Editorial Note: Apologies for the Language
A year and a half ago this blog ran a series of posts about access to clinical trial data – reporting on how industry were going to engineer the appearances of transparency. See Won’t get Fooled Again, Access to Clinical Trial Data, and The Data Access Wars.
Do academics have wild dreams?
Several months later, soon after being fined $3 Billion, GSK trumpeted their endorsement of transparency by signing up to the AllTrials campaign and declaring their intention to put in place a method to allow researchers access to clinical trial data that would go beyond the wildest dreams of researchers. See April Fool in Harlow, and GSK’s Transparency and Access Journey.
Its all to easy to imagine a marketing department figuring that academics don’t have very wild dreams.
When GSK signed up to AllTrials Ben Goldacre rolled over and purred. The BMJ featured Andrew Witty on their front cover as the candidate of hope.
Rain on the parade
In contrast, on this blog, 1boringoldman and on RxISK a small group have warned consistently that this was not good news. That what would be put in place was a mechanism that gave the appearances of transparency but in fact would lock academics into agreeing with GSK and other companies as to what the outcomes of their trials have been.
No one wanted to rain on the AllTrials parade – it never seems like a good idea to fracture a coalition. RxISK put the AllTrials logo on its front page.
Not content with a few academic ghost authors, GSK’s maneuver has put industry well on the way to making Academia a ghost, a glove puppet manipulated by company marketing departments.
Meanwhile Iain Chalmers co-wrote an editorial with GSK endorsing the GSK approach (The Attitude of Chicks to Trojans and Horses) and the British Government produced a document on clinical trial data access that could have been written in GSK central.
The GSMA-ESK model
The great hope for those dismayed at all this lay with EMA who following Peter Gøtzsche’s initiative and a European Ombudsman’s ruling looked like a beacon of hope. But this week EMA has come out and said it is going to put in place the GSK model of data access.
Everyone is in a spin. AllTrials are asking for more donations to continue their successful campaign.
As someone who has been working the GSK system, I can say with confidence that this is a disaster.
The key thing that companies are trying to hide are the data on adverse events. To get to grips with the adverse events in a clinical trial is a bit like playing the children’s game Memory – where you have a bunch of cards with faces turned face down and you get to pick up two and then have to remember where in the mixture those two were when you later turn up a possible match.
Patterns of deception
In the same way, picking up adverse events is about recognizing patterns – patterns of events, and patterns of deception.
To do this you have to be able to spread maybe a hundred documents out over a big area and dip back into them if something in one document reminds you of something in another. The new GSMA-ESK remote access system simply won’t allow this.
Not only will it not allow this but it is about to make things far far worse than they are at present.
At the moment when it comes to studies like Study 329, GSK have been stuck by a Court order with putting the Company’s Study Reports up on the web where they can be downloaded and pored over – all 5,500 pages of them for Study 329. They have refused to do the same for the 77,000 pages of raw data from Study 329, making it available to a small group of us through a remote desktop system.
For all other trials – future and past – investigators won’t even be able to get the Company Study Reports in usable form. They too will only be accessed remotely.
For anyone who wants to look at the efficacy of a drug this might just about work for outcomes that involve rating scale scores or lipid levels. The efficacy of drugs is pretty well all that most Cochrane groups, Iain Chalmers and Ben Goldacre are interested in. The Cochrane exceptions have been Tom Jefferson, Peter Doshi and the Tamiflu group.
But this system is a bust when it comes to adverse events and it won’t work if the efficacy outcomes are in any way complex.
What can be done?
The first point to make is this. Clinical trials are not all they are cracked up to be. Even if well designed, not using surrogate outcomes, of sufficient duration, done on patients who actually exist, and not written up by ghostwriters, clinical trials systematically get the wrong answer, especially on adverse events. Clinical trials are the gold standard way to hide adverse events.
One of the risks of the data access wars is that it will put an unwarranted premium on clinical trials and their data – and in this way play straight into pharma’s hands. This is what led “Crusoe” to warn Peter Gøtzsche a year ago that his data access crusade might backfire – See Marilyn’s Curse.
Let’s make no mistake here – it’s morally indefensible that there is not full access to the data from scientific experiments. In this sense Peter is right and his outrage is well-placed and close to magnificent.
But, ceteribus paribus, it would be better for mankind if all clinical trial data were sunk to the bottom of the sea rather than being made visible to academics stuck in a submarine and only able to view things through a periscope, which is what the GSMA-ESK system offers.
It might have been better if AbbVie had won their legal action. Instead EMA’s accomodation with them has fucked us all.
Rape is a loaded word these days but in so far as what is happening is an abuse of consent and will primarily do harm to women and children it perhaps come close to being the best word. Consent processes in clinical trials were about telling you you were on a new drug that might be dangerous or might be involved in a marketing trial. Instead they have become a way for companies to justify hiding your data on the basis of a confidentiality clause they have slipped into the forms. See When Does Yes Mean No. Iain Chalmers, Ben Goldacre and AllTrials appear to have signed up to this.
