by Holly Watt
‘Can you stop taking the piss?’
‘Probably not.’
She wondered how worried he was, really. He was impossible to make out.
‘All right.’ Casey put the coffee on the ground next to the bench. ‘What do you want, Zac?’
And there it was, the flicker in his eyes. Not so relaxed after all.
‘Have you … ?’ He stopped.
‘What?’
A robin was flitting round the bench, bobbing for the end of a sandwich. A larger bird landed next to it, and the robin squared up, tiny chest puffed out ludicrously.
Zac was staring across the little park.
‘“The Memorial to Heroic Self-Sacrifice”,’ he read aloud. ‘Not really my sort of thing, you know, Casey? Self-sacrifice.’
Casey had been five minutes late, on purpose. As she watched him, she had wondered if he was glancing at the Victorian tiles, sideways, fleetingly. The expression on his face was unreadable.
‘“Harry Sisley of Kilburn, aged 10, drowned in attempting to save his brother after he himself had just been rescued May 24 1878.”’
Mrs Sisley, and her howl of grief, echoing down the centuries.
‘“Amelia Kennedy, aged 19, died in trying to save her sister from their burning house in Edward’s Lane, Stoke Newington Oct 18 1871.”’
A quiet, instinctive self-sacrifice.
For a moment, Casey’s mind was full of Ed, the memory a burn.
We were in this field of maize. And I suddenly realised there were too many of them. Taliban. And I had to cover the others, my men, so they could get out. I had to stay behind. In this endless field of maize. And I just thought, ‘I’m going to die. I am going to die now.’ It felt so simple suddenly. I don’t know … I still don’t know how I got out …
He only spoke about it once. Never realised others mightn’t. That others wouldn’t.
‘“Samuel Rabbath”,’ the cynicism in Zac’s voice jerked her back to the little park. He was reading aloud from one of the ceramic tiles. ‘“Medical officer of the Royal Free Hospital who tried to save a child suffering from diphtheria at the cost of his own life October 26 1884”. Is that what you’re after, Casey Benedict from the Post? Your very own heroic tile on a wall?’
Casey turned towards his profile, raising an eyebrow.
‘Is that what you’re offering, Zac?’
The robin hopped nearer, all impudence. Casey waited.
‘This lot would all be dead by now anyway.’ He gestured at the wall. ‘Years ago. Long gone, and forgotten.’
‘But they’re not forgotten, are they?’
‘I suppose not. Can’t little Noah Hart help you out then? He’s always so keen to help. He’s the classic teacher’s pet, that man.’
‘I’m sure Noah would.’ Casey made her voice deliberately callous, ‘But his sister was killed shortly after he left Pergamex, so he’s not really in a position to help anyone right now.’
It silenced Zac, as she had intended. She heard him breathe out.
‘This isn’t about Corax.’ Zac broke the silence. ‘Me being here. I am never going to tell you about Corax, you understand?’
‘OK. I’ll probably still ask though.’
‘Fine.’
‘“Ellen Donovan of Lincoln Court, Great Wild Street”,’ Zac was procrastinating again, reading aloud from another tile. ‘“Rushed into a burning house to save a neighbour’s children and perished in the flames.”’
‘Zac—’
‘Adsero have two main antibiotics on their books.’ Zac cut her off, as if it hadn’t been him hesitating. ‘Zentetra and a new one called saepio, that hasn’t been released yet.’
‘I know that,’ said Casey. ‘And hospitals are seeing increased resistance to zentetra. But they hope that saepio is going to plug the gap.’
‘Indeed.’
‘And, separately, as the coronavirus crisis proved beyond all reasonable doubt, a medical disaster that starts in one country takes exactly the same time as a flight to reach us. So a catastrophically resistant superbug in, say, Nairobi, is only ever just over nine hours from central London.’
‘Zac,’ Casey was growing impatient, ‘what are you talking about?’
‘“Thomas Simpson”,’ he recited. ‘“Died of exhaustion after saving many lives from the breaking ice at Highgate Ponds, Jan 25 1885.”’
‘Yes, Zac. I know.’
He turned to her, serious at last. ‘But what do you know,’ he said quietly, ‘about drug dumping?’
