Pharmageddon Chapter 6

New York 15:00 Monday 3 January T+44hrs

‘I’m sure you have all seen these figures before.’ Ibrahim Mazzer looked around the darkened auditorium, which held more than a hundred people including executives from a dozen pharmaceutical companies, diplomats and bureaucrats from at least thirty countries, and representatives from half a dozen UN agencies and at least twice as many international NGOs and donor agencies. Behind him secretary general Maryam Kapur and World Health Organization director general Jean Folbert occupied the top table.

He turned back to the screen. ‘This slide shows the HIV prevalence in each of nineteen regions around the world, together with the number of people who are infected.’ He pointed a laser device at the screen and a bright red dot moved across the map.

‘You can see how much worse the situation is in sub-Saharan Africa than anywhere else. Nearly three quarters of the people living with HIV are located in this region, and almost 30 percent of the world total are in the five southernmost countries of Africa.’ He nodded to the projectionist, and a different set of bar-graphs appeared over the same map.

‘These graphs show the current distribution of antiretroviral drugs in each region, broken down into generics and originator drugs. As you can see consumption of ARVs is proportionately lower in sub-Saharan Africa. Seventy three percent of those living with HIV are in this region, but they consume 67 percent of the ARVs. However this ratio is considerably better than it was just a few years ago.’

Mazzer hesitated a moment, wondering whether he should elaborate on the huge advances made toward the goal of universal treatment, but decided to stick to his notes.

‘What is more striking, perhaps, is the difference in the type of drugs consumed in rich and poor nations. As you can see, about 95 percent of the ARVs used in developing and transitional countries are generics, while in developed countries – principally north America and western Europe – more than two thirds of the drugs consumed are from the originators. So-called big pharma.’ He nodded again at the projectionist.

‘This slide shows ARV consumption divided into first-line and later-generation medications. As you can see the developing world still overwhelmingly uses first-line drugs, while in high-income countries more than half of all AIDS patients are now using second-line or later regimens. This is because patients in developed countries have typically been taking ARVs for much longer than those in the rest of the world, so more of them have developed resistance to their initial combinations.’

Mazzer looked around again to see if there were any questions. He was half expecting someone to raise the myth that originator and second-line drugs were somehow ‘better’ than generics or first-line, and were thus reserved for richer nations, or to point out that many patients in Africa never got the chance to advance to later-generation meds, but simply died when their first-line therapy stopped working. However there were no hands or voices raised so he nodded at the projectionist and the lights came up.

‘Our understanding is that nearly all of the active pharmaceutical ingredient for first-line generics comes from India... or at least they did until Saturday night. The drugs destroyed in our warehouse in Stockholm were mainly first-line generic medications, destined for Africa, south-east Asia and eastern Europe. Most of Latin America and the Caribbean is now supplied by Brazil, who also get most of their active ingredient from India.’

Mazzer saw a hand raised in the middle of the audience. It was the British deputy minister for international development, Evan Jones. ‘Ibrahim, forgive me if I’m jumping the gun, but I understand the terrorists haven’t touched the originators, or the many pharmaceutical factories around the world that formulate the finished medications. Surely it’s possible for them to... take up the slack?’

‘Thank you Evan. Before we ask the pharmaceutical industry to respond directly to your question, I want to give you some idea of the scale of the... slack... to which you refer. Nearly all first-line ARV dosage forms today are fixed-dose combinations, three active ingredients formulated into one dosage form – usually a tablet or capsule – taken once a day. About nine million people are taking ARVs, and about 7.5 million are on this kind of pill. That’s nearly three billion doses a year, or more than two hundred million doses each month.

‘The pills are usually packaged in thirties, or a month’s supply, which means 7.6 million packs are dispensed each month. A single package of drugs is about 200 cubic centimeters, or 5,000 packs to a cubic meter. So the consumption in sub-Saharan Africa alone is equivalent to 1,200 cubic meters – or 37 standard shipping containers. Every month.’

There was a silence in the auditorium. Mazzer continued.

