The past few years have been a roller coaster for Big Pharma’s public image. In the 2010s, revelations about Purdue Pharma’s culpability in the opioid epidemic brought scrutiny to medication manufacturers. But in 2021, the names Pfizer, Moderna, and Johnson & Johnson became synonymous with lifesaving vaccines almost overnight. The COVID-19 pandemic catapulted these companies to household-name status and gave them the veneer of being forces for social good.

In his new book, Pharmonomics: How Big Pharma Destroys Global Health, investigative journalist Nick Dearden explores how the pharmaceutical industry wields monopolies and patents to make mountainous profits at the expense of global access to crucial medicines. Pharmanomics demonstrates how, from the HIV/AIDS epidemic to COVID-19, Big Pharma has parasitized public health systems in the Global North and systematically denied vital medications to countries in the Global South. Cal Turner and Sara Van Horn spoke with Dearden for Jacobin about how Big Pharma has manipulated global health crises for profit, how the innovative capacities of public health and medical research are undermined by industry interests, and what a fairer, safer system of medicine production might look like.