In 1944, President Roosevelt asked Vannevar Bush to respond to four questions (or, perhaps it was Vannevar Bush who arranged for President Roosevelt to ask him four questions). These questions formed the foundation for his report Science the Endless Frontier. The first question asked how the new science developed in military research during the war could be made available to the public for beneficial use. The second question was this:
With particular reference to the war of science against disease, what can be done now to organize a program for continuing in the future the work which has been done in medicine and related sciences?
Let’s consider this “war of science against disease.” On the surface, we can read it as simply a flowery metaphor for using the tools of science to understand and cure diseases. If one is into logical abstractions, then that’s probably the end of it. But “war of science against disease” signals much more than that, and it is worth considering this signalling in the context of federal research and invention policies.
Roosevelt’s premise underscores the translation of the war theme–an institutional construct designed to shift around institutional thinking–from the conflict on the battlefields of Europe, Asia, and Africa to civilian purposes:
New frontiers of the mind are before us, and if they are pioneered with the same vision, boldness, and drive with which we have waged this war we can create a fuller and more fruitful employment and a fuller and more fruitful life.
There’s a bunch happening under the surface here. The outline is that for the war effort, American industry was “mobilized” to provide the production necessary to meet war needs under the direction of the federal government. Ordinary competition for profit was suppressed (though not eliminated, of course) and in its place were government contracts for war production. An augmented, “publified” market emerged, dominated by the federal government. Vannevar Bush, at the Office of Scientific Development and Research, also ramped up projects with contracts aiming to use new science to develop technologies outside the ordinary–outside of what military planners were used to specifying, outside what American companies were experienced in making. Radar, say, or atomic bombs. Bush’s priority was to get things done, not to spread work around to every university or company. There was a war on. Get things done as expeditiously as possible. Use the best people you have got. Deal with organizations that know how to deal.
For his methods, Bush was criticized–his approach was elitist; there was too much concentration of “economic power” in his choice of contractors (fewer than ten universities got most of OSRD’s contracts, for instance). Senator Kilgore had proposed a bill that would have spread work around among the states and various research institutions–and it was in the context of this bill, which failed, that Bush countered with Science the Endless Frontier.
Thus, when one sees “war on disease,” there’s more going on. There’s an implied central role for government: the federal government wages war–companies do not, individuals do not. There’s a required mobilization–industry must work for the public good in a time of war, and not merely for itself. Unlike Milton Friedman’s contention that a corporation’s public purpose is to make money for its shareholders, in a time of war, that corporation’s public purpose is to serve the public, as that service is requested and directed by the federal government. What takes place is not a “nationalization”–the federal government does not take ownership of private industry. But there is a “publification”–the federal government asserts a primary role in directing industry activities in the conduct of the “war.” In such circumstances, private property rights granted by the government–patents–have a diminished role. Companies may obtain patents, but the government has already “marched-in” and replaced non-federal marketplaces with a federal market for “war” resources. This mobilization, this “publification” of disease research, is signaled by the “war on disease” usage. It is not merely that the country to mobilize as if at war–that would be just a rah-rah simile–but that the federal government announces that it has chosen to use its war time practices to conduct its activities with regard to health care–not a simile at all, but rather a transference.
At the base of things, then, war practices insist that the federal government has the primary, if not sole responsibility for the conduct of the activity, that American industry must mobilize to assist the federal government as requested and directed, that private competitive interests cannot dominate or impede public effort, stuff must get done expeditiously, and the public (and the government) is not going to mess around trying to make things fair or profitable for everyone. War on disease is not “profit by disease” or “build a wealthy industry predicated on disease.” The war on disease effort is not one aiming to produce regional economic development or innovation for innovation’s sake. It’s about prevention, cure, and meaningful intervention.
In this context, then, consider Science the Endless Frontier as a manifesto of federal government taking control of the “war on disease” effort and wherever the government operates, creating a governmental market–a publified market, if you will–rather than a non-governmental commercial market. Here’s a heading from Science the Endless Frontier:
Science Is a Proper Concern of Government
Here’s the logic:
Moreover, since health, well-being, and security are proper concerns of Government, scientific progress is, and must be, of vital interest to Government.