‘As you’ve pointed out, Evan, a considerable portion of the global production capacity is unaffected by Saturday’s sabotage. But our initial estimate is that nine-tenths of the global production of active ingredient for first line ARVs was destroyed on Saturday night. So the question we are asking today is... can the companies who make the other ten percent increase their production ten-fold? In a month?’

‘In a month!’ Mazzer’s last words triggered a chorus of disbelief from the audience.

‘Yes, if we are to maintain first-line ARV regimens we have to ensure an unbroken supply to patients. I’m sure you’re all aware that, if their treatment is interrupted, we need to abandon first-line therapies and switch to second-line drugs. This morning we polled a number of manufacturers and we believe the undelivered reserve of first-line drugs is sufficient for about one month. This reserve is made up of stock which is ready for shipping, or already in transit, along with finished drugs that can still be produced until the producers run out of active ingredient.

‘The other significant reserve is made up of drugs which are already in pharmacies and dispensaries around the world – especially in public hospitals in sub-Saharan Africa. But as you know from media reports, some of those ARVs have been... removed from the supply pipeline... and we are concerned this trend may spread to other countries. We believe it would be prudent to ignore in-country reserves in our planning.’

Mazzer drew a deep breath. ‘In some countries, patients who were due to renew their prescriptions today... went home empty-handed. In other words, their treatment has already been interrupted. With each passing day the number of patients whose treatment is interrupted will grow. In a month, everyone who depends on those hospitals and clinics will be without ARVs. As you know, there is no practical way to test hundreds of thousands of people for drug resistance, so once we reach that stage we must assume that none of those patients will respond again to first-line medications, and they will all need second-line drugs.’

‘Dr Mazzer – I don’t think that’s possible.’ A graying man in the front row, whom everybody recognized as the chief executive of one of the largest pharmaceutical companies in the world, was shaking his head slowly.

‘Please continue, Mr Hohner.’

‘Well, doctor, as you’ve just pointed out, the quantities of first-line drugs now being manufactured and distributed, particularly to Africa, are simply... enormous. And second-line ARVs – protease inhibitor based drugs – are much more expensive, and complex to administer. And we still need vast quantities of NRTIs to formulate those medications...’

‘I’m sorry, NRTIs?’

Hohner swiveled in his seat to see his questioner. It was a woman two rows back. ‘Yes, both first- and second-line ARVs are formulated with a base of NRTIs. Nucleoside reverse transcription inhibitors. First-line medications combine these with non-NRTIs, while second-line drugs combine them with a protease inhibitor. Our colleagues in India were making almost all of the NRTIs consumed around the world – even by our own company. It isn’t... it hasn’t been economically viable for us to make our own.’

‘What are you saying?’ The woman looked horrified. ‘Are you saying that you also relied on those factories in India?’

Hohner didn’t answer, but turned back to face Mazzer, looking as though he wished he were somewhere else. 

‘Mr Hohner?’

‘Yes, I’m afraid so. It’s common practice to subcontract certain components. Of course we test every batch for quality, so we can guarantee the quality of our medications. But I’m... I’m not sure we can even maintain our existing levels of production in the next couple of weeks, let alone increase supply. Of either first- or second-line medications.’

A quick poll of the audience confirmed the same was true of other pharmaceutical companies, all of whom had been buying active ingredients for at least one component of their first-line regimens from India. Further discussion produced a consensus that it would take at least two weeks for them to spool up their API production to meet this shortfall, but increasing production ten-fold would be impossible.

Maryam Kapur sensed that the meeting was losing direction, and took charge. ‘So, ladies and gentlemen, are we agreed there is no way to avoid an interruption in the supply of first-line ARVs?’

‘No, I think we must qualify that...’ The voice came from Brazil’s ambassador to the UN. 

‘Excellency Da Costa?’

‘Thank you madam secretary general. As I understand it, most of the countries where ARVs have been seized – where they are no longer being dispensed to the general public – are among the largest consumers of these drugs. It seems likely that any further deliveries of these medications to them will be... diverted. In other words, continued supply to those countries will not help those whose treatment has been interrupted.’