Whether raped or fucked, the Dan Markingson case is a stunning example of what has gone wrong – the Markingson petition is probably a much better petition to sign if you really want to save yourself and others you know and love than the AllTrials one.
Let’s do the AbbVie again
Second the data companies are really hiding is their adverse event data. There are other ways to collect adverse event data.
We invited you 18 months ago to join an AbbVie – Let’s Do The AbbVie Again. This Irish invention is the reverse of a boycott – another Irish invention.
A boycott of a company’s drug would mean you don’t get the benefit. If you decide to AbbVie a company’s drug, you – we – can all make these drugs better by reporting on the effects they have.
Company efforts are geared more than anything else to ensuring that doctors and patients don’t report adverse events or ensuring that these events don’t register. If you really want to get up their nose, if you really want to send the marketing departments into a spin, if you really want a company CEO to blow a fuse, this is what you need to do.
Companies want to transform adverse events into non-information. You can stop this happening. If an event happens to you on a drug, you are in possession of the missing information. It’s our tolerance of the patients who have Disappeared in clinical trials that is killing medicine as we have known it.
AbbVie with us and then sit back and take pleasure in a marketer who says “Thank you for helping us make our drugs better – without you we couldn’t do it”.
Now there is of course a huge conflict of interest here. RxISK.org was set up precisely for this purpose – to register adverse events. But we will hand all events on to FDA or MHRA or whoever you want us to. What we will also do though, and we invite any doctors or others out there with backbone to help us do it, is to decide when a drug is causing an event – this is something no regulator will ever do for you or for anyone.
Boycott
The other option is a Boycott. Doctors could refuse to prescribe drugs for which the information was not fully available. The Panalba and Thalidomide cases have shown that this is the one thing industry is scared of – Report to the President.
If I made claims about a drug to my colleagues but refused to show them the data, they’d have no problem telling me to get lost. I’d be boycotted from here to kingdom come. But when it comes to industry, 99% of doctors lack balls.
Doctors have been given a license to degrade us by treating us like addicts – the origins of prescription-only status. They have been given a license to print money – we can only get our drugs through them. The very least they could do in return is show some backbone.
But this is a decadent situation and decadence rarely breeds courage.
Emily’s balls
The boycott was likely invented by Irish women. The Abbvie was too. There is one bulwark still standing in the way of GSMA-ESK. It’s the European Ombudsman, an Irish woman – Emily O’Reilly.
Chrys Muirhead says
Well said, great stuff!
And as a Scottish woman I’m doing my bit to challenge the dominance of big pharma in solidarity with a psychiatrist colleague, by blogging and sending Emails, by attending events to speak out and by taking every opportunity to shift the dominant paradigm. I believe the mantra of mental illness and the easy access to drugs as tools of choice for psychiatry has created a monster that needs to be put back in the box or brought down to size.
I’ve got a 6 inch metal plate in my leg which is likely to be a result of bone loss caused by maximum doses of venlafaxine in my 50’s. I didn’t trip or fall but was just walking down a stair (after a job interview) when my fibula fractured in 3 places, in March 2005. Ironically the venlafaxine in 2002/4 didn’t lift my mood, rather it made me worse, causing suicidal ideation and flatness.
I got it because the risperidone had depressed me. It was forced on to me when I experienced a menopausal altered mind state in 2002 at age 50. But the notes say “schizoaffective disorder” although I made a full recovery in 2004 with only the scars on my leg to show for it. However the label remains in my notes as a reminder to all and sundry that I am a mad woman despite my unbelief and total recovery. My 3 sons have all experienced psychoses at transition from boy into man. In their notes it says “family history of schizoaffective disorder (that’s me)”. Blame the mother. My own mother was labelled schizophrenic and my two younger sisters also. Psychosis is normal in my family.
You’re right to say that women and children will be harmed. We are always it seems at the sharp end of everything, in a man’s world. Picking up the pieces after traumatic psychiatric treatment, daddy knows best, and then getting accused of being “difficult and demanding” in the psychiatric notes of our sons and daughters. How dare we challenge an oppressive system which forces drugs into the non-compliant who in the real world are lauded for their non-conformity and entrepreneurialism. Horses for courses.
But I don’t care and will continue to speak out in a variety of ways and settings so as to influence change. It’s all about hearing voices.
