“Kennedy and Trump are taking a wrecking ball to probably the most important thing we have done consistently better than the rest of the world over the last eighty years, and I don’t get it.” — Barry Werth
Last week on the show, the San Francisco based AI mogul and Eureka Machine author Richard Socher promised a scientific renaissance in which AI will cure everything. Socher’s eureka moment, however, may have already occurred. Not with AI, but with big pharma. At least according to Barry Werth who has spent the last thirty-five years writing about American pharma. Indeed, his new book The Age of Cures: How American Scientists Saved Your Life, a twentieth century history of big pharma, completes a trilogy that began with The Billion-Dollar Molecule in 1994.
When it comes to medical breakthroughs, Barry Werth isn’t particularly optimistic on the AI front. It will add more data to preexisting mountains of data, he warns. And Werth reports that many leading scientific designers of drugs don’t think it will change much. Given, however, the hundreds of billions of dollars now being poured into its ecosystem, what today’s AI revolution does instead is remind you what a real scientific breakthrough costs, both politically and economically.
Thus the significance of The Age of Cures, which The New York Times is already recommending. In his new history, Werth reminds us that ninety years ago there were almost no drugs for anything. Penicillin was discovered by accident in 1928, and by 1941 there was only enough of it to treat a single London policeman — who began to recover, then died when the supply ran out.
Cutting edge technology plus state investment changed everything. The engineer and scientific mandarin Vannevar Bush (the guy who also first imagined the internet) persuaded FDR to fund science publicly without conscripting the scientists. And Bush’s Office of Scientific Research and Development, the same state institution that fathered the Manhattan Project, made penicillin for D-Day its number one priority. Bush then ensured the arrangement continued in peacetime, which it did, for eighty years.
According to Werth, both big pharma’s idealism and its now much derided financial ambition were real. George Merck’s famous line about medicine being for people, not for profits, is true — as long as we remember that those profits will follow from life-saving drugs. What broke this virtuous cycle, Werth argues, was the Wall Street short-termism of the greed-is-good Eighties that focused only on quarterly profits. So today, the term Big Pharma is mostly used as an insult. Big Tech moguls like Richard Socher should thus read Barry Werth’s The Age of Cures with particular care.
Further Reading:
• The Age of Cures: How American Scientists Saved Your Life by Barry Werth (Simon & Schuster, September 22, 2026), one of the New York Times’ recommended books this week — the third book written, and the first chronologically, in a trilogy that began with The Billion-Dollar Molecule (1994) and continued with The Antidote: Inside the World of New Pharma (2014).
• “The system that saved your life is being destroyed” — Werth’s own excerpt from the book, in Fortune.
• Science, the Endless Frontier — Vannevar Bush’s 1945 report to President Truman, still cited today, and the founding document of American public-private science. Reissued by Princeton University Press with essays on what it got right and wrong.
• Empire of Pain by Patrick Radden Keefe, a recent guest on this show, on the Sacklers and OxyContin, and No More Tears on Johnson & Johnson — the case for the prosecution, raised in this conversation.
• Earlier this week on Keen On: Richard Socher on why AI will unlock a new scientific renaissance — the argument this episode answers.
Five Takeaways
• Before the Cures. The premise is a fact most people have forgotten: as recently as eighty or ninety years ago there were almost no drugs for any disease. There were natural substances discovered over the eons, and no established method for finding new medicines. Paul Ehrlich postulated that chemicals could treat disease; it took another twenty years before the sulfa drugs suggested he might be right. The story Werth uses to make it concrete is penicillin. Discovered by accident in 1928 when mould spores drifted into Alexander Fleming’s laboratory, it was still so scarce in 1941 — during the Blitz, before America entered the war — that the entire synthesized supply went to one very sick London policeman. He started to recover. They ran out. They harvested what they could from his urine and reinjected it. He died. The British scientists then came to the United States hat in hand, having found no American company willing to take it on.
• Vannevar Bush’s Machine. What turned that around is the book’s central argument, and its hero is not a chemist. Vannevar Bush was an electrical engineer who had built one of the first room-sized analog computers. Surveying American science in 1940, he and a handful of other administrators found it disorganized and no match for the Germans, who had the best chemistry in the world. Bush went to Franklin Roosevelt alone with a proposal: fund it publicly, but don’t draft the scientists into the military as in the First World War; let committees of leading scientists make the decisions, distribute the work widely, and make rivals cooperate. The result was the Office of Scientific Research and Development — better known for fathering the Manhattan Project — whose head of medical research, Alfred Newton Richards, made penicillin for D-Day the number one priority and delivered it. Afterwards Bush wrote Science, the Endless Frontier, the 1945 report arguing the partnership should continue in peacetime. It did. Sustained federal funding, transparency, cooperation between companies, universities and government: that, Werth says, is how America got great at science. AK’s summary: cutting edge technology plus state investment changed everything.
• Medicine Is for People. George Merck — whose family had been in the pharmaceutical business in Germany since the 1600s, and who was sent to Harvard to become a chemist before anti-German feeling in the First World War pushed him into the family firm — was on the cover of Time the week Werth was born in 1952, under the line that medicine is for the people. The usual ...
