There were relatively few comments on The Thalidomide Catastrophe. There were however more people getting in touch directly. Some said they were going to buy the book. Here are some more reasons to think about buying.
The Once and Future Nightmare
Many seem to think thalidomide is an old story they more or less know everything about? Everyone knows for instance who made Thalidomide – Chemie Grunenthal? Think again. It was probably more than a decade old by the time Grunenthal took out a patent on it in 1954.
The real maker was likely linked to Otto Ambros, the man responsible for the camp at Auschwitz, whose job it was to produce nerve poisons. Ambros was jailed briefly after the War before joining the board of Grunenthal, where he linked up with a number of other Nazis.
Thalidomide was traded in Germany as Contergan. Sounds like a close relative of Antergan – a Rhone Poulenc drug? It is almost for certain the real makers of thalidomide stored it during the War with Rhone-Poulenc – in France – and got it back afterwards.
Nothing Personal Just Business
By 1961, Grunenthal was in big trouble. Deformed babies were being born all over the place. The company was busy denying all responsibility. They needed a get out of jail free card. The company gave the drug to patients with learning disabilities and patients with Alzheimer’s and other vulnerable groups looking for salvation.
Otto Ambros meanwhile sat down with Jacob Sheskin from Israel, and a year later in 1965, Sheskin and colleagues reported Thalidomide cured leprosy.
Grunenthal went on trial in 1968. Another of Sheskin’s group was scheduled to testify for the company at trial – how honorable and proper the company were.
Lots of people have heard that Thalidomide caused problems but it turned out to be a good treatment for leprosy and myeloma. Well, Sheskin’s claim and later patent was based on treating Erythema Nodosum Leprosum (ENL). This is not leprosy.
At the time Dapsone was the number one treatment for leprosy. One of its side effects is ENL. You are particularly likely to get ENL if the dose is pushed up. Sheskin had pushed the dose beyond what anyone was using anywhere, and caused ENL.
Lepers of the World Unite
WHO waded in and endorsed Thalidomide for Leprosy on the basis of these effects on ENL. With an indication on thalidomide for leprosy and WHO support to help get Thalidomide into use in Brazil and elsewhere in South America and Africa, the use of the drug boomed during the 1970s and 1980s.
It came with no warnings. Thalidomide finally reached the market in the United States for AIDS in the early 1990s with a STEPS (System for Thalidomide Education and Prescribing Safety) program. The STEPS program was a monitoring and consent system aimed at ensuring there would be no pregnancies. It justified a then astronomical price. It also turned out to be a way to fight off a challenge to the patent. When Dr Reddy from India tried to produce a generic version, Celgene, Thalidomide’s new owners, claimed the patent was on the combination of the drug and safety system.
In 2003, WHO conceded thalidomide had never been any good for leprosy. They said nothing about their efforts to push thalidomide for over two decades in Brazil and elsewhere without even a hint of a STEPS program, or continuing efforts to push Thalidomide in Brazil and elsewhere without a STEPS program for nearly two decades after one was introduced in the United States.
There were probably more Thalidomiders born in Brazil than anywhere else.
Killing AIDS Patients
Between Leprosy and papers claiming Thalidomide was useful for Behcet’s syndrome – a skin condition which it is claimed has more papers written about it than there ever were patients – when a new plague, AIDS, turned up in the 1980s, one of the features of which were skin lesions, AIDS patients got interested in Thalidomide. Buyer’s clubs began importing it from Brazil and Mexico.
Their interest was strengthened when Celgene – a new company that had appeared soon after AIDS – announced it had been liaising with Gilla Kaplan, an Israeli scientist, who had drawn their attention to the possibilities Thalidomide might have in the treatment of AIDS. All sorts of theories were put forward as to why Thalidomide was going to be the miracle cure – the Holy Grail.
These theories were bananas and diametrically contradictory. But Thalidomide has always been aimed at the vulnerable and beyond them the particularly vulnerable. By the stage it was approved by FDA, the AIDS community had left it behind. But before they did, it seems highly likely it was responsible for a considerable proportion of AIDS deaths, with the peripheral neuropathy and dementia it causes adding to the peripheral neuropathy and dementia that AIDS causes – or does it?
The Holy Grail
Thalidomide was brought back on the market by Celgene. Celgene came into existence in 1986. They were created by Hoechst, who had once been part of IG Farben – the company in which Thalidomide first appeared. Celgene’s parent, Hoechst, went on to merge with none other than Rhone-Poulenc.
Thalidomide was useless for AIDS but made money for Celgene and was Back. An AIDS patient, or so the story goes, shared it with his father who had multiple myeloma and the father got a benefit. Thalidomde began to be used off license for multiple myeloma.
Celgene rushed out a derivative of it – Revlimid – lenalidomide – which appears even more likely to cause birth defects. Complete with a STEPS type program, it cost a fortune. For not very much benefit.
Some years later, Celgene launched another derivative Otezla, apremilast, for minor skin blemishes, complete with warnings about birth defects and suicidality – see HERE.
In 2015, reviewing the pharmaceutical industry Forbes listed Celgene as the second most profitable company in the world – based on its thalidomide franchise. Nazi chic is worth a lot. Just take care asking questions about Celgene.
Chemie-Grunenthal were a family firm – the Wirz family. They had strong Nazi connections. They escaped close to scott-free from the Thalidomide disaster of the 1960s. The German government may have broken the law to save them. The architect of their escape, was Joseph Neuberger, a Jew, who had returned to Germany from Israel and was a Minister in the Social Democrat government, who for whatever reason seem to have wanted to bail them out
Many decades later Michael Wirz, the then owner, son of the original owner, Herman Wirz, was made a Papal Knight. Not by Josef Ratzinger, who of course had interesting links as a younger man, but by Jose Mario Bergoglio. What’s in a name – Argentina. Stop – paranoid fantasies can go too far.
Having played a part in not believing victims of child abuse in Chile, for which he recently apologized, Bergoglio has even more recently managed to get the entire cohort of Chilean Bishops to tender their resignation for their part in covering-up child abuse in the country.
Thalidomide has probably been one of the most devastating examples of child abuse ever. In purely moral terms, Bergoglio is better placed than anyone to play a part in uncovering the cover-up and extracting an apology.
Trouble is no-one is scared of the Catholic Church or the Inquisition anymore. They are however scared stiff of the pharmaceutical industry. Morality for many of us is not annoying those you are scared stiff of.
So you thought you knew the Thalidomide story? This post just scratches the surface.
Mark Twain said that truth is stranger than fiction because fiction has to make sense. The Thalidomide Catastrophe is the strangest of strange books. Everyone should buy.