Wendy Kaysing says
Hi Chrys —
I am a big fan of Dr. Healy –he’s a modern day hero in my book. I love the RxsK site…referred many people to it. But the reason I am writing to you is your comment because of your mention of menopause. I experienced a month long nightmare when I was prescribed Hormone Replacement Therapy…it was like the worst PMS times 1000. A month was enough…I looked for an alternative and found AM PM -at the drug store (on the shelf) –one bottle had black cohash in it as the main ingredient, the other had soy. I also used progesterone cream to eliminate other change of life symptoms and Voila! No more symptoms…felt great, hot flashes diminished.. anyway, kept up with that for a few years, then enter DHEA!!! This is my new “go to” to ward off almost all symptoms of aging…to name a few: My memory has improved immeasurably, my menopausal protruding stomach went away –increased metabolism, better reflexes (in fact great reflexes), better mood, more energy, stamina, my skin has improved…anyway, naturally I tell all my friend about it…DHEA is naturally produced in our bodies –male and female and peaks at around age 35 or so I read…then our bodies simply produce less and less until produces very little or none… DHEA is a precursor to the hormones. (this may not be technically correct, but my simple understand of it. I believe it is derived from the African Yam…(NOT a sweet potato but a real Yam). Look it up…do your own research…it’s been a lifesaver and life enhancer for me…of course I am not a doctor, or medical anything…I used tried it and it works for me…I get it in health food stores and Whole Foods…
BOB FIDDAMAN (@Fiddaman) says
Great use of analogies David.
FDA/MHRA have systems in place that are supposed to help doctors and patients make an informed choice about the drugs they prescribe/take.
Truth is, the system will often report severe adverse reactions then counter-balance with statements that suggest these drugs are still safe because some advisory panel or working group [littered with conflicts of interests] say so.
Any decent doctor, when faced with a patient suffering from a severe adverse reaction, should not only report it, they should follow it up too.
Alas, how can a GP follow up a report when those that assess the report just log it and forget about it? – [Which is basically what the regulator does]
The AllTrials campaign looks good on paper, it’s merely an extension of GSK’s ‘Patient First Program’, a program designed to make it look like GSK actually put the patient first when, in fact, the patient is a long way down the list when it comes to safeguarding their health.
Michael says
What if ethics committees required the consent form to say that consent was conditional on all (anonymised) patient data being published within one year of the end of the study?
RB says
It was a nice try, yet all physicians ever had to do was listen to their patients and pay attention to what they were seeing.
annie says
Obviously, asking nicely “can we see your data please” to drug hooligans isn’t going to work.
Time to step up the ante:
Get a super smart lawyer to go to the European Court of Human Rights when several hundred people allege that Glaxosmithkline are withholding data on a product, Seroxat, which they allege is a harmful product and they would like to see the data which made Seroxat a harmful product.
Sit outside the smart Glaxo building with a few banners Seroxat Sucks or something similar and invite along a few national journalists.
If it isn’t in the press then it isn’t happening……
And, GSK, threatening me with libel doesn’t bother me at all.
David_Healy says
I accidentally omitted Peter Gotzsche’s group when referring to Cochrane and Side Effects. There is a Cochrane Adverse Events group but it has had little impact.
Meanwhile Cochrane are close to the main players behind the notion that Statins have no side effects
Anne-Marie says
Through these fields of destruction
Baptisms of fire
Ive witnessed all your suffering
As the battles raged higher
And though they did hurt me so bad
In the fear and alarm
You did not desert me
My Doctors in arms
Sadly this is just a song and a dream that doctors would side with us in our suffering, I changed one word but it fits so well to how I feel. In reality Doctors are now deserting us and siding with the pharmaceutical companies, their hiding and denying our side effects, surely this is a crime against humanity.
Sarah says
Let’s hope that the ombudsman Emily O’Reilly’s request will provoke an examination of collective conscience of EMA by May 31st. She asks for the legal basis for the change of direction to clinical trial data. I want to know how the medical community can stand aside and allow sales and marketing strategies to determine the health and safety of humanity. There has to be uproar.
Conscience = CON + SCIENCE- surely not!
truthman30 says
Thank you Dr. Healy for speaking the truth about the GSK Transparency Swindle…
Access to data: on their terms, on their watch, by their methods, by their choosing, by their selection process..
This was never in the interests of transparency and always on the interest of generating good PR for gSK while at the same time creating a smoke-screen which gave them more control… they are a clever, devious bunch at GSK!…
I wonder what Ben Goldacre has to say about it all…
He is (or was) their biggest champion…
Ben Goldacre says
This blog post by David Healy is absurd.
The AllTrials campaign is really simple: it calls for all trials to be registered, with their full methods and results made publicly available. Where CSRs have been made, we call for those to be placed in the public domain.
Healy says we’ve created a situation where people are withholding CSRs: that’s simply absurd, this is precisely what we campaign against.
Healy says we’ve created a situation where CSRs are inappropriately redacted: that’s absurd, again, this is specifically what we campaign against.
Healy says we have created a situation where drug companies get to choose who has access to CSRs: again, that is ridiculous, this is exactly what we campaign against.
GSK have signed up to the AllTrials campaign: they join over a hundred patient groups, more than 75,000 members of the public, NICE, Wellcome, MRC, almost all academic and medical professional bodies in the UK, and a growing number around the world. When Bad Pharma came out, industry and others were able to pretend that information about clinical trials is no longer withheld. We’ve transformed that, triggered two select committees and put the policy issue on the map, created a coalition, unpicked a web of dangerous false reassurances by professional bodies, and made it impossible for industry to engage in glib denialism.
