B (3:13)

So it's the Largest healthcare products conglomerate in the world. It's $89 billion in revenue. It's a part of the Dow Jones industrial average. It is one of only two corporations on the planet that has a AAA credit rating. Not even the United States government now has a AAA credit rating. So it is an American icon. I think in American terms, there are two companies that are most important to the American health care system. One is United Healthcare Group, which is by far the largest health insurer. And the other is Johnson and Johnson. And the reason why I wanted to do the book about Johnson and Johnson is that there are all these books about the opioid crisis, and everyone thinks that it was Purdue Pharma and the Sackler who were sort of solely responsible for the opioid crisis. That is not true. And again, it is a sign of just how extraordinary Johnson and Johnson is at its own public relations and its ability to stay out of the firing line from its own behavior that nobody knows that Johnson Johnson was arguably much more important to the opioid crisis than Purdue Pharma and the Sacklers.

A (4:39)

I definitely want us to talk more about that in just a bit, but let's maybe start with Johnson's baby powder. I think this is probably the story that people feel most familiar with, but frankly, I don't think very many people continue to follow it or even kind of know where it landed. What are the major pieces of the story that people should know about baby powder?

B (4:59)

So Johnson and Johnson started selling baby powder in the 1800s. In the late 1800s, the first product that Johnson and Johnson sold were these kind of bandages that could cause skin irritation. So they started including, with certain ones of these bandages, these little tins of talc. Talc is the smoothest mineral there is. And people started asking just for talc refills. And Johnson and Johnson said, well, let's start just selling baby powder. The problem is that talc and asbestos are basically the same thing. They are absolutely have the same chemical constituents, and it just is a little bit of difference in time and pressure depending upon whether something turns into talc or something turns into asbestos. But the two are inextricably linked. So asbestos deposits always have talc in them, and talc deposits always have asbestos in them. You cannot separate these two things completely. And let's just back up Shamita and talk about asbestos. By the middle of the 20th century, there wasn't a car, a boat, a house, a train that didn't have asbestos in it. But Beginning in the 1950s, researchers started learning that even Tiny microscopic amounts of asbestos could lead to cancer. So as the 1960s progress, as researchers start issuing these more and more alarmist warnings about we need to get asbestos out of our lives, because there's a certain kind of cancer that only asbestos causes. It's called mesothelioma, and it's a cancer of the lining of the lung. And mesothelioma rates were soaring. So basically, the United States and the rest of the Western world starts in edging asbestos out of our lives in the 1960s and the 1970s.

A (7:15)

Around this time, the FDA started to consider testing requirements for talc based products like Johnson's baby powder. But the industry, led by jj, pushed back hard and eventually put forward their own testing standards that they said they would implement internally. And the FDA dropped the issue.

B (7:33)

The problem is that as you move through the 1970s and as the rest of the world basically gets very good at getting rid of asbestos, Johnson's baby powder becomes this outlier. And once you get into the 1980s, Johnson and Johnson then knows that they actually have not solved the problem. They have hundreds of subsequent tests that show asbestos and still is in Johnson's baby powder, but they keep those tests secret.

A (8:06)

A major turning point came in 2009 when a woman with mesothelioma sued a talc mining company associated with Johnson Johnson. In response, the company falsely claimed that they had no documentation showing any level of asbestos in their laboratories, mines, or talc. But in this particular case, the plaintiff knew these documents existed because her father had worked in the mining company's lab.

B (8:31)

And she says, actually, my father worked in that lab. He knew that there was asbestos. He also knew that you took all of his documents and all of his lab notes and sent them off to. You know, I like to think of it as the warehouse at the end of the first Indiana Jones movie. And you've been lying about this forever.

A (8:55)

This case ultimately ended in a nearly $75 million settlement, but it led to subsequent lawsuits against JJ that uncovered more and more of this incriminating evidence.

B (9:06)

These documents then for the first time, become public. And a reporter for Reuters does this extraordinary story showing that Johnson Johnson has known for more than a century, essentially, that Johnson's baby powder has been contaminated with asbestos. Fda, which had been asleep at the switch for all this time, suddenly wakes up and says, wait, what? And FDA does its own test in 2019 of Johnson's baby powder, not surprisingly, finds asbestos. And they then give Johnson and Johnson four days to come clean. While, of course, people are still using Johnson's baby powder.

