Why should we trust medicine?

We are constantly being told that when it comes to our health and the health of our families, we should trust our doctors because they practice 'evidence-based medicine' - three words which would indicate to any thinking person that the drugs and vaccines being delivered by medicos have undergone rigorous independent trials and been shown to be both safe and effective.

In fact, nothing could be further from the truth and the evidence for this lack of safety and efficacy is becoming more apparent on an almost daily basis.

On Tuesday this week, an article appeared in Britain's Guardian newspaper, written by Brian Deer of all people. Yes, the same Brian Deer who was the instigator of the charges brought against the authors of the 1998 Lancet paper that hypothesised a potential link between the MMR vaccine and autism.

Entitled, It's time for a register of interests for science academics, this article discusses the fact that a great deal of medical research is being called into question because it has been performed by academics who are financially linked with the drug companies and the products they are meant to be studying. There is no way of knowing about these links in many cases because there seems to be a strong reluctance on the part of these researchers to reveal this information and there is no legal requirement for them to do so. As a result, the conclusions drawn by published, peer-reviewed studies is suspect.

Does this sound familiar? It's exactly what the AVN has been saying for almost 20 years now!

Stating the bleeding obvious in his own inimitable style, Deer says that,

Although triumphant in the common room over their front-of-the-plane funding, successful science academics (particularly in biosciences) are often as publicly transparent about the paymasters behind their publishing as chefs are about rats behind the fridge.

And whilst scientists, academics and pharmaceutically-funded researchers continue to publish studies without independent oversight, the toll of bad medicine continues to mount as does the cost - both emotional and financial - to society.

As long as scientists get more money (which I think was Bhattacharya's point) and the idea doesn't get round that most science articles are advertising, the tobacco industry's dosh is the same colour as Marie Curie's. All it needs is a good scrub for opacity. More worrying to journal editors would be any dent in reader loyalty triggered by stirring public pressures to disclose.

The Bhattacharya Deer was talking about published a blog in the Guardian back in February entitled, Scientists have sold their souls – and basic research – to business. In this article, Bhattacharya says that,

Young scientists who want their research funded are now expected to 'forge lasting links with industry'.

...Can basic research be saved from the tyranny of the profit motive? I doubt it. The coalition government has shown little inclination to question the science policies inherited from New Labour, and judging by the science minister's comments, he has little time for science for science's sake. The devil, it seems, will always get his due.

This new form of chequebook science is what we see happening in Australia via organisations like The Telethon Institute. Their former director, Professor Fiona Stanley, crowed in an interview with the NHMRC that Telethon's relationship with big pharma was pivotal to the Institute's success.

But there's been a really good - we've had a very good relationship with big pharma, some of which has just been, 'Here's the money. We're interested in anything you produce.' That's a very good relation that Pat Holt has had with GlaxoSmithKline.

What's the problem?

The government claims that this cozy relationship between researchers and drug companies is not a problem. They say that the integrity of research is not affected by money and anyway, it's impossible to find qualified experts who are not already affiliated with big pharma so we need to use what we have.

That's simply not good enough, however. Not when our lives and our health are at stake!

In today's New York Times, Peter Doshi from the Johns Hopkins School of Medicine and Tom Jefferson from the prestigious Cochrane Collaboration have contributed an Op-Ed piece entitled, Drug Data Shouldn’t Be Secret. In this article, they describe the inevitable outcome of industry-funded studies which are classified as commercial in confidence with data that is not available to the public or the scientific community for independent scrutiny.

Doshi and Jefferson talk about the Tamiflu debacle where the US government spent over $1.5 billion stockpiling this anti-viral drug during the so-called 'swine flu pandemic'. They did this based upon information provided by Roche, Tamiflu's manufacturer and the only body to have studied the ability of this drug to prevent influenza or reduce the severity of its symptoms or a person's risk of hospitalisation.

IN the fall of 2009, at the height of fears over swine flu , our research group discovered that a majority of clinical trial data for the anti-influenza drug Tamiflu — data that proved, according to its manufacturer, that the drug reduced the risk of hospitalization, serious complications and transmission — were missing, unpublished and inaccessible to the research community. From what we could tell from the limited clinical data that had been published in medical journals, the country’s most widely used and heavily stockpiled influenza drug appeared no more effective than aspirin .

So we had a drug that was not suited to the purpose for which it was sold, being studied only by the drug company that reaped huge profits from its sale and whose data was not made available then or since - despite promises by Roche to provide this information.

After we published this finding in the British Medical Journal at the end of that year, Tamiflu’s manufacturer, Roche, announced that it would release internal reports to back up its claims that the drug was effective in reducing the complications of influenza. Roche promised access to data from 10 clinical trials, 8 of which had not been published a decade after completion, representing more than 4,000 patients from every continent except Antarctica. Independent verification of the data seemed imminent. But more than two years later, and despite repeated requests, we have yet to receive even a single full trial report.

...This is not the way medical science should progress. Data secrecy is a disservice to those who volunteer their bodies for clinical trials, and is dangerous to those being asked to swallow approved medicines. Governments need to become better stewards of the scientific process.

...We should not have to wait for patients to be hurt by the medications they take, as recently happened with the diabetes drug Avandia , before reviewing this wealth of data.

As I said, these are just a few of the reports that come out on an almost daily basis demonstrating that what we currently call science actually represents research available only to the highest bidder and what medicine calls evidence is only smoke and mirrors set up to conceal the fact that actual scientific research has never been done.

Trust? It's something that has to be earned.