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Sir Henry
Wellcome:
thy will be done |
Brian Deer: September
19 1993
This document was
written by Brian Deer as a memo for editors at The
Sunday
Times of London, and formed a starting point for published stories in 1994
Two years ago, a
curiously out-of-place photograph appeared on the
front cover of the house magazine of a pharmaceutical
giant. It was taken in the Sudan, shortly before the
First World War, and showed a round-faced man, aged
about sixty, in the distinctive white suit and topi
hat of the British imperial explorer. He was leaning
on a stick and looking down from a higher place onto
a site of human labour, progressing on an epic scale.
The magazine was the
house journal of Wellcome plc - the London-based
multinational which is best known as maker of the
controversial Aids drug AZT. Like most publications
of this dry genre, it was a worthy effort, which
tried to breathe a little of life by playing-up
personalities. There were bulletins on the company's
senior executives. Items concerning staff who had
recently won awards. And news about the latest world
health leaders that had flown-in to be wined'n'dined.
But the cover-story
was not about such humble individuals. The picture
was taken at the dusty Arab settlement of Jebel Moya,
150 miles south of Khartoum, where - as a long
feature inside explained - the company's founder,
Henry Solomon Wellcome, was leading 3,000 local
labourers in a personally-funded excavation for
ancient artefacts. In the picture he was pausing to
consider the enterprise below.
At face value you
wouldn't think there was anything odd about this kind
of cover-story tribute. When he died in 1936, Henry
Wellcome had built the Wellcome organisation into an
important manufacturing enterprise in both Britain
and the United States. Although today he is unknown
to the millions of people who use that organisation's
drugs, he was hugely rich, renown as a
philanthropist, a famous London and New York
socialite and a noted overseas explorer. So, to be
accorded the honour of the journal cover was the
least he might expect.
If the old man's
North African adventures were not exactly topical,
there was plenty of justification for giving him a
higher profile. Not only did he found the firm that
hit the jackpot with Aids, but - through an
extraordinary arrangement he set down in his will -
he created a production and research alliance that,
more than half a century later, has become the
greatest single concentration of power in the history
of medicine.
First in that
alliance is Wellcome plc - a holding company which
nets about £1.8 billion a year through more than 100
subsidiaries around the world. Apart from AZT, it
sells the anti-herpes drug acyclovir, the
antibacterial co-trimoxazole and the popular cough
medicines Sudafed and Actifed. It has atracurium for
use in anaesthesia, interferon alfa-n1, now
prescribed in some countries for hepatitis B, digoxin
for heart failure and a boxful of other products.
Then - and even more
daunting - there is the Wellcome Trust, which is by
far Britain's richest charity. Its assets, totalling
some £10.5 billion, are twice that of the Church of
England's commissioners - and will allow Wellcome to
spend more this year on medical research even than
the British government. With its tax-exempt status at
a time of tight public spending, it has fingers
reaching into every corner of medicine - and is the
most potent single instrument for the privatisation
of science.
And if this scenario
seems fantastic, be ready - there's more to come. The
company and the trust are not just Henry Wellcome's
hand-me-downs, but contain the heart of the man
himself. Through his will and a lengthy attached
memorandum he drafted in 1932, he left his entire
fortune to his own organisation - which, as a devout
fundamentalist Christian, he believed would carry on
his life's work until the Day of Judgement.
"With the
enormous possibility of development in chemistry,
bacteriology, pharmacy and allied sciences," he
predicted in the documents he signed, "if my
desires and plans are carried out in the way of
research, in co-operation with the several [of my]
industrial organisations, there are likely to be vast
fields opened for productive enterprise for centuries
to come."
He was a member of
the English Grand Lodge of Freemasons and, to carry
out his ambitious plans, he nominated a committee of
trustees - to whom he left instructions about exactly
what should be done. Today, there are seven of them:
a financier, an oil man, a doctor and four
professors. They select their own membership and,
according to Henry Wellcome's instructions, must be
"broad-minded and highly intelligent men of good
sturdy moral character".
In the 1930s, he
could not have realised the power that his committee
would one day hold. But with the passage of years and
a vast accumulation of drug profits, the plan he
wrote has today become nothing less that a guiding
force in science. Devised to gain both the
wealth-generating abilities of a company and the tax
and public image advantages of a charity, it has
lifted Henry Wellcome's hand from his explorer's
stick and placed it on the human race.
