Leslie Wexner’s Young Global Leaders
By Whitney Webb |
UNLIMITED HANGOUT| August 8, 2022
The following is an adapted excerpt from Whitney Webb’s upcoming book, One Nation Under Blackmail, which examines the network behind Jeffrey Epstein and traces it back to the merging of American organized crime and intelligence beginning in the early 1940s. In this excerpt, Whitney examines the Wexner Foundation’s origins and the ties of Leslie Wexner’s philanthropy and Jeffrey Epstein to Harvard as well as the now infamous Young Global Leaders program of the World Economic Forum. Whitney’s book can be pre-ordered here, here or here.
The Origins of the Wexner Foundation
It is hard to know exactly when the Wexner Foundation was originally created. The official website for the foundation states clearly in one section that the Wexner Foundation was first set up in 1983 alongside the Wexner Heritage Foundation. However, the 2001 obituary of Wexner’s mother, Bella, states that she and her son created the foundation together in 1973. Regardless of the exact year, Wexner’s mother, Bella, became the secretary of the foundation (just as she had with his company The Limited), which Wexner wanted people to refer to as a “joint philanthropy.”
The foundation’s website states that the original purpose of the Wexner Foundation was to assist “emerging professional Jewish leaders in North America and mid-career public officials in Israel.” Per the website, Wexner’s main philanthropic endeavors were created after Wexner “reached the conclusion that what the Jewish people needed most at that moment was stronger leadership.” As a result, Wexner sought to focus his foundation’s attention chiefly on the “development of leaders.” As a consequence of this, Wexner’s programs have molded the minds and opinions of prominent North American, as well as Israeli, Jewish leaders who went on to work at the top levels of finance, government and, even, intelligence.
One of the Wexner Foundation’s original advisors, and perhaps one of the most important, was Robert Hiller, who had previously been executive vice president of the Council of Jewish Federations and Welfare Funds. Robert I. Hiller was described in an article in The Baltimore Sun as a “nonprofit leader who helped develop community fundraising strategies and was active in the Soviet Jewry movement.”
As well as being known as a community development leader, Hiller was also an executive with Community Chest of Metropolitan Detroit in 1948. In that position, Hiller helped bring together corporations such as General Motors to create “social service groups under an umbrella organization, a precursor to collective fundraising efforts today.” In 1950, Hiller became the associate director of the Jewish Community Federation of Cleveland and six years later he also joined the United Jewish Federation of Pittsburgh. He would spend another nine years in that position before his move to Baltimore.
In his autobiography, Hiller wrote about his extensive dealings with various Israeli heads-of-state, saying: “I had pictures of every Israeli Prime Minister from David Ben Gurion to Menachem Begin. I would have many more with Begin because he was the current Prime Minister. My favorite picture, however, (it was to be hung) was taken in Washington, D.C. at a gala party where Marianne and I were with the then Ambassador, Yitzhak Rabin, and his wife, Leah.”
Hiller was extremely proactive when it came to seeding suitable, high ranking candidates for appropriate positions in Jewish community organizations, a task that the Wexner Foundation would later reproduce on a grand scale via its various Fellowship programs and subsequently apply to the worlds of business and government. One example of this matchmaking was the appointment of Larry Moses as assistant to Rabbi Maurice Corson. Corson is credited as having co-founded the Wexner Foundation with Leslie Wexner in 1983, per the foundation’s website, and he served as its first president. After Corson left that post, Moses stepped in to serve as the foundation’s president.
Maurice Corson and Leslie Wexner in an undated photo, Source: The Wexner Foundation
Hiller wrote in his autobiography that he had “personally enticed” Moses to become Rabbi Corson’s assistant and this later resulted in Larry Moses becoming the executive vice president of the Wexner Foundation. When Hiller was 33 years-old, he was presented with an opportunity to become a member of the Big 16, which was classed as an informal grouping of the 16 largest communities in North America headed by prominent Jewish executive members. One of the people who Hiller connected with the Wexner Foundation was originally meant to lead the Big 16 Federation, Fern Katelman. Katelman declined this prestigious leadership role in order to join Larry Moses, where he became his assistant at the Wexner Foundation.
Hiller, when revisiting his life, would state: “One of the most stimulating relationships I had was with the Wexner (Leslie) Foundation of Columbus, Ohio, and New York City. Rabbi Maurice Corson was the foundation president. My relationship with him started in Baltimore where he had been a new rabbi for one of the city’s largest Conservative synagogues. He came from Philadelphia with an interesting background and credentials.”
Hiller goes on to write: “He [Corson], however, seemed bored and uneasy with the routine of being a synagogue rabbi. When he and the congregation decided to part company, I assisted in getting him an executive position with the United Israel Appeal of Canada. He did so well that he was recruited to return to the U.S.A. in an executive position with International B’nai B’rith. Leslie Wexner met him through his work with B’nai B’rith, and when Les began to put together a formal foundation, he engaged Rabbi Corson as the chief executive.” B’nai B’rith is a “Jewish fraternal organization” that was founded in the 19th century and is modeled as a secret society, leading some to compare the group to the freemasons.
Hiller went on to assist Corson in the initial stages of setting up the Wexner Foundation while they put together “a distinguished advisory group” with the group meeting in Columbus, Ohio, and New York City. Hiller describes assisting Corson in creating the foundation, which Hiller called: “an unusual foundation with its own agenda and programming.” After several years of service to the Wexner Foundation, Hiller retired from his consultancy role and was replaced by Philip Bernstein, the former executive of the Council of Jewish Federations and Welfare Funds (CJF).
Now, it makes sense to examine Rabbi Maurice S. Corson himself. Corson was a prominent Jewish educator who, as previously mentioned, already had associations with various Jewish welfare organizations prior to serving as co-founder and then president of the Wexner Foundation. Corson had been ordained as a rabbi in 1960 through the Jewish Theological Seminary, after previously studying at the University of Cincinnati where he graduated in 1955. By 1964, Corson had become the president of the Religious Education Society in Seattle, and he remained in that position until 1966.
Over the following decade, he began working for the Zionist Organization America in Atlantic City and, shortly thereafter, became the Senior Rabbi at the Chizuk Amuna Congregation, a position he held from 1976 until 1979. Around this time, Hiller helped Corson get an executive position with the United Israel Appeal of Canada, where he went on to work for only a year before joining B’nai B’rith.
Once recruited into serving a leadership role within the influential “secret society,” Corson worked as director of development for B’nai B’rith International, based in New York City, between 1980 until 1985. During this very period, the board of overseers of B’nai B’rith included Edmond Safra, a notorious banker with close ties to Robert Maxwell and later Jeffrey Epstein; Edgar Bronfman, scion of the family behind Seagrams whose fortunes have long been tied to organized crime and Max Fisher, a Detroit businessman who re-launched the Jewish Agency, worked as a “private” diplomat on Israel matters and later served as a mentor to Leslie Wexner.
As noted previously, while Corson was at B’nai B’rith, he first met Leslie Wexner, who persuaded him to co-found the Wexner Foundation (per the version of events on the foundation’s website). Although he had been recruited by Wexner and subsequently left the B’nai B’rith organization, Corson became a member of the executive committee of B’nai B’rith Hillel Commission in Washington in 1987.
Another key figure who is important to mention is the co-founder of the Wexner Heritage Foundation, Rabbi Herbert A. Friedman. Depending on which part of the Wexner Foundation site you visit, that Foundation is listed as having been founded in either 1983 or 1985. However, Friedman is clearly listed as the co-founder of the foundation and as having served as its president for a decade.
The Wexner Heritage Foundation, per its website, was created “to strengthen volunteer leaders in the North American Jewish Community.” It spawned the Wexner Heritage program, which “provides young North American Jewish volunteer leaders with a two-year intensive Jewish learning program, deepening their understanding of Jewish history, values, and texts and enriching their leadership skills.”
Friedman was a US Army chaplain during World War II and also served as an “adviser on Jewish affairs to General Lucius D. Clay, the commander of American occupation forces in Germany.” He was later personally recruited by David Ben-Gurion, who went on to serve as Israel’s first Prime Minister, to join the paramilitary group, the Haganah. The Haganah was the pre-cursor to the Israeli military and was armed in large part by organized crime-linked networks. Per the New York Times, “as a member of the Haganah, Rabbi Friedman participated in the Aliyah Bet, the illegal transport of European Jews to Palestine.”
From 1954 to 1971, Friedman was the chief executive of the United Jewish Appeal (UJA) and, in that role “raised more than $3 billion to support the fledgling state of Israel.” During this period, UJA was intimately involved in the relaunching of the Jewish Agency by Wexner’s mentor Max Fisher in 1970. Fisher was also intimately involved with the related United Israel Appeal. Throughout the 1980s, Wexner was “one of the largest individual contributors to the United Jewish Appeal in America” and, after creating the Wexner Heritage Foundation with Friedman, Wexner became UJA’s vice chairman.
While Wexner was serving in these capacities, he was also engaged in closed door meetings with the highest levels of Israeli leadership, not just about “philanthropy,” but also about his business interests. One specific meeting saw him meet with top Israeli government officials about “Chinese and Israeli interests” working with his company, The Limited, to establish factories in the occupied Golan Heights.
Notably, the Wexner Foundation has direct and controversial ties to at least one former Israeli head of state, Ehud Barak, who was intimately involved with Jeffrey Epstein and an alleged participant in his sex trafficking operation. As reported by Israel Today in 2019:
“[Barak’s ties to the Wexner Foundation] became an issue only after right-wing journalist Erel Segal called last October to investigate the $2.3 million ‘research’ grant Barak received from the Wexner Foundation, which has in turn for years been the beneficiary of Epstein’s financial contributions. According to Segal, the grant under question was given to Barak in 2004-2006, when he held no public position. Barak insists he has no authority to disclose details about this grant. Only the Wexner Foundation can, if they so choose (they choose silence).”
Developing Leaders
Set up simultaneously alongside the Wexner Foundation, Wexner’s Heritage Program (WHP) planned to connect American Jews with the ever expanding nation-state of Israel. The program was created so as to “expand the vision of Jewish volunteer leaders, deepen their Jewish knowledge and confidence and inspire them to exercise transformative leadership in the Jewish community.” The foundation defines the program as: “essentially a Jewish learning and leadership development program for volunteer leaders in North America.”
There have been, to date, around 2000 “leaders” who have taken part in the program. The WHP is a vehicle for standardizing a certain perspective on the history of Israel, as well as Judaic texts. The two year program is made up of 36 evening seminars, which occur bi-monthly for four-hour periods, as well as three short-term and out-of-town summer institutes hosted in either the US or Israel. Each of these summer institutes are between 5 and 7 days long and take place throughout the program.