Kapur spoke over a rising murmur from the audience. ‘What are you suggesting, excellency?’

‘Madam, I am questioning the wisdom of continuing deliveries of ARVs to those countries until they have restored universal treatment...’

‘You are advocating genocide!’ The ambassador from South Africa had risen to his feet. He was trembling with rage. ‘I will not sit here and listen to this!’

‘I agree, madam secretary general, this is unthinkable.’ The Nigerian ambassador had also risen. ‘We are not lambs to be led to the slaughter!’

Kapur was also on her feet. By now there were five angry African ambassadors, all shouting their indignation. The secretary general fixed them with a stony gaze, but said nothing until they resumed their seats, glaring around them. Then she spoke. ‘Nobody is cutting off Africa, and I cannot believe his excellency Da Costa meant that we should. Mr Da Costa, would you care to clarify your statement?’

Da Costa looked shaken by the reaction to his comment. ‘Madam, I am certainly not proposing that we withhold drugs from African patients. On the contrary. My point was simply that if any government is unable to deliver ARVs to the people who need them, for... logistical reasons, then it would be pointless to deliver fresh stocks to them, until they have overcome those problems. In the meanwhile the drugs should be delivered to countries that can use them. In this way fewer countries will face treatment-interruptions, or need to abandon first-line treatment.’

Half a dozen hands shot up in the audience.

Kapur deferred to the South African ambassador. ‘Excellency Gumede?’

‘Thank you, madam secretary general. The South African police have secured ARVs in our public hospitals as a preventative measure, to keep them out of the clutches of gangsters. There is no truth whatsoever to the claim that patients are being turned away from hospitals empty-handed.’

The secretary general kept her voice even. ‘Thank you, excellency. That is very good news. I’m sure we all agree that our task is to use all the available drugs to treat as many patients as possible, for as long as possible. The key problem, as I see it, is that we do not know how big the national reserves are, so we are unable to calculate the date by which fresh supplies of ARVs must be available.’

There was a murmur of agreement from the audience. Kapur continued.

‘What if we were to agree that all ambassadors will supply UNAIDS with an estimate of their national reserves of ARVs within 24 hours so that we can ensure an equitable distribution of the undelivered reserve? These estimates must be verifiable, of course...’

‘No, no, no!’ Once again the South African ambassador was on his feet. ‘Madam, that is unacceptable. We demand that supplies continue as before, until there are no more ARVs in the pipeline.’ The other African ambassadors were nodding. ‘How we use those drugs is an internal matter. We are a sovereign nation – we cannot be expected to account for ourselves like schoolchildren.’

The ambassador for Namibia was also on his feet. ‘If this is your demand, madam, then we report that we have no ARVs. We have run out. We need to be re-supplied immediately.’

Once again Kapur stared silently at the handful of ambassadors who were now on their feet, willing them to return to their seats. Unfortunately the tactic did not work this time, and after a few more minutes of heckling the ambassadors walked out of the meeting. As the door closed behind them an uncomfortable silence fell over the rest of the audience. Finally the Thai ambassador raised his hand.

‘Excellency Talent?’

‘Thank you, secretary general. Dr Mazzer had made it very clear that the world is facing a crisis. It is also obvious that this crisis needs central management, and that the United Nations is the appropriate body to play this role. I do not believe it is unreasonable for every nation to provide the UN with an estimation of their reserves of ARVs, both first and second-line, within the next... well, shall we say three days? Any nation which does not supply this information, or which does not submit to UN verification of their reserves, and also that patients in public hospitals are, in fact, being treated, should not be re-supplied.’

Once again there was a murmur of agreement and a nodding of heads.

‘Thank you, excellency. But how do we enforce this? We have no authority over the drugs which are in the pipeline. We have no mandate from the security council in this matter.’

‘Madame, if I may?’ The WHO director general spoke for the first time. 

‘Please go ahead, Dr Folbert.’

‘Most of the generic ARVs in the pipeline have been ordered by the UN, or by a donor nation, for delivery to our central purchasing facility in Stockholm. The normal practice is to allocate those drugs to countries that need them, subject to availability. The question of which country needs the drugs most, and of what constitutes “availability”, is left to us to decide. Of course we have no control over direct sales by pharma to individual governments but... they have discretion over who they sell to.’