As a war practice, scientific progress becomes publified. The “market” for such publified efforts becomes a governmental market. As in war, the government has the primary responsibility to conduct the activity, to mobilize resources, and to delegate duties. The Kennedy executive branch patent policy distinguished “established nongovernmental commercial position” from a “field of science or technology in which there has been little significant experience outside of work funded by the Government, or where the Government has been the principal developer of the field.” To declare a war on disease means to declare that the scientific and technological progress necessary to wage that war are to become a matter for a governmental market. There may still be a non-governmental commercial market, but that is beside the point. The government market is the market of vital interest to government. That governmental market exists to deliver victory–in the case of a war on disease, cures and prevention, eradication, and at the very least, making acute conditions less acute. The tools to wage the war on disease, used to fight disease, are a matter for the governmental market. If there is a nongovernmental commercial position to be had for such tools, it is not to fight disease but rather to do something else–to treat animals, say, or to be adapted–used as sensors to detect impurities in water or to improve sanitation of industrial surfaces or telephone handsets.
The governmental market for research does not come into existence to supply technology to private concerns so they may profit in a non-governmental market and there do whatever fighting is to be done. That would be like having the government declare war and then spend its money on equipment to hand over to companies to do whatever fighting they wanted or didn’t to, based on whatever money they thought they could make. Yes, the for-profit war. A strange concept–though companies may get rich on war, they don’t take the lead responsibility for fighting the war but rather they prefer to sell to the combatants–all the more so if the combatants are happy to pay premium prices for what they need. They are then all for laws that force the government to pay premium prices, and it’s even better if the government also subsidizes the development of what they will eventually sell to the government.
Once there is this declaration to use war practices with regard to disease, then industry is called upon to mobilize to serve this effort. In this regard, it makes perfect sense that the 1962 Public Health Service patent policy would insist on federal government ownership of inventions made with PHS support, with release of these inventions to all companies except when public health needs required expeditious manufacturing and then Bush’s method of awarding sole source contracts–exclusive licenses, if you will–were entirely appropriate. There was no need to worry about “commercialization” of inventions. The effort was to advance science, make those advances broadly available to mobilized companies, and in the area of mobilization–waging war against disease–to use those advances to identify therapies and then rig for mass production (if mass production was required). Depending on the need, mass production could involve a single mobilized company, a few companies, or many companies producing sufficient product for their service areas.
The pharmaceutical company boycott of PHS-supported compounds in the early 1960s was not merely about the possible “contamination” of company proprietary positions by company involvement with research in the same area supported by the federal government. Rather, it was a rejection of the government’s primary responsibility to “wage war” against disease. The pharmaceutical industry, in effect, refused to mobilize, refused to accept the publification of disease science and technology, refused to accept the rapid expansion of a federal market for disease therapies. Instead, the pharmaceutical industry cast federal funding as “basic” research that was to serve as a public subsidy to assist the industry in developing commercial products, and that the federal government should step aside and permit the industry to meet public health needs on its own terms, as profit-seeking ventures. The government’s role, beyond subsidies, was to buy as much product as it wished to buy, but at the prices set by the industry in a non-governmental commercial market.
One might observe that in an actual war, the profit sweet spot for a company that refuses to mobilize, might be a tank that is somewhat easy to destroy. Destroyed tanks mean more orders for tanks, more profits. All the better if a company then could hold a twenty-year monopoly on tanks, preventing the production by others of longer-lasting, less profitable tanks. Sure, another company might come up with its own profitable tank–perhaps not so easily destroyed, but that is prone to breaking down so that it must be replaced or that there’s good profit in supplying replacement parts. A competition to build a profitable tank, rather than a tank that will win the war. If the war is to be a profit center, then a profit-focused, non-mobilized company would dream of a prolonged war, an endless war. There’s nothing in the corporate DNA that argues for developing products so good that they destroy the market altogether. An industry predicated on making products to treat disease cannot be one that is determined to win the war on disease. It wants, rather, a profitable on-going role in a standoff with disease, making acute conditions chronic and extending the time of dependency on medications. To think otherwise is to mobilize, to subordinate profits to public objectives, to work to eliminate the “market” for weapons aimed at disease, to seek profit based on patent monopolies only for uses of technology that are not directed at disease therapies.