As with other well-founded leadership programs, such as the World Economic Forum’s Young Global Leader program, the Wexner Heritage Program targets a very specific age group, aiming at professionals who are generally between the ages of 30 and 45 years-old. Some of the most important criteria required of program participants include showing a demonstrated commitment to Judaism, the Jewish community and/or Israel and a track record of leadership in Jewish communal life.
The Wexner Foundation website claims that:
“The 2,300 Alumni of the Wexner Heritage Program are top lay leaders at the local, national and international level. In the 35 cities where we have convened WHP cohorts, virtually every Jewish communal organization continues to be supported by our alumni. They become presidents or chairs of synagogues, Federations, JCC’s, Hillels, day schools, camps and more; they often are founders or chairs of allocations or annual campaigns. They serve on the boards of JFNA, 70 Faces Media, the Foundation for Jewish Camp, International Hillel, AIPAC and J Street; The Shalom Hartman Institute, Pardes, Hadar and every US rabbinical seminary; the Jewish Education Project, Prisma, the JDC and so many more.”
It is worth noting that, of those aforementioned groups, the Wexner Foundation (and especially the Wexner Heritage program) enjoys particularly close ties to AIPAC. For instance, Elliot Brandt, AIPAC’s national managing director, is an alumnus of the Wexner Heritage Program and, in a 2018 speech at that year’s AIPAC policy conference, Brandt noted that “most of the [AIPAC] National Board consists of Wexner Heritage Alumni, not to mention its regional chairs and some of its most committed donors as well.”
Elliot Brandt and Alan Dershowitz at the 2017 AIPAC policy conference, Source: Screenshot
Wexner’s close ties to AIPAC take on a different tone when one considers, not only his close association with the Israeli intelligence-connected Jeffrey Epstein, but also the fact that AIPAC itself has long-standing and controversial ties to Israeli intelligence. For instance, AIPAC was at the center of an Israeli espionage scandal in the US in the mid-1980s as well as again in 2004, when a high-ranking Pentagon analyst was caught passing highly classified information over to Israel’s government via top officials at AIPAC.
Despite extensive evidence, particularly in the latter case, AIPAC itself avoided charges. As journalist Grant Smith noted at the time, “the Department of Justice’s chief prosecutor on the [AIPAC] espionage case, Paul McNulty, was suddenly and inexplicably promoted within the DOJ after he backed off on criminally indicting AIPAC as a corporation.” The charges against the specific AIPAC officials involved were also dropped.
In the years after the Wexner Heritage Program was launched, other similar efforts followed. In 1987, the Wexner Foundation announced it would begin channeling “$3-$4 million in grants to the first year of a program dedicated to the enhancement and improvement of professional leadership in the North American Jewish community.”
Per the Jewish Telegraphic Agency, “Wexner said an Advisory Group drawn from among leading Jewish academicians and communal professionals recommended that attention be focused on three critical groups: rabbis, communal professionals and educators.” These efforts would result in the formal creation of the Wexner Graduate Fellowship in 1988. Chairmanship of the Wexner Fellowship Committee was given to Professor Henry Rosovsky.
Henry and Harvard
Henry Rosovsky was an economist at Harvard University. Like Wexner, and like many other of the Wexner Foundation’s associates, Rosovsky was born to Russian Jewish parents. He grew up speaking Russian, German, and French and, in 1940, Rosovsky emigrated to the United States of America with his parents.
During World War II, he served in Counterintelligence Corps of the US Army. He became a naturalized US citizen 9 years later. That same year, he received his B.A. degree from the College of William and Mary public research university in Williamsburg, Virginia, followed by his PhD from Harvard in 1959.
Rosovsky taught overseas as a visiting professor in Japan at Hito Subashi and Tokyo Universities, and subsequently taught Japanese studies, economics and history at the University of California at Berkeley until 1965. He also taught at the Hebrew University of Jerusalem in Israel, again as a visiting professor, as well as working as a consultant with the United States government, the Asian Development Bank, the World Bank, and UNESCO.
Rosovsky settled down into his eventual career at Harvard in 1965 and brought with him the intention of making Jewish life at Harvard flourish. By 1978, Rosovsky had helped to establish the Center for Jewish Studies, which was led by Harry Wolfson, the first chairman of a Judaic studies center at any American college. Rosovsky was the first Jew to serve on the board of the Harvard Corporation. Rosovsky’s wife, Nitza Rosovsky, also had a presence at Harvard, and in 1986, during Harvard’s 350th anniversary celebrations, she wrote a piece entitled “The Jewish Experience at Harvard and Radcliffe,” which traces the Jewish history at the university dating back to the 1720s.
Henry Rosovsky posing with Israeli Prime Minister Menachem Begin, Source: Harvard Hillel
Rosovsky developed a close relationship with some key faculty members at Harvard, including future US Treasury Secretary and Harvard president Larry Summers. In 2017, Summers stated in a video tribute to Rosovsky the following: “Thirty-five years ago, I sat in your office as a young recruit to the Harvard faculty, and I was trembling with the majesty of it all,” he said. “Over time I became less intimidated and came to value your wisdom and your experience.”
Rosovsky became involved with the Wexner Foundation in 1987, when the Wexner Foundation announced the aforementioned initiative to recruit, support, and retain “the highest quality professional leadership” in the American Jewish community through grant-making to individuals and institutions. Those individual grants were awarded as Wexner Foundation fellowships and the Foundation appointed Rosovsky to serve as the chairman of the Wexner Fellowship Committee.
Rosovsky was prominent and well-connected by the time Wexner approached him, with his connections including Israeli politicians and heads of state like Menachem Begin and Yitzhak Rabin. By this point, Rosovsky was also being publicly honored for his many achievements. In 1987, after Wexner had launched several of his philanthropic endeavors, the American Academy of Achievement – a non-profit educational organization that recognizes some of the highest achieving individuals in the country – had awarded Rosovsky its “Golden Plate Award.”
One of Rosovsky’s most important links that were likely of interest to Wexner was his strong connection with Harvard Hillel. What is today referred to as the “Harvard-Radcliffe Hillel,” the Harvard Hillel is commonly described as a service organization that provides Jewish educational, cultural, religious, and social opportunities for students and faculty. Rosovsky had been a key player in paving the way for Hillel’s relocation from a simple home at the outskirts of campus to a location at the heart of Harvard life. Wexner’s subsequent involvement with Harvard Hillel would also mark Epstein’s own entry into what would become his controversial, and intimate, relationship with the prestigious university.
According to a 2003 article in the Harvard Crimson on Epstein’s donations to the University, Rosovsky was not only one of Epstein’s closest associates at Harvard, but was also Epstein’s “oldest friend of the bunch,” having been introduced to Rosovsky by Wexner around 1991. That is notably the same year that Epstein and Ghislaine Maxwell began their sexual blackmail/sex trafficking operation.
1991 was also the year that the New York Times reported that four donors, among them Leslie Wexner and Jeffrey Epstein, had pledged to raise $2 million for the construction of the new student center of Harvard-Radcliffe Hillel. In that article, the Times lists Epstein as the “president of Wexner Investment Company.” The building was completed in 1994 and named Rosovsky Hall in Henry Rosovsky’s honor. Rosovsky Hall is a 19,500-square-foot building, which cost $3 million to complete and includes a garden courtyard, a student lounge, a dining hall, a library, offices, and multi-purpose rooms for worship and meetings.
After Epstein’s 2019 arrest, Hillel executive director Rabbi Jonah Steinberg claimed that Epstein had merely “facilitated” a gift that was actually donated by the Wexners and did not involve Epstein’s personal money. However, a now-absent plaque on the building, cited by the Harvard Crimson in 2003, named both Epstein and Wexner as donors responsible for funding the center’s construction.
Steinberg did note that Epstein did donate $50,000 to Hillel in 1991, the same year that the gift for the construction of Rosovsky Hall was also made. The following year, records from Harvard’s Office of Alumni Affairs and Development reveal that Epstein was courted as a potential donor by the University, with Harvard’s “most senior leaders” first officially meeting with Epstein to “seek his support.” It is unclear exactly what resulted from this meeting, as Epstein’s first official donation to Harvard was recorded in 1998, raising the possibility that support could have been given in other ways that did not necessarily involve direct donations to the University.
Indeed, when Harvard moved to reject donations from Epstein following his 2008 conviction, Epstein continued to donate indirectly to the University by directly sponsoring several professors as well as a student social club at Harvard. Epstein may have contributed in this fashion during this earlier period, especially given that he had already donated to Harvard’s Hillel by the time of the 1992 meeting.
Jeffrey Epstein speaks with Larry Summers at a 2004 dinner he hosted for Harvard’s biggest names. Also pictured is Alan Dershowitz, among others. Source: Sott
It is worth noting that Epstein’s first “official” donation to Harvard in 1998 was the same year he was using his private plane, now best known to the public as the “Lolita Express,” to transport then-Deputy Treasury Secretary Lawrence “Larry” Summers. Summer’s then-boss, Treasury Secretary Richard Rubin, had previously facilitated Epstein’s first official visit to the Clinton White House in early 1993. Summers would become president of Harvard University shortly after the conclusion of the Clinton administration, in July 2001. During Summer’s tenure, Epstein’s access to Harvard’s campus and many of its most notable professors increased exponentially. While president of Harvard, Summers continued to fly on Epstein’s plane.
Developing Young Global Leaders
Though Epstein’s ties to Harvard have been scrutinized, Wexner also dramatically expanded his donations to Harvard during much of the same period. However, the role this may have played in facilitating Epstein’s own connections to the university have been largely glossed over by mainstream media reports on the matter.
Even before Wexner and Epstein donated to Harvard’s Hillel in 1991, Wexner’s philanthropic “development of leaders” had become entangled with Harvard University. In 1989, the year after the Wexner Graduate Fellowship was launched, the Wexner Israel Fellowship program was created to specifically “support up to 10 outstanding Israeli public officials earning their Mid-Career Master of Public Administration (MC/MPA) at Harvard Kennedy School.”
Per the Wexner Foundation’s website: “The goal of the Fellowship is to provide Israel’s next generation of public leaders with advanced leadership and public management training. More than 280 Israeli public officials have participated in the Israel Fellowship, including leaders who have gone on to become Directors General of government ministries, Generals and Commanders in the Israeli military, and top advisers to Prime Ministers.” As part of the program, participants “meet with senior U.S. government officials.” Wexner Israel Fellows also “commit to returning to Israel and remaining in the public sector for at least three years after completing the program.”
