September 19 1993
Memo on Sir Henry Wellcome

Sir Henry Wellcome

- thy will be done

brian

This document was written by investigative reporter
Brian Deer (left) as a memo for editors at The Sunday Times,
and formed a background 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.


Copyright, Brian Deer. All rights reserved. No portion of this article on Sir Henry Wellcome, founder of the Wellcome Trust and Wellcome drug company may be copied, retransmitted, reposted, duplicated or otherwise used without the express written approval of the author. Your feedback is appreciated