New York Magazine recently ran an article titled, “Is The World Ready for Libido in a Nasal Spray?” (1) The drug, PT-141, has not yet gone through phase III clinical trials, has not been approved by the Food and Drug Administration (FDA) and, even then, would not reach the market for three years. But it still appeals to the ever-hungry press. Sex makes news. Sex drugs really sell news. This could be a new Viagra, even a female Viagra. Wow.

Out there somewhere, on both sides of the Canada-U.S. border, are public servants holding information on government misconduct that the rest of us should know about.

You’ll have to excuse them for being hesitant to go public given the plight of recent whistleblowers who have been punished, and punished hard, for exposing scandals.

A December 21, 2004 report by the watchdog group Public Citizen provides information that explains why it’s been a holiday every day for the pharmaceutical industry, since George W. Bush took office.

Some of you may observe the actions of the pharmaceutical industry and wonder why, from a PR perspective, it seems intent on taking dead aim somewhere between the second and third metacarpals (bones in the feet, in case you were wondering), then determinedly pulling the trigger. Not once, but time and time again. To quote Arnold Schwarzenegger in the movie The Terminator, “I use an Uzi nine millimetre.”

The traditional glass ceiling for women has a slightly different shape when it comes to the fields of hard science. There, the barrier is more like a test tube.

In the most recent edition of Science magazine, a group of prominent women scientists and administrators, including college chancellors and provosts, analyzed the issue. Lead author Jo Handelsman, a professor at the University of Wisconsin-Madison, noted, “The good news is we have made progress — the bad news, we still have a long way to go to achieve equality.”

‘The House of Representatives voted this afternoon to prohibit outside doctors and scientists who work for drug companies from sitting on Food and Drug Administration panels that pass judgment on those same companies’ products.’

Don’t get me wrong. This is good news……But….but... At present Saddam Hussein sits in a prison cell, awaiting his trial for crimes against humanity. The trial of Slobodan Milosevic (remember him, Kosovo, murder of thousand of Albanians – ring any bells?) has been going on forever, and will go on forever, until Slobodan has to be brought into court preserved in formaldehyde, having died eight hundred years previously. Even then his defence lawyer will still be bleating for more evidence to be heard.

The phrase Direct-to-Consumer Advertising of Prescription Drugs (DTCARx) brings to mind images of Viagra, and the Wagnerian certainty of happy households and contented spouses.

Sometimes you read something of such blinding obviousness (if that is actually a word), that you wonder why anyone even bothered writing it at all. You know the sort of thing  - ‘constant criticism of children does not lead to a sense of self-worth.’ ‘A centralized command economy does not create wealth for citizens.’

But the blindingly obvious can be critically important depending on who says it. I can bang on and on about the fact that medical journals have basically turned themselves into advertorials for the pharmaceutical industry, and be readily dismissed as a fringe lunatic.

‘Pharmaceutical Industry Opposition to Reimportation ’Financial Suicide,’ Pfizer’s Rost Says

‘Pharmaceutical companies are being led by "dinosaurs who are committing financial suicide" by opposing US residents’ reimportation of lower-cost drugs from abroad, Peter Rost, a vice president of marketing at... Pfizer, said in a speech at the Minnesota Senior Federation Monday, the Minneapolis Star Tribune reports.

I always have to remain silent whilst fellow doctors inform me – in all seriousness – that drug advertising, and drug reps, have no influence on their prescribing habits. For I know that, were I to start, a great wave of scathing sarcasm would descend upon my fellow medic that would probably wash away any friendship now, and forever more, amen.

So I merely swallow hard, nod, smile weakly and change the subject to something safe like religion or politics. What moral cowardice… I prefer to think of it as pragmatism.

“Many a man stumbles across the truth, then picks himself up and hurries on as though nothing had happened.”
Winston Churchill

For some time now, I have been following the work of a UK parliamentary committee which has been looking into the activities of the pharmaceutical companies, and their influence over the healthcare system. Whilst this committee was sitting you could even watch the proceedings on television, although I wouldn’t recommend it - other than as a cure for insomnia.

Most of us are struggling today, doctors and patients alike, with soaring costs, the incredible maze of regulations and paperwork, the long delays for approvals, and the rushed office visits. The primary blame for this dysfunctional health care system (at least in the USA) is the domination by large, profit-oriented corporations.

