Thursday, April 24, 2014

August 1943 to August 1945 : when Pax Americana was soft penicillin power, not hard atomic bomb power

Why exactly does Penicillin remain the best known and best loved medication of all time ?

Consider these points in its disfavour.

Its amazing life-saving qualities were not truly unique - not before or after it first became famous in late 1943.

The then still new Sulfa drugs, first popularized in the late 1930s , were also miracle life savers.

But , unlike 1943 penicillin , they were also inexpensive, abundant in supply and could be taken as infrequent pills.

Penicillin was in extremely short supply and was very, very expensive . It also required refrigeration and had to be given by needle.

In fact, in some ways, the original Penicillin was one of the worse ever drugs for a patient to receive.


It required one to be awakened every few hours, night and day , often for weeks at a time, to receive ever more painful injections with old-fashioned big dull needles.

And it is easy to forget that to cure a case of truly drug resistant endocarditis - then or today - may require a kilogram of pure penicillin.

In the Spring of 1943, at the beginning of penicillin's fame, that was equivalent in cost , as a percentage of the average industrial wage, to an extended treatment of Avastin today.

(It was also more penicillin than all of humanity had yet produced since its discovery !)

Yet most people still regard penicillin as the one truly good thing to come out of WWII.

(Sure when polling males,  one finds raves for radar , rockets and jets : boy toys. But among women ?  Yetch !!!)

Was most of the "miracle" of wartime penicillin its unusually equitable distribution , not its medical cures ?


So could it be that the unusually equitable distribution of penicillin that made it so beloved ?

Perhaps - but its equitable distribution as of what date ?

Because, despite being discovered in September 1928 , it was not until fifteen years later , in September 1943, that most in the world even heard of this life-saving wonder.

The Allies had determined to keep its wartime civilian trial life-saving successes out of the scientific and popular media.

They wanted to save it, to use as a surprise military weapon.

One to be unleashed on D-Day, where it would get Allied lightly wounded casualties back into combat faster than the Germans could do so with their wounded - thus winning the manpower war.

So , early wartime penicillin was highly un-equitably distributed - a war crime in fact.

This weaponizing of new technology by keeping it secret was hardly limited to things like new explosives or new engines or even new medicines.

For example , DDT's newfound ability to reduce food losses due to insects was kept secret from all farmers during the war , despite the worldwide desperate shortage of food - it was exclusively used instead to keep Allied military encampments insect free.

A huge potential public health crisis looms


In the Fall of 1942, early secret trials of penicillin had showed how well it worked.

This was potentially truly great news , because at that same date, the chemists had just agreed that, for molecular reasons, the supplying of ever newer (and ever better types) of Sulfa anti-bacterial drugs was definitely over.

(The chemists had run out of any more appropriate atom-attachment angles on the sulfa molecule structure that would allow anti-bacterial qualities in the resulting new drug .)

Worse - far worse - the current Sulfas were also starting to fail , due to ever increasing bacterial resistance.

A public health crisis loomed.

So two key Allied government bodies met to plot their secret 'solution'. (Absolutely no apologies if this choice of words seems an allusion to the Wannsee Conference.)

Despite all this new evidence, the British Ministry of Supply medical division and America's supreme war science body the OSRD medical division , both run by politically conservative leadership , still decided to only make a severely limited supply of penicillin during the war.

If a WWI style pandemic of pneumonia had broken out that the Sulfas could not treat , perhaps 75 million people might of died worldwide .

That is even more than the final death total of WWII caused by bullet or hunger.

A War Crime , like the German Hunger Plan , doesn't have to be fully carried out, to be a moral sin


Morally, it was one of the worst decisions of WWII - made all the worse by having been taken by senior doctors who had personally tried to treat the Spanish flu pneumonia of WWI and failed, just 20 years earlier.

Yet this niggardly approach to a huge potential public health crisis view was supported by the British socialist party and the leadership of all the Allied nations.

Only enough wartime penicillin was to be produced to treat all the moderately wounded frontline Allied troops.

Little or none for severely wounded Allied troops,  Allied civilians, enemy and Allied POWs or for civilians of occupied countries.

Floyd Odlum to the rescue ?


Only the  leadership of the New Deal oriented WPB (War production Board) bucked this idea , perhaps because of advice from senior advisor Floyd Odlum, himself a patient of "humanitarian penicillin distribution advocate" Martin Henry Dawson.

The WPB decided they wanted enough American penicillin made during the war to at least be able to use penicillin to treat all those in the world who would die without it.

In a sense, they saw that American mercy-exports of penicillin to meet dire cases in Allied, Neutral and Occupied (and later Enemy) nations would become an extremely valuable tool in the Allied soft power effort to win WWII.

Surprisingly , the WPB's eagerness to buy huge amounts of penicillin at profitable prices , after also giving Big Pharma soft dollar loans and tax write-offs to finance penicillin expansion, was still met by indifference by most firms.

Despite the desperate need of the war-wounded and the big profits available , they sat on their hands , awaiting till (if ever) that penicillin was made by chemical synthesis.

Doctor Mom gives the WPB a leg up


But in September 1943, when Doctor Mom found out about penicillin's ability to save the lives of her children at home and overseas , she made this drug company apathy too hot to handle for either her Congressman or her husband who worked at a drug company .

Soon abundant cheap American penicillin - as the WPB had hoped - was saving lives at home and abroad -  enough for all Allied troops and for increasing numbers of civilians in Allied , Neutral and Occupied lands.

For two brief  years , before Hiroshima changed everything, the wonderful possibility existed that the postwar Pax Americana might have been based on soft penicillin power, not on hard atomic bomb power....

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