I’m delighted that GSK have signed up to AllTrials, along with all the other organisations. There are lots of problems in medicine. There lots of people and organisations who’ve done – and continue to do – things I think are harmful to public health. But where people do the right thing, I will applaud them for it. I genuinely think that’s the right thing to do. It doesn’t mean you’re part of an elaborate and complex conspiracy with people. It doesn’t mean you approve of everything they do at work and at home.
It’s easy, and attractive, to scream from the sidelines, and carry on screaming forever. It’s also possible to shout out clearly and succinctly about problems, try to set out and discuss clear solutions, floodlight the path forwards, and encourage people to go down it.
Lastly, and specifically, the issue of individual personal data. The AllTrials campaign doesn’t call for all the rich individual patient data from all trials to be simply posted publicly in the public domain: that poses too much of a privacy risk, because patients are identifiable in this data. This privacy risk isn’t as big as is claimed by some of those who seek to block transparency, but we decided that the issues around graded access control to IPD are too complex for a simple headline campaign, and we didn’t want to risk industry using the issues around protecting participants’ privacy as an excuse to derail discussion on the very important separate issue of access to methods and summary results. We were absolutely right: industry have repeatedly tried to pretend that AllTrials calls for individual trial participants’ personal data to be posted online, even though AllTrials is specifically focused on registration, methods, results, and CSRs. But as David Healy knows, most of the people involved in the AllTrials campaign, myself, Iain Chalmers and the BMJ included, are closely involved in pushing for greater transparency on IPD too. It is simply absurd to claim otherwise.
The comments section on this blog is clearly the worst place to say this, but it really is a big waste of everyone’s time to have to deal with the kind of misrepresentation and abuse that David Healy keeps posting. From past experience, I don’t believe that David will engage constructively with my taking the time to correct these repeated misrepresentations, and I honestly think that’s a shame. We’re all – most of us at any rate – trying to get things improved. Everyone’s time is short, and people run things like AllTrials in their spare time. If Healy has a better way to make things better, that’s great, he should crack on with it and get others behind him. If it involves misrepresenting campaigns, smearing people, shouting abuse, and hectoring from the sidelines, then I won’t be in.
As an addendum, three brief specifics, since time is short:
David Healy, above:
“Consent processes in clinical trials were about telling you you were on a new drug that might be dangerous or might be involved in a marketing trial. Instead they have become a way for companies to justify hiding your data on the basis of a confidentiality clause they have slipped into the forms. Iain Chalmers, Ben Goldacre and AllTrials appear to have signed up to this.”
– This is complete and utter fantasy. Neither I nor AllTrials have signed up to this. David Healy will be unable to provide any evidence to show that we have. Consent forms being used to justify withholding information is exactly what I’ve campaigned against.
David Healy, above:
“That what would be put in place was a mechanism that gave the appearances of transparency but in fact would lock academics into agreeing with GSK and other companies as to what the outcomes of their trials have been.”
– This is completely bizarre. AllTrials simply calls for all trials to be registered, with their full methods and results made freely publicly available, and CSRs where they’ve been created. It is impossible to argue that this “locks academics into agreeing with GSK and other companies as to what the outcomes of their trials have been”.
David Healy, above:
“Rape is a loaded word these days”.
It’s always been a loaded word, David.
http://dictionary.cambridge.org/dictionary/british/rape_1?q=rape
David_Healy says
The first point to make is this post isn’t about AllTrials. AllTrials is a footnote.
It’s about the dismay that many felt at EMA backsliding. It’s about how it was obvious that something like this was on the cards. Against this background uncritical endorsement of industry looked like a bad idea. There was a desperate need to stay awake. It looks like too many of us have been asleep.
Ben offers an outline of the AllTrials strategy here. It’s helpful to have this.
His accusation that these posts misrepresent campaigns, smear people, shout abuse, and hector from the sidelines looks like a description of posts by others elsewhere. With very few exceptions any comments to the various posts on this blog that in any way fail to support Ben or AllTrials have been deleted.
The post repeated an alternate analysis – that the main thing industry wants to hide are adverse event data.
In a post 18 months ago I outlined how to achieve this industry would in public deploy the issue of patient confidentiality as a main justification for hiding data. In this it seems to me they have been assisted by Iain Chalmers editorial with Patrick Vaillance and now by Ben.
The historical evolution of the confidentiality issue is that the first informed consent forms said nothing about not showing your data to anyone else. Unnoticed industry have slipped in a “we will of course show your data to no-one clause”.
At the EMA conference on data access in November 2012, I made two points. The second was that industry would assert the notion of their privacy rights – which they have done. The other was that no one signs to have their data sequestered. Afterwards, Iain Chalmers congratulated me on the point – I thought we were on the same page.
Whether adverse event data is key or not, Peter Gotzsche through the European Ombudsman and Tom Jefferson and Peter Doshi through Tamiflu and RIAT seem to me to have done more in practical terms to move the issues forward than anyone else. It leaves me wondering why there is an endless call to celebrate Ben and not Peter or Tom.
