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As our insurance systems seem to swing farther and farther from any kind of sane healthcare reality, it’s old and depressing news that people on the low-end of the income spectrum have little to no recourse.

If our government is going to stick it to the majority, maybe the answer is in individual innovation. What if there was a device that could give anyone access to life-saving drugs?

What if the information for making medications was free and available, as opposed to controlled by pharmaceutical companies?

Sounds like some fantasy nutjob revolutionary idea, right? Well…

This poor man’s dream machine is called the Apothecary Microlab.

It’s an automated chemical reactor, currently in beta testing, and the group responsible is Four Thieves Vinegar Collective. They can be found at this web address.

You can’t buy this device. FTVC doesn’t actually produce anything at all. What they do is provide information, free of charge, for people to buy the parts they need and assemble an Apothecary Microlab. The face of the organization, Dr. Michael Laufer, says assembly requires skills at the level of putting together Ikea furniture.

In his words:

“We’ve developed an open-source automated chemical reactor for which we are also developing programs that can synthesize the active pharmaceutical ingredients in key medication (…) from which people are often disenfranchised for reasons of price or legality or lack of infrastructure.”

This open source software (read: free) for specific medications is loaded into the machine along with commercially available chemicals. The device takes care of the science. The individual gets the treatment.

On the list are Epi-pens, HIV treatment and pre-exposure meds (PrEP), early-stage chemical abortion, opiate overdose reversal, and the relatively newly discovered cure for Hepatitis C.

This is huge. But not without caveat.

Dr. Michael Laufer is not a medical doctor, his PhD is in math. He is a hacker, a maker, someone who sees a need and believes that availability of information can help the enormously overblown costs of essential drugs. Those accessing this information have options they would not otherwise have, but without the benefit (questionable or otherwise) of control from government and medical agencies.

Treatment is not easy. Making chemical compounds is risky and dangerous. Individual production of patented medication is illegal. But for many, the choice could be sickness, death, or copyright violation.

Four Thieves Vinegar Collective takes their name from a group of brothers who pillaged graves in plague-riddled France. The brothers avoided catching the Black Death by taking an antiseptic solution developed by their herbalist mother. When they were caught, they shared the secret, saving their own lives, and spreading information that would keep thousands from dying of infection.

The collective definitely involves some cloak-and-dagger. No one knows the names of every person involved, and they ride the edge of technicality in not directly providing patent-infringing drugs. They don’t even keep track of the number of visitors to their website.

Hopefully this will keep Laufer off of big-money hit lists as the group plays Robin Hood, stealing from Big Pharma and giving to the unmedicated poor. For Laufer, “the idea is the information should be free, science should be accessible to anybody who wants to do it.”

Of course, this is the answer! We could all go rogue and self-treat!

But we don’t all hold medical degrees. People are afraid of doing chemistry, and with good reason. Even the ER doctors I spoke with said they wouldn’t feel comfortable using the Apothecary Microlab on themselves. Though they would absolutely support it for people with no other options.

Laufer believes this hesitation in the face of chemistry will fade in the same way as our fear of technology has, and that in time people’s comfort level with compound creation will increase. In his opinion, “the jump is a little bit of automation and a nice user interface…”

The key in home drug-production lies in automatic chemical reactors. They are expensive, proprietary, and hard to get. “But they’re not technically very complicated devices. They time, they stir, they control temperature, they inject reagents at particular moments. I was like, I can do that…” And so was born the Apothecary Microlab.

BAS sat down to talk more.

BAS: There are people who are going to say, “Oh God, I’m afraid to do this, I don’t want to poison myself.” Do you have like an answer for that?

Dr. Michael Laufer: Yeah. There are two answers. The more important one is, if you’re dying, and you don’t have access to medication, why are you so afraid that you’re going to poison yourself? You’re already dying. How seriously are you taking your life?…

[Secondly,] we work very hard with the computational chemists who develop synthesis pathways [that] are different than the standard ones, which allow for a much greater margin of error. So that it’s not one of these things where you have to be super technical and you have to be really careful in the lab and one drop of something or a degree’s difference in heat is going to suddenly change your lifesaving medications to poison. So there is a greater margin of safety as well.

BAS: And most of these chemicals are inexpensive to buy online?

Dr. Michael Laufer: When we develop a synthesis pathway, one of the parameters that we put into the computer is all of the precursors have to be commercially available and relatively cheap.

BAS: What are your biggest hurdles now?

Dr. Michael Laufer: Probably just publicity… We’ve had a couple of breaks in the media, which has been nice… when I did the Epi-Pencil thing, a lot of people picked that up.

BAS: Tell me about that.

EPI-PEN



Dr. Michael Laufer: Well, we debuted the first gen reactor in July of last year in New York, and we got sort of a small cultish following. And when the whole bullshit shook down with the Epi-Pen people, we started getting a lot of queries through the website… so we figured a way you could pull some off-the-shelf units and put them together and build yourself an Epi-Pen for 30 bucks.

BAS: Can you do me a favor and list off a couple other drugs and things that you put out there that you could make?