Kapur stared at the head of the WHO. ‘What are you suggesting, Dr Folbert?’

‘Madame, I am saying the policy articulated by his excellency the ambassador of Thailand is both practical and enforceable, as long as our colleagues from donor nations and the major pharmaceutical companies agree to go along with it.’

She turned to the audience. ‘May I ask whether the representatives of pharma agree with this proposition?’ They did. As did the ambassadors from the USA, UK and European Union, among other donor nations.

‘SG?’

‘Yes Dr Mazzer?’

‘This decision will certainly help us to allocate the ARVs which are presently in the pipeline, but it offers no guidance as to how to recover our capacity to produce these drugs.’

‘Do you have a proposal?’

‘I do. I believe we will find that nearly every country has at least a month’s reserves of ARVs. Together with the undelivered reserve, this gives us roughly two months before those countries run out of first-line generics. The central question is whether we can restore production of first-line drugs in that time? If the answer is no, then we need to begin work right now to increase production of second-line medications, which will work even if there has been a large scale treatment interruption.’

‘Dr Mazzer, how long do we have in that event? Before patients start dying?’

Mazzer looked surprised. ‘Oh, I think any discussion of mortality is... premature, SG. If nobody is left without medications for a month, or perhaps even two, I believe the death rate will be insignificant – as long as they move on to the next generation of drugs, of course.’

Kapur noticed another hand in the audience. ‘Yes sir. Forgive me but I do not know your name.’

‘Thank you madam secretary general. I’m Paul Stanislav from the Centers for Disease Control. I have a logistical concern about restoring treatment after a general treatment-interruption. When ARVs are made available again, all the patients will turn up for treatment. Simultaneously. Many will be extremely ill by then. Depending on the location and duration of the treatment interruption, we could be talking about millions of people demanding drugs, all at the same time. It’ll be a logistical nightmare – a recipe for disaster.’

‘Do you have a suggestion, Mr Stanislav?’

‘Well ma’am, just that we need to avoid treatment-interruptions at all costs. There’s no question at all in my mind that we must go for broke. We must ensure an uninterrupted supply of first-line ARVs, or die trying. It’s that important.’

The SG noticed both Mazzer and Folbert nodding, along with others in the audience.

‘So how can we ensure an unbroken supply? Especially when small-scale interruptions have already begun in some countries. Anyone?’

Kapur saw another hand in the audience. ‘Yes madam. Again I apologize for not knowing your name.’

‘My name is Nicola Kershaw, ma’am. I’m head of drug procurement for UNAIDS. I’d like to make two points. The first is that we can conserve a lot of first-line ARVs by substituting second-line drugs in those countries which have fully functioning public health systems...’

‘But my dear...’

Kapur was surprised by the interjection from the UNAIDS director. ‘Dr Mazzer?’

‘Forgive me, SG, but Nikki... Dr Kershaw... is suggesting taking thousands of patients off a perfectly effective drug regime. There are significant practical and medical implications...’

‘Dr Kershaw?’

‘Actually ma’am I’m suggesting that patients in high-income, low-prevalence countries like the European Union and the USA should be allowed to volunteer to switch to new-generation drugs. In effect to donate their first-line drugs to low-income countries. I believe that a great many will do so, as a gesture of solidarity to people in less privileged circumstances.’

‘That is a very interesting proposal, Dr Kershaw. You said you wanted to make two points?’

‘Yes, thank you ma’am. The other point is that we haven’t mentioned China as yet. The Chinese produce more active pharmaceutical ingredient than everyone else put together. It’s true there have been problems with quality, and also true that no single Chinese manufacturer can produce the kind of volumes we need. But they are a huge resource, and one which we must exploit.’

‘Another excellent point. Thank you Dr Kershaw. Excellency Weng, can you comment on this?’

