The article discusses how the Epstein scandal reveals the mechanisms by which governments acquire, use, and abuse power. Governments are influenced and corrupted, shifting their priorities from the public interest to the interests of ministers or their acquaintances. These skewed priorities have detrimental consequences for population health. Political integrity affects the health of the population. The BMJ frequently publishes concerns about the failure of government ministers and politicians to declare competing interests. The extent of the compromise of high-ranking politicians, business leaders and academics by the Epstein files confirms the political corruption exposed during the covid pandemic. Policy codes serve to limit damage and manage reputation.