Everyone knows the legend of the penicillin. It’s 1929 and Alexander Fleming has installed his laboratory in a basement of an English hospital. One day, returning from vacation, he finds a culture of bacteria contaminated with a fungus and, instead of throwing it away, he observes it carefully and realizes that, around the invader, there is a safety circle where bacteria do not grow. He deduces that the fungus secretes a substance that keeps its enemies at bay and decides to name it penicillin.
Perhaps it is not so well known that this discovery already it had been done half a century beforeeven though it had gone unnoticed. Or that while Fleming usually gets the glory, those who take credit for making penicillin the first widely used antibiotic are Howard Florey and Ernst Chainwho unearthed Fleming’s find nearly a decade later and understood its potential medical utility.
Let’s jump to 1940. Europe is at war and, as always, they are more soldiers dying from infections than from bullets. Someone in the British Government sees an article that Florey and Chain have just published in the journal ‘Lancet’, where they describe an experiment in mice infected with streptococcus: Those who had been previously injected with penicillin survive, while their companions die in less than 24 hours. From that moment on, penicillin becomes a state secretas protected as efforts to build an atomic bomb, because politicians realize that can be a key to win the war. You just have to find a way to make enough.
It is not easy but, with the help of the Americans, and making a spectacular investment of effort and money, second only to the race to create the vaccine against covid eight decades later, in a matter of four years the allies will be producing more than a billion doses. But, meanwhile, there is not for everyone who needs it, and this is where we collide with reality. How do we prioritize the distribution of a scarce drug, which has the capacity to save lives?
The first part of the choice is relatively easy: what the world needs are soldiers, so it is decided that the antibiotic will initially only be available for military uses. Thousands of civilians who could have been cured of deadly infections – women, children, old people – have to give way to young men who have to stop Hitler’s advances. But the penicillin that arrives in Europe from American pharmaceutical companies continues to be insufficient. You have to spin thinner. And here Churchill makes a decision that may seem surprising: antibiotics will be given earlier to soldiers suffering from syphilis and gonorrhea, two incapacitating and widespread venereal diseases, but not fatal (at least in the short term), than to the wounded. Thinking well, the logic is undeniable. A wounded man may not be able to return to the front lines when he leaves the hospital. Instead, once untimely purges are eliminated, the soldier is ready to continue being cannon fodder. And so, the life of someone who has been hit by a bullet defending freedom and democracy becomes less important for the country than the one who has fallen in the line of duty in a brothel. It’s grim.
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could study the distortion suffered by human morality in times of crisis. In fact, there is already a discipline that studies ethics in times of pandemic, called pandemic. At the height of the first waves of covid-19, Churchill-like decisions had to be made in some overwhelmed health systems, albeit with perhaps less cynical results, to decide how resources were distributed that did not reach everyone. As much as it horrifies us, it is inevitable, at least when we have not done our homework and have not prepared ourselves to deal with health problems of this type. Perhaps in the next pandemic we will have already learned.
It is also ethically dubious the decision to pretend that the pandemic is over and return to normal, and this may not seem so obvious to us. But, with a virus that is increasingly contagious (the BA.4 and BA.5 subvariants of ómicron are very contagious) and still aggressive (there are fewer deaths, above all, because we are vaccinated, not because the virus is now mild), no doing nothing to protect ourselves endangers the most vulnerable sector of the population, especially as immunity declines (antibodies do not last forever and ever). When someone studies it eighty years from now, perhaps they will also raise their hands to their heads.