After the antivirals and Comirnaty stories, we looked at the evidence base of a few amazing interventions paraded by the media. The first was Lecanemab, a monoclonal antibody (MAB) that, according to its manufacturer, Eisai Ltd, attacks amyloid plaques, lowers their burden in the brain, and modifies the course of the earlier stages of the disease. This leads to an improvement in Alzheimer's Disease (AD) with its consequent dementia.

As our readers know, we got interested in the story of lecanemab because of the mainstream and scientific media hype. We are old dogs, and miracles are usually reserved for those around St Peter’s Square in Rome. Concerns over the cost and potential toxicity were downplayed or ignored by our current generation of brilliant journalists.

AD is a prevalent and progressive condition which is devastating to the sufferers and their families. So it’s a worthy target. We are not sure of the causes of AD. The prevalent hypothesis up to a short time ago was the deposition of inert plaques, which destroyed or slowed down cognitive functions. Like all things in real science, this hypothesis has recently attracted criticism. The potential significance of Lecanemab is partly due to the background of pharmacological solutions for AD. The last 20 years have seen one failure after another in clinical trials for a series of molecules or biologics targeted at various presumed chains of pathological events leading to AD.

Each one was hailed as a breakthrough but, in the end, barely shifted the needle, sometimes at significant cost to the manufacturer and to the public. The latest is the “breakthrough test” for prostatic cancer.

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Remember that all of these miracles carry a hefty price tag: continued monitoring of the infusion and its aftermath for the MAB given its toxicity, a spike in a diagnosed prostate cancer and a run on the Zum Zum drug of eternal youth and its potential harms. So it’s no wonder the health systems are….what’s the term? Dysfunctional?

There’s more to the MAB story, though. Like a soft evening breeze from the shimmering waters of the Med, something brought us back to the antiviral story: institutional schizophrenia. The Japanese regulator PMDA gave the MAB the green light, albeit with a request for an unusually long follow-up (9 years). The facilitator MHRA welcomed it with open arms, like the FDA and patients’ associations, but not so NICE or the European Medicines Agency EMA. 

Health Canada (the world's number one regulator for transparency) did not have any documentation on the MAB under Leqembi or Lecanemab.

How strange. 

So, as usual, we went to the regulatory data and started searching the evidence development programme for Leqembi/Lecanemab. We wrote up what we found.

Eisai apparently owns or co-owns all or most of the pressure and marketing outlets. Is Esai a one-off?

There hardly seems to be a day that goes by without the media spreading Zum Zum water or governments making decisions or suggesting changes, which appear to be taken from a Laurel and Hardy script. No smoking in pub gardens is the latest, and it is a curious throwback to miasma theory, like chopping off the bottom half of doors in Scotland.

The transformation of regulators into enablers, the continuous arrival of more interventions, and the idea that you should go to your GP (or more likely to Casualty) to check on your health lead to longer queues, a higher work burden, dubious outcomes, and a higher expenditure on pharma. Finally, politicians' refusal to carry the buck for their decisions leaves us quite uncertain about what is going on and, most of all, who is in charge.

Thanks to Donald Trump, we know what some politicians value more than service and courage: cash. Trump is on record claiming that the Medal of Freedom (in the specific case awarded to one of his funders) is better than the Medal of Honour, the US equivalent of the Victoria Cross. Contributors to this or that party's funds, have replaced Tom Custer and Manila John Basilone.

So if cash speaks, cash is in charge. We should “follow the money” like classic B-movie actors. Four entities seem to be in charge, all linked by cash flows or influence trafficking: politicians, media, pharma, and scientists (we use this last term loosely). 

Politickers need the cash to keep their vote catching alive, but they are the ones who made dictatorial decisions based on no evidence. Please bear in mind that we do not give ten Hancocks who is in charge; they all seem the same to us. You think you live in a free, democratic country, but you do not. Censorship, control, and coercion are everywhere. Trump’s funders have worthier recognition than Alvin York or Dr Mary Walker.

All types of media need to push Zum Zum stories out and feed on each other. One cites the other, and the content is now so debased that it looks like a nasty counterfeit 4th-century Roman coin. If you still think biomedical journals are worthy of some credence, remember their use of an untested quality control pantomime called peer review and their reluctance to publish criticism of their articles. They are a business and do very well out of pushing the Zum Zum. 

Pharma is the most honest of the lot. It aims to make money and keep its shareholders happy. Anti-pharma extremists may not like this message, but it is real and, at times, undisguised. It acts through various agents, such as patient associations, but its sponsorship and promotional intent is mostly clear.

Last but not least, scientists. What can we say when 99% were silent or, in some cases, openly supportive of mass control policies with untested interventions? They were abusive of “enemies” as they saw them. Influencer charlatans and wokery took the place of those who knew the topic and the limits of its science. Some of them forgot to tell us who was paying them. Certainty took the place of uncertainty. The Inquisition killed Galileo; Dr Goebbles replaced Colonel Stevens, and Giordano Bruno is still burning.

To add to all these, we have all those associations, whether for patients, doctors or those who want to line their pockets - or progress up the ladder - that are part of the marketing machine as their significant funders are pharma. 

In 2023, the global pharmaceutical market generated revenues of $1.6 trillion, up by $100 billion from 2022.  For those taking the Silver, the future is lined with more water from the Zum Zum fountain.  So, expect more of the same from those following the money.

Two old geezers who eagerly await the next miracle wrote this post.

Note: Tom Custer, brother of the better known George Armstrong Custer, was the first man to be awarded the Medal of Honor twice. He lies where he fell.