Similar claims can be found among Israeli media. For example, Israel 21c stated the following about the program in 2002:
“Several Wexner graduates have gone on to become Director-Generals of government ministries. Others have reached the highest echelons of the military, the health service, and the educational establishment. But ultimately, for Israel, the value of the program is not the titles of its participants, but in the quality of leadership exercised by these individuals at every level.”
That same article also notes that Wexner’s interest in having this program be hosted at Harvard’s Kennedy school “is the quality of the international exposure it permits. It attracts the highest caliber of public sector leadership from around the world and Israeli participants find themselves sitting next to ex-presidents and future prime ministers from every continent. It also creates a rare opportunity for high quality public relations, as future world leaders are exposed to some of the finest and most dedicated individuals Israel has to offer.”
Among the 10 alumni of the first class of Wexner Israel Fellows is Shay Avital, a prominent leadership figure in the Israeli military and who had first served under Benjamin Netanyahu’s brother, Yonatan Netanyahu. Other alumni include Avinoam Armoni, former special adviser to Teddy Kollek, as well as Israeli prime ministers; Moshe Lador, former Israeli state prosecutor; Arik Raz, former governor of Israel’s Misgav region; Uzi Vogelman, current justice on Israel’s Supreme Court; Eduardo Titelman Goren, a Chilean economist who has played a major role in managing Chile’s copper mining industry (the world’s largest); and Yossi Tamir, Director General of the JDC-Israel, “the leading global Jewish humanitarian organization.”
Another interesting alumnus from this first class was Amos Slyper, who was Deputy Director-General of the State Comptroller’s Office in Israel, making him responsible for the auditing of Israeli government ministries and offices. During Slyper’s tenure, the legal adviser to that office was Nurit Israeli, an alumnus of the second class of Wexner Israel Fellows.
As can be seen from just the first class of fellows, the Wexner Israel Fellow programs and its active alumni community have given Wexner considerable clout with prominent Israelis in major positions in government and industry. Years after this program was launched, it has since expanded to include the Wexner Senior Leaders program, which “leverages the training and scholarship of the Harvard Kennedy School to strengthen Israel’s public service leadership and spur innovative, collaborative projects across government departments and agencies.” It specifically seeks applicants from “senior level positions within Israel’s public service sector, including the civil service, local government, government agencies, and security forces.”
Thus, even before the 1991 donation by Wexner and Epstein, Wexner was actively bringing prominent Israelis, many with careers in Israel’s national security apparatus or in the public sector, to study at Harvard’s Kennedy school. In the years that followed, Wexner would become one of the guiding forces behind this particular school and would have even greater influence over the “development of leaders” at the institution.
Shortly before Larry Summers became Harvard’s president, Leslie Wexner, via the Wexner Foundation, funded the creation of the Harvard Kennedy School’s Center for Public Leadership (CPL). The CPL is described as “a premier training ground for emerging public leaders in the United States.”
The long-time director of CPL, who was likely chosen with direct input from Wexner, is David Gergen, an adviser to former presidents Nixon, Ford, Reagan, and Clinton. Gergen has also had a parallel career in journalism and, in the late 1980s, “he was chief editor of U.S. News & World Report, working with publisher Mort Zuckerman.” Zuckerman was a close associate of Epstein and bought the New York Daily News after the death of its previous owner, Robert Maxwell. Gergen is also a long-time member of the Council on Foreign Relations and the Trilateral Commission, where Epstein also had memberships.
Wexner’s contributions to Harvard’s CPL reached $19.6 million by 2006 and totaled more than $42 million by 2012. Notably, during this period, Jeffrey Epstein – one of Wexner’s closest associates until they parted ways between 2007 and 2008 – was also making major connections and gaining unprecedented access to the school.
In 2006, when the Wexner’s announced an additional donation of $6.8 million to the CPL, Gergen was quoted by the Harvard Crimson as saying:
“It has been a great personal privilege to work with Les and Abigail Wexner over the past half-dozen years, at the University and beyond. They are both leaders in their own right – people of vision, imagination, and keen dedication to advancing the quality of public life. They have been wonderful partners.”
In 2014, Gergen participated in the Wexner Foundation’s 30th anniversary gala, hosting a session where he interviewed former Israeli Prime Minister Shimon Peres at length.
Before Epstein’s second arrest, the Wexner-dominated CPL saw Epstein associates like Glenn Dubin and Leon Black creep into its top leadership bodies. For example, Dubin had become a member of CPL’s advisory council, which Leslie and Abigail Wexner co-chaired. Both Wexner and Dubin were pressured to remove themselves from that council after Epstein’s second arrest and subsequent death and departed in February 2020. At the time, the Harvard Crimson noted that the chief of staff to then-Harvard president Lawrence Bacow, Patricia Bellinger, had been added to the board of directors of Wexner’s L Brands (the current corporate name of The Limited).
Also at the time, Dubin had been named in court documents as one of the men Virginia Giuffre was forced to have sex with when she was under Epstein’s control, with another being Harvard Law professor emeritus Alan Dershowitz. In addition, as noted by the Crimson, a “former manager of the Dubin household Rinaldo Rizzo recount[ed] his encounter with a 15-year-old girl allegedly trafficked by Epstein who was brought to the Dubins’ house in 2005.” In 2010, Dubin had donated $5 million to the CPL to create his own fellowship aimed at “developing leaders,” called the Dubin Graduate Fellowships for Emerging Leaders.
In another example, Leon Black, of Apollo Global Management and whose “philanthropic” family foundation was also managed by Epstein for years, was on the CPL’s leadership council. Black, however, did not resign his post after the Epstein scandal became a national concern. However, after Wexner and Dubin had left their positions on the advisory council, Black’s connection to Epstein resulted in considerable media scrutiny as well as an “internal investigation” by Apollo. As of 2022, Black is no longer listed on the CPL’s website as a member of its leadership council.
In 2006, plans were made for the Wexner-funded CPL to team up with the World Economic Forum’s Young Global Leaders (YGL) program. The World Economic Forum, which describes itself as the pre-eminent facilitator of “public-private partnerships” on a global scale, originally created what would become YGL in 1992 under the name the Global Leaders of Tomorrow. It was rebranded as the YGL program in 2004.
In recent years, the Forum and its YGL program have become infamous in some circles, specifically after a clip of the Forum’s chairman Klaus Schwab went viral. In that clip, Schwab states the following of the YGL program:
“I have to say then I mention names like Mrs Merkel, even Vladimir Putin and so on they all have been Young Global Leaders of The World Economic Forum. But what we are really proud of now with the young generation like Prime Minister Trudeau, President of Argentina and so on, is that we penetrate the cabinets… It is true in Argentina and it is true in France now…”
Notably, that clip comes from a 2017 discussion between Klaus Schwab and the CLP’s David Gergen that took place at the Harvard Kennedy school. In the introduction to that discussion, the close ties between the Harvard Kennedy school and the World Economic Forum are highlighted and it is also mentioned that YGL participants are also present and attending the Harvard Kennedy school for an executive session. Gergen, in addition to his many roles and appointments, is also formerly a board member of the Schwab Foundation for Social Entrepreneurship, which Klaus Schwab co-founded with his wife in 1998, and is also an agenda contributor to the World Economic Forum.
The CPL began hosting an Executive Session for Young Global Leader participants in order to allow “the Young Global Leaders a much greater opportunity to form personal connections and bonds that will encourage opportunities for the leaders to working together, across multiple sectors, to solve international issues and problems in the future.”
These executive sessions were “designed and hosted by the Kennedy School of Government” and a significant amount of the funds raised were connected to the Clinton Global Initiative (CGI). In 2007, Epstein’s defense lawyers claimed that Epstein had played a major role in developing the CGI, writing to federal prosecutors that “Mr. Epstein was part of the original group that conceived the Clinton Global Initiative, which is described as a project ‘bringing together a community of global leaders to devise and implement innovative solutions to some of the world’s most pressing challenges’.”
At the time, the executive director of the CPL, working under David Gergen, was Betsy Meyers, a former senior adviser to president Clinton, specifically on women’s issues. Meyers also played a “critical role in Clinton’s re-election effort in 1996.” The corruption surrounding Clinton’s re-election campaign that year and Epstein’s own connections to that corruption are a key focus of my upcoming book.
Klaus Schwab’s now infamous “penetrate the cabinets” quote may offer insight as to Leslie Wexner’s own interest over the decades in “developing leaders” in American Jewish communities, in Israel and beyond. With nearly 40 years focused specifically on training men and women of influence in American Jewish society – as well as in Israel’s government and private sector – ideas and policies that benefit Wexner both personally and professionally have been instilled into generations of leaders and influencers, who then go on to influence many others. In the specific case of the Wexner Israel fellows, Wexner has been able to “penetrate” key posts in Israel’s government, and even its national security/intelligence apparatus, with people he has funded and who have participated in courses that were shaped by, and reflect, Wexner’s views.
Over the past two decades, Wexner’s foray into becoming one of the main donors of the Harvard Kennedy school allows for much the same to occur, but this time for leaders who operate and influence those far outside of the boundaries of the global Jewish community.
Wexner’s exact reasons for establishing and maintaining this legitimate yet massive influence operation, which paralleled Epstein’s own blackmail-based influence operation, have never been made explicit.
Yet, in speculating as to why he would want to mold the powerful and soon-to-be powerful, it is worth considering Wexner’s lesser known connections, including to organized crime and to Jeffrey Epstein.
Whitney Webb has been a professional writer, researcher and journalist since 2016. She has written for several websites and, from 2017 to 2020, was a staff writer and senior investigative reporter for Mint Press News. She currently writes for The Last American Vagabond.
New Evidence: Fauci Imposed a Vaccine Delay that Cost Trump the Election
By Toby Rogers | July 31, 2022
I. Fauci fires Trump
Think back to July 2020. Trump and Fauci were at war with each other. Key leaders within the Trump administration, including Peter Navarro, wanted to fire Fauci. There were riots in the streets as people protested the murder of George Floyd. And new evidence shows that behind the scenes, Fauci was working to torpedo Trump’s chances for re-election.
We already knew that Fauci, the FDA, CDC, and the pharmaceutical industry went to great lengths to block safe and effective treatments including hydroxychloroquine and ivermectin in order to prolong the pandemic and create the market for Covid-19 vaccines. But a new book reveals that Fauci also forced Moderna to delay their clinical trial by three weeks — which pushed the release of their preliminary results until after the presidential election.
This key piece of information comes from The Messenger: Moderna, the Vaccine, and the Business Gamble That Changed the World published last week by Harvard Business Review Press. The author, Peter Loftus, is a reporter for the Wall Street Journal and they published his essay about the book in their Review section on Saturday. What’s astonishing is that Loftus does not even realize the enormity of the story he just stumbled upon. Cultural capture and too many shots apparently prevent one from connecting the dots, so I will do it for him.
