Thursday, March 7, 2013

Needed: a political - not Technological/Whig - history of wartime penicillin

Almost all histories of penicillin have but one plot : the dramatic, last minute come-from-behind victory of the little guy, HIGH TECH MAN, over the vast evil forces of Nature and fungi spores.

In pointed fact, the technical problems of producing life-saving penicillin was solved very quickly, basically done by one or two  individuals with remarkably low level technology, by the Fall of 1941.

But even the most affluent members of the world could not reliably access life-saving penicillin for another five years and it still remains important to discover why.

And most of the world's poor couldn't access it for many more years after that ---- and in fact millions still die worldwide every year because properly prescribed antibiotics are beyond their economic reach.

The delays in delivering life-saving medicine were not technological in nature (the technological difficulties dog ate my penicillin homework) but rather political --- and ultimately moral.

Conservatives, Republicans & Nazis - and penicillin

It is not a coincidence that the only one of the four English speaking countries ( the four that produced 99% of  WWII's penicillin) that was dominated by a Conservative Party also did by far the worst wartime job in getting penicillin to their dying civilians --- for whom penicillin was their only hope of survival.

I refer to Winston Churchill's UK government.

Penicillin rationing from 1942 onward, in all the Allied nations,  was a deliberate choice made by government bureaucrats and politicians and company CEOs - not something imposed upon them from without by sheer technological necessity.

Academic 'Bad Faith'

To still deny that - 75 years after the events and in light of all our archival knowledge - is to exhibit academic bad faith.

In 1943 that cosy consensus, about rationing penicillin and news about penicillin cures, broke up as some bureaucrats, politicians and CEOs in some countries decided to go all out to produce enough penicillin for everyone - in their own nation and beyond.

Others still much preferred that any spare national cash go to extra weapons and not into building extra penicillin plants.

They did not want to admit the absolute need for a medicine to save the lives of their own civilians , now needlessly dying of infections that the sulfa drugs had once cured.

Today, we have dozens and dozens of alternative antibiotics to suit almost any imaginable life-threatening infection.

Unheard amid the din of war , the Sulfas started failing bad

But each of the half dozen successful sulfa drugs were best over a different narrow array of diseases - so if a patient had a strain resistant to the sulfa drug best suited to their disease, they generally had nothing left between them and death.

Except penicillin - effective against most all gram positive bacteria and much slower to gain strains resistance to it.

Simply put, diverting money that could have gone to building more penicillin bottle plants into building yet more military weapons instead, meant that Allied civilians died needlessly so more Axis civilians could die from Allied bombs.

Britain declared war on Germany in 1939, but thanks to a deliberate decision made by Winston Churchill, British soldiers were not fighting German soldiers on German soil till 1945 - and if he had had his way, British troops would never have set foot on German soil till after the German surrender.

The lives of Axis and Allied soldiers were spared, the lives of Axis and Allied citizens condemned, by this Churchillian decision.

However, his bomber-led vision for winning the war was probably not the main reason his government rejected building enough bottle penicillin plants in 1943 to supply soldier and citizen alike.

The Beveridge Report and Penicillin

After the release of Beveridge Report in the Fall of 1942 - a report he didn't want his government to publicly release -  the idea of his government facilitating the means to give life-saving penicillin to all that needed it seemed to smack of approving of the Beveridge Report.

Penicillin for all civilians needing it seemed the thin edge of a socialist edge.

America's equivalent of the Beveridge Report happened in the mid 1930s under the rubric of calls for more Social Medicine.

That report's main thrust was calling upon governments to actively commit to freeing citizens from freedom of want , particular freedom from want of life-saving medical care.

To Churchill's Conservatives, a government seeing to it that all dying citizens got penicillin would have been as repugnant in peacetime as it was in wartime.

It couldn't politically survive publicly advocating the denial of needed medicine to poorer dying civilians in peacetime, but under the spurious blanket claim of 'military necessity', a government could get away with it in wartime - as the American Republicans and Hitler both found out.

(Hitler only nerved himself to start killing Germany's 'useless mouths' after the war was underway and even appeared to back off as news got out and citizens protested.)

(During WWII, the dominant Republic core of the American medical establishment long denied life-saving penicillin to the mostly poor (aka Democrats) citizens dying of subacute bacterial endocarditis.)

I happen to think that telling the story of the ultimate abundance of wartime penicillin not as a victory over technological challenges but as a battle between different political ideologies is not only truer, but it is almost much more dramatic : a page-turner and good history.....

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