Although you are also deeply frustrated, you doctors have just not resisted being programmed and conditioned.

They are at it again. Those determined federalists and lobbyists for big Pharma, who view informed consent advocates and vaccine victims as an impediment to exercising more control over and making more money off of America’s forced vaccination system. This time, they are using the public’s memory of September 11, 2001 to push a Senate bill (S.3) deceptively entitled "Protecting America in the War on Terror Act of 2005."

In our increasingly competitive world even the historically ethical industry of Health Care is not free from propaganda, dirty tricks and vested interests. So what is a health care consumer (that’s all of us) to do? How do we distinguish between objective and biased information? Especially in this digital age of information overload?

And what song do we expect the pharmaceutical company wishes to hear sung by international medical opinion leaders? In general it goes like this ‘Use more of the new expensive drugs. For they will make you well.’ To the tune of Amazing Grace.

How much money does it take to get an international opinion leader to sing for their supper? That depends. In the case of Dr Bryan Brewer, a leader at the National Institutes of Health, it took $57,000/year.

Baltimore, MD - Researchers have found that 100% of industry-sponsored studies recently presented at the annual scientific meeting of a medical professional society reported findings that support product use. The study, by Drs Thomas Finucane and Chad Boult (Johns Hopkins School of Medicine, Baltimore, MD), appears in the December 1, 2004 American Journal of Medicine.

‘Blood pressure screening for children should start at age 3, according to the latest government diagnosis and treatment guidelines that were presented at the American Society of Hypertension’s Nineteenth Annual Scientific Meeting.’

To tell the truth, I was tempted to make that statement my entire column. Perhaps arrange it artistically in the midst of white space. Or maybe I should just stencil it out on a huge sheet of paper, frame it and send it in for an international arts prize. I would entitle it ‘Proof of a world gone mad.’

I was sent a very good article that was published in the April 2004 edition of The Washington Monthly about the influence of the pharmaceutical industry on medical research. Whilst agreeing with most of what was said, as usual I find myself looking one major issue raised in the article from a very different angle.

The major question raised was this:  Should medical journals demand disclosure of financial ties between the author of a paper and any, or all, drug manufacturers with whom they are financially entangled? The author said yes, many journals say yes, more and more researchers and journals say yes. I say…. no.

A few days ago, the British Medical Journal (BMJ) produced a list of medical procedures which provided no clear benefit, and therefore should not be done. The list included the usual suspects, grommets for glue ear, removal of adenoids, removal of wisdom teeth, surgery for early prostate cancer, etc.

I suppose that one should welcome the idea that useless medical procedures should not be done, and that someone is willing to stand up and say so. Bernard Shaw – a famous Irish writer – wrote a book called Doctors’ Dilemmas in the nineteen twenties. In it, he highlighted the most commonly carried out operation of the time which was removal of toxic colon.

In my business career as a pharmaceutical buyer and later as a Drug Marketing executive, I had nothing but the highest respect for Merck. They had an image of impeccable business and medical ethics and they ran their own show. This image was confirmed by trade surveys year after year. Somewhere along the way, they started to lose focus on healthcare and the focus shifted to the bottom line.

On 31 January 2001, New Zealand Doctor ran an article on page 9 by Penny St John, called Mandatory Jabs Short Cut To Increasing Rates. This was a "briefing", sponsored by the manufacturers of the MMR vaccine, Merck and Co, for journalists in the Asia/Pacific regions.

Theheart.org, a large cardiology site that receives sponsorship from the drug industry, is generally a well-regarded source of information for health-care professionals. The editorial board lists 85 doctors in 19 countries. Three of the eight editors, including the editor-in-chief, have declared they own stock options in the website’s parent company.

Not that long ago, a number of people were put under general anaesthetic and had holes drilled into their skulls. These procedures carried all the risks of major surgery, yet the doctors who carried out the operations knew that they would provide no benefit. Surely, you might think, this flies in the face of the primary imperative of the medical profession ‘First, do no harm.’

A Real Scientist - And More

Max Perutz died on Feb 7, 2002. He was many things: a great scientist who shaped modern biology and a creator of a scientific environment that fostered innovation and creativity. A rare breed, Max Perutz. And a powerful beacon for dark times.

