According to the author Stephen King, the Crimson King was “the orchestrator of chaos and decay” – and so it is with many faceless corporations: Big Tobacco, Big Oil, Big Pharma and now maybe Big Tech. 

To be sure the “Big” ones have some extremely bad history, lead in petrol, brutal marketing for a known killing habit, many medical scandals (from thalidomide to opiate epidemics), and now for Big Oil the entire carbon footprint of billions of consumers. Orchestrators of chaos and decay, you bet. 

The above may be a fair representation – and is one beloved of headline writers. However, there are alternative narratives that can be equally true and yet coexist. We have to be ready to accept some uncomfortable cognitive dissonance to be able to hold conflicting but valid narratives at the same time. Or just have very short memories.

The Big Pharma Redemption

Big Pharma has a bad rap – the brilliant Ben Goldacre has provided grist with Bad Pharma and indeed Bad Science. In the US “aggressive marketing” of opioid painkillers led to “100 deaths a day” from overdoses – and huge profits for the corporations. 

Add into this, the very human reaction of “chemophobia” and you get mistrust of the whole industry. Indeed, this may even be part of the reason for the rise in the anti-vax (pre-covid) movement.  Fear of chemicals and technology with very little understanding of the science is a common problem because cutting-edge technology in any domain is way ahead of a lay-person’s understanding.

But the other side of the narrative is so huge and so important that it is largely not noticed.

Absence is invisible 

By way of example, modern medicine has been so successful in eradicating infectious diseases that they have been literally forgotten in most developed countries. We don’t see the killer diseases that are no longer here. So, we get the anti-vax movement festering amongst people who should know better. Anecdotal, but emotionally charged, stories of vaccinations and autism take hold because there is no counter weight in the narrative.

People can look at the balance of perceived costs and benefits – and simply be blind to the enormous benefits. Lets call it Pathology Blindness.

List of top killer diseases in 19th century Europe

Cholera, Smallpox, Typhus, Yellow fever, Plague, Scarlet Fever, Measles

Do you know anyone who has had, let alone died of, any of these? No. probably not.

Today the biggest killers are Cancers and “lifestyle” diseases (cardio-vascular and increasingly diabetes).  In the post-covid world we will undoubtedly hear more about the UK’s terrible covid toll and the euphemistic “underlying health issues” – which is often shorthand for comorbidity of CVD and/or diabetes.

Whilst the lifestyle killers have become more prevalent – there is little evidence, outside of smoking related cancers, that cancer has become vastly more fatal than Cholera, Smallpox et al.  No, the absence of these historic killers has been a big factor in a huge increase in average lifespan. Not only do most children survive (which clearly affects the average), but also a lot more people live longer. Sadly, cancer is mostly (but clearly not exclusively) a disease of older age – in 1900 many people never made it to old age – so it is logical that it will kill more people now that 100+ years ago.

So when weighing up the value of a vaccine of say measles, one needs to be able to ascribe value to the absence of something fundamental and important and not focus on anecdotal and incorrect stories – no matter how they trigger emotions.   

Big Pharma deserves a bad reputation for all the real scandals, but it also deserves recognition for the immense good it has delivered to society over 100+ years.

Today, we are only just over a year into the Covid 19 pandemic, and the much reviled Big Pharma (and little Pharma to be fair) have already delivered 5 (or maybe more I am losing count) clinically proven vaccines. As I noted in Part 1 of this post, Covid-19 for all our losses, remains quite benign relative to SARS, Spanish Flu or god-forbid, Ebola. We are hugely grateful for the new vaccines – multiply that by orders of magnitude if Covid-19 had had a higher fatality rate.

We don’t hear much about the evils of Big Pharma in the mainstream today.  When an existential crisis hits the invisible becomes visible and we can start to properly balance the trade-offs. 

Yes we would like a pharmaceutical industry without heinous profit motifs leading to human tragedies, but I wouldn’t shut down the whole industry simply because the benefits – though they be mostly forgotten – vastly outweigh the negatives.

Energy blindness

So to energy.  The fossil-fuel industry is considered to be an existential threat to humanity, and politicians are calling for it to be shut down

As with pharma, the benefits of fossil fuels – which have literally powered the whole global development since the industrial revolution and all the HDIs that evidence this – are invisible or forgotten.  We have been so good at providing “always-on” energy that people are simply blind to it.

There is a case that we can “just” swap out dirty and dangerous fossil fuels for clean alternatives – and in many narratives these will be cheaper as well. If this is true then the transition is a no-brainer. 

However, the challenges are monumental and vastly underestimated. Most importantly is the cost – and whilst not the subject of this post, it is fundamental. If we accidentally replace the motor of growth (cheap energy) we will have unintended de-growth. That won’t be pretty.

In the meantime, Big Oil (and gas and coal) will remain public enemy No.1 until we have a covid-19 moment in the energy space. In a good scenario this will be a minor energy shock that will simply redress the balance – and provide weight to the argument that we should recognize that energy involves trade-offs and simply laying all the worlds problems at the door of fossil fuels is ignoring a critical aspect of human development over the last 200 years.

A less good scenario is that we have runaway energy prices, which are inherently unsustainable. 

Its not that we can simply adapt to higher energy prices or that energy will suddenly get cheap again, but we will simply no longer be able to afford it. 

Higher energy prices mean less. Less of everything.  A poorer world will be less resilient and undoubtedly less equal and less safe.

Part 1 – can be seen here