A (9:55)

Even after all of this, Johnson and Johnson stood by its product. They said the FDA's tests were wrong. But by 2020, JJ had been ordered to pay out billions of dollars in lost legal battles over claims that its talc based products caused cancer, including an order by a St. Louis jury to pay more than $4 billion to 22 women with ovarian cancer. And that same year, JJ announced that it would stop selling talc based baby powder in the United States and Canada. But notably, the company said this stoppage was not because of asbestos. It was because of slowing demand, fueled by misinformation around the safety of the product. The company finally stopped selling talc based baby powder globally in 2023. They continue to sell a cornstarch version of the product today. Gardner says the scale of the harm done is difficult to know.

B (10:49)

The best epidemiology suggests that something like 15% of women with ovarian cancer in the United States got it from talc based powders. And the biggest seller of those talc based powders was Johnson and Johnson's baby powder. And so there's probably on the order of around 100,000 women died from ovarian cancer alone because of Johnson's baby powder. I think they did that analysis over the last 50 years. So it's likely twice that over the course of the history of Johnson's baby powder.

A (11:32)

Right now, tens of thousands of people are suing Johnson Johnson, claiming that its talc based products caused cancer. And over the past few years, Johnson Johnson has attempted to use a rare bankruptcy maneuver to resolve those claims.

B (11:46)

Johnson Johnson put its liabilities into this small little company now called Red river and declared that company bankrupt, even though Johnson and Johnson itself, of course, is highly profitable and continues to make billions upon billions of dollars in profits.

A (12:05)

But just this past week, a judge denied the company's proposal, making it the third time the company's bankruptcy trust had been shot down in court. In a statement, Johnson and Johnson said that rather than appeal, it would return to the civil justice system to, quote, litigate and defeat these meritless talc claims. Let's turn now to talk about Johnson and Johnson's role in the opioid epidemic in this country. You've mentioned already that Purdue is the name that most people are familiar with now and associate with the opioid epidemic. How do you see Johnson and Johnson in terms of placement within the. Within the epidemic story?

B (12:46)

So the extraordinary thing about the opioid story is the exclusive focus on Purdue pharma and the sacklers Certainly they were bad, and they played a major role in the opioid crisis, but they were far from alone. In fact, during the height of the prescription opioid crisis, about 10 to 20% of the bodies that showed up in morgues had a Purdue Pharma product in their system. Roughly 60% had a Johnson and Johnson product in their system. So this is a company that played, if not the major role in the opioid crisis, one that was equally bad with Purdue Pharma and the Sacklers. And they did that two ways. One way was that they, through this subsidiary, actually on the Tasmanian island in Australia, they produced most of the natural opioid ingredients used for all opioids in the United States, including Purdue Pharma's OxyContin. OxyContin could never have become as popular or been as widely used without Purdue's partnership with Johnson and Johnson. Johnson and Johnson supplied all of their opioid ingredients. In addition to that, Johnson and Johnson actually is the original creator of fentanyl, which, as you know, is a synthetic, fully synthetic opioid. And Johnson and Johnson, in 1992, start selling a patch, a fentanyl patch that they call Duragesic. And it delivered fentanyl into your system over the course of three days. And originally, the patch, when FDA approved it, was intended exclusively in the immediate aftermath of surgery in which you might have intensive pain or for cancer patients who were dying. Purdue then comes along, four years later, starts selling oxycontin, and demonstrates that you can make huge amounts of money if you start selling to people with just modest and moderate pain, like back pain. And Johnson and Johnson quickly realizes, oh, my God, this is amazing, and pivots towards selling Duragesic to this same set of patients. And in fact, what then happens, as you know, Shamita, is that my former colleague Barry Meyer of the New York Times in 2001 writes a famous story about Purdue Pharma and the Sacklers that lays out the entire opioid crisis, about how addictive OxyContin was, about the role of the FDA in this crisis and about the role of payments to doctors that has led to this explosion in prescriptions of opioids writ large. And so from that Moment on, from 2001 on, OxyContin prescriptions really don't grow. They flatline, because people understand from that moment on just how dangerous it is. But the opioid crisis continues to barrel forward, and that's because Johnson Johnson is doing the exact same thing as Purdue Pharma. And in fact, it's now selling its Duragesic patch, this Fentanyl patch, by telling doctors that it's non addictive. Okay, it's hard to even conceive of this now that anyone could possibly claim that fentanyl is non addictive. But that's what Johnson and Johnson did for years and years and years. So of course, death soared. But Johnson and Johnson didn't just stick with Duragesic. It started launching its own branded opioids, just like oxycontin, these long acting opioids that everyone knew at the time were easily abused. So it really was an expression of Johnson and Johnson's heart and soul, which is, despite the clear proof before them of the huge number of deaths, the huge number of injuries, just rushed in because they saw Purdue Pharma's PR problems as an advantage for them.