30
‘Drug dumping?’ Casey blinked. ‘I don’t think I know anything about it at all.’
‘Not many people do.’
Casey sat quietly, watching the robin and waiting. ‘All right. What is it?’
‘When there is a disaster … ’ Once he started talking, Zac spoke fast, ‘Anywhere in the world, you see appeals, right? On TV, in the newspapers. For earthquakes, floods, war, whatever. Starving children, huge eyes. Especially if it’s happening in one of the poorer parts of the world, you see the big appeals everywhere.’
‘Yes.’ Casey nodded slowly.
‘Well, quite often pharmaceutical companies will respond to those appeals,’ said Zac. ‘And send medicines off to the crisis. It looks good, after all. It looks public-spirited. It shows you care.’
‘Sure.’
‘You can see how it made sense originally,’ said Zac. ‘Pharma companies have got the medicines to hand, and someone else needs them desperately, so why not encourage them to donate drugs in times of disaster? Plus it’s often difficult to manage cash donations in a crisis situation, for all sorts of reasons. So if there is a need for a certain product, why not just take donations directly from the drug companies?’
‘Why not, indeed?’ said Casey.
‘Quite,’ Zac said. ‘The drug companies get the good publicity and the photogenic earthquake victims get the drugs.’
‘Everyone’s a winner.’
‘Well,’ said Zac, ‘not exactly.’
‘Why not?’
Zac paused again, watching the robin scuffle a crisp packet. Casey waited.
‘The thing is,’ he said slowly, ‘that for years, US drug companies received tax breaks for those donations.’
‘What do you mean?’
‘Pharmaceutical companies work out how much a drug costs to make, and how much it would theoretically have cost on the open market,’ explained Zac. ‘Then a proportion of that amount is knocked off the company’s tax bill. Quite a big proportion, actually. And if you don’t have to pay $10 million in taxes, that’s basically the same as an extra $10 million in profit. The bottom line doesn’t care where the money actually comes from.’
‘And so what happens? With the dumping?’
‘Well, pharmaceutical companies started sending stuff in response to the appeals, and then they immediately claimed the money back off their tax bill. Sometimes, they were really sending stuff that was desperately needed on the ground, but quite often, they sent whatever they had to hand. Unfortunately, that meant that mountains of drugs and equipment were dispatched for years, and tonnes of it was completely useless. Breast implants were sent to Malawi. After the huge tsunami in 2004, Indonesia was left with tonnes of cough syrup. Slimming products were sent to Sudan, for God’s sake, in the middle of a famine. And all along, the companies were claiming the tax breaks.’
‘But that doesn’t make any sense.’
‘It is madness. And on top of that,’ Zac said, ‘for years, there were no checks on the use-by dates of the drugs at all. So millions of doses of these drugs would be sent off when they were already past their expiry date, and that freed up lots of nice, expensive warehouse space back in the States. The added beauty for the drugs companies is that it costs money to dispose of even useless drugs properly. You can’t just pour them down the drain. But all of a sudden pharma companies could pack them up and send them off, and claim the tax break. During the Eritrean war of independence, it apparently too
k six months to burn all the out-of-date aspirin sent by donors. And on top of all that, because of the rules around transporting drugs, once the useless pills have been dispatched from the US, you can’t send them home again. During the nineties, 17,000 tonnes of useless drugs were sent to Bosnia.’
‘But … ’ Casey was lost for words.
‘And furthermore,’ Zac’s mouth twisted ironically, ‘the drugs would be shipped off with no instructions in the relevant language, no packaging, nothing. Aid workers, who were already up to their eyeballs in chaos, would then have to decide whether or not to try and use the drugs. A sort of pharmaceutical Russian Roulette. At one point, eleven women in Lithuania were temporarily blinded because a doctor guessed what a pill was, and it actually turned out to be something that was meant to be used on animals.’
Casey found that her coffee had gone cold. ‘That’s insane.’
‘I suppose the thing is,’ Zac said, ‘it’s easy to convince yourself that something is better than nothing. And no one in the real world understands tax breaks anyway, because your readers just glaze over and go on to the next thing.’