The Chinese ambassador looked as though he had been dozing, but he responded immediately, and apparently without opening his eyes. ‘Thank you madam secretary general. As the previous speaker said, the People’s Republic of China has a very large pharmaceutical industry. I have no doubt that we can mobilize them to meet this shortfall in good time.’

The secretary general glanced at Mazzer and Folbert and was surprised to see they were not applauding or even smiling, but simply looking at the Chinese ambassador. A few members of the audience looked like they wanted to break into song, but also picked up on the neutral reaction from the two agency heads. Maryam Kapur was too experienced to put her colleagues on the spot in a meeting like this, so she played for time.

‘That is very encouraging, excellency. I am sure that Dr Mazzer will follow up with you immediately after this meeting. Are there any other potential sources of active pharmaceutical ingredient?’ She looked at Mazzer.

‘There are, SG. And we have a team under Dr Kershaw already canvassing every potential supplier around the world. We have been looking into other possibilities, too, such as the new injectable drug which has been approved by the FDA and is being prepared for commercial production in Iceland.’

Kapur nodded. ‘Ah, yes, I...’ Kapur caught herself before making a reference to the thwarted sabotage, which was not yet public knowledge. ‘Please continue.’

‘Unfortunately this new drug is still many months away from entering the market, and there are factors relating to production and administration which make it unsuitable for large-scale application in the developing world.’

Kapur saw another hand in the audience, and recognized its owner. ‘Yes, Dr Gupta. My sympathies for the setback you suffered in Chandigarh.’

‘Thank you, madam secretary general. We may be down, but we are not out. I believe Professor Stanislav is correct in saying that recovering from a large scale treatment-interruption will pose huge... unprecedented... challenges. But we should take note that those issues relate to our current pill-a-day treatment regimens. The new injectable drug to which Dr Mazzer has just referred could go a long way to overcoming these challenges.’

‘Dr Gupta, forgive me, but I’m not sure I see the relevance. Dr Mazzer said the new drug is still many months away from production...’ The secretary general’s Pakistani accent was noticeably stronger as she addressed her neighbor from India, even though his own voice was made in England.

‘Madam secretary general, this new drug is already approved for use. The delay in commercial production is simply a matter of logistics and technology. With respect, these are matters which we are able to do much faster in India. If the originators licensed us to produce their drug, we could produce sufficient quantities within three months to administer them across Africa. Using a high-pressure aerosol gun, a doctor can inject several hundred people an hour, which is vastly better than trying to restore a pill-a-day regime to several million people.’

‘But Dr Gupta, how would you produce this drug? Your factory has been destroyed.’

‘Ah, I’m sorry madam, I should have explained. It is public knowledge that this new-generation molecule is engineered in an entirely different way to existing ARVs. You... um... grow it, rather than cooking it, so to speak. I have a large bio-pharmaceutics laboratory in Shimla and I would be happy to suspend the experimental work we are doing there and convert it to commercial production.’

There was a palpable sense of excitement in the room. Hohner raised his hand. He didn’t look the least bit excited.

‘Madam, I must sound a note of caution here. As Dr Gupta is aware, my company owns the patent on this injectable. It is important to understand that it has not yet been used outside of clinical trials, and we have not yet perfected the production methodology. It is also very expensive to produce. It was never envisaged for use on a massive scale, or in a low-income setting.’

Kapur turned on him. ‘But Mr Hohner, I’m sure you would agree that nobody envisaged finding themselves in a situation where millions of people are at risk...’

The discussion was obviously not going the way that Hohner wanted it to, so he stalled. ‘I will certainly take this idea to my board, madam, and to my research team, to see whether there is any possibility... but please do not count on this idea to... save the world.’

Within ten minutes the meeting had dispersed, with everyone needing to be somewhere else. Nikki Kershaw left with ambassador Weng, while Shan Gupta and Kurt Hohner went looking for a place to talk in private. Maryam Kapur found herself alone again with her two agency heads.

‘Dr Mazzer – I have the impression we stirred up a few hornets’ nests this afternoon?’ 

He smiled grimly. ‘Yes, SG, they are hornets we know very well.’

‘The Chinese drug companies?’

