Pharmageddon Chapter 1

Chandigarh India 06:00 Sunday 2 January T–0:30hrs

Anil Sirkandar knew he shouldn’t be drinking bhang at work, but it was just over an hour to the end of his shift and the cannabis drink made the time pass quickly and painlessly. These were special circumstances, he told himself. For one thing it was freezing in the unheated building, and for another this was a holiday, when bhang was traditionally drunk. But most of all, the bhang was his way of getting back at the production manager for springing this shift on Anil and his team at the last minute, when they were supposed to be off duty.

He took another sip and let his thoughts drift back for the millionth time to the car he was due to collect in a couple of days. Instead of queuing for a bus or flagging down a surly auto-rickshaw driver at the end of each shift, from next week he would walk casually to the staff car-park, step into the shiny blue Tata Nano, turn on the radio and drive through the factory gate just as the company executives did. When he sat in the car at the Tata showroom last week he was shivering so hard with excitement he’d barely been able to say ‘I’ll take it.’

For a Dalit – an untouchable – whose family had been sweepers since the beginning of time, the idea of owning a car was as far-fetched as... being called into Dr Chaturvedi’s office, asked to sit down, and offered the job of shift supervisor. But that is exactly what happened, barely six months ago. Anil still felt light- headed when he thought of it. The manager of the plant, a Brahmin, shaking the hand of a Chura, inviting him to sit – on a chair – and offering him a supervisory position! Truly, this was a new and wonderful world.

Anil kept imagining his mother’s expression when he parked the new Nano outside her shack and offered to whisk her and his two sisters off to the market to do their shopping, just like the higher castes did. His father had never dared to dream of owning a scooter and here Anil was, not quite 24 years old, able to borrow enough on the strength of his salary and prospects at Maurya Pharmaceuticals to buy a car.

In truth Anil was more than happy to work this shift, supervising his team while they readied the laboratory for the return of the production staff in a couple of days. Working a Saturday night meant double-pay, as did working during the holidays. A Saturday during the holidays meant three times his regular wage which, on a supervisor’s pay-scale, was a huge sum – thousands of rupees! Anil could almost picture the money gushing into his bank account. Come to think of it, he was actually grateful to the production manager for canceling his day off, even though the man always spoke to him in the contemptuous manner of a higher caste addressing a Dalit, ignoring Maurya’s policy of equality at work. But Anil’s skin was thickened by centuries of abuse, and money had no caste.

The work tonight was particularly hard for his team because the engineers who installed and serviced equipment during the holidays had left a mess in the normally spotless laboratory. But Anil was careful and methodical, qualities which Dr Chaturvedi had noticed and mentioned when he promoted the young cleaner, even though he had worked at the plant for only three years. Now, as a supervisor, he did not clean anything himself but made sure his team embodied the same qualities, frequently telling them that if he could become a supervisor – and buy a new car – so could they.

Anil swallowed the last of the bhang just as his new Casio watch chimed stridently. He pressed the button to turn on the backlight, even though he didn’t need to, and read the time although he already knew from the wall-clock in the tiny supervisor’s cubicle that it was 6am. Time for a last inspection. He straightened the black surgical scrubs which he wore over his regular clothing because of the cold, pulled on his surgical mask and cap, and a fresh pair of white cotton gloves, and headed into the laboratory hall.

He knew the plant manufactured a range of ingredients used to make drugs – ‘active pharmaceutical ingredients or API’ he told his friends, with the air of one who knows much more than he is permitted to disclose. The laboratory was a huge space filled with work-benches, each fitted with basins and faucets, gas and electrical connections, and stacked with computers and other apparatus which performed functions that he could not even guess at. Along the two longer walls 20 glass doors opened into smaller rooms, each containing a mystifying collection of glass, steel and plastic tubes, bulbs, cylinders and machines. All Anil knew was that his cleaners were only allowed into those spaces when they were empty, or if they were told to clean specific surfaces under the supervision of a chemist.