‘Maybe.’
‘The other thing is,’ Zac was watching the robin, hopping to and fro, ‘it wasn’t just implants and slimming pills they were packing up.’
‘What else were they sending?’
‘They also sent antibiotics.’
31
Mary Rogers Stewardess of the Stella, Mar 30, 1899, self sacrificed by giving up her life belt and voluntarily going down in the sinking ship.
Henry James Bristow, aged eight – at Walthamstow, on December 30 1890 – saved his little sister’s life by tearing off her flaming clothes but caught fire himself and died of burns and shock.
‘Which antibiotics?’ Casey asked quietly. ‘And where were they sent?’
‘It happened a few times.’
‘Tell me.’
‘Well, back in 1994,’ said Zac, ‘there was the genocide in Rwanda. Hundreds of thousands of women were raped. Family after family massacred. There were probably a million dead.’ Zac stared across at the old memorial wall. ‘And the world did nothing until it was far too late.’
He stopped. The air was an icy blue, the rumble of the city all around them.
‘I remember.’
‘And after that, the war sprawled into what was then Zaire. The First Congo War.’
‘What happened with antibiotics?’
‘You’ll have heard of Swann Hopkins?’ Zac waited for Casey’s nod. ‘One of the biggest pharmaceutical companies in the world. And it happened to have millions of capsules of Garso parked in a warehouse. Garso’s a second-generation ciprofloxacin and for whatever reason, Swann Hopkins had made 8 million doses of Garso with a different strength to their usual one, assuming that the FDA would wave through the new version. But as it turned out, the FDA was slow to approve the new dosage. So Swann Hopkins had this mountain of Garso just sitting in a warehouse in Idaho or wherever, getting closer and closer to its expiry date.’
The robin was hopping between the snowdrop blades now. ‘Then what?’ Casey asked.
‘The war rumbled on. Millions of people ended up stuck in refugee camps, in absolutely horrendous conditions. As usual, an appeal went out, and at that point, Swann Hopkins got in touch with a charity, offering $50 million worth of Garso. Naturally, the charity bit their hand off, and off went the antibiotics.’
‘Could the charity actually use Garso on the ground?’
‘No, not really. You tend to use really basic antibiotics in refugee camps, because the testing facilities are either limited or completely non-existent. Ciprofloxacin isn’t something you can just hand out randomly, either. You’re meant to be really careful using a drug like Garso. And you can create antibiotic resistance quite quickly if you don’t.’
‘So what happened to the Garso that Swann Hopkins sent to the Congo?’
‘A lot of it had to be destroyed, they think. But how do you ensure the security of millions of doses of an antibiotic in the chaos of a Congolese refugee camp? Especially when lots of the people stuck there would desperately need antibiotics, anyway.’
‘And if you need antibiotics, and you’ve got antibiotics to hand … ’
‘Exactly. And a few months later, Swann Hopkins got tens of millions of dollars back in tax rebates for its unuseable, unused Garso.’
They sat side by side on the bench. Casey’s feet were blocks of ice.
‘So how does all this connect to Adsero?’
Zac’s eyes roamed around the park. His hands were fists on his knees.
‘A few years later, a cyclone hit the east coast of Africa. Massive floods. Catastrophic flooding. Hundreds of thousands of people trapped in refugee camps, again. All the crops, everything washed away, again. The appeal went out, once more. And this time, Adsero responded.’
‘What did they send?’
‘Adsero sent millions and millions of doses of zentetra down to Mozambique. Apparently, there had been some deal to export it to the Middle East but that collapsed, so Adsero’s US division was stuck with loads of this drug, and it was heading towards its expiry date. When the cyclone hit, they just loaded the zentetra on a plane and sent it off to Africa.’
‘So tonnes of zentetra arrived in a refugee camp?’
‘Yes, and then Adsero lost control of the shipment. Now the drug’s turning up all over southern Africa.’
‘And now what’s happening?’
‘I don’t know,’ Zac said bleakly. ‘I have absolutely no idea. But I don’t think it’s good.’
32
‘Hang on,’ said Miranda. ‘What does any of this have to do with Corax?’