Most people already know the broad brush strokes of the Moderna story — they had never successfully brought a product to market before Operation Warp Speed. They were grifters — they took $25 million from the Defense Advanced Research Projects Agency (DARPA) in 2013 to develop mRNA products that never worked and another $125 million from the Biomedical Advanced Research and Development Authority (BARDA) in 2015 for a vaccine for Zika that also failed. But Fauci really liked these grifters and so when the pandemic began in 2020, BARDA directed $483 million to Moderna for Covid-19 vaccine development — and Moderna cut NIH in on the patents. That gave NIH and especially Fauci control over what came next.
The key paragraphs from Loftus’ WSJ essay are here:
Dr. Zaks [Chief Medical Officer for Moderna] had wanted to use a private contract research organization to run the whole trial, but NIAID officials wanted their clinical-trial network involved. Eventually, Dr. Zaks backed off, and both entities participated. “I realized we were at an impasse, and I was the embodiment of the impasse,” Dr. Zaks said.
Next, when Moderna’s 30,000-person study began enrolling volunteers in July 2020, the subjects weren’t racially diverse enough. Moncef Slaoui, who led Warp Speed’s vaccine efforts, and Dr. Fauci began holding Saturday Zoom calls with Mr. Bancel and other Moderna leaders to “help coax and advise Moderna how to get the percentage of minorities up to a reasonable level,” Dr. Fauci recalled.
Drs. Fauci and Slaoui wanted Moderna to slow down overall enrollment, to give time to find more people of color. Moderna executives resisted at first. “That was very tense,” Dr. Slaoui said. “Voices went up, and emotions were very high.” Moderna ultimately agreed, and the effort worked, but it cost the trial about an extra three weeks. Later, Mr. Bancel called the decision to slow enrollment “one of the hardest decisions I made this year.”
The claim that Fauci cared about racial diversity in the clinical trial is a lie. How do we know this? Later “clinical trials” for Pfizer and Moderna in kids looked at antibodies in the blood, not actual health outcomes, in only about 300 study participants. The number of people of color enrolled in those undersized trials were in the single digits (literally two or three Black participants total) — so those results were not statistically significant. Yet this did not stop authorization. It appears that Fauci’s delay tactics were designed to accomplish a different goal.
Let’s do the math:
Moderna released their preliminary results — claiming 94.5% effectiveness — on November 16, 2020.
The presidential election was less than two weeks earlier — on November 3, 2020.
Trump lost by less than 1% of the vote in 4 key swing states.
Fauci’s demand to slow down enrollment in July 2020 cost Moderna 3 weeks.
If Moderna had released their results 3 weeks earlier — on October 25, 2020, Trump would have scored a major win in the final week of the campaign and won the election.
It does not matter how one feels about Trump or Biden. A massive political win in the week before the election would have convinced enough voters of Trump’s competence and thus pushed Trump’s vote total over the top.
What about Pfizer? They also could have published their preliminary results prior to the election which would have secured Trump’s re-election. According to Loftus, Pfizer “opted out of Operation Warp Speed for fear it would slow the company down.” Pfizer still took $2 billion off of the Trump administration for advance purchase orders. But Scott Gottlieb and Pfizer clearly preferred Biden and so they held their preliminary results until November 9, 2020 — just 6 days after the election. The Biden administration returned the favor by giving Pfizer a blank check and authorizing shots for additional age groups based on the worst “clinical trial” results anyone has ever seen.
The important thing to understand in all of this is that Fauci, the FDA, NIH, and CDC are political functionaries pretending to be scientists. Pandemics, vaccines, and public health are a way for the Democratic Party machine to direct billions of dollars to their base and reward large donors to the party. These companies and their bureaucratic enablers were happy to take money off of Trump. But they knew that they could get an even better deal from Biden.
As you know, the results of this criminal scheme are gruesome. The Covid-19 shots authorized right after the 2020 election have made no discernible impact on the course of the pandemic. Far more people have died of Covid-19 since the introduction of the shots under Biden than during the Trump administration when no Covid-19 shots existed. The Covid-19 shots have negative efficacy and even quadruple-dosed Biden and quadruple-dosed Fauci have contracted Covid-19, twice. These are the deadliest and most toxic shots in the history of the world.
So what started out as a grift turned into mass murder and a crime against humanity.
And now it’s happening again…
II. Pfizer and Moderna move up the release date for reformulated Covid-19 shots in the effort to help Democrats win the midterm elections
On Thursday of last week, the White House and the FDA told their favorite stenographers at the NY Times that Moderna and Pfizer are going to release their reformulated Covid-19 shots, that will completely skip clinical trials, in mid-September.
As readers of my Substack will recall, back on June 28, Pfizer said that the fastest the reformulated shots could be released was October; Moderna said “late October or November” — provided they could skip clinical trials (which of course the FDA granted because they work for Pharma). Did Pfizer and Moderna not understand their own production capabilities? How did Pfizer and Moderna suddenly speed up their production schedule by 6 weeks?
It appears that once again, the public health gatekeepers are doing politics not science. If shots go into bodies in the last two weeks of September, Democrats will claim progress against Covid during October right before the midterm elections on November 8. It’s basically the political win that these same actors denied to Trump (it’s not a public health win, as I will show below).
What’s likely driving this is that Fauci, Pfizer, Moderna, the FDA, CDC, and NIH all want Democrats to retain the House and Senate in order to prevent hearings into their bungling of the Covid-19 response. Of course they also want to keep the Covid-19 vaccine gravy train going as long as possible.
But, you’re surely saying to yourself, we know that these 5th dose reformulated shots are likely to cause catastrophic harms. We’re already seeing a 5% to 15% increase in all-cause mortality across the most heavily vaccinated countries as a result of non-specific effects from these shots. There are 29,790 VAERS reports of death following these shots and this is likely an underestimate by a factor of 41 (so actual death toll = 1,221,390). These reformulated shots are going to use a form of mRNA never tried before and skip clinical trials altogether, so the harms could be even worse. There also seem to be cumulative harms from these shots — the more doses, the more messed up the immune system, the more vulnerable one is to Covid and all sorts of other diseases including cancer.
So how exactly do they plan to get away with this, especially right before an election?
The same way they always get away with it — they own the media. Pfizer and Moderna will rush out press releases claiming that these reformulated shots are a miracle. The CDC’s in-house newsletter, MMWR, will rush out articles and janky studies claiming that these reformulated shots are a miracle. The mainstream media will dutifully report that these reformulated shots are a miracle. Meanwhile, people you know and love — coworkers, friends, neighbors, and family — will be getting injured and killed by these shots. Yet all of the stories in the news will be hosannas about the genius of Tony Fauci, Peter Marks, and the FDA. Billions of dollars of dark money from Pharma will flow into Democratic Congressional campaign coffers. If Democrats can retain the House and Senate they will reward Pfizer and Moderna by blocking any inquiry into the failed Covid-19 response. Win, win, win for Pharma. Everyone else loses.
Which brings me to my last point….
III. Republicans, you have to step up and fight for us or you will lose
Republicans thought that they could take back the House and Senate simply by not being Democrats. Most Republicans did not really fight for us, they just sat back and let Dems destroy themselves. That plan was working until the Supreme Court overturned Roe. Now the Republican advantage in the generic Congressional ballot (‘which party do you prefer’) has evaporated. Pelosi has passed a range of popular bills. Manchin has fallen in line so Biden will likely get some late legislative wins. Gas prices have declined somewhat. And now it appears that Democrats, who were left for dead just weeks ago, will retain the Senate and may retain the House.
IF REPUBLICANS WANT TO WIN THE MIDTERM ELECTIONS THEY HAVE TO MAKE IT ABOUT DEMOCRATS’ FAILED RESPONSE TO COVID!
No more sitting back. No more making warrior mamas do all of the emotional labor for our country. If Republicans want to win they have to make it clear that they will fire, arrest, and prosecute Fauci (and all of his lieutenants) as soon at Republicans take power. Fauci funded the creation of the chimera virus, blocked access to safe and effective treatments, and inflicted deadly toxic vaccines on the entire population. Over 2 million Americans are dead as a direct result of Fauci’s corruption (1 million dead from/with Covid, over 1 million dead from the shots). If Republicans cannot be bothered to sink this two-foot putt then they don’t deserve to win. If Republicans want the votes of the 18 million single-issue medical freedom voters who decide every national election these days — that’s what they have to run on: #ArrestFauci!
Hotter than the Sun: Finally, a Book Worth Reading
The top seller on Amazon for books devoted to war and peace as of this writing, Scott Horton’s newest offering, Hotter than the Sun: Time to Abolish Nuclear Weapons, is a timely must read. As Washington barrels heedlessly along into Cold War II, the American public badly needs educating on the current risks, past close calls, and the utter insanity of an entire for-profit industry built on the flawed concept of thousands of thermonuclear bombs as “weapons” that keep us safe.
With major papers like the Wall Street Journal and New York Times now regularly running pieces arguing everything from the need to show the Russians we aren’t afraid to fight a nuclear war—that we can even “win” one—to the idea that a “small” nuclear war can help mitigate climate change, Scott’s book is a vital weapon in the hands of the sane, convincingly making the case that it really is time to get rid of the thousands of nuclear and thermonuclear bombs in existence.
Because the truth about thousands of nuclear and thermonuclear bombs, the overwhelming majority of which are possessed by the United States and Russia, is immutable. Just as Ronald Reagan said forty years ago, a nuclear war cannot be won and can never be fought.
And forget even about launching a life-ending nuclear exchange on purpose, as Hotter than the Sun notes there have been plenty of accidents that could have resulted in exactly the same outcome. From the Air Force accidentally dropping a nuke over North Carolina to absent-minded technicians dropping wrenches down armed missile silos, careless scientists playing with plutonium rods to the Norwegians launching a satellite, the game theoretical strategic calculations that form the basis of US and Russian nuclear postures mean that an apparent threat or actual detonation on their soil would mean an almost immediate escalation to a full-on nuclear exchange.
Apart from documenting such accidents that nearly resulted in the deaths of potentially millions or billions of people, if not every single one of us, over the course of the ensuing nuclear winter, the book revisits past insanities. From the decision to test the first bomb, despite its creators’ real concerns that it would immediately ignite atmosphere and oceans, instantly killing everyone on earth, to deciding to drop the first bombs on Japan only in order to justify their expense, ensure continued funding for making more, and intimidating the Soviets, Scott’s book takes the reader right up to the present day, where Washington, having started an unnecessary new arms race by unilaterally ripping up important arms control agreements in the name of pursuing a first-strike capability and enriching Lockheed Martin and Northrop Grumman execs, is now in full panic mode because it is apparently losing.