At the far end of the hall an airlock led to an area where raw materials were stored. Chemists or their assistants collected materials from the store before measuring, testing and preparing them, after which the materials were taken to one of the 20 small rooms – called reaction chambers – where the mysterious equipment somehow transformed them into tiny quantities of powder or liquid which were vastly more valuable than gold. These precious essences were then packaged and sent off to hundreds of pharmaceutical plants around the world, where they were made into medicines to save or improve the quality of countless lives.

Usually Maurya’s Chandigarh plant was open around the clock, working a three-shift system, and the main laboratory was a hive of quiet, ordered activity. Staff wore different colored surgical scrubs – green for chemists, blue for assistants, and orange for cleaners. Supervisory staff wore a darker shade of the same color while executives wore black and visitors, on the rare occasions they came into the laboratory, wore white.

However the dress code was sometimes bent during the night shift, from 23:00 to 07:00, when chemists deliberately wore the wrong colors. It was all done in good spirit, and nobody would dream of committing a serious breach of the rules by, for example, working without a mask, gloves or hat. Tonight, in a moment of recklessness when he entered the deserted laboratory, Anil put on a set of the black executive scrubs and invited his team to wear any color they wished, although they all put on the familiar orange. And, because the heating was turned off, they all wore their own clothes underneath their scrubs. Even though Chandigarh is only 300 meters above sea level it lies in the foothills of the Himalayas and winter nights can be chilly, sometimes falling below freezing.

Production at the plant stopped only four times a year, each time for a week or ten days. The breaks were timed to coincide with each of the major religious festivals – the Christian Easter in March, the Muslim Eid al-Fitr in September, the Festival of Lights celebrated by Hindus, Sikhs and Jains in November, and of course the current break for Christmas and New Year.

These were the times when professional staff took their vacations but they were also the busiest times for the plant’s engineering staff and cleaners. Anil’s team had worked every night during the past week, cleaning and sterilizing empty reaction chambers before the engineers filled them with new equipment.

But Saturday night was supposed to be their night off.

Anil walked along the north wall, stopping at several benches to check they were free of dust by running his gloved fingers over the surfaces. His crew were well trained to know what to clean, and what to leave alone. They had been shown videos of the invisible animals called bacteria which live on surfaces that look clean but are not. The age-old trade of the sweeper had been updated and they were now equipped to sweep away all of these tiny animals – using special machinery and chemicals. And they took pride in their work, which was essential to making the drugs which saved many lives.

Right now Anil could see only Parvati working in the main hall, but he wasn’t concerned. He knew she was finishing off the last of the benches and floors, while two of her colleagues had gone to help the remaining two cleaners finish sterilizing reaction chambers seven and 13. Outside chamber seven Anil saw the steam- cleaner standing alongside cases of equipment which would be unpacked and installed by the engineers later today. Through the glass door he could see Amit and Kavita drying the walls and floor with disposable swabs. He knew the chemists would find no invisible animals in chamber seven.

Anil continued around the perimeter of the hall, pausing to check the airlock area. Cleaning the storage section beyond the airlock would be the responsibility of the cleaners on the next shift. Outside reaction chamber 13 he saw another cluster of packing cases, but no steam cleaner. Inside, as he feared, he found Suresh and Arpita were running late, so he briefly reminded them how privileged they were to be on his team and to be earning triple time for this shift, and how happy every other cleaner at the plant would be to do this work if they found it too tiring. He left them working frantically to catch up.

The plant had fifteen cleaning teams in all, one for each shift in each of five zones. Anil had worked every shift in each zone before being promoted to one of the three elite laboratory teams and then, quite unexpectedly, to the post of shift supervisor! Truly he felt good in these black scrubs!

On several occasions he had seen the owner of Maurya Pharmaceuticals, Dr Gupta, inside the laboratory, accompanied by Dr Chaturvedi. Both men would be wearing the same black scrubs with hats and masks, but the older and heavier plant manager was instantly distinguishable from the slim, youthful figure of his employer. Dr Gupta was world famous, one of the richest men in India. He usually arrived at the plant in his black helicopter from his headquarters in Shimla which, thanks to the mountainous terrain, was a couple of hours away by car or train but only a few minutes by helicopter.

Dr Chaturvedi himself was reputed to be one of the best research chemists in the world, although you’d never guess it to meet him. He usually arrived early at the plant in his modest Honda Accord, and he made a habit of stopping to chat to any staff he encountered – even cleaners – asking after their families and checking whether there was anything he could do for them.