Some of us have been working the GSK system and can see what the pitfalls are. Even if not redacted, this is a system that will make it close to impossible to analyse CSRs properly. But if it’s not proclaimed by AllTrials first it seems like such insights are unwelcome.
In several posts before the latest debacle I outlined how in my opinion there was a real chance that magnificent though he has been and clearly morally right, Peter Gotzsche’s efforts may do more harm than good. Even without taking GSK’s preposterous data access system into account, pushing for data adds to the undue premium being put on RCTs Twenty years ago the moral case for access was as strong and the risks consequent on failing were much less in that we were less hypnotized by RCTs than we are now.
Far from responding shrilly, Peter Gotzsche recognized the risk and we have been collaborating ever more closely since. The issues are so complex we might all be making mistakes – the only people unwilling to concede this seem to be AllTrials.
The push for data access remains morally compelling but there are other things that can be done that might be more effective.
As the BBC program a week ago on Thalidomide, and previous posts here, make clear, industry fear a boycott more than anything else. It is the only thing they have ever responded to.
At the moment the focus is on a bunch of bureaucrats in EMA, who aren’t there with a brief to protect us other than by regulating the wording of advertisements.
The focus should be on doctors who treat patients. We could refuse to use drugs where there is no access to the data. It shouldn’t even take courage to do this. In my opinion, this is the call that’s needed now rather than a call to support more of what AllTrials have been doing. But who will lead such a call?
Along with colleagues I put forward a softer version of a boycott – an AbbVie – which encouraged doctors and patients to use drugs but to report on the adverse events which would in fact make these chemicals better medicines. It would be difficult for government or anyone else to gainsay this win-win option in the way they might come out against the lose-lose of a boycott.
There is a conflict of interest here. RxISK.org has a stake in this idea. It was set up before AllTrials to move ideas like this forward. I suspect those of us working on RxISK in the evenings and at weekends have been putting far more hours into the effort than the AllTrials team have.
At the end of the day, I may well be wrong on this, but I personally think AllTrials have been naïve. I don’t think industry are concerned about patient confidentiality except in so far as they are concerned to avoid being sued for injuries in clinical trials.
Recent decades have seen industry put Litigation Support Defences in place. As outlined a decade ago in Let Them Eat Prozac, putting a premium on clinical trials has been a key element in their litigation support strategy. Seen from this vantage point AllTrials offers Pharma a lot – all without the effort of having to conspire or fund a conspiracy.
Playing straight into industry’s hands is a hazard for all of us. Good intentions aren’t enough to save us. I’d rest more comfortably if the key players in AllTrials had a track record in bringing adverse events to light or even a record of supporting those trying to do so – if they’d really antagonized industry good and proper. It’s not that partnership isn’t nice but perhaps after playing hard to get first.
1boringoldman says
Over recent years, there has been a growing awareness that the data in pharmaceutical clinical trials has been routinely manipulated, and that we often can’t trust what we read in our journals about either efficacy or adverse effects. There’s a building consensus that there’s a space between the actual raw results and the public presentation that has been a devil’s playground and that the only solution is make it totally transparent. Goldacre’s AllTrials Movement, Godlee’s BMJ, the Cochrane Collaboration with Chalmers and Goetche, Healy’s efforts and RxISK, Doshi and Jefferson’s RIAT project, and many others have come at the problem from different angles trying to set things right. And the decision of the European Medicines Agency to implement a broad data transparency policy was an exciting step in the right direction.
Throughout this process, the pharmaceutical industry has erected roadblocks to data transparency at every turn. The suit by AbbVie against the EMA, the current attack mounted against Dr. Godlee, the article posted right now on the PhRMA site on intellectual property rights [http://www.phrma.org/innovation/intellectual-property], are just a few examples of industry’s attempts to undermine full data transparency. Even the concessions they’ve made are suspect. I’m on a RIAT team currently using the “remote desktop” interface provided by GSK for our project. The data is there, but the interface is so constricted that it severely limits anyone trying to do a thorough analysis of the information. I can’t see how it protects confidentiality or trade secrets. It just makes checking the data much harder than it needs to be. So I’ve come to see it as just another obstruction, nothing more. The recent turnaround in the EMA policy with a movement to view-on-screen-only access is a major setback – making the task of vetting clinical trials un-necessarily difficult.
I can see no reason for industry to have a seat at the table in the negotiations about data transparency at all. The misuse of their current ownership of the data, the record of the level of corruption in reporting, the number of negative studies with-held, the soft-pedaling of adverse effects, all point to what happens when they are allowed to control the data. The only pertinent issues are the true efficacy of the drugs and an accurate reporting of the adverse effects. The economic health of the current pharmaceutical industry is, in my mind, an immaterial point, as is whether they join AllTrials or not. If the standards required to guarantee the integrity of our pharmacopeia are prohibitive to our current system, then our system needs to change – not our standards. So as to the argument in the comments in this post above, I have nothing but respect for all parties represented and all of their efforts. But when it comes to the involvement of industry in deciding where we’re headed on this issue, I agree with BMJ editor Dr. Fiona Godlee who said that they have an “irreducible conflict.” In my mind, their track record is ample proof that they aren’t responsible players and should be viewed with the highest index of suspicion they’ve earned. This is closer to a war than a negotiation. The task of evaluating the efficacy and safety of medications is an essential obligation of the medical scientific community to our patients – a bottom line. It’s irrational to move that line because of the economic needs of any commercial sector. If that impedes research into new treatments, that simply means we have to rethink how we do medical research.
