The BMJ

Medicine is Corrupted By Dominance of Big Pharmaceutical Companies, Which Suppress Negative Results and Hide Adverse Effects, Says Peer-Reviewed BMJ Article

Evidence-based medicine has been corrupted by corporate interests, failed regulation and commercialisation of academia, which act to suppress negative trial results, conceal adverse events and withhold raw data from the academic research community, according to a peer-reviewed article in the British Medical Journal by Jon Jureidini of the University of Adelaide and Leemon B. McHenry of California State University.

Medicine is largely dominated by a small number of very large pharmaceutical companies that compete for market share, but are effectively united in their efforts to expanding that market. The short term stimulus to biomedical research because of privatisation has been celebrated by free market champions, but the unintended, long term consequences for medicine have been severe. Scientific progress is thwarted by the ownership of data and knowledge because industry suppresses negative trial results, fails to report adverse events, and does not share raw data with the academic research community. Patients die because of the adverse impact of commercial interests on the research agenda, universities, and regulators.

The pharmaceutical industry’s responsibility to its shareholders means that priority must be given to their hierarchical power structures, product loyalty, and public relations propaganda over scientific integrity. Although universities have always been elite institutions prone to influence through endowments, they have long laid claim to being guardians of truth and the moral conscience of society. But in the face of inadequate government funding, they have adopted a neo-liberal market approach, actively seeking pharmaceutical funding on commercial terms. As a result, university departments become instruments of industry: through company control of the research agenda and ghostwriting of medical journal articles and continuing medical education, academics become agents for the promotion of commercial products. When scandals involving industry-academe partnership are exposed in the mainstream media, trust in academic institutions is weakened and the vision of an open society is betrayed.

The corporate university also compromises the concept of academic leadership. Deans who reached their leadership positions by virtue of distinguished contributions to their disciplines have in places been replaced with fundraisers and academic managers, who are forced to demonstrate their profitability or show how they can attract corporate sponsors. In medicine, those who succeed in academia are likely to be key opinion leaders (KOLs in marketing parlance), whose careers can be advanced through the opportunities provided by industry. Potential KOLs are selected based on a complex array of profiling activities carried out by companies, for example, physicians are selected based on their influence on prescribing habits of other physicians. KOLs are sought out by industry for this influence and for the prestige that their university affiliation brings to the branding of the company’s products. As well paid members of pharmaceutical advisory boards and speakers’ bureaus, KOLs present results of industry trials at medical conferences and in continuing medical education. Instead of acting as independent, disinterested scientists and critically evaluating a drug’s performance, they become what marketing executives refer to as “product champions.”

I suspect the authors’ confidence in Government and public funding to free medicine from predetermined agendas is misplaced, as the Government propaganda during the pandemic (and on numerous other issues) has shown. But the points about the corruptions that the dominance of big pharmaceutical companies bring to the development and testing of medicine deserve to be taken seriously.

Worth reading in full.

UK Life Expectancy in 2020 Was Still at 2010 Levels and Over 80, OECD Report Shows

A new report from the OECD has shown that the pandemic took life expectancy in the UK in 2020 back to 2010 levels. Life expectancy at birth dropped by one year from 81.4 to 80.4, a level last seen in 2009. In 2008 it was even lower at 79.8.

This has largely been reported as something shocking – “Pandemic wipes out decade of progress on improving life expectancy”, declares the Telegraph – but in fact what it really shows is how limited the impact of the pandemic has been.

Despite all the daily reports of deaths, the running total of over 165,000 Covid deaths, and the repeated lockdowns imposed to protect a health service ever on the brink of collapse, the country has experienced a mortality rate no worse than 2009. I don’t know about you, but I can remember 2009. I don’t recall any lockdowns and panicking, or coerced experimental medicine, or bodies piling up in the morgues. Yet it was a worse year for deaths than the great pandemic year of 2020. Let that sink in.

Why are we destroying people’s lives and livelihoods and dismantling our freedoms to avoid going back to 2009 levels of mortality? Are we that obsessed with extending life at all costs that we regard it as intolerable to return to mortality levels last seen around the time the current party of Government came to power?

BMJ Publishes Belated Attack on the Great Barrington Declaration, but It Doesn’t Hit the Target

The Great Barrington Declaration, which advocates a focused protection strategy for dealing with COVID-19, was published in October last year – before many countries around the world imposed their winter lockdowns.   

Recently, The BMJ Opinion – a journalistic offshoot of the well-known medical journal – published a very belated hit piece against the authors. As you might expect, it’s light on scientific arguments and heavy on tactics like ad hominem, guilt by association and appeals to authority.

The authors, David Gorski and Gavin Yamey, really don’t mince words. For example, they describe the Declaration (which has been signed by hundreds of scientists and healthcare professionals) as a “well-funded sophisticated science denialist campaign based on ideological and corporate interests”.

Not exactly a respectful way to talk about your colleagues. But it’s hardly the first time the Declaration’s critics have sunk to this level. Just last month, Jay Bhattacharya became the subject of a censorious petition which claimed that he “sows mistrust of policies designed to protect the public health”.

Gorski and Yamey begin their article by criticising the Declaration’s authors for collaborating with the American Institute for Economic Research, which they claim is a “libertarian, climate-denialist, free market think tank”.

I’m not sure why this is a ‘gotcha’. Lockdown is about as un-libertarian a policy as you could imagine, so it’s not really surprising that a libertarian think tank would oppose it. And in any case, the Declaration’s website clearly states that the document was “was written and signed at the American Institute for Economic Research”.

Martin Kulldorff has since clarified that the AIER president and board did not know about the Declaration until after it was published. But even if they had done, so what? As Kulldorff notes, universities like Duke and Stanford have received money from the Koch brothers. Should we therefore completely disregard what their academics have to say?