But it is important to note, as Scott does, that “losing” in Washington’s mind is not being able to potentially threaten with virtual impunity anyone it wants: that is hardly a concern most American voters express, if any.
Important as the topic of nuclear arms is, the over fifteen thousand nuclear and thermonuclear bombs in existence being the number one short-term threat to humanity’s continued existence, Scott’s title frankly sells the book’s contents rather short. At over four hundred pages, consisting of several dozen interviews conducted over a period of nearly two decades, Hotter than the Sun is a critical primer on everything from diplomatic history to US Middle East policy to the military-industrial complex, corporate lobbying, and a range of other issues.
From corporate lobbying for North Atlantic Treaty Organization expansion to Israeli misinformation about the fake Iranian nuclear threat to how the decision to invade Iraq was made to why any random Pakistani colonel on the border with India could end all life on earth, Scott and his guests never fail to inform, surprise, disgust, and alarm, with Washington’s misguided, corporatist, imperialist, or just plain idiotic policies usually at or near the root of virtually every serious problem facing humanity today.
Featuring interviews with Daniel Ellsberg, Seymour Hersh, Gar Alperovitz, Chas Freeman, Ray McGovern, Doug Bandow, and many others, Hotter than the Sun is a book worthy of your time and money. And this at a moment when any trip to your local bookstore or Barnes and Noble outlet is sure to leave you much poorer and much more badly informed about the world than you otherwise would have been had you not bought anything to read at all.
Joseph Solis-Mullen is a graduate of Spring Arbor University and the University of Illinois, Joseph Solis-Mullen is a political scientist and graduate student in the economics department at the University of Missouri.
Malcolm Nance: White Extremists Are An ‘Insurgency’ Worse Than ISIS – ‘We May Have to Fight’ Our Neighbors
By Chris Menahan | InformationLiberation | July 14, 2022
MSNBC regular Malcolm Nance, who has spent 36+ years in US intelligence, told Zerlina Maxwell on Wednesday night that around 30% of the country are white extremists and they’re part of an “insurgency” that “we may have to fight.”
WATCH:
From Breitbart :
“Here is the United States — to characterize that to understand what kind of terrorism we might be dealing with, you have to label it as white extremism because we have 30% of the population of the United States who no longer believe in the democratic norms that we established in the founding of the country. Let’s just be honest about that. The January 6 uprising was an attempt to overthrow American democracy. And we have now learned from the hearing that Donald Trump intended to go there to march down to the well of the House of Representatives and essentially be crowned as a king,” [Nance said.]
Anchor Zerlina Maxwell asked, “You call what is happening an insurgency. We have heard that term in foreign wars recently in Iraq. Talk about why you apply the term insurgency to what you see here as a persistent and ongoing threat of domestic extremists?”
Nance said, “I was reading their forums. I was reading their own intelligence about what they intended to do. It was pretty clear at that point that they were going to try to either overthrow the government or they were going to settle in for a long-term series of destabilizing actions using a political party, the Republican party, as their political base and then using violence, threat of violent extremism as a way to manifest change in the street. So remove politics from the halls of power and change politics through violence on the street. This is called an insurgency. The insurrection that happened on January 6 that was one event. An insurgency is a chain of events. It’s common knowledge. A year and a half ago, when I was calling this an insurgency, people were saying, that’s crazy, this isn’t an insurgency, this isn’t like Iraq, it’s not like Libya, it’s not like Syria. Well, it is. And it’s well on its way. It’s closer to the beginnings of the Irish Republican Army. You know Irish Republicanism, where now the Republican Party is Sinn Fein, and it’s just a matter of seeing who comes up as the original Irish Republicans in this story and starts carrying out acts of violence to affect change. So we are well on our way to a multi-year campaign that we are already two years into this campaign where we may have to fight them. The ‘they’ in my title and the ‘they’ in my title is those who want to kill Americans are your neighbors.”
Here we have a US intelligence analyst, who has admitted previously to torturing hundreds of people on behalf of the DC regime, suggesting that white Americans who voted for Trump are part of a terrorist “insurgency” that needs to be put down with force and he’s preparing MSNBC viewers to fight (and presumably kill) their neighbors.
DHS head Alejandro Mayorkas expressed similar views last year when he said that “extremist” white Americans support the Taliban and are poised to carry out terror attacks at any moment.
The FBI has been manufacturing fake terror plots to bolster this narrative and the media has been using fake data to hype the phony threat.
Back in April, Nance went over to western Ukraine to show his support for the Azov Battalion and joined the Ukrainian military’s foreign legion. He claimed he was fighting on the “frontlines.” He came back late last month and released his new book two weeks later.
The description for his new book, “They Want to Kill Americans: The Militias, Terrorists, and Deranged Ideology of the Trump Insurgency,” says extremist white Americans, “who benefit from the ultimate privilege — being white,” are “a generational terror threat greater than either al-Qaeda or the Islamic State.”
“America is primed for a possible explosive wave of terrorist attacks and armed confrontations that aim to bring about a Donald Trump led dictatorship,” the description continues.
Nance is an intelligence asset working to prop up a false narrative to bolster the DC regime’s new Domestic War on Terror.
Sacrificing Children’s Needs for Those of Adults was Devastating and Must Never Happen Again
BY MOLLY KINGSLEY AND LIZ COLE | THE DAILY SCEPTIC | JULY 6, 2022
A photo circulating on social media in summer 2021 shows a scene which would have been unimaginable in 2019. In it, a row of small children – aged four or five perhaps – line up holding hands. They are all masked. Behind them stands a row of adults, one of whom is the Governor of New York. None of the adults are masked, and their smiles beam out at the camera. It is an archetypal example of the inversion at the heart of our global pandemic response.
Over the last two years the youngest members of society have often borne the heaviest burden of Covid restrictions, even though the risk from COVID-19 increases dramatically with age. This has created a deep and seemingly perverse inequity between adults’ and children’s lives, spanning contexts and borders. Indeed, it has become so ubiquitous that it risks becoming normalised.
At its most extreme, this upending of society’s natural responsibility to care for our young has endangered children’s lives.
In autumn 2020, U.K. university students finally returned to their campuses after months of isolation during lockdown. Even pre-pandemic, mental health issues were spiralling into a full-blown crisis for this age group. Barely out of childhood, this extremely vulnerable cohort deserves our protection and care. Yet, with a single-minded fixation on ‘protective’ measures, the institutions’ leadership too often discarded any compassion for these vulnerable teenagers in favour of decisions that can only be described as inhumane.
In November 2020, with the second lockdown underway, University of Manchester students awoke one morning to find metal barriers constructed around their halls of residence. The reported objective was to prevent student households from mixing. Horrified by the lack of prior warning, students protested by tearing down the barricades. The university backed down, but for a nervous 18-year-old away from home for the first time, the effective imprisonment must have been terrifying, and the mental health consequences could have been fatal.
Then, at the nearby University of York, during the same period, health and safety guidance decreed that in the event of a fire, self-isolating students should wait behind to allow ‘non-self-isolating’ colleagues to exit first. This ludicrous diktat not only displayed a profound lack of risk balancing, but also a dereliction of a fundamental duty of care and an ignorance of basic safety standards.
In January 2022, in a particularly shocking example, officers in Texas arrested a teacher for suspected child endangerment after her son was discovered in the boot of her car at a drive-through PCR testing site. The mother allegedly told officials that she had transported her child in this way so she wouldn’t be exposed to his infection.
These distressing cases testify to something deeply dysfunctional in our societal response to Covid. We have normalised the mistreatment of children, collectively justifying it against the backdrop of the pandemic state of exception.
This treatment of children should be unacceptable in any civilised society, no matter what respectability it is given by the cloak of ‘public health’. Much has been made throughout the pandemic response of the need for public health to act in the interests of an ill-defined concept of a ‘greater good’. Yet it’s striking that a now reengineered concept of ‘public health’ has barely acknowledged children as part of the ‘public’. In its name, we have not only marginalised our young people’s wellbeing, but often actively put them in harm’s way.
A pre-pandemic 2019 Public Health England strategy document lays out its vision and goals for the next five years. The document notes that:
Giving children the best start in life is vital for a healthy thriving society. The foundations of good physical and mental health, healthy relationships and educational achievement are laid in preconception through to pregnancy and the early years of life, which is when many inequalities in health often begin.
In crisis, we chose to cast aside these principles and priorities and inverted our public health paradigm by requiring the young to sacrifice their own health and wellbeing to safeguard that of adults. In doing so, we have shattered our implicit social contract.
In the brutal landscape of the Arctic Circle, reindeer do whatever it takes to protect their young. When the herd is threatened, the animals stampede in a cyclonic formation, making it impossible for predators to target an individual. A swirling wall of adult deer on the perimeter shields the fawns at the heart of the circle from harm.
How is it that the U.K. and most Western democracies have failed this basic tenet of nature, systematically and deliberately placing our young on the outside of our societal herd and demanding that they shoulder a burden that should never have been theirs to carry?
Molly Kingsley and Liz Cole are the founders of UsForThem, which since May 2020 has advocated that children be prioritised during the pandemic response. This is an extract from their new book The Children’s Inquiry: How the state and society failed the young during the COVID-19 pandemic, which is out now and you can buy here and here.
Commendations:
A devastating analysis of a country’s failure to prioritise its children and young people during a global disaster.
Professor Lucy Easthope, author of When the Dust Settles
Brave, urgent, fierce and vital.
Laura Dodsworth, author of A State of Fear
A truly important book. It needs to be read by policymakers and parents so that never again will our children be betrayed as they have been in the last two years.
Allison Pearson, Daily Telegraph columnist and bestselling author
About the book:
Despite being least affected by the virus itself, children and young people bore the brunt of COVID-19 pandemic restrictions. When schools were closed, playgrounds taped up and play outlawed, children’s lives were closed down. The catastrophic impact on children and young people’s education, mental health, wellbeing, and life chances is becoming ever clearer, with the most disadvantaged suffering disproportionately.
In May 2020 Liz Cole and Molly Kingsley founded UsForThem to advocate – in an often hostile climate – for children to be prioritised during the pandemic response. Having heard from thousands of families, and having often clashed with policymakers, they have a unique perspective on how the state’s response to the pandemic has affected our children.
Here they document their shocking findings: how completely children’s health and welfare were sacrificed for that of adults; how policymakers appeared to disregard the harms they were causing; and how adults charged with protecting the young stood by and watched as children visibly struggled or slipped out of sight altogether. This dereliction of duty should haunt us for decades to come.