And these weren’t empty words. Dr Chaturvedi had encouraged Anil to improve his education so he could move up in the company, suggesting he enroll for an engineering diploma at the Chandigarh Technical College. Naturally Maurya would provide letters of recommendation to the college. Both men knew a Dalit would never be admitted without this letter but that, with the company’s endorsement, his acceptance was assured. Anil was waiting for the offer to be repeated, as protocol demanded, before accepting it. But in the meanwhile he saw no reason not to use his vastly improved income to buy the little Tata Nano.

Moving back towards the supervisors’ cubicle Anil imagined he was already a company executive, wearing these black scrubs not as a prank but as an entitlement. He surveyed the vast laboratory with a proprietary air, clicking his tongue with displeasure at the stacks of rough crates and grubby tool-boxes cluttering the normally pristine space. Still lost in his fantasy Anil imagined reprimanding the engineers, telling them to take their dirty tools back to their workshop while the laboratory was being cleaned.

Then he spotted a tool box on top of a work bench and yanked himself back to reality. He hadn’t noticed it earlier because it was obscured by two large pieces of laboratory equipment. Engineers were strictly forbidden from putting anything on the near-sterile workbenches. As a junior cleaner he would never consider moving an engineer’s tools, but as a supervisor he was expected to show initiative. Hopefully the engineer who put it there would realize his mistake when he found the toolbox had been moved to the floor, and would be suitably grateful that he had been spared a tongue-lashing by the production manager.

Anil called to Parvati, telling her to bring her cleaning trolley. He explained that she was right to have left the toolbox when she cleaned this area, but she should have told him about it. She stepped forward to take hold of the toolbox but he tapped her arm smartly.

‘No, it is not your place to move something belonging to the engineers.’

Parvati lowered her eyes respectfully and stepped back – something she would never have done before Anil was promoted to supervisor, since she was of the same caste as he, but older and married. As he stepped forward to take hold of the toolbox himself, Anil’s Casio chimed the half hour. In the same instant he had a fleeting impression of light, heat and sound, then nothing.

The explosive in the toolbox was so powerful that it reduced both Anil and Parvati to a spray of tiny fragments, which were evenly distributed over the western end of the laboratory. The laminated glass doors to the reaction chambers lining the north and south walls were designed to resist fires, but were no match for the enormous pressure of 30 kilograms of military-grade explosive, which transformed the thick glass into millions of sharp-edged projectiles, shredding everything inside the chambers.

In chamber seven Amit was killed instantly when a cube of glass entered his brain through his right eye. The pressure of the blast knocked Kavita unconscious, while one of the several hundred shards of glass which sliced into her body nicked an artery in her neck. She awoke in the semi-darkness to find Amit was taking a nap. It didn’t make sense, but she was so tired herself that she decided to close her eyes, just for a moment.

Across the hall in chamber 13, Suresh recovered consciousness and picked himself up, then lost his footing on the slick blood pouring from countless lacerations all over his body and fell heavily, striking his head hard on the corner of the steam cleaning unit.

When she regained consciousness, Arpita was deaf and confused, and her clothes and flesh were hanging in ribbons. However she was able to walk, and she stumbled from chamber 13 into the darkened laboratory hall, picking her way between overturned benches and scattered equipment, heading toward the light from the gaping hole where the front airlock had been.

When she was almost there, one of the plant’s security guards appeared in the opening, silhouetted against the light but recognizable by his black turban and uniform, his shotgun held ready across his chest.

In the same instant, clouds of invisible and odorless LP gas and oxygen, streaming from a dozen broken gas lines, reached a smoldering fragment of black cloth from Anil Sirkandar’s illicit scrubs, stuck like a funereal Post-It to the west wall of the laboratory.

Guard Nirmal Singh was standing motionless in the broken airlock, transfixed by the sight of some kind of prehistoric creature shuffling out of the darkness toward him. Beyond this viscid figure, the laboratory looked more like the charred maw of a dragon than the bright sterile workplace he knew. Before he could make sense of these images, or decide what he and his shotgun should do about them, the dragon breathed blue-white fire on them both.