A (17:21)

So tell me, I mean, you've mentioned the FDA a few times now, but I mean, where was the FDA in all of this? Right? They approved Duragesic, they approved OxyContin. But what is the role of the FDA in drug approval processes like these? And what were their real failures at this time?

B (17:42)

So the FDA has an entire unit of police officers. These are sworn officers with guns who investigate crimes. But in 1992, the FDA took a fateful step, and that is that at that point, Congress had limited the FDA budget to the point where FDA's approvals of new drugs were taking as long as two years. So there was something called the drug lag. And these new drugs were coming out in Europe before the United States, which was causing FDA all kinds of political problems. And Republicans in Congress were starting to say we should get private contractors to do these approvals because FDA can't get it done. So FDA in 1992 struck a deal with drug makers in which drug makers basically started paying the FDA for its reviews. And at this point, the vast majority of FDA's budget is paid for through these industry fees. And as payback, basically, FDA put its criminal investigators in a lockbox and wouldn't let them out. And so FDA from 1992 onward basically never launches another criminal investigation of drug makers ever again. Basically, they leave the policing of the industry alone. And even though the FDA knows exactly what's going on, because they still have people looking at the marketing materials of many of these companies and realizing that that many of these marketing materials are completely misleading and are frank lies. And they often send warning letters to Johnson and Johnson like you're saying things that are not true. But they never let their own police Officers out. And so this is the story of the opioid crisis, which is that the FDA basically let it happen on its watch. And the opioid crisis, balloo. Companies like Johnson and Johnson and Purdue Pharma sold opioids as safe and non addictive when they knew that that was not true. And the FDA did nothing about it because by then the FDA had been bought and paid for.

A (20:14)

And what type of repercussions have there been to this point for Johnson Johnson for its role in the opioid crisis?

B (20:22)

So Johnson and Johnson has agreed to a settlement. The opioid litigation continues on. There's been an enormous back and forth between cities, counties and others in trying to put together a sort of global settlement amongst Purdue Pharma, which of course, as you know, has declared bankruptcy. Mallinckrodt, another maker of opioids, and Johnson Johnson. So that litigation continues. But of course Johnson Johnson was never prosecuted criminally. Its executives were never prosecuted criminally. The state of Oklahoma sued Johnson and Johnson to try to get some money back. And that's where many of the documents showing Johnson and Johnson's behavior during the opioid crisis became public. But there's been very little accountability for Johnson and Johnson's role in the opioid crisis.

A (21:19)

Wow. Let's turn now to the COVID vaccine. I'm sure that people listening remember when the JJ vaccine was introduced. Again, this is one of those stories. Similarly with baby po, maybe a lot of people don't quite know where things landed up with the vaccine. In June of 2023, the FDA revoked its authorization for the JJ vaccine entirely after investigating cases of severe blood clots. What exactly happened with JJ's vaccine? What led to its authorization being revoked?