With exclusive testimony from academics, politicians, scientists, educators, and parents, as well as former Children’s Commissioners, the book exposes the problems at the heart of policymaking which led to the systemic and ongoing betrayal of children. From public health to politics, and from media discourse to safeguarding, the authors show how children were too often used as the means to further adult interests. Ahead of the public inquiry, the authors call for an honest appraisal of what went wrong, and commitment from stakeholders to reimagine – not just recover – childhood.
Climate Change Committee Warns Government Must Go Further To Limit Warming
By Richie Allen | June 29, 2022
The UK government’s official advisers on climate change have warned that much more needs to be done to persuade people to fly less and eat less meat in order to meet climate targets.
The Climate Change Committee (CCC) says that unless policies are radically improved, the UK won’t achieve its target to reach net zero emissions by 2050.
According to The BBC:
The committee is an independent body advising on climate policy. This report is an annual review of progress to MPs.
It does praise ministers on two issues: it says the government’s renewable energy programme will save people £125 a year on bills by 2030.
And it congratulates ministers on promoting electric cars – even though it says more charge points and more electric vans are needed…
The committee agrees that carbon-cutting policies are now in place for most sectors of the economy – but it says there’s “scant evidence” that these goals will be delivered.
And it warns that ministers need a back-up plan, including measures they may prefer to avoid such as asking the public to change behaviour by eating less meat and flying less.
The chairman, Lord Deben, told BBC News that recent climate extremes were “very, very worrying”. He continued: “The public should be proud of the UK setting best targets but I’m very worried that there’s no convincing programme for delivering policies.
“I’m seriously worried that we are not moving fast enough to avert real catastrophe.”
Legendary Australian Geologist Ian Plimer has just published a new book entitled “Green Murder.” I’ve just finished reading it. I wish every man, woman and child on Earth had a copy to hand.
In the book, Professor Plimer forensically annihilates the claim that man-made Co2 is responsible for global warming.
He warns us that ludicrous net zero policies will result in ruined economies, the destruction of the global food chain, permanent travel restrictions, the death of civil liberties and worldwide unemployment.
Each and every claim in his book is backed up by peer-reviewed evidence, yet you’ll never hear Ian Plimer on the BBC.
The Lockdown Advocacy of Devi Sridhar
By Jeffrey A. Tucker | Brownstone Institute | June 20, 2022
The Covid era gave rise not only to popular mania but also to astonishing intellectual pretension. The experts were everywhere. They had all the answers. They knew for certain that a path never tried in anyone’s lifetimes was the certain way to go in order to control a virus. And this fanatical attachment to one goal caused all other considerations to be pushed aside.
The end of the story was baked in from the start. The experts were proven to have massively exaggerated their prowess and understanding of events. On point after point, their models blew up. The epidemic would end the way they always have, through acquired immunity and endemicity. Nowhere did the methods of the vaunted experts achieve the goal; at best they delayed the end point and created tremendous destruction along the way.
Now there is a problem: how to dial it all back without admitting profound error. This is a particular problem for those who wrote books before the story was complete. And by complete I am referring especially to the tremendous waves of infections that came 20 months after lockdowns were first imposed.
A paradigmatic case is Devi Sridhar, professor and chair of global public health at the University of Edinburgh, Scotland. During the pandemic, she became a ubiquitous presence on television for two years both in the UK and the US. Her main message was to advocate and defend lockdowns, masking, mandates, and the entire apparatus of compulsion that characterized the pandemic response in nearly every country in the world. Her message was always geared toward what is called eliminationism or zero Covid.
As a Rhodes scholar in a high prestige position, she was well positioned to be this messenger. She has a compelling way and presents well in the medium. Plus, the message she delivered was the one that earned an official stamp of approval from all mainstream media. She was also a pro at delivering an attitude of disdain toward anyone who dared question the zero Covid story.
Now she has a book out that further elaborates on her point of view. It has the right title: Preventable: How a Pandemic Changed the World and How to Prevent the Next One. It’s a pretentious title, presuming that she knows for certain that the pandemic was preventable and therefore she should be trusted to tell us what to do next time.
What’s striking is the contrast between the certitude of the body of the book in which she is an unapologetic defender of China-style lockdowns and the afterword, which must have been written only days before the book went to print. Here we have a very different tone, discussed toward the end of this review.
Sadly for her, the book came out just before a wave of new lockdowns came to China that wrecked the lives and liberties of hundreds of millions of people and made an enormous mess of the entire economic mission of the country. She must not have had time to revise the manuscript.
Of China, her book says:
The way China set about eliminating SARS-CoV-2 could be described as draconian. It undertook house-to-house testing and removed individuals to quarantine facilities if they tested positive (sometimes against their will); it used tracking technology to trace 99–100 per cent of those who had had contact with the infected; it locked down entire buildings so individuals could not leave their flats or have free movement; and it constructed completely new hospitals within days…
The Chinese government understood well that the virus moves when people move. So it stopped people moving internally…
The efforts to contain the spread within Wuhan were effective and focused on reducing the R number…
These measures to contain spread worked…
[China showed that] containment strategies (however draconian) could be effective at stopping this respiratory pathogen…
The evidence in February 2020 showed that containment was successful…
Within the span of three months, China had eliminated the virus fully within its borders…
This is the same message she delivered to millions day after day for two years.
We could just stop this review here, observing that none of the above turns out to be true. Currently, China faces an enormous problem. If we are to believe the data, vast swaths of China’s population still lack acquired immunity to Covid. Millions or billions need the exposure, and, as with all places in the world, the result for nearly everyone moderately healthy and not elderly will be recovery. This will happen with or without lockdowns.
President Xi Jinping, however, became convinced either by virtue of his ego or his circle of sycophants that his lockdowns two and a half years ago were his greatest achievement. He was celebrated by the World Health Organization and nearly every country in the world copied his brutal methods of virus suppression. He regarded it then as evidence that the CCP was destined to rule the future, by virtue of its masterful social, economic, and now medical management of society.
So of course the CCP cannot turn back now. He has stated repeatedly that there will be no compromise of the zero Covid stance that both he and Dr. Sridhar have long advocated. He must now either continue to threaten and enact lockdowns or figure out some clever way to back away from the position without admitting past error. He may in fact figure it out at some point.
After all, nearly every other government in the world has finally figured it out. Even under the best of assumptions that lockdowns offer some contribution to mitigate the ill-effects of a pathogen, the costs far outweigh those benefits. And those costs not only include economic, educational, and nutritional ones but also costs in terms of deaths from overdoses, despair, and self-harm from the inevitable demoralization from being treated like a prisoner or lab rat.
So I did read Dr. Sridhar’s book in search of some insight as to why she could have made such a profound error. All I found was a relentless and single-minded attachment to a zero Covid agenda, or some version of it, a genuine belief that the right deployment of human force could somehow make a virus go away. It truly boggles the mind.
The rest of the narrative is utterly predictable.
Countries that locked down are good, especially New Zealand and Australia. Countries that did not are bad, especially Sweden but also the UK and the US after reopening. Countries that kept lockdowns longer are good. Countries that opened up too soon are corrupt and rejecting “the science.” The Great Barrington Declaration is bad. Ramdesivir is good while Ivermectin is bad. And so on.
Her hard-core bias extends even to a rousing defense of Rebekah Jones, the low-level data employee in Florida who wrongly accused the Governor’s office of manipulating data in a case that was later tossed out.
The book is so partisan that she sometimes lets her politics even race ahead of her epidemiological position. For example, and this probably won’t surprise you, she comes to the defense of the George Floyd protests even in the midst of lockdowns:
In late May 2020, I was asked whether protesters were wrong to take to the streets. I replied that racism is also a pandemic, and one that Black Americans feel can’t be swept under the carpet any longer. While clearly mass gatherings during a pandemic are risky, I could understand that people were willing to take this risk in order to effect change for their children and the children of their children. This is how the civil rights movement has attempted to progress racial equality over decades.
In any case, you get the point here. She has a tribe and she wants to be its messenger. Still, I struggled through the entire text to see if I could find insight. This one jumped out at me:
While WHO was at the forefront of press briefings and leading technical and normative guidance to the pandemic, the World Bank had the financial power to help governments respond with key policies, whether through building up health systems and testing, putting in place economic packages to support lockdown measures, or in acquiring and distributing vaccines.
There we go: the World Bank subsidized lockdowns. Fascinating. That I did not know. This is a serious problem that needs to be fixed. How many millions face malnutrition as a result?
So much for the body of the book.
Probably the most telling part of the book is the afterword, written January 2022. Here our author jumps in with the latest information, namely that China had not in fact eradicated the virus and now keeps locking down, which she says is due to inferior vaccines. Within a few paragraphs, she – for the first time in the book – recognizes that even the best vaccines do not stop infection and do not stop the spread..
Whoops. Is she willing to rewrite the entire book in light of this last-minute realization that lockdown eliminationism and even mass vaccination cannot achieve the goal? No. Is she willing to rethink? Perhaps a bit but not enough.
While some say we should adapt normal social relations and mixing for the foreseeable future, I struggle with this line of thought. Humans are social: we need to hug, talk, dance, sing, kiss and be around others. We’re not bears or rhinos or other solitary creatures. We like seeing each other’s faces. And we know that a sense of community and connection are vital to wellbeing too. A holistic approach to public health is vital, and this includes not just people’s mental health but also their ability to pay rent, feed their family, stay warm through the winter and have a meaningful role in society, be that going to church or being part of a glee club. For a certain period of time, altering these made sense, so that we could avoid preventable illness and deaths; allow vaccines to be created, trialled and distributed in 2020 and into 2021; allow clinicians to better understand how to treat COVID-19; and allow a better understanding of transmission and risk.
Again, very interesting, especially because the change in tone from the rest of the book is so sharp. She doesn’t come close to repudiating her entire book – and she still believes that totalitarian measures somehow make sense for a “period of time” – but she does say that she is tired and exhausted and perhaps ready for some rethinking.
“I’ve taken a step back from media work… I’ve been testing several times a week, and, while I cautiously avoid crowded spaces, and wear masks on public transport and in shops, I continue to go to the gym and to hot yoga and to see friends outside or in small groups. I’ve found a sustainable way to live alongside COVID-19 for now… You’ve heard enough from me.
These are hopeful signs. It’s possible that even Devi Sridhar might eventually come to see the error of her ways. Or perhaps like most of the exalted experts who assisted in driving the world into the greatest calamity of the modern era, she will quietly disappear from the op-ed pages and television screens and go back to her prior life as a public health professor with degrees in anthropology. At some point, too, she will get Covid and discover with millions of others that it is part of the human experience to get sick and get well and become stronger as a result.
We will wait in vain for any sort of extended literary mea culpas. Not even the pensive afterword comes close. After all, when the next great health crisis presents itself, the WHO pushes for lockdowns again, and the major media empires need some great excuse to order people back home to be glued to the screen, the expertise of these compelling pundits – now with real media experience – will need to be called upon again.