Istanbul, Turkey, 04:00 Sunday 2 January T+1hr

In my dream Emily and I were hosting a party at the villa. It was great fun, even though nobody spoke English. Emily had no trouble speaking to them in Turkish and Hindi and Croatian, but it was all Greek to me. It made no difference – when we raised our glasses and toasted the new year we were all good mates, and life was good.

The bash was in full swing when my phone rang. I struggled to hear the caller over the din but finally made out that it was Jim. I was so relieved that he was speaking American that I didn’t ask myself why he wasn’t at the party, or why he wanted me to get my ass into the office. He said something about one of Shan’s factories being blown up, which made no sense, but I didn’t argue because it was, after all, just a dream. The next thing I was in the Aston, rumbling across the Bosphorus Bridge and into the jeweled arms of European Istanbul.

Only... it wasn’t a dream. At least, not all of it. It felt like I really was driving across the floodlit bridge, which was practically deserted at this hour. Em and I really did host a New Year’s party in Fenerbahçe, but it ended 24 hours ago. And, even though our guests came from many countries, they all spoke perfect English. Except for Emily, of course, who could no longer form the words in any of the seventeen or so languages she understood.

Jim’s call must’ve been real, too, or I wouldn’t be driving to the office. The champagne from the party had worn off, but Em had insisted we stay awake for the first day of our first full year in Istanbul, so we’d only got to bed a couple of hours ago, and I was more unconscious than asleep when Jim called.

It crossed my mind that maybe I was still dreaming. What if Istanbul, the Aston Martin and my job were all just figments of Bollinger-induced unconsciousness? I pushed on the Aston’s horn, which was piercingly real. If this was just a dream, how would I know that this bridge is usually crammed full of crawling traffic? Or how to drive toward the thousand-year-old Galata trading district, and my place of employ in Karaköy?

We could have chosen to live on the European side of this ancient city, say in Baltalimani or Etiler-Levent, but we both liked the idea of living on one continent and while I worked on another, so I bought the south- facing villa in Fenerbahçe with its great views over the Sea of Marmara and the Princes’ Islands. Not that I was at home much to enjoy the place, but Emily loved it.

Along with the other senior editors I spend most of my time on the road. Or rather, in the air and in hotel rooms. Usually I could count on being with Emily over Christmas and New Year, because it’s a flat period for the news industry. The silly season. But, unless I’d imagined Jim’s call, the silly season had ended early this year... and with a bang.

Jim’s call must have woken Em as well. She never grumbled about being disturbed in the middle of the night, or about me having to leave her at a moment’s notice. Sometimes I wished she would, but I suppose she felt it was the one thing she could do for me. Give me space. She must have watched this morning while I dressed and grabbed my carry-on – a familiar sight for her and something which, evidently, I could do in my sleep.

In Karaköy I pointed the Aston into the underground parking at the TWO headquarters. Even at this hour there wasn’t any space at the kerb - street parking is rarer than a pork pie in Istanbul. Then I took the lift – or should I say ‘elevator’, since we’ve standardized on lingua Hollywood. I normally take the stairs for the exercise but this was my dream, so I took the elevator.

I wasn’t surprised to find the fourth floor hopping at 04:30 on a holiday Sunday – there’s always something happening somewhere, somebody writing about it, and somebody wanting to read about it, even in the silly season. So we’re always here, serving up fresh-baked news to the global village.

It looked like every workstation in the ECO – the editorial coordination office – was filled, and I knew it would be the same one floor down, in the content section where they pull it all together. Or at least where they oversee the process – all the heavy lifting is done by contractors scattered around the world. Karaköy is simply where the puppet-masters sit, jerking the threads, 24–7–365.

As I walked through the ECO I laid a hand on Nerisha’s shoulder. She was the editorial coordinator on duty for the health section that night, talking into her headset as usual. She gave me a big smile and I gestured not to interrupt her call. Then past the row of editors’ offices, including my own, and into the executive editor’s suite. His assistant’s desk was empty but Jim saw me through the open door and came out to give me a hug.

‘Gip - glad you’re here. Sorry about the time. Come take a load off.’