B (21:54)

So the COVID vaccine project for JJ was really this shot at redemption for the corporation by then. When Covid swept the world in late 2019 and early 2020, Johnson Johnson at that point was really starting to come under pressure. The FDA had just recently announced that asbestos was in baby powder. The company's metal on metal hip implants had caused a complete disaster around the world. The company's vaginal mesh product had led hundreds of thousands of women around the world to bleed from their vaginas endlessly and be unable to have vaginal sex. The opioid crisis was running full tilt and Johnson and Johnson's role in that was becoming public. So the company understood that it was in trouble and, and saw COVID 19 as a chance at redemption. And they had a partnership with a research team at Harvard that had been using a cold virus as a kind of gene therapy vector or vehicle to deliver vaccines. And so they created this partnership to do the same thing for COVID 19. Now the. The problem with using a cold virus as a vector, and Johnson and Johnson knew this from day one, is that it has this odd effect that it can cause both excessive bleeding and excessive clotting. They nonetheless pushed ahead with this project. But Johnson Johnson doesn't really have a vaccine business. So they didn't themselves have a good way of manufacturing this. They hire a manufacturing company based in Baltimore to manufacture their shot. But this company, Emergent, it's called, had a history of terrible manufacturing problems. Again, something Johnson and Johnson knew. So this company starts trying to manufacture it. Unfortunately, they are also manufacturing a similar vaccine from AstraZeneca. And the two vaccines end up cross contaminating each other in this facility again and again and again. Something Johnson and Johnson's own investigators knew was happening. But of course, for the PR benefit, Johnson and Johnson does not let on. And in fact, the CEO of Johnson Johnson attends multiple events at the White House to bask in the praise from President Biden and others that Johnson and Johnson is going to save the day. Even though at that point they must have known that they were not gonna save today, that their vaccine was contaminated. Eventually the contamination comes out. Most of Johnson and Johnson's lots are condemned. The ones that do come out, Shamita, as you said, end up causing all kinds of problems. People start getting, particularly young women start getting these clotting disorders. And then even more concerning, some people start getting this neurolog condition called Creutzfeldt Jakob disease, which is a terrible and frightening condition that leads to horrible palsy. So as you know, vaccines are given to healthy people to protect them from illness. So any side effects that affect people in more than one in a million are simply unacceptable. And Johnson and Johnson's side effects were in the range of 1 in 100,000 and perhaps even 1 in 10,000. So as these side effects build up, as the manufacturing woes keep Johnson and Johnson's vaccine from really playing much of a role at all, it basically starts to fade into the background. And eventually, because of these safety woes, the FDA pulls its authorization from the vaccine entirely.

A (26:33)

What's been the response from Johnson Johnson to your reporting and these allegations?

B (26:37)

Well, so Johnson and Johnson has myriad responses. Much of what I relay in the book comes out of sworn testimony, not only in civil trials, but also I have files from multiple grand juries. These are secret files in which Johnson and Johnson executives give sworn testimony to the behavior of their corporation. But as they basically always have with me, I went to them as soon as I got this book contract and said, look, I'm going to be working on this for a few years. I'd love to talk to you. I'd love to engage with you. They shut me out. In these grand jury files, I have thousands of names and cell phone numbers of executives. And over the. Of doing the research for this book, I called hundreds and hundreds of them. And some 90% of these people told me to take a hike, but 10% ended up talking to me. I am certain that the 90% who told me to take a hike immediately called corporate headquarters and said, do you know this guy is calling around and asking. I also have friends who know the chief executives and went to them multiple times and said, look, this guy is a serious journalist. He's doing a serious thing. You should really consider talking to him. They never changed that stance. But, Shamita, that has been their strategy ever since the 1970s, when serious newspaper reporters first started doing stories about the presence of asbestos in Johnson's baby powder. Look, this project I knew was gonna be really tough. Many people told me, Shamita, that it was basically a suicide. Johnson and Johnson not only is the worst behaved company in this industry, and I would argue, in American capitalism, but it spends more on corporate lawyers than any other company. And it's not even close. In many years, they spend a quarter of what all large companies spend on litigation combined. And they do not take prisoners. And, you know, this book is supposed to come out. We'll see how long it's available because I expect them to come after us. It was a miracle that this book got through an extensive legal review at Random House. But I will tell you that none of Random House's foreign partners, not the British ones, not the Indian ones, none of them have agreed to publish this because they fear the legal risks.

A (29:30)

Wow. Wow. So tell me, is part of this strategy of not making a representative available for comment in stories like this and on reporting like this, is this part of the strategy that has allowed Johnson and Johnson to maintain this really high public image standard while, like you said, having a very different private way of operating?

