc/dissent/documents/AIDS/Pascal91.html Proctor, Robert N. 2012. Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition. Berkeley, CA: University of California Press. Rost, Peter. 2006. The Whistleblower: Confessions of a Healthcare Hitman. Brooklyn, NY: Soft Skull Press. 22/23 Schmidt, Jeff. 2000. Disciplined Minds: A Critical Look at Salaried Professionals and the Soul-Battering System that Shapes their Lives. Lanham, MD: Rowman & Littlefield. Sismondo, Sergio. 2018. Ghost-managed Medicine: Big Pharma’s Invisible Hands. Manchester: Mattering Press. https://www.matteringpress.org/books/ghost-managedmedicine Smith, Richard. 2005. “Medical journals are an extension of the marketing arm of pharmaceutical companies.” PLoS Medicine 2(5), e138. https://doi.org/10.1371/journal.pmed.0020138 ******************** Brian Martin [email protected] 23/23