The journal article
added fascinating background on the architect of this
scheme. Wellcome's expedition to the Sudan (between
1911 and 1914) was one of the more telling incidents
of his life, and he brought back to London a number
of historic finds. In the light of his present-day
influence, you would not think it out of place on the
front of Newsweek or The Sunday Times.
But while all this
would make you think that Wellcome company journal
stories would be routinely produced on him, to those
few people who are in the know, the article about
Jebel Moya was an unusual event. While everything, at
face value, says that Henry Wellcome is the
figurehead to his empire, he has for many years been
carefully shielded from public view. And though his
spirit seeps through every pore of medicine, hard
information has been studiously suppressed.
At the trust's £60
million headquarters in London's Euston Road (which
Henry opened in the same year as he wrote the will),
there is a world-famous library of medical texts that
date from antiquity. On the old man himself, however,
the words are thin on the shelves. There are three
terse old pamphlets, a copy of an obscure polemical
volume he wrote in 1887 and a few passing references
to him in books about other people. But the
librarians who owe him their livelihoods do not even
catalogue the will.
During the Second
World War, the trust's committee commissioned a staff
member to write Henry Wellcome's biography - but
then, once they saw what it said, ruled that the book
should not be released. Since that time,
collaboration with browsers has been polite, but
mostly unrevealing. There is an elegant portrait of
the man on display - in the basement. But if you
speak about Henry at Euston Road, they give you funny
looks.
Such is the scale to
which his legacy has grown, however, that insiders
believe this secrecy cannot be sustained much longer.
Sales of Wellcome plc's shares by the trust in 1986
and 1992 were so big that only public utility
flotations were comparable in scale. It could hardly
be long before strangers appeared, raising awkward
points.
The article in the
journal was one small effort to prepare for such
events. As last year's share sale approached, any
keen researcher looking for background would have
been able to skim through the Sudan report and lift a
little colour. How Henry Wellcome was born an
American, crossed the Atlantic the wrong way and
became more British than the Brits. How donning the
topi hat to lead north African digs in those days was
the sport of aristocrats.
But once that
abridgement was exceeded, anyone who sensed that
there was a big Wellcome picture might have to do
some digging as well. In the article - headlined
"The Benevolent Autocrat" - author John
Symons (who works for the trust at Euston Road),
awkwardly revealed that as Jebel Moya was stripped of
artefacts (which dated from between 1,000 and 400BC),
they were not carefully inspected and catalogued, but
were merely dumped in basements until ten years after
Henry Wellcome died.
The old man had
trained as a pharmacologist in his youth and
therefore knew something about science - so this
indifference to what had been found was bad enough in
itself. But there was an even more telling
observation in the Jebel Moya piece - that gives a
hint of who the Wellcome Trust may be keeping out of
the way.
"He always liked
to think of the site as prehistoric," Symons
noted of Henry Wellcome's attitude towards his desert
quest, "and cherished the romantic idea of
discovering traces of a prehistoric white
tribe."
* *
*
In sandbagging Henry
Wellcome against public scrutiny, there's no doubt
that the Wellcome organisation today is following its
founder's example. One of his favourite sayings was:
"Never tell anyone what you propose to do until
you have done it." And even the most cursory
look at his life reveals him as a notoriously
defensive and aloof man - a trait that, as he got
older, became a reclusive hostility. By the time of
his death, he had no real friends, apart from his
Masonic contacts, but had bunkered himself against an
unpredictable world with a quest for eternal success.
His story begins in
the upper Midwest before the American Civil War.
Henry - or "Hank" to family and friends -
was born in 1853 in a log cabin among the forests
around Almond, Wisconsin. His father, Solomon, and
two of his uncles (and also, later his brother) were
ministers of the Second Adventist church - an
evangelical faith then in turmoil after predicting
that the world would end in 1844. In the
French-German Wellcome household, the Bible was
regarded as literally true and Henry Wellcome
acquired a lifelong belief that the just would rise
and live again when Christ returned to earth.
In his Bible, still
kept at Euston Road, it's interesting that Henry
Wellcome heavily marked and underscored in pencil
verse 26 of Deuteronomy chapter 14, where it talks
about the freedom to spend money however you want:
"And thou shalt bestow that money for whatsoever
thy soul lusteth after, for oxen, or for sheep, or
for wine, or for strong drink, or for whatsoever thy
soul desireth."
If people have
moments that define their lives, then the first of
two such events for Henry Wellcome occurred when he
was eight. With the frontier's rapid closure, his
family had wagon-trained 300 miles south east from
his birthplace to Blue Earth county Minnesota. The
European immigrants' conflicts with the Sioux nation
were just getting under way - and almost as soon as
the Wellcomes stopped to put down roots at the
settlement of Garden City, it was suddenly attacked.
