The Constant Gardener

Author: John le Carre

Genre: Fiction

Pharmaceutical MNCs have always been mired in controversy. On the one hand, they have given humanity so many life saving drugs. On the other hand, there are equal number of allegations of illegally launching flawed medicines, paying off doctors, corrupting government officials, silencing critics, pricing exhorbitantly and so on. 

Many moons ago, when I was just starting my career in pharmaceuticals, a knowing friend suggested I read The Constant Gardener, a heart-breaking story chronicling the unbridled greed of big pharma. Apparently, the book is loosely inspired by a real life case in Africa where a lot of kids died, exposed to the trial of an anti-bacterial drug Trovafloxacin. Washington Post newspaper uncovered that the trials were illegal and the drug company, one of the largest in the world, had to settle law suits to the tune of US$75m, and withdraw the drug.

The author, John le Carre, is an ace story teller (Times list of 50 greatest British writers) with 26 novels to his credit. Former agent at MI6 (British Secret Service, of James Bond fame), his novels are generally spying thrillers. [He created the fictional spy character George Smiley, as popular – at least in Britain – as James Bond]. 

The Constant Gardener starts with the brutal rape and murder of young and beautiful Tessa. Her husband Justin (the mild mannered protagonist) flies around the world trying to piece together what went wrong. After a long chase, he understands that Tessa had just uncovered a massive scandal involving a large pharmaceutical company which was testing a new tuberculosis drug. The drug had severe side effects which everyone – pharma company, corrupt politicians, bureaucrats – knew but were trying to cover up. 

In the end, Justin meets the same fate but only after he has sent the entire evidence to his lawyer. The story takes different shades – investigative journalism, love & loyalty, a crash course in African politics and even a statement on British diplomacy.

The book was adapted to a movie of the same name, which was nominated for 4 Oscars.

So is the greed and subterfuge true? Big pharma is often vilified about trying to bring hugely profitable, even if sometimes dangerous, drugs to the market by suppressing data on the drug’s side-effects. The book has many excerpts highlighting such malpractices. For example, “Lorbeer… describes buying health officials, fast tracking clinical trials, purchasing drug registrations… and feeding every bureaucratic hand in the food chain.” Or showing how doctors were corrupted through “education trips” to Thailand where “recreation was provided for those who wanted it, also attractive partners… All they had to remember was how to write their prescriptions and learned articles.”

John himself says that “by comparison with the reality, my story was as tame as a holiday postcard”. He says, “I drew on several cases… where highly qualified medical researchers have dared to disagree with their pharmaceutical paymasters and suffered vilification and persecution for their pains.” We may agree or disagree with him but he believed in his cause and even donated one of his prize monies (US$100,000) to Medicines San Frontiers (also called Doctors Without Borders), a Nobel peace prize winning international aid organization. The Constant Gardener is a thick book, almost 600 pages. Not a casual reading. The plot veers at places and could have been trimmed by a couple of hundred pages. The “revelation” of big pharma involvement is rather obvious from start, so there is little suspense left. Some of the characters are too strait jacketed, like Gloria, Sandy’s wife. Would have loved to see the complexity that real life characters possess. 

Why You Should Read the Book: A good fiction is a narrative for life. While the plot itself is engaging, there are descriptions of our society which will make us pause and think deeply: the dark side of capitalism, the spread of corruption, the poverty of the third world, the collectively failures in Africa. And then, the story visualizes many deeper conflicts and dilemmas of human lives: temptation and guilt, love and redemption, idealism and realism, partners we live with but never really know. Sandy Woodrow, for instance, has been developed well as a character. Justin’s senior at the embassy, who was enamoured by Tessa and had asked her to elope with him, symbolizes what many of us are guilty of – not evil ourselves, but occasionally succumbing to temptations, then living with the guilt, and ignoring the call of conscience when our career is a stake. 

Goodreads Link: The Constant Gardener by John le Carré | Goodreads