Ulrike Thoms

History Teaches Us That Confronting Antibiotic Resistance Requires Stronger Global Collective Action

Antibiotic development and usage, and antibiotic resistance in particular, are today considered global concerns, simultaneously mandating local and global perspectives and actions. Yet such global considerations have not always been part of antibiotic policy formation, and those who attempt to formulate a globally coordinated response to antibiotic resistance will need to confront a history of heterogeneous, often uncoordinated, and at times conflicting reform efforts, whose legacies remain apparent today. Historical analysis permits us to highlight such entrenched trends and processes, helping to frame contemporary efforts to improve access, conservation and innovation.

Pharmaceutical firms and the construction of drug markets: from branding to scientific marketing

In January 2011, the French General Inspectorate for Social Affairs (IGAS) issued a special report on the drug called Médiator, a benfluorex preparation, which had been marketed in the country since 1976 by the firm Servier. Three months earlier, the French Ministry of Health had commissioned IGAS to organize and expedite a special investigation on this one drug. The exceptional status of the inquiry can only be understood against the background of the enormous public scandal generated by the growing number of deaths attributed to the widespread use of Médiator. By the end of 2010, Servier’s drug had been associated with lethal adverse cardiac events, the overall toll of which, as estimated by epidemiologists, ranged from 500 to 2000 deaths. Since its first marketing authorization, Médiator had been prescribed as a means to reduce the concentration of lipids in the blood, and the official indications for its use had been problematic cases of diabetes with heavy weight on the one hand and excess of blood triglycerides on the other. These indications had already been contested in the 1980s. What was even more controversial, at least from the mid-1990s on, was the fact that Médiator was also often prescribed off-label as a means to reduce weight. The IGAS report took a harsh stand, stating that the French regulatory boards had completely failed in this case. It placed blame on the public authorities for having taken 15 years to register the adverse events and react to them and, especially, for having granted Médiator a marketing permit at all. According to the inspectors, Médiator was, both at the molecular and pharmacological level, an amphetamine derivative: a preparation with anorexic potency belonging to a class that had been gradually taken off the market in most industrialized countries in the 1980s and 1990s. The IGAS report attributed responsibility for this failure to major flaws in drug administration: its slow and bureaucratic nature, its dependence on data generated by the firm, and the massive conflict of interests that had been hidden by the many experts involved in the evaluation of Médiator. The main culprit – and on this point the report did not differ from hundreds of comments and articles in the press – was Servier itself. The company conducted an aggressive marketing strategy, produced incomplete and biased data (which it used in lobbying to gain approval for the drug and eventually threatening dissenting experts) and undertook a massive promotion campaign aimed at physicians. The problem was less that Servier had broadened the approved indications of the drug (for diabetes and obesity) but had undermined expectations on the standards of scientific communication. Servier had deliberately sought to obscure that Médiator acted

Standardizing selling. Pharmaceutical marketing, the pharmaceutical company and the marketing expert (1900–1980)

This paper investigates the development of pharmaceutical marketing in Germany between 1900 and 1980. Based on material from business archives, it demonstrates that such marketing developed from practice and the theoretical reasoning supporting it followed later. The standard narrative of marketing handbooks presents its development as the result of the period after World War II and of American influences. In contrast, this article points to the 1930s as the most important phase, a time in which the field of market research took shape, with major impacts on producers and consumers, sellers, and buyers. The period after the 1950s, especially in the 1970s, brought some change, but it was primarily a matter of scale and scope, combining statistical methods with opinion research and its sophisticated tools.