It was a particularly
bloody incident and, by the time the Sioux were
routed and their local chiefs hanged, more than a
thousand settlers had died. As men fell around them,
Hank had led the other children in overcoming their
terror by alternately tending to the wounded and
making bullets to fire back. Although his
preacher-dominated family survived the calamity, it
was a lesson both in leadership and in circling the
wagons that Henry Wellcome would not forget.
By the time he had
lived a further eight years, his life was all mapped
out. Another of his uncles, Jacob, was the Garden
City doctor and drugstore proprietor - who hired his
brother Solomon's boy to help run the enterprise.
Such was the inspiration of this task that, when the
future pharmaceutical millionaire was just 16, he
prepared and marketed his first product:
"Wellcome's Magic Ink".
Wellcome's
Magic Ink
THE GREATEST WONDER OF THE AGE
This is something entirely New and Novel!
DIRECTIONS
Write with a quill or golden pen on white paper.
No trace is visible until held to the fire when
it becomes very black.
Prepared only by
H.S. WELLCOME
Garden City, Minn.
Apart from the
psychologically elegant aspect of secrecy to his
inaugural foray into business, it was also rather
telling in being a straightforward confidence trick.
Henry Wellcome's wonder product was almost certainly
lemon juice and, though one might forgive a teenage
boy for the element of prank, even the author of an
otherwise anodyne trust pamphlet, published in 1980,
could not avoid observing that his claims "set
the pattern for the future".
This pattern got a
massive boost when Henry left home. After graduating
from the Philadelphia College of Pharmacy, he soon
discovered his business forte as a travelling
salesman. At the time, the latest craze was for the
gelatine-coated capsule - and Henry Wellcome was
quick to realise that devising new drugs was one
thing, but the big bucks were most easily made from
how you packaged and promoted them.
For those with a
smash-and-grab business approach, this period was the
golden dawn of the American Dream - when rapid
industrialisation saw the rise of tough-minded
entrepreneurs like Rockefeller, Carnegie and Morgan.
Anxious to get in on the boom, Henry Wellcome formed
a partnership with Silas Burroughs, a college friend
and fellow salesman, to make their fortunes out of
drugs. (The US Burroughs Wellcome company is a
wholly-owned subsidiary of Wellcome plc.)
In a style that was
to become the Wellcome hallmark (and was the historic
bridge between snake-oil salesmen and the modern
pharmaceutical industry), the two men concentrated
their efforts on a product's form rather than its
content. Developing the capsule idea, they obtained a
patent on equipment that compressed powdered
medicines into tablets. From this, they became
millionaires almost overnight - although Burroughs
died in 1895, so missed much of the profitable fun.
Whether either man
actually invented this equipment will probably never
be known. Around the time Henry Wellcome wrote his
will, the US government auctioned - sight unseen -
200,000 working models of inventions registered with
the federal patent office prior to 1890 (after which
drawings were allowed). Except for a few items - like
Bell's telephone - which went to the Smithsonian
Institute, the entire collection was bought by
Wellcome, warehoused and destroyed or dispersed.
Alongside the tablet
machine, Henry Wellcome and his partner pulled off
another master stroke. Realising that their
convenience product needed a powerful brand label,
they devised a new word - "Tabloid" - to
describe their compacted medicines. It was registered
in 1884 and, despite its common usage today, is still
technically Burroughs Wellcome property.
By then, Henry
Wellcome had also come to the conclusion ( wrongly as
it happened) that, for all the growth in America, the
prize for business was still in the mature global
markets of the mighty British empire - and he quickly
established a home in England. He may also have been
a snob, since he was fond of writing to Burroughs
from London about his European style of life. In
1882, for instance, he wrote:
"I wish very
much you could have been with us on 17th July. We had
some magnificent singing and instrumental music,
recitations, etc. Among our friends present were many
eminent in literature, music, drama and art, but what
would have most pleased your fancy - so many really
handsome girls."
He had taken the
house of a former Indian Rajah in Marylebone Road -
"second door from the Tussauds' private
residence", he gleefully noted - from which he
began another distinctive Wellcome activity that
continues until this day. Realising that there was
nothing like personal endorsement to boost a
product's image, he began lavishing freebies, junkets
and hospitality on people of influence.