‘Well, it’s true they have hundreds of plants which produce API, but they have an equal number of problems. A few years back the head of their own regulatory agency – the equivalent of America’s FDA – was executed by the Chinese government for taking bribes and granting licenses illegally. In 2005 they approved more than 11,000 drugs while the FDA approved 80. Some of these Chinese plants flood the global market with counterfeit brand-name drugs, which sometimes have no API in them at all.’

‘Does that mean they cannot make the API we need?’

‘No, I’m sure they can. But they are notorious for variable drug quality. You can test one batch and it’s fine, but the next one turns out to be placebo.’

‘But surely with appropriate oversight...?’

‘Yes, indeed. I know that Nikki will be looking at this.’

‘And what about this new generation drug, in Iceland? Mr Hohner did not look very pleased about Dr Gupta’s offer.’

‘SG, I think that’s the understatement of the year. Hohner would happily kill Gupta with his bare hands, if he could. Maurya have been reverse-engineering his drugs for years, and Gupta made Hohner and his colleagues look like avaricious psychopaths when he sold generic ARVs at cost price. His offer today... well, it’s like a thief asking you to hand over the keys to your vault for safe-keeping.’

‘But is there no chance Dr Gupta can do what he said – produce this new drug in three months? Surely that would give us a valuable safety-net, in case there are treatment interruptions?’

‘Well, it would be a good answer, if it were possible. But...’ Kapur saw Mazzer and Folbert exchange looks. Folbert cleared his throat.

‘Madame, shortly before this meeting I received an update from Iceland. It seems the attempted sabotage was not altogether unsuccessful, after all. The bomb may have failed to detonate, but the saboteurs erased a huge body of technical data on the new drug. It has set back the development process by many months. Even with this data, I doubt that Maurya could have begun commercial production in three months. But without the data, there is no chance. None at all.’

The secretary general took the news in her stride. ‘That’s a pity. What is your view on the proceedings this afternoon, Dr Folbert?’

‘I think it was very productive, madame. The protocol proposed by Da Costa and Talent is extremely useful. It provides a strong incentive to countries to maintain universal treatment, or to restore it before any serious damage is done.’

‘Do you have the capacity to verify which countries are dispensing ARVs?’

‘Mais oui, madame. We have officers in every country, and we’re in touch with medical institutions and NGOs. Verification, at least, is no problem.’

‘And how will you process the drugs which are... in the pipeline?’

‘I believe we should continue as before – send them to Stockholm, where we will arrange for their onward dissemination. With increased security, of course. And we will simply withhold shipments to those countries which do not conform to the new protocol, if there are any.’

The secretary general took a step back so she could face the two men squarely. ‘Gentlemen, if there are any countries that do not – or cannot – restore universal treatment, how do we answer to accusations that we are committing genocide, by withholding drugs?’

Folbert didn’t hesitate. ‘But madame, there is no case to answer. It is their governments who are withholding ARVs, not us. If they resume and maintain treatment, we will replenish their stocks. It is that simple.’

‘Dr Mazzer?’

‘Jean is right, SG. Controlling the supply of the reserve inventory is the only leverage we have to... persuade... those governments to restore universal treatment.’

‘And if our leverage works? If they all restore treatment, what then?’

‘Then, SG, we have two months. After which the fate of Africa is in the hands of the Chinese. And Allah!’

Johannesburg 01:00 Tuesday 4 January T+46hrs

I was still awake when I got a text from my spy at Maryam Kapur’s emergency meeting in New York, outlining what happened. I called her right back.

‘Hey Nik, can you talk?’

‘Hey Gip! Yeah, I’m in a taxi heading back to the office. It’s too cold to walk. Where are you?’

‘In Jo’burg. Where it’s as hot as hell! Listen, thanks for the info from that meeting. I’ve already posted most of it, and also passed it on to Bettina.’

‘I hoped you would. Who knows what her bosses tell her?’