Jeffrey A. Tucker is Founder and President of the Brownstone Institute and the author of many thousands of articles in the scholarly and popular press and ten books in 5 languages, most recently Liberty or Lockdown.
Trudeau-bashing children’s book a best-seller
TCS WIRE | June 20, 2022
“How the Prime Minister Stole Freedom” by Derek Smith has topped the Amazon Canada best-seller chart.
The picture book illustrated by Kaeda Knipe pokes fun at Trudeau’s response to the Freedom Convoy and his subsequent clampdown on the rights of Canadians.
“In the city of Ottawa on Parliament Hill, the Canadian Government debate and pass bills. Every person in Canada liked freedom a lot, but the Prime Minister who ran the country did not,” the book summary reads.
“He took everyone’s freedoms and locked everyone down tight. It seemed like the lockdowns had no end in sight. Until one day, Truckers became very annoyed, so they decided to form a Freedom Convoy. Will the Prime Minister be let off the hook? You’ll only find out if you read this book.”
Although the book, which is written in the style of Dr. Seuss, doesn’t reference Trudeau by name, the principal character is an obvious placeholder for him.
“The book is a fictional parody dramatization based on a true story and real events and was drawn from a variety of sources, including published materials and interviews. For dramatic and narrative purposes, this book contains fictionalized scenes, composite and representative characters and dialogue,” a disclaimer explains.
“The views and opinions expressed in this book are those of the characters only and do not necessarily reflect or represent the views and opinions held by individuals on which those characters are based.”
The independently published book has since garnered 770 ratings and has four and a half stars.
On Twitter, author Smith has promised more books lampooning Canadian political figures.
“We have multiple books in the works,” Smith wrote on Monday. Among the proposed titles is “The boy who cried racist,” which would be a parody of NDP Leader Jagmeet Singh.
Should the patient really get the drug?
By Sebastian Rushworth, M.D. | June 14, 2022
I recently gave a lecture to 70 primary care physicians here in Stockholm, titled “should the patient really get the drug?”. The lecture seemed to generate quite a bit of cognitive dissonance among some in the audience, based on the somewhat aggressive discussion that followed the lecture, which suggests to me that much of what I was saying was stuff they had literally never been exposed to before – not at any point in medical school, and not at any point during their careers after medical school either. Cognitive dissonance is good. It’s the first step towards change.
I thought it would be interesting to re-write the lecture as an article, so that more people can hopefully achieve similar levels of cognitive dissonance. Please feel free to share it with any doctors you know that you think might benefit from an expanded perspective. Anyway, here we go.
Let’s imagine a common patient. Every primary care physician meets this patient, or someone much like her, on an almost daily basis. She’s 75 years old, and overweight. She experienced a wrist fracture two years ago, and was subsequently diagnosed with osteoporosis. She has high cholesterol levels, but she’s never had a heart attack or other “cardiovascular event”. On top of that, she has type 2 diabetes, chronic knee pain due to osteoarthritis, and high blood pressure. She was diagnosed with depression a few years ago, after her husband died.
Our patient takes seven drugs every day:
- Alendronate, because of her weak bones.
- Atorvastatin, because of her high cholesterol levels.
- Sertraline, because of her depression.
- Metformin, because of her type 2 diabetes.
- Insulin, also because of her type 2 diabetes.
- Paracetamol (a.k.a. acetaminophen), because of her knee pain.
- Enalapril, because of her high blood pressure.
So, the question is, are these drugs doing her any good?
Well, to answer that question, we need to consider NNT (Number Needed to Treat). NNT is the number of patients who need to take a drug for one patient to achieve a noticeable benefit.
For alendronate, the NNT is 20, i.e. if you treat 20 people for a couple of years, you prevent one fracture. For atorvastatin the NNT is 200, i.e. you need to treat 200 people for five years or so in order to prevent one heart attack. For sertraline, the NNT is 7, which means that you need to treat seven people in order to have a noticeable effect on depression in one patient. Note that this doesn’t mean that one out of seven gets cured of their depression, it just means that there is a noticeable difference on a rating scale for depression.
For metformin, the NNT is 14 – If you treat 14 type 2 diabetics with metformin for ten years, you prevent one death. For enalapril, the NNT is 70 – If you treat 70 people with high blood pressure with enalapril for five years or so, you prevent one stroke.
For insulin, however, there is no NNT, because insulin has not been shown to result in any benefit on any clinically relevant outcome, even though big studies have been carried out that have included thousands of patients and followed them for five or ten years. Note here that we’re talking about insulin for type 2 diabetics. When it comes to type 1 diabetes, insulin is pretty much magical – you don’t even need to do a randomised trial in order to show benefit. People with type 1 diabetes virtually return from the dead when treated with insulin. But when it comes to type 2 diabetes, there is no benefit, at least not to any hard outcomes. All insulin has been shown to do is reduce blood sugar, but it’s never been shown to result in any meaningful patient oriented benefit for type 2 diabetics.
The same is true for paracetamol/acetaminophen. When it comes to patients with knee pain due to osteoarthritis, the drug doesn’t provide any benefit whatsoever.
Ok, so we have seven drugs, and we know what their NNT’s are. If we plus the probabilities of benefit together, then we get the probability that our 75-year old woman will benefit in some way from at least one of the drugs she’s taking. So, what probability of benefit do we get?
We get 30%. Only 30%.
What that means is that there is a 70% probability that this woman doesn’t benefit at all from any of the seven drugs that she takes every day for years on end!
If you told her, I’d say there are pretty good odds she’d decide to stop taking her pills. Seven drugs a day, every day, and two to one odds of zero benefit.
And we haven’t even talked about harms yet. Because none of these pills are inert. All have widespread biological effects. And all can cause harms. So any rational treatment decision must include not just the potential benefits, but also the potential harms.
For figuring out harms, we have NNH (Number Needed to Harm), which is the counterpoint to NNT. NNH is the number of patients who need to get a drug for one to be harmed. Like I said, the drugs all have widespread biological effects, so there isn’t just one NNH – there is an NNH for each possible harm. That means that there are multiple NNH’s for each drug.
With our 75-year old woman and her seven drugs, we don’t have time to go through the NNH for every possible side effect, so we’re just going to look at a few, and put them side by side with the NNT, to get a somewhat more complete picture of benefits vs harms. I’ve tried to make sure that the NNH numbers apply to the same time period as the NNT numbers, since otherwise it’s an apples to oranges comparison.
If we do that, we get something like this:
Alendronate
NNT: 20 (fractures)
NNH: 200 (esophagitis), 260 (atrial fibrillation), 4,000 (osteonecrosis)
Atorvastatin
NNT: 200 (cardiac infarction)
NNH: 20 (myalgia), 20 (type 2 diabetes)
Sertraline
NNT: 7 (depression)
NNH: 2 (sexual disturbance), 10 (hyponatremia)
Metformin
NNT: 14 (death)
NNH: 2 (stomach upset), 5 (B12 deficiency), 1,000 (lactic acidosis)
Enalapril
NNT: 70 (stroke), 125 (death)
NNH: hyperkalemia (10), acute kidney failure (100)
Insulin
NNT: 0 (no benefit to clinically relevant outcomes)
NNH: severe hypoglycemia (5), weight gain (1)
Paracetamol/acetaminophen
NNT: 0 (no benefit to clinically relevant outcomes)
NNH: Hypertension (30), liver damage (?)
It’s possible to quibble here about specific NNT and NNH numbers. Different studies show different things. And many of the numbers come from studies carried out by pharmaceutical companies, which generally means that the risk of a certain side effect is massively underestimated (as we will discuss shortly). The point here isn’t to get hung up on any of the specific numbers. It’s to illustrate that we quickly end up with a very complex equation, where it in many cases isn’t clear at all whether the benefits outweigh the harms.
Take alendronate, as an example. We know that it decreases fractures in elderly osteoporotic women. But it doesn’t decrease hospitalisations. The only reasonable conclusion is that the reduction in hospitalisations that is seen due to the reduction in fractures is made up for by an increase in hospitalisations due to the many and varied side effects. So at the end of the day the only way to decide whether or not to take the drug is to have a detailed discussion with the patient and get them to decide which set of risks they’d rather be taking.
Hippocrates is supposed to have said “primum non nocere”, which is latin for “first, do no harm”. Actually he didn’t say that, and couldn’t have even if he wanted to. Hippocrates was greek, and didn’t speak latin. The quote comes from a 19th century American physician, Worthington Hooker.
Of course, as doctors, we all know that “first, do no harm” is completely unrealistic. Every intervention we do carries some measure of risk. If our primary guiding principle was to never do harm, we literally would never be able to do anything. A more reasonable principle is “only do something if the benefits clearly outweigh the risks”. If it isn’t clear to you that the benefits of a drug outweigh the harms, then don’t give it to the patient.
That’s a good general rule to stick by. However, it probably isn’t enough, for a few reasons we’re now going to discuss.
A study was published in JAMA Internal Medicine in 2021 that sought to establish how good physicians are at estimating the likelihood that a patient has a certain disease. 500 primary care physicians in the US were asked to consider various hypothetical scenarios, and then answer what they thought the probability of disease was. Here’s an example of a scenario that they were asked to consider:
Ms. Smith, a previously healthy 35-year-old woman who smokes tobacco presents with five days of fatigue, productive cough, worsening shortness of breath, fevers to 102 degrees Fahrenheit (38.9 degrees centigrade) and decreased breath sounds in the lower right field. She has a heart rate of 105 but otherwise vital signs are normal. She has no particular preference for testing and wants your advice.
How likely is it that Ms. Smith has pneumonia based on this information? ___%
Ms. Smith’s chest X-ray is consistent with pneumonia. How likely is she to have pneumonia? ___%
Ms. Smith’s chest X-ray is negative. How likely is she to have pneumonia? ___%
Go ahead and make your own guesses in relation to each of the three questions.
Once you’ve done that, you can take a look at the table below, and the answers will be revealed.
So, for our pneumonia example above, we see that the actual initial risk of disease based on the presented information was around 35%. If we then move along and look at what the doctors answered, they thought the risk was 80-85%. In other words, they thought pneumonia was more than twice as likely as it actually was!
The same phenomenon was seen in all clinical scenarios tested. The doctors consistently overestimated the initial risk, and they continued to overestimate the risk after both a positive and a negative test result. In some cases the difference between reality and what the doctors thought was huge, with the doctors overestimating risk by a factor of ten or more.
What can we conclude from this?
Doctors consistently overestimate disease risk.