Perutz was one of the principal founders in 1947 of the Medical Research Council’s famed Laboratory for Molecular Biology in Cambridge, in the U.K. The discipline of molecular biology can be traced back to this famous place, where Perutz inspired and cultivated an unprecedented surge in cutting-edge research.

Creative environments attract creative scientists. Thinking outside the box is a requirement for information advancement. The "science box" is now so large, well-funded and out of control that it has successfully killed attempts to deal effectively with many of today’s tough medical challenges: chronic fatigue syndrome, AIDS, Gulf War Syndrome, neurologic diseases, vaccine safety, biowarfare defense and others.

Perutz’s death comes two weeks after my testimony to Congress on the current stalemate in medical research. I had suggested that if government and science were to continue any partnership, they must find a new paradigm in which creative research can flourish. I had no suggestions to offer on exactly where to begin the search for successful models. But Max Perutz’s passing tells me to start looking for examples starting at the top. Namely with Perutz.

By studying history we just might be inspired to repeat the best of it. Perutz’s own words provide us with a conceptual framework to consider. Here are some thoughts taken from one of his speeches:

On laboratory structure:
"In business jargon the laboratory would have been called a merger, because four groups joined to bring it into being."

On job specification and management style:
"My job [as Chairman] was to take an interest in their research and to make sure that they had the means to carry it out."

On ensuring success:
"Experience had taught me that laboratories often fail because their scientists never talk to each other."

On governance:
"Since there was no difference in age or distinction between us, I persuaded the Medical Research Council to appoint me Chairman of a Governing Board rather than Director…"

So, let’s see if I got this right. Perutz created a scientific Camelot by recognizing:

ON HOW THE SCHOOLS ARE BECOMING COMMERCIAL CESSPOOLS

The decade-old debate about ads for commercial products, such as Nike and AOL, being allowed in public schools, is flaring up again - but the contestants avoid the real issue, which, if confronted, would change the whole nature of the debate.

The flack centers around the fact that, in public schools today, corporations like Coca-Cola, Hershey’s, AOL and Nike have showered students with a variety of in-school marketing schemes. There’s a math curriculum, for example, which encourages students to count pairs of Nikes, a history lesson that touts the role of Tootsie Rolls in the diets of World War II soldiers . . . and then - most important - there’s Channel One.

ITCHING FOR A DEBATE

This week, Dr. Anthony Fauci, one of the principal supporters of HIV theory, received one of medicine’s major monetary awards (second only to the Nobel Prize) — and here’s someone who has been misinterpreting laboratory results for two decades.

These are truly dark times for science and medicine. Fauci is one of the US government's major architects of the myth that HIV has been proven to be the cause of AIDS and that stopping HIV will save lives -- a myth that has become so entrenched in medicine's conventional wisdom that to question it is tantamount to treason.

When the leadership at Enron decided profits were more important than protecting their employees and stockholders, a lot of people lost their life savings. When companies making medical products put profits before public safety, people lose their lives.

CAN WE TRUST THE REGULATORS?

Twenty years ago, as a newly qualified doctor, I spent a lot of time in the library reading review articles about my patients’ diseases.

Twenty years later, my time in the library is too often spent reading about problems and conflicts of interest within the medical establishment.

The Enron Obscenity Requires Our Collective Attention

I don’t know which is more obscene: the fact that, for all practical purposes, our government has been bought, or the ridiculously low price it went for.

On Making Clinical Trials Fair

Looking into the subject of human clinical trials and the informed consent of their subjects opens a big can of worms.

Honoring Demented Visions And Ravenous Avarice.

January 05, 2002 - The Annual Golden Dick Awards are given out to recognize those products, services, organizations and/or industries that most padoodled the general citizenry during the past year in our buy-or-die nation-malls.

On Dancing Dead People and Patriotism

December 21, 2001 - If I say "digital insertion" to you, what is the first thing you think of?

Internet sex would be a good answer, and a likely one, but it is not what I have in mind. What I have in mind are advertisements that are digitally inserted into shows and sporting events on television, so that people watching a tennis match at home, for example, see a logo for Mercedes Benz or Nike on the center of the tennis court - but neither the players, nor the live audience see the ad.