Mark Andrews says
Ben’s use of the word conspiracy reminded me that Sense about Science is a major partner in the AllTrials coalition. I worry about what this might mean – see below. Either Ben Goldacre doesn’t know about this in which case I’ll be interested in what he does next or he does and I’ll be interested in how others react to his knowing.
http://www.lobbywatch.org/lm_george_monbiot.html
The LM network is a political group that infiltrates media organisations and science-related lobby groups in order to promote its own agenda. The Science Media Centre, the Genetic Interest Group, Sense About Science, the Progress Educational Trust, and the Pro-Choice Forum, all have had directors, CEOs, policy directors, and other staff, who are part of the LM network.
Interview with George Monbiot
Do you actually think there is a network of people concertedly working together as this LM group?
That is a good question and I think it could be answered in several different ways. There is a group of people who have more or less stuck together for a long time. To what extent they consciously organise under a single name or under a single banner, I don’t know – you would have to ask them. But that they have pursued a very consistent agenda for quite a long time and the fact that they have moved first of all into one industry, television, and then into another, science communication, more or less as a body, suggests to me that there is a coordinated programme of action.
We all have networks of people that we interact with. What makes this so different? Why do you find it so worrying?
There are two reasons why I find it worrying. The first is that the agenda they pursue appears not to be pursued overtly. For example, when they ran the magazine Living Marxism it was very far from a Marxism journal – it was just about as far from a Marxist journal as you could possibly get. And it seemed to me that the title was a direct and deliberate attempt to distract attention from the fact that this was a far right wing libertarian publication which was using the terms of the left to make it look as if the positions it was taking were new and unusual ones. Whereas in actual fact they were very well trodden ones, but well trodden by people like the Libertarian Alliance who in theory were at the other end of the political spectrum.
I have never heard of the Libertarian Alliance before.
Mad as a pile of buckets. But what Living Marxism did, I felt, was to give the impression that it was saying something new because it was dealing with the issues from a left perspective whereas it was very plainly dealing with them from a right perspective. And it was taking a line almost identical to that taken by right wing organizations – particularly some of the business come lobbyist organisations in the US, such as the Heritage Foundation, the CATO Institute, the Competitive Enterprise Institute – and so they were able to play very effectively on this semblance of left parties. People find it is very hard to believe that a magazine called Living Marxism would be a right wing magazine. And so they said ‘oh look – the left has come up with something new – really I think that maybe we should be following this line ourselves’. It led to a great deal of confusion really, including among some people I know.
But it also gave, particularly Channel 4 who were the primary targets of the network’s manoeuvres, it gave them an excuse to run a lot of right wing diatribes, indeed some extreme right wing diatribes, while claiming that it was doing nothing of the sort.
This is particularly ‘Against Nature’?
‘Against Nature’. There was a series called ‘Zeitgeist’. There was a programme called ‘Attack of the Killer Tomatoes’. There was a programme called ‘Storm in a D cup’. All those and more involved the network’s members. And all took an almost identical line. And a line which was identical to that of Living Marxism. And in every case Channel 4, if you challenged them on this, could say ‘well, we should represent the whole of the political spectrum including the far left’. And you’d say ‘but this isn’t the far left – this is the far right’. And they would say ‘no, no, no – Living Marxism’. And that made things doubly difficult for critics. One because it distracts attention from the fact that Channel 4 had itself turned very sharply to the right under Michael Grade and Michael Jackson. From about 1992, it really swung quite sharply to the right.
So it wasn’t just political naivety on the part of Channel 4?
Well, they always claim that they want to get up people’s noses and upset people – and they do that very well. They upset the left all the time. But I see precious little evidence of them getting up the noses of the right and upsetting the right – it just doesn’t seem to happen. And it was partly the agenda, in particular, of Michael Jackson because I saw how the agenda was imported from BBC 2, where he was previously the controller.
But also, of course, it just happens to fit the needs of the advertisers. If you launch ferocious attacks on environmentalists there couldn’t be anything better from the point of view of the advertisers because the greatest political threat to the continued profitability of some of the major advertisers – like car companies, oil companies – is from environmentalism. So Channel 4 was able to say ‘well, of course we are not taking a right wing position on this – because this is the position articulated by a left wing outfit’.
So to get back to your original question, that is one reason why it concerns me. Because what you see is not what you get. And so that, for me, was a principle reason for trying to publicise what was happening and what they were doing.
But the second reason is that I don’t know what is going on. I don’t understand this move into science-related lobby groups. I know what is happening, but I don’t understand why it is happening.