Nikki Kershaw and I had been good mates since we attended medical school together in London, back in the nineties. Although our careers took us in different directions, we stayed in touch and made a point of attending the same medical conferences – particularly when they were held in interesting cities. And while we danced the conference-shuffle during the day, I’m sorry to say our evenings often descended into somewhat questionable behavior. One of our regular partners-in-crime at these conferences was Dr Bettina Shabangu, who had recently been appointed director general in South Africa’s department of health.

‘Yeah, I’m going to see her tomorrow. So tell me, Nik, are the Chinese going to save the day?’

‘Time will tell. We’ll place a huge order for API – and then test the shit out of every molecule they send us.’

‘First- or second-line?’

‘Both, babe. We’re going to order enough to go either way, or both ways.’

‘That sounds familiar!’

Nikki had a wonderful laugh. I was sorry we didn’t have a video link. ‘Wash your mouth out with soap! That was a long time ago.’

‘So tell me about my boss.’

‘Oh yeah, that was fun, Gip. He tried to get Kurt Hohner to hand over the recipe for his new generation ARV. Said he could make it in his research lab in Shimla. Kurt was not amused...’

‘Could it work? I mean, you should see his headquarters – it’s like something out of a James Bond flick. I didn’t see any laboratories, but then I didn’t stay long.’

‘Not a chance. It was a clever offer, but there’s something your boss doesn’t know...’ 

‘I’m all ears!’

‘Okay, hang on a sec.’ I heard her telling the taxi driver to ride around the block, then she came back on the phone, speaking in a low voice. ‘There was a bomb at Vikmed. Kurt Hohner’s laboratory in Reykjavik. But it didn’t go off.’

‘Jesus! Are you serious?’ I found myself speaking softly too.

‘Deadly. Should have been triggered by a phone call at the same time as the other bombs, but the local network was down.’

‘Fuuuuck! This is hot! Did they catch whoever planted the bomb?’

‘Dunno, girl. You may have to do some work yourself.’

I blew a wonderful raspberry, speckling my computer monitor with spit.

‘You always could do great tricks with that tongue of yours, Gip!’

‘Thank you, Nik. You’re still doing good work with yours. So – how does a non-exploding bomb affect Shan’s offer to Kurt Hohner?’

‘Oh, it doesn’t. But whoever planted it also managed to destroy all their research data. It’s set them back by yonks.’

‘Holy crap! So... without this data, there’s no chance of anyone making this drug anytime soon?’ 

‘That’s right. Listen, I’ve got to go. But you be careful out there. It could get a little weird.’ 

‘Weird? In South Africa? Surely not!’

I took her laugh to bed with me, but not before I’d blown the lid off the Vikmed story.

+++

Getting into bed was easy but getting to sleep wasn’t, which was unusual for me, so I let my thoughts go where they wanted, which turned out to be my first day at The World Online – barely two weeks after that first meeting between Jim’s ‘dream team’ and Shan Gupta.

I’d spent some of that time sitting in my solicitor’s – sorry, my attorney’s – office as she paged through Shan’s offer, shook her head and muttered things like ‘some people have all the luck’. And of course I spent a difficult half-hour in my boss’s office at The Economist explaining that all good things come to an end, and asking if I could take my accumulated leave in lieu of notice. I also spent quite a bit of time with Emily. No dice without her. Fortunately she was incredibly supportive, as usual. My rock.

When I finally walked into the TWO building as a fully-fledged employee I was amazed at the transformation. The name was up on automatic glass doors. A uniformed concierge handed me a visitor’s pass. The fourth floor was carpeted, partitioned, furnished. No decorations yet, nobody sitting at the reception desk – I just walked into Jim’s office. Classy but functional, with that huge wall monitor at one end and picture windows down two sides.

‘Gipsy girl!’ he said, coming out from behind the table with a huge smile and giving me a hug. ‘Welcome to your new home! Well... your virtual home, I guess. What can I get you?

As we sat drinking Turkish coffee, Jim showed me some of his new toys. He picked up a remote, pressed a button and some magic happened to the windows, dimming the bright morning outside without obliterating it altogether. Which made it much easier to see the finer detail on the huge multi-function monitor.