His office looked like a boardroom. No desk, just a table running down the middle and a huge plasma screen taking up the whole wall next to the door. At that moment the screen was showing half a dozen cable news channels and a bunch of online news services, including our own. The end wall and the wall to my left were made of glass, giving his office one of the most impressive – and expensive – views in the world.

Without asking, Jim poured Turkish coffee into a tiny cup and handed it to me and then slid a plate of pastries within grasping distance. Since the usual rules don’t apply in the virtual reality of dream-world, I grasped.

Jim’s face suddenly filled with concern. ‘So, how are you feeling, Gipsy girl?’

I cocked an eyebrow at him. ‘Probably a damn site better than you, Jimboy. If I remember correctly you had at least two ambers for every glass of champers that I put away.’

He dropped the fake concern and laughed. ‘Naah, I think that’s two beers for every BOTTLE of champagne you had, Gip. Sheesh, but you can put it away! Your party invitations should come with a government health warning!’

We chuckled, sipped and nibbled, thinking back to the rowdy do. It was good to have a bunch of colleagues over, and I knew Em had made a few new friends. Certainly she was the center of attraction, despite her mangled speech, even if I was the life and soul. I was happy to chew over the gory details, even at this time of night, but I wasn’t surprised when Jim got serious.

‘Gip, like I told you on the phone, Shan’s factory in Chandigarh blew up... was blown up... about an hour ago. Of course they thought it was an industrial accident, but then they heard that two other pharmaceutical plants in Hyderabad were sabotaged at exactly the same moment. Three different companies, a thousand miles apart.’

‘Jesus! And we thought competition in the news business was tough!’

He gave a thin smile, but didn’t play. ‘Thankfully all three factories were closed for the holidays or we’d be talking hundreds of deaths, but they did lose half a dozen cleaning staff and a guard.’

‘Did Shan call you himself?’

‘Yeah, from Shimla. Then I called you.’

‘Does Shan know why they were targeted?’

‘He said there are a few possibilities. Actually he didn’t say very much, except that he thought it would be a good idea if you were there.’

‘Where? In Shimla?’

Jim nodded and smiled as he watched me struggling with my biorhythmically challenged brain.

‘Hey, I like India and all, but... isn’t this a crime story? More than health? Unless you are one of the dead people, of course.’ I also wanted to remind him that TWO editors don’t generally run after breaking news – that’s why we’ve got stringers – but, shit, that would be like reminding the Pope that he’s Catholic.

‘He’s sending his jet for you.’

‘He’s... you’re kidding! Are you kidding?’

‘I never joke about executive jets. He said his plane was already en route from Frankfurt to Delhi, so he diverted it. Should be landing at Ataturk about now.’

‘Jesus! That’s... amazing! Aah... d’you think he’d mind if we stopped off in Paris while I pick up a few clothes – I could use some new threads.’

This time he played. ‘Sure, wherever. Rome, Milan, New York.’ We sat smiling at each other as we lived out this little fantasy. A dream within a dream. My turn to get serious.

‘So... are we getting coverage on this from our stringers? And the competition?’

He reached for the remote lying on the table in front of him. ‘Yeah, I got Nerisha to wake up some guys in Chandigarh and Hyderabad. In the past few minutes they’ve posted some stuff from the cops, fire brigades, eye witnesses.’

As he jabbed at the remote a couple of the windows on the massive monitor expanded. One showed our page on the breaking story, featuring video clips of the bombed factories with firemen rushing about, and stills of Shan and the other CEOs.

‘We’ve also got some comment from pharma in the US. Shock, horror, the usual. The opposition are a bit slow off the mark...’ he pushed another button and his monitor returned to the default collection of opposition electronic newspapers and TV networks. ‘They started reporting it just a few minutes ago, but so far they’re having to credit us.’

This was good. The name of the game is to get the opposition to admit to the world that they are relying on The World Online for their news. Do TWO’s advertising for us. And we have a talent for putting other media in that position. They hate us for it.

‘Then again, Jim, it’s not their owner who’s been bombed. D’you think they’re holding back their own reporters? Professional courtesy?’

He gave a scornful laugh. ‘Yeah, right!’

I slapped my jeans. ‘So... that’s it? I’d better get going.’