Is it the kind of position that many of these organisations take that you don’t understand?
Not their position but their colonisation of the means of communication between scientists and the public and the way it happened so suddenly, so quietly. The way they are able to move into so many bodies.
And, of course, since I wrote that article they have taken some more positions – the Human Fertilisation and Embryology Authority and other places like that. And I don’t know what the agenda is. I mean, I know what their position is, but I don’t know what they are trying to do. And it just does seem very odd. That, suddenly, out of the blue, all these places were colonised by people who had no scientific credentials at all – they didn’t even have science degrees, and had no claim to have any special knowledge or to be able to speak on behalf of scientists with any special authority, but had just occupied these positions. From the point of view of the things I am interested in, this was problematic.
First of all because the people who presented themselves as neutral communicators of science were actually extremely biased. On an issue like GM, for example, they took a wholly pro-industry line. They were far to the right of the government. They are even to the right of some of the industry lobby groups actually in some of the stuff that they put out. It was even more extreme than Monsanto or Europa Bio or people like that.
But also it meant that when there were issues which desperately needed communication to the public, like climate change, what has theScience Media Centre, what has Sense About Science, ever done on climate change?
Yes, I have noticed that looking at their output. It is quite astounding.
And that is the greatest challenge to science that there has been since the days of Trofim Lysenko – climate change denial – which receives a massive amount of publicity in the Telegraph, the Mail, the Spectator – which has got huge industry backing and which, in the United States, of course, is official policy. And not a squeak from these people – who claim to be defending science.
And that to me is a dead give away that these people are industry lobby groups – they are industry lobbyists, they are not science lobbyists. And maybe that answers the question. Maybe… they are obviously trying to swing things towards their right wing agenda by making use of these outlets.
But why? Why do they want to do that? Why have a large number of politically active people dedicated their careers to that task? It is not the sort of thing you get up in the morning and you say, ‘Right, I feel very strongly about an issue and therefore I am going to apply for a job with the Human Fertilisation and Embryology Authority in some administrative position and try to do something about it that way’. There has obviously been a concerted programme of action here, but why they are motivated to take that action – I do not know.
Just to go back a little bit. I want to question you on your evidence for this network. Where does that come from?
Well, it is the same names that just keep coming up. There are several places in which they keep coming up. First of all Living Marxism, or LMas it turned into, then Spiked Online, the Institute of Ideas – which are the principle intellectual outlets of it. And the people in these organisations, like the Science Media Centre, Sense About Science, are regular contributors to those. Also, of course, some of them were students of Frank Furedi’s sociology courses at Kent. And so there is a clear link between these people. They are clearly ideologically linked. They are clearly organisationally linked in that they have been working through or for the same organisations. And they seem to gravitate around the same figure, which is Frank Furedi. But I don’t believe they are card carrying members. I don’t believe they have a membership card with their name and a number on it, or that they have necessarily swirled their blood around in a bowl and made some sacred pact. But that they are working together and working more or less as a body is quite clear.
When your article Invasion of the Entryists came out, how did you feel the scientific establishment reacted?
Of course there is no single scientific establishment, so I can’t say that it did this as a body or it did that. I guess my initial surprise was how quiet it was. What I had imagined, perhaps fondly, was that people like Sir John Maddox and Susan Greenfield would say, ‘What the hell have we been involved in – we had better do something about this and distance ourselves from it’. But that didn’t happen. I was surprised to see that didn’t happen. However, subsequently there have been quite a lot of fairly prominent scientists who have been in touch with me saying, ‘We are concerned about this. What do you think is going on’? Whereupon I say, ‘I don’t really know – what do you think is going on?’ But what absolutely staggers me is none of these people have lost their positions. And indeed, some of these people have gained positions subsequent to that. Which suggests either profound complacency on the part of the trustees and advisory boards and governing bodies of these organisations, or profound ignorance – they simply haven’t bothered to read the material, or collusion of some kind.
Now I have no doubt that Susan Greenfield [head of the Royal Institution and a key player in the setting up of the Science Media Centre] is very close to industry in her views. I don’t believe that she is an industry flack. Dick Taverne is [Taverne is the Chairman of Sense About Science and was also involved in the setting up of the Science Media Centre]. There is no question about that. He makes no bones of the fact that he is a PR man, and that is what he has always been and so I don’t see him acting against that. I see him working very closely with them. And I see him deliberately and consciously adopting their agenda. But people like John Maddox – I can’t understand. I think he has been staggeringly complacent about it.
So how would you characterise their ideology – particularly in relation to science?
Their ideology bears very little relation to science. It actually bears a close relation to corporate demands and where those demands are consistent with science they will claim to be on the side of science and where those demands are inconsistent with science they will keep quiet about it.
Like, for example, climate change?
Like for example climate change. Climate change is a classic example. As I suggest, it is where science has been most severely challenged and by anti-scientists. And yet, of course, many of those anti-scientists have been sponsored and promoted by corporations. And surprise, surprise…the LM network keeps quiet about it or indeed occasionally there are articles on Spiked Online that say there is no problem and that take the side of the anti-scientists, the climate change deniers.