Hold that thought, as we move on to take a quick look at another study, which was published in BMJ Open in 2015. This study sought to do something about a problem inherent in statin trials (and for that matter, all trials in medicine), which is that the results they produce, in the form of percent absolute risk, percent relative risk, and NNT, are so abstract that they’re completely meaningless to patients (and for that matter, to doctors as well). We know that statins have an NNT of 200 when used for primary prevention (to prevent a heart attack in someone who has risk factors but hasn’t already has a heart attack), and 40 when used for secondary prevention (to prevent additional heart attacks in someone who has already experienced a heart attack). But what do those numbers actually mean? Are they good or bad?
What the patient really wants to know is “how much longer will I live if I take this drug?”
So, what the researchers did was gather together data from all the big randomised trials of statins, and use the survival curves provided to estimate how much longer the patients actually lived. Here’s what they came up with:
All the big statin trials are included here. What’s interesting to do is look at the NNT provided, and then compare that with the number to the right of it, which is how much longer the patients actually lived, on average. So, for the ALLHAT trial, to take the topmost example, we have an NNT (for primary prevention) of 250, which comes down to a postponement of death of 4.96… well, 4.96 what?
Is it years? No.
Is it months? No
The patients in the statin group lived 4.96 days longer than the patients in the placebo group. That is what the NNT of 250 means in real terms.
Let’s look instead at 4S, which was published in 1994 and is the statin trial that has produced the best results of any statin trial ever. It’s the trial that initiated the massive boom in statin prescribing that we still see today. In 4S, the NNT (for secondary prevention) is 27.8. So, in other words, one in 27.8 patients benefited from the treatment.
But what does that actually mean in terms of life extension?
It means 27 days.
Not as impressive as you would have thought, right?
When the researchers put all the data together, from all the trials, in order to get an overall average, what they found was that when statins are used for primary prevention they prolong life by 3 days. When they are used for secondary prevention, they prolong life by 4 days.
I can imagine quite a few patients turning down the offer of a statin if they knew that it will on average only prolong their life by days.
The purpose of bringing up this study was to illustrate the following general point:
Doctors consistently overestimate the benefit of the drugs they prescribe.
Hold that thought in your mind as we move on and look at a third study.
This one was published in The Lancet Healthy Longevity in 2021. It compared the rate of serious side effects seen in randomised trials with that seen in the real world. If randomised trials give us good information about what to expect in reality, then the rate of serious side effects in the trials should be the same as that seen in reality.
But that isn’t what the researchers found. What they found was that serious side effects were three to four times more common in reality than they are in the randomised trials! Three to four times!
How is this possible?
Well it’s important to remember that the randomised trials are funded and run by the drug companies, and the drug companies want to sell their drugs, so they will do what they can to make side effects appear as rare as possible.
Why is this a problem? Because it’s the randomised trials that doctors mostly use as a basis for determining whether a drug is safe to give to a patient or not.
So, what can we conclude from the study?
Doctors consistently underestimate side effects of drugs.
Ok, so we have three conclusions, that are all pointing us in the same direction:
- Doctors consistently overestimate disease risk.
- Doctors consistently overestimate drug benefit.
- Doctors consistently underestimate drug harm.
What does this lead to?
Massive overprescribing of drugs.
Peter Gotzche, a founding member of the Cochrane Collaboration and former director of the Nordic Cochrane Center, has estimated that prescription drugs are now the third biggest cause of death in the western world, after heart disease and cancer.
That on its own should lead to massive humility among all doctors about our drug prescribing. It should make us much more careful every time we think about prescribing a drug to a patient.
Ok, so we’ve identified the problem. The causes of this problem are many and complex, so I’m just going to bring up one that each of us as doctors can actually do something about – industry sponsored meals.
A study was published in JAMA Internal Medicine in August 2016 that sought to estimate the extent to which physicians are influenced by partaking in industry sponsored meals, which often take the form of a lecture about a specific drug given by an drug company salesperson, which the physician is supposed to sit and listen to in return for getting a free meal. Industry sponsored meals are very common. Most physicians probably take part in at least a couple of these per year, and many take part in far more than that.
As the saying goes, “there’s no such thing as a free lunch”. The drug companies are not charities whose goal it is to keep starving doctors alive. If they spend vast sums of money of sponsored meals, it’s because they’re pretty damn sure that it increases sales of their drugs, and thereby their profits.
So, anyway, the study sought to estimate the extent to which industry sponsored meals influence physician prescribing patterns, by comparing participation in such meals with later prescribing behaviour. Here’s what they found:
They looked at four different drugs. As I think is clear from the tables, participation in industry sponsored meals increased prescribing of the drug the meal was about, and the more such meals a doctor participated in, the more often he or she prescribed that drug.
The purpose of these meals is not to educate us, or make us better doctors. It’s the opposite – the purpose is to make us do a specific profit-driven company’s bidding. And it works.
If you’re a doctor, and you think you don’t get influenced by participating in industry sponsored meals, then you are very naive. The more industry sponsored meals we participate in, the worse doctors we become.
Doctors in general massively underestimate the extent to which their thoughts, beliefs, and opinions are influenced by the pharmaceutical industry. We like to think that we are evidence based. But the truth is that much of what we think we know is not based on sound scientific knowledge, but on pharmaceutical industry propaganda, which quickly becomes clear to anyone who starts going through the studies in detail themselves.
On that note, I strongly recommend reading these three books, all written by physicians, to help get some perspective on the scale of the problem we face in relation to the pharmaceutical industry.
- Bad Pharma by Dr. Ben Goldacre
- Doctoring data by Dr. Malcolm Kendrick
- Deadly medicines and organised crime by Dr. Peter Gotzsche
There is one very simple thing every doctor can do, to at least partially free themselves from the onslaught of drug company propaganda, and that is to refuse to take part in industry sponsored lunches, and all other forms of industry sponsored “education”. Just say No.
Ok, so, that’s number one: refuse to take part in industry sponsored lunches.
What else can you do as a doctor?
Well, something that was once considered standard, but has fallen by the wayside in recent decades, is to never have a patient on more than five drugs at the same time. With drugs, as with everything else, there is a state of diminishing returns – the more you add, the less benefit (and more harm) each additional drug confers. So try to keep a patient on at most five simultaneous drugs. If you want to add a sixth, then rank them all, and get rid of the one that you think is least important. Most likely, the sixth least important drug in a list of six is not going to do anything useful for the patient anyway, just increase their risk of harm.
Ok, so that’s number two: try to avoid having your patients on more than five drugs simultaneously.
Number three: go through the patient’s drug list with them once a year, and get rid of anything that isn’t clearly conferring a benefit. As any doctor will know, it’s common for patients to stay on drugs for years, even though the original reason they were put on the drug resolved itself a long time ago. The patient often doesn’t remember why they were put on the drug in the first place, but they keep taking it dutifully. Drug lists require regular pruning or they will become increasingly bloated as the years go by, which is one reason why so many elderly people are on 15 simultaneous drugs or more.
Number four: only prescribe a drug if the benefits clearly outweigh the harms. This should be obvious, but it requires a deep knowledge of the size of both potential benefit and potential harm, which unfortunately most doctors lack. And what they think they know is often incorrect because it’s based more on pharma propaganda than real science.
As a doctor, the only way to get around this is to start doing your due diligence and getting in to the weeds of the scientific studies. Do that for the ten drugs you prescribe most commonly, so that you’re an expert on those ten drugs, and you’ve already done a lot. If a patient asks you about the probability of benefit and the probability of harm, you should be able to answer that question correctly, at least for the ten drugs you use most frequently. It requires an up-front investment of time, but it will pay massive dividends to your patients over the remainder of your career.
Ok, so that was number four: only prescribe a drug if the benefit clearly outweighs the harm.
Here’s number five: prioritise lifestyle changes. Most of the diseases that doctors spend most of their time dealing with are caused by poor lifestyle choices. And most can be rectified by switching to good lifestyle choices, which invariably produce greater benefits than any drug can, with less risk of harm.
Doctors can accomplish a lot with their patients with simple lifestyle coaching. To take one example, a primary care clinic in the UK decided to try putting their type 2 diabetic patients on a ketogenic diet, since the drugs they were using clearly weren’t making the patients better. They published their six year follow up results in BMJ Nutrition, Prevention, and Health in 2020.
Over six years, the patients following the ketogenic diet decreased their median HbA1c (a measure of average blood sugar over the preceding few months) from 66 to 48. Normally, that would be unheard of. HbA1c doesn’t decrease over time in a type 2 diabetic. It increases. Yet here it was far better at the end of the six years than at the beginning. The same goes for body weight. Normally it goes up over time. But here the median decreased from 99 kg to 91 kg. And on top of that, median systolic blood pressure dropped from 152 to 141.
All this just with a simple diet intervention. Thanks to the improvements in all health markers, the patients were able to get off a lot of their drugs. This meant that after six years, the clinic was spending less than half as much money on anti-diabetic drugs as the other primary care clinics in the region.
To take another example of a simple lifestyle intervention, a randomised trial published in BMJ in 2021 that was carried out in nursing homes in Australia found that a diet high in protein has an effect on fracture risk that is equivalent to that seen with bisphosphonates.
There is a massive amount that can be accomplished with simple lifestyle interventions, and since they are much less risky than drugs, and actually treat the underlying problem rather than just putting a patch on top of it, they should be the primary intervention we use whenever possible. Drugs should be viewed as a complement to lifestyle interventions. It shouldn’t be the other way around.
Ok, so that was my fifth and final point. I’ll repeat the five points here again. These are five things that you as a doctor can do about the situation we currently find ourselves in, where prescription drugs are the third biggest killer in the western world:
- Refuse to participate in industry sponsored lunches and other industry sponsored “education”.
- Try to avoid having your patients on more than five drugs simultaneously.
- Go through the patient’s drug list with them once a year, and get rid of anything that isn’t clearly conferring a benefit.
- Only prescribe a drug if the benefits clearly outweigh the harms.
- Prioritise lifestyle changes.
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From the Archives
UK Researchers: Tax Food to Reduce Climate Change
I doubt these professors have anything to fear from a food tax
By Eric Worrall | Watts Up With That? | November 19, 2016
A group of researchers in Oxford University, England have suggested that imposing a massive tax on carbon intensive foods – specifically protein rich foods like meat and dairy – could help combat climate change. […]
This proposal, from a group of people who have probably never missed a meal in their lives, is totally obscene. High income countries often have a lot of poor people who would be hard hit by increases in the price of food.
Needlessly exacerbating the risk poor people don’t get enough to eat, especially children and pregnant mothers, who are especially vulnerable to adverse health impacts from lack of protein in their diet – if this ghastly proposal is ever implemented, future generations will look upon it as a crime against humanity. – Read full article
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