B (29:55)

Absolutely. And. And in the book, I tell story after story after story of journalistic predecessors of mine who tried to do pieces of this story? And Johnson and Johnson went to the corporate headquarters of those media organizations. And Johnson. Johnson being one of the largest advertisers in the world, remember they have a Tylenol brand. They had Johnson's baby powder. They have all these prescription medicines. And you know, when you watch the evening news, as you know now, nearly half of the advertisements that run on the CBS Evening News, NBC, all of them are prescription drugs. Johnson and Johnson is a huge source of revenue for all of these major media organizations. And so when reporters tried doing these stories, Johnson and Johnson would call the corporate headquarters and say, if you run this story, we are pulling all of our ads. And in case after case after case, the stories got pulled. That is an incredibly important reason why Johnson Johnson has managed to maintain this pristine image, because corporate media simply didn't want to take it on.

A (31:16)

Let's talk about the fda. I know that we've touched on them at so many different points in our conversation already, but what are some of the major weaknesses that you would say you've identified over the course of your reporting in the way that the FDA works today that have allowed JJ to function in the way that it has and end up causing harm to so many people?

B (31:40)

So one sort of larger message that I would love to get across is that in many ways, my book is a guidebook for navigating the healthcare system for you and your family. And what I hope is that the many stories I tell in the book will help people understand the weak points in the system and make clear to them that some of the people in this system that they think are trustworthy are simply not as trustworthy as they think they are. And that is certainly true of the fda. As I mentioned, the FDA now is largely, largely funded by industry. And so FDA professionals to this day will say in speeches that their customers are the industry. Not the American public, but the industry. And so in 2012, the industry decided that they weren't going to continue to pay these Feees to the FDA. It led the FDA into a panic because, because if the industry didn't agree to another five year fee authorization legislation, the FDA was going to have to fire hundreds and hundreds of reviewers. So the FDA commissioner at the time, Margaret Hamburg, called Alex Gorski, who was then head of Johnson and Johnson's device division and was about to be appointed its CEO and and begged him to save the agency. He then rallied. He created a funding bill for the fda. He sold it to the industry because Johnson Johnson is the most powerful player in the industry. And then he used Johnson and Johnson's vast lobbying network to sell it on Capitol Hill. He saved the FDA and the FDA then paid Johnson and Johnson back in multiple, multiple way. One way was by not withdrawing Johnson and Johnson's dangerous metal on metal hip implants so that Americans were exposed to this dangerous product for more than a year. After Australians, for instance, they did not withdraw Johnson and Johnson's dangerous vaginal mesh. So hundreds of thousands more women had their lives destroyed by this vaginal mesh that ripped apart their vaginal walls. And FDA then issued a series of statements, sometimes seemingly out of the blue, to help Johnson Johnson in its legal problems. For instance, in 2015, Johnson and Johnson lost its first baby powder case in federal court in North Dakota. Now, FDA had not been paying attention to baby powder for decades. Suddenly, out of the blue, FDA issues a statement attesting to the safety of talc based cosmetics, even though of course, FDA hadn't tested any of these products in years. It even issues an opinion about how wonderful opioids are on the eve of Johnson and Johnson's opioid trial in Oklahoma. So what you see is an agency that is partnered and deeply invested in the safety of Johnson and Johnson and doing not only nothing to police this bad behavior, but actually enabling is so

A (35:30)

disheartening to hear you describe this relationship. And at the same time, I think for many Americans who have grown very distrustful of public health institutions in America, it feels like very validating, right? That it sounds like people have real reason, good reason, to not trust the American medical establishment because of flawed incentives. And at the same time, in order to keep people safe and keep people healthy, we need people to opt in to certain parts of this system, like agreeing to get vaccinated against dangerous diseases. So how do you reconcile these two things? How do you speak to Americans who have concerns about our public health institutions like the FDA and really feel wronged by this agency?