‘We’ll also use this setup for our news conferences – you’ll get the same software on your laptops, so we can see each other. You’ll be able to connect through LAN cables, WiFi, cellular or satellite – whatever’s available – so you’ll never be away from the office. Best that money can buy, I’m told.’

‘Beats the shit out of anything I’ve seen before. And I thought we were just starting out.’

Jim laughed. ‘Well, yeah, Shan has had a bunch of guys working on the technology, design and so on. All I had to do was tell them what I wanted. But there’s more good stuff to see... finished your coffee?’

The next room was a large open-plan office, furnished with a dozen or so computer workstations. ‘This is our ECO – editorial coordination office. When you want to know anything about anything you’ll speak to your editorial coordinator, who’ll be sitting here. You’ll have one on duty at all times. They’ll work only for you, and they’ll delegate research, monitor inputs from stringers and so on. Free you up to be wherever you need to be.’

‘Why here, Jim? Couldn’t we locate our coordinators anywhere?’

‘Yeah, we could. But they are also my point of contact with your beat. I can talk to them, they can talk to each other, so we all know what’s going on at any time. Our HR consultants have a short list of people for you to interview, but you can have anyone you want. And they’re assembling a global database of hot-shot researchers.’

‘Impressive.’ It really was. ‘Next you’ll tell me that these guys can whisper in my ear while I’m conducting interviews.’

Jim looked at me, deadpan. Then I caught the twinkle. ‘We’ve already ordered headsets which work with cellular or satellite technology, just like your laptops, handhelds and mini-cams. They are pretty much invisible when worn...’

We moved on, and passed a string of smaller offices, all unfurnished. ‘Your office is down here Gip,’ we paused outside a glass door with my name embedded somehow in a solid chunk of glass: Dr Gipsy North. Health Editor.

Jim opened the door. ‘We have a decorator – just tell him what you want. Unless you have the time to do it yourself.’ Jim knew I didn’t, so he didn’t wait for an answer. ‘Look, it isn’t a huge office Gip but, frankly, I don’t expect you to be here much. It’s really so you have somewhere to hang your pictures, make phone calls while you’re in town...’ he looked at me closely. ‘Unless you want to be based here?’

‘Well, actually Emily is quite open to the idea. But... you know, it takes time to sort things out. You hinted that I don’t need to relocate right away...?’

‘Sure, take your time. It’s just that you may have more time to get Em settled now, rather than later when it gets... busy.’

We went down a flight of stairs and found a huge open plan area, occupying the entire third floor and dotted with what looked like a hundred workstations. ‘This is the content office, where copy is assessed and referred for editing and translation. Then it comes back to the page-makeup department which takes up the second floor. It’s all controlled by the duty content manager who will be over there,’ he pointed to a glass door at the far end of the room.

‘What’s on the other floors?’

‘Computer servers and communications equipment on the first floor and generators in the basement. Our primary servers will be in at least five other locations around the world, to reduce intercontinental traffic and manage risk.’

‘Risk?’

‘Sure, power failures, hardware failures. And maybe political risk – there will always be someone who doesn’t like what we’re saying.’

‘What about languages? You said translation...’

‘Yeah. We’ll carry news in the language it’s sent to us. Of course automatic translation means it can be read in pretty much any language, but high-grade news will be translated into a panel of languages, and we’ll have dedicated portals for each one. Within a month or two we should be up to ten...’ he closed his eyes and stabbed at the air, like he was pointing at countries on a map of the world. ‘Spanish, English, Portuguese, French, German, Russian, Arabic, Hindi, standard Chinese and Japanese. We may consider other portals later, such as Indonesian, depending on demand. I’d also like to get into some African languages. Translation should take about fifteen minutes for the average story.’

‘Holy crap, Jim – how many people are you hiring?’

‘Altogether? We’ll probably be up to six hundred or so by the end of the year. But that’s not counting contractors – we’ll keep a few thousand people busy at any given time. As for stringers – well, the sky’s the limit.’

‘Jesus – I know that Shan is rolling in cash, but... we’re going to need it!’ 

Jim chuckled. ‘What did I tell you Gip? Blank check.’

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