By the turn of the
century, anybody of consequence - from the Royal
Family and Prime Minister downwards - had, at the
very least, a free Tabloid Medicine Chest to show
family and friends. Although this was forty years
before antibiotics and many of his remedies had no
obvious effect, Henry made his greatest efforts in
wooing the rock-star/astronaut figures of the time -
the glamorous white African explorers.
He presented the very
first free Tabloid chest to Sir Henry Stanley, the
man who had found David Livingstone - and who became
the nearest thing to a close friend that Wellcome
ever had. When Stanley lay dying in 1904, at the age
of 63, Wellcome came each day and loyally sat at his
bedside, perhaps regretting that his medicine chests
could not be of more benefit.
Stanley's death was
the kind of misfortune in Wellcome's relationships
that was evident throughout his life - culminating in
the second of the moments which shape his legacy
today. In 1901, he had married Syrie Barnardo,
daughter of Thomas Barnardo, the doctor and
child-care philanthropist. She was 21 and he was 48
and - since Syrie had agreed to marry a friend of her
father's - things were predictably doomed from the
start. But their break-up put a twist in the Wellcome
story that seems almost too bizarre to be true.
What is known of this
incident comes mainly from two quarters. There was
press comment at the time and there was a leak from
Henry Wellcome's secret biography that is held by the
Wellcome Trust. According to these sources, Syrie and
Henry had a son (who was mildly brain-damaged and
sent away at the age of three), but then the
husband's peculiarities started to get on the wife's
nerves. One was his habit of running into her room,
naked apart from a raincoat, throwing it off
spectacularly and jumping into her bed.
More seriously, she
was getting tied of being beaten. According to one of
her friends, Dame Rebecca West, Henry Wellcome would
sometimes attack Syrie with a heavy cattle whip -
even while she was pregnant. "From what she told
me," said West in a book interview about Syrie.
"I'm sure there was a streak of sadism, or
perhaps unconscious sadism, in Wellcome."
There was also an
allegation published in John Bull magazine (which at
one time posted signs all over London saying simply
"Wellcome") that one of the druggist's
pleasures in his African explorations was flogging
his native workers. Even allowing that such behaviour
was de rigeur for the period's white adventurers, the
suggestion of a cruel racism might itself be a cause
for his trustees today to succumb to a Masonic
silence.
Despite these traits,
however, Henry Wellcome was strongly driven by
Christian paternalism. He spent a fortune on a
mission in Uganda and one of his lifelong projects
was with a native north American tribe, which a
preacher that he specially admired was trying to
"civilise". Wellcome wrote his only
full-length book on this people - The Story of
Metlakahtla - where he attempted to speak kindly of
"the poor groping, savage, with inferior
intellect."
The story of Syrie,
however, has even more of a sting. Tired of her
husband's brutality, his endless travelling and his
Grand Lodge meetings, Dr Barnardo's daughter broke
with him - and began to sleep with a number of
younger men in London society. At one time she
settled for Gordon Selfridge, the American-born
department store magnate, before finally going the
whole way in 1911 with the writer (and doctor) W
Somerset Maugham. Even while still married to Henry
(who was by then mostly presiding over his Sudanese
labourers), she had a daughter by Maugham and - after
Henry Wellcome brought a sensationally bloody divorce
trial - married him six years later.
As is usually the
case with a Wellcome story, there is yet still more
to be said. Despite fathering Syrie's second child,
Liza, Maugham was homosexual - and had mainly taken
up with Henry's wife because he needed a woman when
dining-out, and a party hostess at home. Ten years
and as many boyfriends later, THEY were divorced as
well.
Raised in the strict
fundamentalism of the Adventist church, Henry
Wellcome had never approved of sexual immorality -
and he especially disliked homosexuals. The
humiliation that he felt then was almost too much to
bear. According to the secret biography, the
explorer, socialite and brilliant salesman fell into
a "morbid misery only to be soothed by a vicious
preoccupation in his own interests." Their
separation, it concluded, "soured his character
for the remainder of his life."
* *
*
If Henry Wellcome's
ghost today stalks the marble staircases and
corridors of his building in Euston Road, he can only
be of the conclusion that the last laugh was his. At
the time of the divorce hearing, he could hardly
bring himself to think of Syrie's acts of betrayal
and Maugham's indifference to Christian morality.
But, another lifetime later, it was precisely the
conduct that had once caused him misery which had
given his empire its clout.
Henry Wellcome's
consolation was a long time coming, but when it came
it was big. The collapse of Victorian attitudes - to
which he felt Syrie and Maugham had so shamefully
contributed - first showed its darker side when, in
the mid-1970s, an epidemic of gonorrhoea and urinary
tract infections struck major cities around the
world. Along with syphilis, physicians in sexually
transmitted disease clinics suddenly found themselves
deluged with cases - and reached for their remedies.