B (36:21)

It's a great question, and unfortunately there is not a good answer. But I am here to tell you that I am sympathetic to people who have thrown up their hands and say, I don't trust any of this stuff. Because the difficulty is that again, public health people will say, look, trust us on these particular announcements that we're saying, and you really do need to take these particular vaccines. On the other hand, agreeing, yeah, we did lie about that. Yes. We did not know about all of this terrible research that was kept secret from us. You know, one of the stories I tell is about IPO in cancer. It's a complicated story. But in that story, Johnson and Johnson kept secrets study after study after study after study that showed that EPO killed cancer patients, that it was miracle grow to tumors. They kept that secret, not just from patients, but they kept it secret from the fda. Now, when the FDA found out about this, the FDA should have charged Johnson and Johnson with crimes, because keeping that kind of information away from the agency is a criminal offense. It did nothing of the kind. So the problem with the system, Shamita, I'm afraid, is that it is corrupt through and through. And what I'm trying to do, at least in this case, is to allow people to do some of their own research. It's still under construction, but I have a website where I am putting thousands of these documents related to all nine of these products on a website so that people can read hundreds of thousands of pages of these documents themselves. But this is the fundamental dilemma of public health institutions. They either have to actually police this space, or they have to understand that the American public will not trust them anymore.

A (38:33)

How do you feel about our new health secretary, Robert F. Kennedy, Jr. He is someone who has expressed a lot of distrust toward a lot of these institutions, some of which he now leads.

B (38:47)

Again, it's a complicated answer. I do believe in childhood vaccines. I do believe in the measles, mumps and rubella shot. I got my own children vaccinated according to the vaccine schedule. I think it is really concerning that this measles outbreak in Texas, Oklahoma and Arkansas. And Robert F. Kennedy has obviously expressed all kinds of views about childhood vaccines that I think are concerning. I am persuaded by the research that shows there has been no connection between autism and childhood vaccination. On the other hand, I am really hopeful about Robert F. Kennedy's leadership that finally we might have someone who is willing to take on these entrenched players, Food companies, pharma companies, device companies that have really owned this space for so, so long. The FDA has seen its heart and soul bought by the industry. It is dependent on industry funding. It sees the industry as its customers. Robert F. Kennedy has said many times that we need to change the funding formula for the fda. I have multiple suggestions in the back of my book about how to change the system. One of them is that I think healthcare needs to be like the aircraft and airlines industry, where you have FAA which approves new airplanes, but when there are crashes, you get this independent group called the ntsb, the National Transportation Safety Board, come and investigate. The problem right now is that the FDA approves all of these products and then investigates when it finds out that there are all these problems with it. And the FDA has a clear interest in not finding these problems, not doing anything about them, not withdrawing dangerous as products. And I think we need an entirely different agency to essentially monitor products once they are on the market.

A (41:07)

We're already talking about solutions in a way, but you do lay out some of the solutions that you think of in the book that would make it less likely, at least for a company like JJ to behave the way that it has. Could you lay out some of those solutions?

B (41:22)

I think there needs to be a policing mechanism. The healthcare system is opaque. It's very hard for people to see what's really going on. Another thing that I think is extremely important is that we should be able to trust our doctors. They are what are known as learned intermediaries, which means they have all kinds of knowledge that we don't. And they should be an actually unbiased intermediary. But we're when drug companies pay them and they continue to pay doctors to the tune of more than a billion dollars a year, they are no longer an unbiased intermediary. And in all of the cases that I talk about, the reason why so many people died is that Johnson and Johnson paid doctors to use products in dangerous ways. To the this day, there are many oncologists in this country who prescribe EPO to cancer patients, even though EPO made by Johnson and Johnson has been shown to be miracle grow to tumors. But doctors make an enormous amount of money when they prescribe EPO to cancer patients. So I think if your doctor wants to take money from Johnson and Johnson, that's fine. They can do that. They just can't treat patients anymore. So choose one or the other. Work for industry or work for your patients, but you can't do both. That's probably my most important piece of advice.

A (43:05)

Gardner, thank you so much for your time. Thank you for this investigation. It was really a pleasure to have you on to talk about this.

B (43:13)

Thank you so much for having me.

A (43:18)

You can find no more the Dark Secrets of Johnson and Johnson by Gardner Harris on Apple Books. We'll include a link to it on our Show Notes page. And every weekend you can find new episodes of Apple News in conversation in the Apple News app. Just tap on the audio tab. That's the little headphones at the bottom to find it.