Henry
Wellcome:
thy will be done
Brian
Deer: September 19 1993
This
document on the life and legacy of Sir Henry Wellcome
was written by Deer as a memo for editors at The
Sunday Times of London, and formed a starting point
for published stories
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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