Top of the list was a patented and heavily-advertised
Wellcome tablet: co-trimoxazole, branded in the
United Kingdom under the name "Septrin", in
the US Septra [and also marketed by Roche as
Bactrim].
Herpes simplex was
not far behind. Even as doctors and patients were
getting used to the idea of sexually-transmitted
infections as tablet-treatable inconveniences, the
early 1980s saw new crowds in the clinic queues
complaining of genital blisters. And as if guided by
some out-of-this-world inspiration, Wellcome was
there again with the drug acyclovir - patented as
"Zovirax" - the first mass market
anti-viral. It wasn't a cure, like Septrin seemed to
be, but temporarily suppressed the symptoms.
With Aids came AZT,
or "Retrovir". This was developed at the
Burroughs Wellcome headquarters in North Carolina and
rushed into use in 1987 on US government orders.
Highly toxic and with real benefits usually lasting
only a few weeks or months, it nevertheless found a
ready market through the same doctors who had learnt
in the 1970s that there was a tablet for everything.
In the face of this
triple epidemic, if Henry Wellcome isn't shouting:
"I told you so", it is only for technical
reasons. Among drug companies, only the contraceptive
pill manufacturers have made money on the scale of
Wellcome from the sexual revolution. Last year alone,
sales of Zovirax - it's top product - reached nearly
£590 million (up 24% year-on-year). Retrovir turned
over £213 million (up 22%) and Septrin (on which the
patent has long expired) £47 million. The Wellcome
Trust's income has risen tenfold in the last twenty
years.
Unless Henry
Wellcome's ghost really has been at work, he could
never have predicted such windfalls. But he was clear
in laying the groundwork which made them possible. In
his will and memorandum, he required the committee he
established to follow a twofold strategy for
industrial success. And this not only scooped
billions in drug profits, but has ever since kept the
Wellcome organisation teetering on the edge of
controversy.
The first element
harked back to his "magic ink" and Tabloid
tricks. In the memorandum he wrote for his committee,
he was clear about the main tactic:
"It is my
special desire that there should be no material
reduction in the proportional expenditure for
publicity and other forms of propaganda of the
several organisations, as I wish my trustees and the
directors continuously to develop and increase the
output and sale of the products of the industrial
organisations of the Foundation throughout the world.
The consistent pursuance of this policy will
ultimately result in greatly increased profits."
His trustees and
staff have always done a good job in carrying out his
wishes, but the Wellcome obsession with marketing its
drugs has raised many eyebrows since. And although
his organisation is not alone in boosting sales
through hard-sell methods, he was the driving force
for this conspicuous feature of the pharmaceutical
industry today.
In the first example
- Septrin - this is particularly easy to see.
Although it is effective for urinary tract
infections, it is a so-called
"broad-spectrum" antibiotic, which means it
attacks many kinds of bacteria. This feature was
massively advertised in the medical press in the
early 1980s, resulting in a huge rise in the amount
prescribed by doctors in general practice - commonly
for viral infections, against which it does not work.
Even worse for the
drug is that later research reveals that it should
never have been marketed in the way it was at all.
Many deaths were associated with Septrin, which was a
mixture of a much safer Wellcome compound called
trimethoprim and a sulphur-based product sold by
super-giant Hoffman-La Roche. The evidence shows that
Henry's organisation took a dive with its own product
in order to form a mass-marketing cartel with the
bigger company.
Deciding which drugs
are safest, of course, is the job of doctors and
licensing authorities, but that does not defend the
case of the herpes drug Zovirax. There are many
doubts about this highly-promoted product - including
the fact that it leaves users infectious - but
perhaps most telling is that Wellcome has got a
licence to broaden its use to chickenpox - a
self-limiting, almost universal, illness on which it
has little effect - and also as an over-the-counter
cream for cold sores, for which research shows it
also barely works.
This marketing
approach is called "extending the
indications" and is most pronounced with AZT.
Although scientific investigations point to a meagre
benefit for Aids sufferers, Wellcome has skilfully
ensured that Retrovir is widely given to HIV-positive
people who have no symptoms of disease. This
extension increases the potential market for the drug
100-fold - yielding, according to analysts, 70%
profit on its US price of $3,000 a year.