‘Zac won’t talk to me about Corax,’ Casey explained patiently. ‘But he will talk more broadly about Adsero.’
‘Why won’t he talk about Corax?’
‘I don’t know.’ Casey bit her lip.
‘But he’s saying that we can hit Adsero a different way?’ said Miranda. ‘By targeting them on dumping tonnes of zentetra into Mozambique?’
‘I think Zac definitely wants to take out Adsero,’ said Casey. ‘But for whatever reason, he won’t tell me about Corax. And presumably, he can’t be linked to the zentetra problem in Africa, so he knows he can’t be blamed if that ends up in the Post.’
‘How much do these companies make out of the tax breaks?’ asked Miranda.
‘Millions,’ said Casey. ‘The taxpayer essentially funded these companies to dump their junk medicines into struggling countries. It was all out in the open, but because tax breaks sound tedious, no one pays them any attention. The WHO pushed back on it all, and the charities have got wiser to it all now, but it used to happen a lot. And in Adsero’s case, the zentetra dumping seems to be triggering serious antibiotic resistance.’
Miranda shook her head slowly. ‘How bad is the resistance in Africa now?’
‘Antibiotic resistance is the silent pandemic,’ Casey recited. ‘That’s what one of the doctors I spoke to called it. In his research in Zimbabwe, he found that 50 per cent of children in a hospital were carrying ESBL-producing bacteria. In the UK, those kids would be off in a side room, safely away from everyone else, with the doctors and nurses in full PPE. Over there, they’re barely tested. Zentetra triggers the same sort of resistance to lots of antibiotics. Pan-resistance, they call it.’
‘But they wouldn’t do that on purpose … ’
‘Wouldn’t they?’ snapped Casey. ‘Look at what these companies get up to that we already know about. Cranking up the price of insulin. Cranking up the price of cancer drugs. Decades of promoting opioids, although they knew about the addiction risks. God knows what else. These companies are giants, and they make billions more every year. They’re hugely powerful and they are absolutely ruthless.’
Miranda pondered. ‘So what’s the plan?’
‘I’ll try and convince Zac to fly out with me, to find out what is going on. The science is complicated, and he knows what
he’s looking for.’
‘Will he go with you?’
‘I don’t know yet. But he could have just rung me up from Mauritius and told me this stuff. He says he was coming to London anyway, but I think he wants to get out there.’
‘Casey,’ Miranda said slowly, ‘I really don’t think it is a good idea.’
‘It’ll be fine,’ said Casey. ‘I’ll be fine.’
‘You don’t know—’
Ross stuck his head around the investigations room door.
‘Any chance of you filing any time soon, Casey?’ The sarcasm was heavy. ‘An extra 300 words on the care home crisis if it wouldn’t interrupt your day too much.’
‘You only need the extra words because you cut out the reference to DartCare,’ Casey said pertly. ‘They own over 400 homes and they’ve just cut the hourly rate for their care workers while paying out a massive dividend to the shareholders.’
‘Yup,’ said Ross. ‘But then again, the chief executive is a very good friend of our owners, and I simply can’t be arsed to start World War III for 800 words on CQC reports. Focus on Brightweather, OK?’
‘Ross—’
‘Get on with it, Casey.’
‘This is a lovely reverse ferret on the Naji doping story, by the way.’ Casey waved that day’s Post at Ross rebelliously. The front page was a big photograph of the cyclist hugging his baby son. ‘A real classic of the genre, I have to say. I so enjoyed hearing about his favourite cycling shorts and his lucky shamrock necklace. Heart-warming stuff. Really cutting-edge journalism.’
‘Shut it,’ Ross advised amiably.
He disappeared across the newsroom, pausing only to bawl at Eric. ‘Unless you’ve got today in that sweepstake, you can stop dicking around too.’
‘What sweepstake?’ Eric stared at Ross’s departing back. He glowered around the room. ‘Is this about that Islington fuck-up? Are you bastards actually betting on when I’m going to be sacked? That’s not bloody fair.’
‘Oh, don’t worry,’ the home affairs editor said soothingly. ‘It’s not as if we’re letting Ross get involved. That,’ he finished primly, ‘would be insider trading.’