The Economist Magazine Cover For 10/26/2024

The Economist Read in browser October 26th 2024 How we chose this week’s image SUBSCRIBER ONLY Cover Story How we chose this week’s image The Economist Zanny Minton Beddoes Editor-in-chief We had one worldwide cover this week. And it featured some very good news. GLP-1 receptor agonists such as Ozempic and Wegovy started as treatments for diabetes and obesity. That alone would have qualified them as wonder drugs. Now they are being found to help with cardiovascular and kidney disease, too, and are being tested for use against Alzheimer’s and addiction. Researchers are even talking, in hushed tones, of their anti-ageing effects. They may turn out to be one of the most successful classes of drugs in history. We started with an image that conveyed their ability to alleviate a bewildering variety of diseases. They are the pharmaceutical industry’s Swiss Army knife—and the way their applications keep growing, you may indeed soon be able to use an Ozempic pen to prise a stone from a horse’s hoof. How can one class of drug do so much? As our briefing explains this week, not only do the drugs act in the gut, but they also bind to receptors all over the body and in the brain. The drugs appear to reduce inflammation and interact with mechanisms linked to cravings and feelings of reward. The pill-as-knife is a lively textual metaphor, but visually it falls flat. Actually seeing the tools on display reminds you that neither the Swiss Army nor its knives are very useful. Here is another attempt to show an all-in-one drug. The possibilities of GLP-1 agonists are thrilling. In 2019 heart disease, stroke, diabetes, Alzheimer’s and kidney disease ranked among the top ten global causes of death. By 2050, as the world ages and developing countries’ health care improves, these diseases will take a bigger toll. Last year more than 100,000 Americans were killed by opioid overdoses and 180,000 died from drink. Just imagine if a pill could help spare them. Somehow, a plastic funnel does not get across the immensity of this potential. One way of conveying transformation is religious, but this idea will surely be seen by some as sacrilegious. And besides, we needed a little more restraint. Although GLP-1 agonists have been used in diabetes for 20 years, some of the newer findings are based on observational studies, which will need to be supplemented by randomised trials. Patients may need to remain on these medicines for their whole lives, and their long-term benefits and side-effects have yet to be quantified. “Lord of the Rings” strikes a better balance—epic, with a hint of self-mockery. However, it is not entirely suitable. GLP-1 drugs are mostly administered by injection rather than by pills. And look at those fingernails. Frodo, poor hobbit, is obviously suffering unbearable cravings: Ozempic doesn’t seem to be working for him. The magician waving a Wegovy wand is lower-key—indeed in our sketch we thought it too low-key. When we worked it up our artist gave it some razzmatazz. That is entirely justified. For patients, the new uses of GLP-1 drugs would mean not just longer, healthier and more productive lives, but happier ones, too. In a world of abundance people succumb to their impulses even if they know their behaviour is harmful in the long term. Still we weren’t sold on this cover. Even if we could have come up with a headline that avoided the off-putting term GLP-1, rabbits and hats and sleight of hand seem the wrong imagery for something that is life-saving and scientific. We preferred a simple celebration. We started with streamers and confetti and ended by replacing the syringe with a pen and adding handfuls of pills, to create a “pharmucopia”. The final cover needed a bit of explanation in a subhead to bring the message home. Rather as the contraceptive pill encouraged women to stay in education and work, these new drugs could lead to profound economic and social change by enhancing productivity and freedom. The GLP-1 revolution is just beginning. Cover image • View large image (“The everything drugs”) Backing stories → It’s not just obesity. Drugs like Ozempic will change the world (Leader) → GLP-1s like Ozempic are among the most important drug breakthroughs ever (Briefing) → Competition will make weight-loss drugs better, cheaper and bigger (Business) → The economics of thinness (Finance & economics)