DARAPRIM

Dr. Michael Laufer: So the one that we did in New York [at the Hackers Planet Earth conference in July] was pyrimethamine, which is the active ingredient in Daraprim… it’s the only toxoplasmosis drug that’s available.

Toxoplasmosis is … a gut and brain parasite that for healthy individuals is not dangerous, a lot of people have it, I probably have it. But if you have a suppressed immune system, advanced stages of cancer, advanced stages of AIDS, [or if you’re] pregnant, [it’s] very dangerous. So you need to treat it.

[Daraprim]’s the only treatment that’s out there, and you need a course for two weeks. You take a pill a day, 50 milligrams, your first dose you take four pills. These pills were $13.50 a piece prior to Turing Pharmaceuticals buying the patent, and then overnight it was $750 a pill.

GSK-744 (PreP)

Dr. Michael Laufer: … We’re working on GSK-744, which is an advanced antiretroviral. So… HIV cocktails.

Typically if you’re HIV positive you need to take a combination of two or three drugs. They’re in pill form, you have to take them every day, you have to take them at certain times of the day, certain ones with food, certain without food… You fuck up that rhythm, your viral load spikes and that’s when it’s very dangerous and you can pass it to other people…

One intramuscular injection [of GSK-744 via nanoparticles] can serve you for up to four months. And it works both as a pre-exposure prophylaxis and as an antiretroviral treatment.

BAS: So pre-exposure — what’s that called?

Dr. Michael Laufer: Truvada [or] PrEP… Pre-exposure prophylaxis.

The reason that this is so poignant is that because it works as both [treatment and pre-exposure], and because it’s so long-lasting, you could go into a community where the viral load is very high…, and you can bypass the stigma of testing. That’s the biggest problem with trying to treat HIV in the community… figuring out who has it and who doesn’t.

BAS: Right.

Dr. Michael Laufer: Because nobody wants to know. It’s understandable. But — with this, you can go into the community … [and say] “We’re giving this to you all. Everybody who has it will stay healthy, everybody who doesn’t have it won’t get it”. With that you could wipe out HIV in a generation within a closed community.

SOVALDI (HEP C)

Dr. Michael Laufer: Hepatitis C can be eradicated from your body with Sovaldi. You take one of the pills a day for 12 weeks. Problem is, the pills are about $1000 a piece. So if you’re very wealthy hepatitis C is not your problem anymore. For everybody else, it’s still a big problem. It shouldn’t be…We have a cure for hepatitis C? Everybody should get it. And then it could go away. We could forget about it like smallpox and polio.

CHEMICAL ABORTION

Dr. Michael Laufer: Mifepristone and misoprostol… They are the two drugs that, when taken in combination, induce abortion 95 to 98% of the time. Again, this should be in every drugstore… It’s not. People should have access. It’s getting easier to get because you can order it online from certain places, but again, if you make something yourself, you’re not trusting an outside institution, saying “is that real, is that fake”, you have control over it and you see it happening yourself.

NARCAN

Dr. Michael Laufer: We were going to do naloxone. Naloxone [aka Narcan] reverses opioid overdose.

BAS: Oh wow… That’s saving a lot of lives right now. They’re handing it out at needle exchanges.

Dr. Michael Laufer: They’ve been doing that more and more. And they just passed a law that [makes it] technically over-the-counter in California and Oregon. Hard to find, but technically available… So, because it’s becoming more and more widely available that’s a back burner one.

But for a long time it was only available if you went to a hospital or a police station. And not to, you know, pigeonhole people who tend to overdose on opiates but the last place most of those people are going to want to go is a police station or a hospital. And so it was very stupid that people were dying out of fear of going to get medication.

What next?

In true open-source form, Laufer hopes someone will pick up where he left off.

Bringing the Apothecary Microlab into communities requires someone with a technical comfort, who knows some medicine and a little chemistry. Nurses and doctors who give a shit, and don’t mind getting a little dirty. What he’s hoping for is a coming-together of radicals and liberals in the name of life, liberty, and the pursuit of actually affordable care.

“The moment when somebody says ‘hey, I took this technology and I sort of forked it, I figured out a way to do it better, I improved it’. Once that first step happens in the open source community, where somebody picks up what we did independently, somebody who is not a friend of ours, and says ‘hey, I built this’, or ‘I figured out a way to use it in a new way that you didn’t think of, I developed a new synthesis that you guys don’t have yet. I figured out and improved implementation for this and this’. Then I’ll be like, awesome. And at that juncture, we don’t have to exist as an organization anymore… Because the technology’s there and will be developed by everybody.”

It remains to be seen if this collaborative open-source hybrid model of health care can truly save lives. But the potential for crossing open information sharing with something as essential as medicine is pretty damn exciting, and the idea of individual voluntary superheroes contributing to collective innovation might be more appealing to American ideals than socialized health care. The Four Thieves Collective has the possibility of being revolutionary, assuming people hear about it, and it becomes widespread enough to perform its own non-government-regulated controls. At the very least, projects like the Apothecary Microlab could re-instate a little bit of hope for those with nowhere else to turn.