There are unknown
risks in giving any medicine to much larger
populations, or for longer periods, than were
included in medical trials. In the case of Septrin,
Zovirax and Retrovir, there are already worries that
they are fostering drug-resistant "super
strains" of infectious agents. With the two
antivirals (which both interfere in DNA synthesis) -
there are also growing concerns about possible
cancers and genetic mutation.
That
sexually-transmitted diseases have proved such an
opportunity to Henry Wellcome's empire has an irony
to make you smile. But it is specifically Aids that
has given the organisation its record-breaking boost
- causing, for instance, its London share price to
jump from £1.55 in 1986 to £11 five years later.
And it is where it first seriously flexed its muscles
as an arbiter of health.
Here Henry Wellcome's
obsession with marketing is most in evidence. People
with immune system problems are commonly given AZT,
acyclovir and often Septrin as well. (The company has
additionally submitted a licence application in the
United States for atovaquone, to treat Aids-related
pneumonia.) This is cash-rich territory for a good
promotional campaign - and the Wellcome organisation
has been running one on an astonishingly daring
scale.
Step one - identified
by The Economist magazine - was to increase the
market by persuading more people to take HIV tests.
This was accomplished by financing advertising
campaigns fronted by activist organisations and
charities - like the American Foundation for Aids
Research in the US and the Terrence Higgins Trust in
England. Often these bodies were staffed by people
with careers in Aids and were happy to accept
industry cash that would bring them more customers.
Step two was to pump
marketing money directly into the activities of
doctors, scientists and opinion formers. Such is the
profit from each new person prescribed Wellcome
products that - through research grants, travel
expenses to international events and straightforward
cash - thousands of individuals, hundreds of
organisations and scores of publications which could
influence patients' drug consumption have been
bankrolled by the company.
Step three was an
advertising blitz for the products on a scale never
seen before. Burroughs Wellcome, in particular, has
so bombarded Aids specialists and general physicians
with video- and audiocassettes, sponsored symposium
reports and independent-looking promotional journals
- that it has sometimes proved hard to locate Aids
material produced by anyone else.
The effect of this
strategy cannot be calculated - and the grip it has
given to Wellcome on science is beyond any
comprehension. Even by the late 1980s, the most able
researchers, the biggest medical practices, the key
pressure groups and the patients themselves were all
swamped with AZT. Other, perhaps more promising,
strategies towards the epidemic have had little
chance of progress - and there are few people of
consequence who are willing to voice their dissent.
Wellcome has seen the future and knows that - for
them - it works.
Wellcome's impact on
the pharmaceutical industry has been even more
remarkable. The rapid licensing of AZT became the
"Trojan horse" for drug manufacturers
anxious to destabilise the all-powerful US Food and
Drug Administration, which often held new products
back for years to facilitate safety testing. With
this drug, however, new "fast track"
systems were introduced, shaving years off the time
it takes to get products licensed - adding billions
of dollars, overall, to the industry's receipts.
This far-reaching
impact of what was one a minor company has, in recent
months, begun to stir concern. But, looked at from
Euston Road, it was just what the founder ordered.
Henry Wellcome's campaigns for the Tabloid brand
medicines, his free supplies to people in the public
eye and his lavish entertaining were all forbears in
their modest way to what his empire does today. As he
emphasised in 1932:
"I consider it
in the best interests of the several industrial
organisations and of all concerned, that the
publicity, advertising and other propaganda shall be
steadily increased as the output is increased in
volume and profits."
* *
*
The year when the old
man wrote these words was for him an important one.
Apart from drafting his will and opening his
building, he was elected a fellow of the Royal
Society and was knighted by King George V. Although
he had naturalised as British in 1910 and lived like
an aristocrat, he always felt that London's Mayfair
set accepted his Tabloid medicine chests, but did not
truly accept him. Now he was sure that, as Sir
Henry Wellcome, he would be regarded as one of the
best.
Ironically, it was
this "cultural cringe" which lay behind the
second extraordinary element of the master plan in
his will - and helps to account for the image he
acquired as a leading philanthropist. In part, he may
have been puffing himself up after losing face over
Syrie, but had he not felt inferior about his redneck
Midwest origins, the £10.5 billion Wellcome Trust
might not exist today.
Despite his desire to
be British, Henry Wellcome had that typically
American trait in being obsessed with things that are
old. Both came together in his dig at Jebel
Moya. And like many of his rich contemporaries, such
as the newspaper publisher William Randolph Hearst
(who was at the time scouring Europe to fill his new
Californian castle), Henry Wellcome became a
fanatical collector of things with historical
pedigree.