Between Promise and Threat

ZusammenfassungProduktion und Verbrauch von Nahrungsmitteln sind traditionell mit weit reichenden Ängsten verknüpft. Bezogen diese sich in vormodernen Gesellschaften vorrangig auf eine ausreichende Versorgung, sind sie in der modernen Industriegesellschaft eher auf die Qualität der Nahrungsmittel gerichtet. In diesem Zusammenhang spielten in der Nachkriegszeit Antibiotika eine zentrale Rolle. Der Aufsatz stellt die Einführung der Antibiotika in die westdeutsche Veterinärmedizin, ihre frühe Diskussion als Konservierungsmittel und ihre wachsende Rolle als Wachstumsförderer dar. Vor dem Hintergrund einer zunehmend industrialisierten, auf Maximierung ausgerichteten Produktionspolitik werden die Rolle der Veterinäre, der Forschung und der wissenschaftlichen Experten sowie die Probleme der Regulierung des Antibiotikaeinsatzes in der Landwirtschaft diskutiert, die in die Entstehung eines unübersichtlichen grauen Marktes für Antibiotika und die Verlagerung ihres Einsatzes in die Therapie mündete. Besondere Aufmerksamkeit wird der Frage zugewandt, welche Rolle das Vertrauen und die Ängste der Verbraucher in diesem Prozess spielten.

Physical Reproduction, Eating Culture and Communication at the Workplace. The Case of Industrial Canteens in Germany 1850–1950

Starting from the point of visual representation the article examines the history of the industrial canteens in Germany. Beginning with the developments of the 1850s it discusses the economic calculations and social motives that led to the foundation of the first eating facilities in factories. It works not so much with statistics about consumption but with different ways and media of communication, among which pictures play an important role, and it traces the ideas and assumptions behind these media, while also showing their impact on further developments up to the 1950s. The main aim of the article is to point to the highly contradictory role of the canteens for uniting and dividing the workforce along the lines of income, gender and performance.

„Eingeschlossen/Ausgeschlossen“. Die Ernährung in Gefängnissen vom 18. bis 20. Jahrhundert

Der Antritt einer Freiheitsstrafe ist mit einer mehr oder weniger formalisierten Aufnahmeprozedur in der Strafanstalt verbunden: Im 18. Jahrhundert noch hochst drastisch in Form einer Tracht Prugel, dem so genannten „Willkomm“ (Quanter 1970, 160).

Geschichte des Max-Planck-Instituts für Bildungsforschung in Berlin

Der Beitrag untersucht die Geschichte des 1963 gegrundeten Max-Planck-Instituts fur Bildungsforschung in Berlin, mit einem Fokus auf die Zeit bis Mitte der 1970er-Jahre. Davon ausgehend analysiert er Zielsetzung, Strukturen und Arbeitsthemen des Instituts bis zur Jahrtausendwende und fragt nach der Reaktion des Instituts auf den Wandel in Wissenschaft und Politik.

Handlanger der Industrie oder berufener Schützer des Tieres? – Der Tierarzt und seine Rolle in der Geflügelproduktion

Um den Zwiespalt des modernen Tierarztes, zugleich Dienstleister fur die Agrarindustrie, Fursprecher fur den Tierschutz und Garant der Lebensmittelsicherheit sein zu mussen, besser verstehen zu konnen, wird zunachst kurz die Geschichte des Berufes und seine Rolle fur die Lebensmittelproduktion rekapituliert, bevor sich der Beitrag der historischen Entwicklung der modernen Geflugelproduktion und der Rolle des Tierarztes darin zuwendet. Ziel ist es, die gegenwartige Entwicklung als historisch gewachsen nachvollziehbar zu machen. Auf der Basis einer Einsicht in historische Pfadabhangigkeiten sollen die gegenwartigen Zielkonflikte des Tierarztes herausgearbeitet werden, um sie uber die Diskussion fur notwendige Veranderungen zuganglich zu machen.

The Introduction of Frozen Foods in West Germany and Its Integration into the Daily Diet

Frozen foods are a matter of course today; they form part of our daily life and we hardly think about the long time span between the technical invention of freezers and the availability of frozen products in almost every supermarket and even corner grocery. From today’s perspective frozen foods are an ongoing success story. Even though food expenditures in Germany somehow stagnate over the last decades and there is a sharp cut-throat competition in the food business, consumption figures and all-over turnover in frozen foods still increases and is expected to increase further on. (See ‘Absatz-Umsatzentwicklung. Tiefkuhlkostmarkt in Deutschland gesamt 1990–2010’, http://www.tiefkuehlkost.de/tiefkuehlmarkt/statistiken/ (Accessed 18 Feb. 2012).) Nevertheless, this finding is a late development. Although the mere machinery for freezing was already available at the end of the 19th century, it took almost 50 years, that frozen foods became a widely used product of mass consumption.