‘I guess so. I’ll see you back here in a day or two, I suppose. Unless it gets interesting. You want me to do anything... for Emily?’

‘No worries Jim, I’m sure she’ll be fine. I’ll call her, and she’s got the barbarian and the others to look after her. But of course she loves it when you drop in. If you want to spend the night in the guest room, she’d be very happy.’

‘Sure Gip. You know I’m here for you both.’ He stood to give me another hug, and walked me out.

After a brief stop with Nerisha I was back in the Aston and on my way to Ataturk International, also an easy drive at this time of day. Now that I was fully awake I felt a little regretful. It would’ve been nice to spend a bit more time with Em before disappearing on yet another crusade. I knew she wouldn’t be sleeping, so I called her to tell her what was going on. I told her it felt like a dream, and that I kept expecting to wake up next to her.

‘Happy somnambulations, lover. Bring me something from Shimla.’ Or at least I think that’s what she said. ‘Sure babe. Go back to sleep.’

Then I focused on the next thrilling installment. It didn’t disappoint – a uniformed steward waving a placard with my name on it, valet parking, VIP passport facilities. At 5am! I could get used to this!

If anything, it felt even more like a dream as I settled into one of the sculpted seats on Shan’s black Gulfstream, with the gleaming golden logo of Maurya Pharmaceuticals on its tail. A beautiful girl in a black silk sari with the same emblem embroidered on it offered me spiced tea and asked me to fasten my seat belt.

After we were airborne the pilot (black suit, gold logo on pocket) came back to tell me it would be a five- hour flight to Delhi’s Indira Gandhi Airport. Unfortunately we couldn’t fly direct to Shimla – something about runway length and visa facilities – but there would be a helicopter standing by in Delhi to take me to the Maurya headquarters.

Oh sure. Of course. Warm up the chopper, Jeeves. And while you’re at it, top up my tea, wouldya? Just kidding. Send the babe.

Washington DC, 21:00 Saturday 1 January T+2hrs

Yvonne Delgado felt a fluttering in her chest and goose-bumps on her arms as the cellos poured their rich cream into the auditorium, sprinkled with the sweetness of the violins. The sound flowed thickly and then vanished, as if imagined. Before the audience fully registered the silence they were pummeled by the bass drums. Another in-breath of silence, and a lone soprano began her bitter-sweet story.

Delgado looked over at her husband and daughter. Vernon and Halley were completely engrossed in the familiar story, waiting for the appearance of the lover. That’s what’s important, she thought. Not how far I’ve come, or where I’m going. You. The fact that we have each other. Suddenly the opera seemed contrived and false by comparison. She looked back at the stage and raised her opera glasses to hide her tears.

After a moment she felt a touch on her elbow and heard the whisper. ‘Madam secretary?’

Outside in the hall, when the door to the private box had closed behind her, her personal assistant told her the UN secretary general has asked that she receive the head of the World Health Organization as a matter of extreme urgency.

‘What’s it about, Harry? Did she say?’

‘Only that it relates to the sabotage of some pharmaceutical factories in India a couple of hours ago.’

Delgado knew better than to ask if it could wait. Harry was a fierce watchdog. He would never allow anyone to waste the secretary of state’s time, especially these precious moments with her family.

‘Secretary general Kapur said she would have come herself but she’s currently en route from Karachi to New York. And she says it can’t wait.’

‘Well, I’d better see him then. Is he here?’

‘Any minute, ma’am. The theater manager has made his office available.’ 

‘Thank you Harry. I’ll just tell Vernon and Halley that I’m deserting them.’

Whispered apologies made, and received stoically, secretary Delgado was escorted downstairs and offered refreshments. Five minutes later the director general of the World Health Organization, Dr Jean Folbert, was shown in. Introductions and courtesies were kept short and Folbert came to the point.

‘Madame, we are facing a major crisis and we need your government’s support.’

‘Go ahead, doctor.’

‘Are you aware of the sabotage of three pharmaceutical plants in India?’

‘Yes, I saw something on the news this evening, just before we left for the theater.’