There was, however,
an important difference between the approach of the
two men. While the media magnate collected to impress
friends at his remote hilltop palace, the tablet
tycoon wanted his Euston Road building to become a
medical museum and library. And thus was born the
Wellcome Institute for the History of Medicine - a
foundation unequalled in its field for priceless
books, artefacts and facilities for research.
Henry was also a
noted collector of antique furniture - much of which
he hoped would be used in the museum after his death.
As he wrote in his will memorandum, giving a sense of
his management style:
"In every
instance where the legs with carved ball and claw
feet are used, each foot should be supplied with a
socketted disc to raise it about one inch from the
floor, to avoid wear and damage caused by the boots
and shoes of visitors."
Today, the history
institute is a only minor activity of the Wellcome
Trust - costing around £5 million a year. But it is
both a dramatic expression of Henry Wellcome's
mid-Atlantic personality and is at the core of the
Euston Road building from which his organisation runs
a worldwide research arm of unparalleled reach and
strength.
Research is a
tradition that goes back almost to his empire's
beginnings. In 1894, he founded the Wellcome
Physiological Research Laboratories - a facility
unrivalled by other companies for nearly thirty
years. Such has been the organisation's commitment to
investigation that staff scientists have won a share
of five Nobel prizes. The most recent were reported
in that journal issue with Henry Wellcome on the
front.
The trust's support
for research today could hardly be grasped in one
mind. From tropical diseases to veterinary medicine,
from physiology to pharmacology, there is barely a
field related to health where you cannot see
Wellcome's hand. It funds investigators, academic
departments and whole institutions. There are
fellowship schemes in Britain, the United States,
Australia and New Zealand. Alone, it contributes more
cash to science than Britain's national medical
research council. With Wellcome plc's subsidiaries,
the organisation is only outspent on medical inquiry
by the US government.
Significantly for the
future, almost a third of its funds goes into the
field of neurosciences - with long-term grants in
1992 almost tripling on the year before. It's here
that scientists are tackling the fundamentals of
Alzheimer's disease and the intractable riddles of
ageing. As the 1960s campaigns to find a cure for
cancer lapse into memory, it is in this domain that
Henry Wellcome's money is hunting the next century's
holy grail.
The trust's other
most ambitious projects are in genetics and cell
biology. At Hinxton Park, near Cambridge, England,
Wellcome and the Medical Research Council are jointly
setting up a centre for 300 scientists to sequence
the human genome - the great race for the keys of
life. Also at Cambridge, the trust has installed a
world-famous team from Johns Hopkins University,
Baltimore, to investigate auto-immune diseases.
Bearing the awesome
responsibility for this brave new world portfolio is
Henry Wellcome's seven-man committee (advised by
panels of experts). This committee, which produces no
minutes for outside scrutiny and which is accountable
only to the will, rules supreme in the Wellcome Trust
- and through it exerts a formidable power on
medicine everywhere. It currently commands 40% of the
stock of the company (which trades in Britain as The
Wellcome Foundation Ltd) - a comfortably controlling
block.
But the committee's
powerful position may have dangers for medicine.
While nobody criticises cash for research, there
would be room for doubt if any club of seven
had such a hold on the agenda of science - especially
if their founder was a Freemason. Much of their
spending is potentially taxpayers' money, rebated
through charity status. And, as its reach has
extended, the questions about Henry's empire can no
longer be put aside.
In the trust's annual
report, published earlier this year, even its senior
member of staff saw that the writing was on the wall.
"It is inevitable that the actions of a private
organisation, now roughly equal in size to the
national body responsible for medical research,
cannot be ignored by others concerned with the
funding of biomedical science," wrote Dr Bridget
Ogilvie, the trust's director.
This is particularly
true in a period of tight public spending. Over the
last decade, the proportion of scientists working on
short-term grants has doubled to around 40%, making
them more vulnerable than ever to the need for
sponsorship. And, although the trust is registered as
a charity, the nature of medical (and particularly
pharmaceutical) research is such that no sponsor just
gives money away like a guide-dog fund for the blind.
Whether
trust-sponsored research is passed to the company, or
slanted for its benefit, is the leading matter of
concern. Despite the widespread impression that
Wellcome is one operation, it would be a breach of
British charity law if the organisation's two arms
colluded over research. It could, among other things,
make it liable for unquantifiable millions in unpaid
taxes. Both the trust and the company insist they are
separate concerns.
But, as Henry
Wellcome's will memorandum suggests more than once,
this - now unlawful - activity should be the name of
the Wellcome game. He called for "frequent
consultations" between the research and
profit-making enterprises and emphasised that
sponsored scientific findings, "may be of
practical interest and importance to the industrial
organisations of The Foundation". Philanthropy
was the playing field, but profit was the goal.