Gorski and Yamey’s next move is to cite social media censorship of lockdown sceptics as evidence that their arguments constitute ‘misinformation’. (Incidentally, that term – which basically means ‘information that’s missing from the mainstream narrative’ – appears no fewer than six times in the article.)  

However, this argument relies on circular logic: ‘Something was censored on social media? Therefore, it’s misinformation. How do we know? Well, misinformation is what social media companies censor.’ In reality, of course, the fact that something was censored is no indication whatsoever that it’s factually incorrect.

The authors then allege that when Sunetra Gupta and Carl Heneghan met Boris Johnson in September of last year, they were successful in “persuading him to delay” a ‘circuit breaker’ lockdown, which could have forestalled the second wave of infections.

As historian Phil Magness has already noted, this argument is deficient on two counts. It’s not clear that Gupta and Heneghan did persuade the Prime Minister to shelve the ‘circuit breaker’ idea. But even if they did, there’s no reason to believe that policy would’ve prevented a large number of deaths.

Finally, Gorski and Yamey compare lockdown sceptics to ‘climate science deniers’, insofar as both groups “argue that evidence-based public health measures do not work”. They call for experts to push back against the Great Barrington Declaration by highlighting “scientific consensus”, citing the John Snow Memorandum.

Of course, the pro-lockdown John Snow Memorandum is just another public statement signed by scientists and health professionals. If it constitutes “scientific consensus”, then so does the Great Barrington Declaration. I’m only aware of one attempt to gauge overall expert opinion on focused protection: the survey by Daniele Fanelli.

He asked scientists who’d published at least one relevant paper, “In light of current evidence, to what extent do you support a ‘focused protection’ policy against COVID-19, like that proposed in the Great Barrington Declaration?” Of those who responded, more than 50% said “partially”, “mostly” or “fully”.  

Regardless of the exact number of experts who support focused protection, claiming there is a “scientific consensus” against it is simply false. Long before the Declaration itself was published, many scientists had proposed some version of precision shielding. In fact, this was basically the U.K.’s plan until the middle of March, 2020.

On March 5th, Chris Whitty told the Health and Social Care Committee that we are “very keen” to “minimise economic and social disruption”, and mentioned that “one of the best things we can do” is “isolate older people from the virus”.

Another prominent scientist who has argued in favour of focused protection is Sir David Spiegelhalter. In an article published on May 29th, he and George Davey Smith said that we ought to “stratify shielding according to risk” because lockdown is “seriously damaging many aspects of people’s lives”.

They noted that this would require “a shift away from the notion that we are all seriously threatened by the disease, which has led to levels of personal fear being strikingly mismatched to objective risk of death”.

Among the ad hominems, appeals to authority and repeated uses of ‘misinformation’, finding a scientific argument in Gorski and Yamey’s article is not easy. And given that the content’s almost a year out of date, I’m not sure why the authors felt the need to publish it.

Editor-in-Chief of The BMJ Says Lab Leak Is “Plausible and Worthy of Serious Inquiry”

The two most famous British medical journals are The Lancet (founded in 1823) and The BMJ (founded in 1840). The Lancet – which is arguably the more famous of the two – has come under criticism in recent months for publishing a letter that dismissed the lab leak as a “conspiracy theory”.

Now the Editor-in-Chief of The BMJ has written a surprisingly bold editorial, which is titled ‘Covid 19: We need a full open independent investigation into its origins’. Referencing a longer BMJ article by the science journalist Paul Thacker, she notes that “suppression of the lab leak theory was not based on any clear evaluation of the science.”

She goes on to say, “We don’t know which theory is right, but a lab leak is plausible and worthy of serious inquiry.” And she concludes by calling for a “a full, open, and independent investigation.”

Thacker’s article, which is much longer, examines the role that scientific journals and journalists played in shaping the now-punctured narrative that COVID-19 couldn’t possibly have leaked from a lab in Wuhan.

The story begins with the aforementioned Lancet letter, published in February of last year. That letter, it subsequently transpired, had been organised by Peter Daszak – president of EcoHealth Alliance – who has funded controversial gain-of-function research at the Wuhan Institute of Virology.

Daszak’s letter helped to stifle debate on COVID origins for more than a year. As the molecular biologist Richard Ebright told Thacker, ‘conspiracy theory’ is a “useful term for defaming an idea you disagree with”. Ebright, incidentally, blames not only The Lancet, but also Nature and Science – the world’s two preeminent scientific journals – for suppressing the lab leak theory.

As an aside, Nature’s role in suppressing the lab leak has been covered extensively by the journalist Ian Birrell. As he notes, “Allegations swirl that it was not down to editorial misjudgement, but something more sinister: a desire to appease China for commercial reasons.”

Returning to Thacker’s article, he suggests two main reasons for the “U turn”, whereby the lab leak went from “conspiracy theory” to plausible hypothesis. The first is that Trump lost the election. Because Trump had endorsed the lab leak theory, Thacker argues, “Daszak and others used him as a convenient foil to attack their critics”. (So much for guilt-by-association being a logical fallacy.)

The second factor is that the WHO investigation into COVID origins, which had gone looking for evidence of zoonotic spillover, came back pretty much empty handed. “More worryingly,” Thacker notes, “members were allowed only a few hours of supervised access to the Wuhan Institute of Virology.”

In the final part of the article, Thacker documents the various media outlets and “fact-checking” organisations that have scrambled to retroactively cover their anatomy. For example, Vox added a correction noting, “Since this piece was originally published in March 2020, scientific consensus has shifted.”

Thacker’s article offers a case study in what happens when scientific journals and journalists neglect their duty of independence, and instead become purveyors of an official narrative. It is worth reading in full.