‘Bon. I regret to inform you there was another act of sabotage at the same time. It was at a UN warehouse on the outskirts of Stockholm, where we store drugs and emergency supplies for global disasters and epidemics.’

‘That’s... very bad news. I assume there is a connection?’

‘Oui, madame. The Indian factories were the biggest producers of the active ingredients for antiretroviral medications, and our warehouse contained the world’s largest stockpile of those drugs.’

Delgado stared at the Frenchman for a moment, wondering if she had misheard. ‘Antiretrovirals? For AIDS?’

‘Precisely. Those three factories together manufacture the molecules which are used in the manufacture of more than ninety percent of generic first-line antiretrovirals.’

‘My God! I had no idea... when I heard about the blasts...’

‘No, that information has not yet entered the public domain. And we have prevailed on the Swedish authorities to say nothing of the fire at our warehouse, or what we lost.’

‘But... why?’

‘The factories in India produce many ingredients, not only those for antiretrovirals. It is unlikely anyone will make the connection, for a while at least. But the incendiary device in Stockholm... well, it is obvious the target was ARVs.’

‘And you don’t want the public to know this?’

Folbert stared at the secretary of state for a moment as if gathering his thoughts.

‘Madame, as of today about nine million people depend on antiretrovirals to stay alive. Most of them - about 7.5 million - are using generic first-line medications.’

Delgado had heard the numbers before. The state department controls the US foreign aid program, which in turn donates huge quantities of ARVs to developing nations.

‘I understand this, Dr Folbert. Are you suggesting this sabotage poses an immediate risk to those people?’ She was expecting a reassurance from the UN executive, and was shocked when he did not immediately reply. She took a deep breath. ‘Okay. How bad is it?’

‘Madame, for several years the producers of antiretrovirals have had difficulty keeping up with demand. The rapid rollout of treatment in many low-income countries has given them no opportunity to build up any... safety margin. I would be surprised if the global reserves are sufficient for more than a few weeks. In some countries it could be a matter of days.’

‘How long will it take to restore production?’

Again Delgado’s heart lurched as Folbert hesitated. ‘We can only guess at this stage, madame. As I said before, this is a major crisis...’

‘What are you asking for, Dr Folbert?’

‘Madame, our immediate concern is that the existing reserves of these drugs will... disappear... when word of this gets out.’

Delgado’s hand flew up to her mouth, and she stared at Folbert for a moment. ‘Of course! They will be worth a fortune on the black market if they are no longer freely available.’

Folbert nodded. ‘Yes. We are also concerned about people selling fake medications. Or using these drugs for political leverage.’

‘But Dr Folbert, surely it’s just a matter of time before word gets out?’

‘Oui madame. But we are hoping to secure a significant quantity of the drugs in the high-prevalence countries within the next day or two. With your help.’

Suddenly the penny dropped for Delgado. She sat back in the theater manager’s chair, and looked at Folbert. ‘You’re asking us to store these drugs in our embassies. To... withhold them from host governments.’

Folbert returned her gaze. ‘Embassies are effectively foreign territory, madame. Since the attacks in Kenya and Tanzania in 1998, your embassies have been the best fortified of all foreign missions. Also your government has paid for most of these drugs through your foreign aid program. In my view, this is no more than safeguarding your investment.’

Delgado put her elbows on the theater manager’s desk and massaged her temples while the WHO chief continued.

‘We wouldn’t ask this of you, or any country, if it were not a matter of life or death for... many.’ She looked up. ‘Many? How many, Dr Folbert? What’s the worst-case scenario?’

‘Our concern is that these events could destabilize a number of nations, madame. In some African countries there are more soldiers and policemen living with HIV than without it. The same problem extends across many categories of workers in industry and public service. And there are the unemployed, who are the most vulnerable and unstable group in society. An interruption of the supply of antiretrovirals could be a catalyst for... catastrophe.’

Delgado had not been long in office, and so far she’d managed to tip-toe along the knife edge of history. But she saw immediately that the new administration’s mantra of ‘incremental progress in every domain’ simply didn’t fit this situation. This was all or nothing – back away, or take a giant and dangerous leap into the unknown. Either decision could change the world, and America’s place in it.

She sighed. ‘How do you suggest we proceed, Dr Folbert?’

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