Nobody suggests
impropriety by any individual in the trust or
company, but the way the two arms operate might give
an observer the eerie feeling that a single mind is
at work. The trust, for instance, invests heavily in
virology, but last year spent almost nothing on
vaccine research. In parallel, the company recently
sold its vaccines division (including its pertussis
jab which raised fears about brain damage among
children). The trust shows virtually no interest in
huge fields, like psychiatry, asthma and cardiology.
Neither does the company.
It could, of course,
be that clever people everywhere will tend to reach
the same conclusions. In 1989, for instance, the
purely charitable Sir Henry Wellcome Medal and Prize
were awarded in the United States for a project on
mandatory HIV tests - which at the time was the
company's most pressing concern. In 1990, another
American team won the honours for acyclovir-related
investigations on the herpes simplex virus.
Thanks to the trust,
the name "Wellcome" is everywhere -
boosting the company's image, as Henry had sought to
do. Besides its presence in universities and
hospitals, there is trust money for the Parliamentary
Office of Science and Technology, for the British
Association for the Advancement of Science, for the
"Michael Swann Bursary in Broadcasting" and
for a syndicated newspaper column provided to the
regional press.
What difference it
all makes to the health agenda is not possible to
assess. But it is clear that the organisation's
decisions may have a crucial impact on which diseases
and disabilities are most urgently addressed - and
whether profit or wider needs decide the means by
which this is done. So far, the experience with Aids
has not been a fortunate one.
Whether these
anxieties are justified or not (and both the trust
and company are adamant that any such fears are
misplaced), it has become clear that throughout
medical science, Wellcome is perceived as a
formidable power - and that only a fool (or someone
close to retirement) would treat it with disrespect.
Would you still get funds from the trust, some have
wondered, if you rubbished AZT?
If Henry Wellcome
were available to give his response, the answer would
seem to be "No". Not only was his empire
set up to cash-in on its own philanthropy, but he
never believed in handouts - for science or anything
else. One of the things he felt he had learnt from
his pursuits in freemasonry, travelling and
archaeological digging was that efficiency always
meant that he had to crack the whip.
His own way of
running things illustrates the point. One anecdote
has it that he forced workmen to paint his medical
museum 26 times before he agreed to pay them. And
during his famous overseas adventures, his manners
were closer to a Mississippi slave boss's than a
druggist's from Minnesota.
In the Wellcome house
journal, John Symons did not mention the floggings,
but noted that when Henry was at Jebel Moya he seemed
to gain most pleasure from having thousands of people
to command. He loved to watch men and boys picking
through rubble. He revelled in planning housing,
transport schemes, a savings bank and a dispensary.
He personally gave out peacock feathers to those who
abstained from drink.
Henry Wellcome's
book, The Story of Metlakahtla, was part of a
personal hobbyhorse that tells the same kind of tale.
An English evangelist, William Duncan, had
established a model village and mission for a native
tribe in Western Canada, based on the principle of
self-reliance. Even after Duncan was accused of
skimming funds, Wellcome obsessively stood behind the
project with his money and political might.
These enterprises
showed more than anything else that, although Henry
Wellcome had no personal goals in politics, he felt
an enduring desire to create and lead a community. In
the memorandum to his will, he suggested that perhaps
a "model works and village" would one day
be constructed to immortalise the Wellcome name.
Cadbury had one, he noted, as did the Levers and the
Rowntrees. His committee could judge when the time
was right. It did not have to be soon.
Perhaps, when he
wrote and signed his will, he reflected on the
origins of this compulsion - the battle at Garden
City - and himself surrounded at the age of eight by
death on a terrible scale. We know that he thought of
Syrie because, although he left her nothing in his
estate, he gave £500 to Dr Barnardo's homes for
children. Four years later, at the age of 82, he died
at the London Clinic and was cremated at Golders
Green.
Henry Wellcome could
not have known, although he might have dreamed, that
the labours at the Jebel Moya settlement would one
day be re-enacted as a pharmaceutical pageant. And,
half a century after his death, it would be more than
a few thousand native workers who would buckle to his
command. It would be the people of consequence in
medical science, all around the world.
A chart of
the Wellcome organisation at the
time this memo was written raised questions about a
conflict of interest.
An index of
material compiled by Brian Deer on the antibiotic Septrin - Septra -
Bactrim sheds more light on Sir Henry
Wellcome's legacy.
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