GM – well the GM controversy is largely not a scientific controversy. It is a political and economic controversy; it is about the control of the food chain by multinational corporations. And what the Science Media Centre and the whole network have done is to portray it as a scientific controversy and to say that those who are anti-GM are anti-science and to claim to take the side of science. Now in my view GM crops are not science, they are technology. They are the products of science. And a scientist has no more obligations to be in favour of the production of GM crops than he does to be in favour of the production of barbie dolls. In both cases, it is simply outcomes of the science – not the science itself. And to say that someone who doesn’t want GM crops to be planted is anti-science is like saying that someone who doesn’t like the millennium dome is anti-architecture.
So clearly theirs is not a scientific position. And despite their claims it is not a pro or anti science position – it is a pro-corporate position and they will adapt their claims to what science is and isn’t around the demands of that pro-corporate position.
What impact do you think the Science Media Centre and Sense About Science are having? Are their messages resonating? For example, the journalists that you know, how do they respond to the organisations?
At the height of the GM controversy they had a big impact. I am thinking in particular of the BBC programme, Fields of Gold, where they waged a massive campaign against that and against the writers of the programme of the script and against the BBC. It was a two part drama I think. And they drew blood. There is no question that they drew blood. They portrayed it all as an anti-science conspiracy. And of course the right wing press loved it. Partly because the two authors were connected to the Guardian. One was the editor of the Guardian, Alan Russbridger. One was Roland Bennett who is an occasional contributor to the Guardian but is married to the deputy editor of the Guardian. And so, of course, this was a wonderful opportunity for the right wing press to bash the Guardian, bash the BBC, and bash the opponents of a technology the corporations wanted to roll out. So they were pushing at an open door – it wasn’t hard to score media hits on that. But, there is no question that people like Fiona Foxmanaged to co-ordinate it – the campaign against that drama. And in my view the response both from the SMC and the right wing press pretty well amounted to a call for censorship.
Which is ironic, as of course that lot have always claimed that they are pro-free speech and anti-censorship. But then they have always been staggeringly inconsistent in this way. Frank Furedi was quoted in The Times Higher as feeling victimised and a victim of a McCarthyist witch-hunt and everything. This is a man who rails against the victim culture; whose whole politics is about people claiming to be victims and wrapping themselves in the mantle of victimhood. The moment anything is turned against him, he is very happy to do the same thing.
How would you characterise the political position of the Times Higher?
I don’t know. I don’t know what the politics are within it. I know that Furedi is a columnist and it is a Murdoch publication. To what extent that influences its coverage, I just don’t know.
And Mick Hume does the column in The Times.
We should not be at all surprised to find the corporate press embracing these people. They are putting out exactly the message that the corporate press want people to hear.
I accept that you have these spikes where the Science Media Centre make an impression, but what about on a day to day level? How do you think that they influence the science journalists?
Well, that I don’t really know, because it is only really the spikes that we notice. From the point of view of what I have seen, they seem to have been quite quiet recently. But I don’t know what they have been up to. I don’t know who they are talking to and you don’t know about the quiet and covert influence that they might have.
Could you give more examples really of how you see them as not being as transparent as they might be? You gave an example earlier.
The idea of them sitting behind what appears to be a front?
Well another example is the way in which you have got this great proliferation of organisations which all do the same thing and have the same people in it, but run under a host of different names.
And perhaps, even more importantly, the way in which they stage debates which claim to be objective and even-handed debates but are totally controlled and managed. And this is what the Institute of Ideas specialises in. Where it will…it is very clever, it knows how to get famous names…because it will write to Melvyn Bragg or someone and say, ‘Mahatma Ghandi, Nelson Mandela and Jesus Christ are coming to speak at this conference we are having in six months time – would you like to join them?’ and they say, ‘Oh yes’. And then they’ll write to Fay Weldon and say ‘Melvyn Bragg, Mahatma Ghandi, Nelson Mandela and Jesus Christ are coming’. Etc. And then they’ll say ‘Unfortunately, Mahatma Ghandi, Nelson Mandela and Jesus Christ can’t come, but anyway we have got Melvyn Bragg and Faye Weldon’. And that is how they operate. So they get all these names together and everyone thinks ‘Oh look…look at all these big names doing this debate, it has got to be a really good debate’. And then they will stuff the panels with these network people. And then you’ll suddenly say ‘Well no, hang on, wait a minute – there’s Tony Gilland, and there’s Juliet Tizzard, and there’s Fiona Fox – what are they doing on the panel?’
Have you been to any of them?
I’ve read the line-ups quite often and I went to a couple at the ICA, when the ICA was working very closely with them.
The ICA particularly seems to have been quite close in the past.
Well that was under Phillip Dodd, and I don’t know if it’s still the case. He actually came up to me quite unsolicited last time I met him and said ‘Oh yes – we’re not going to work with those people anymore’. And he didn’t explain why and he didn’t quite explain what he meant either but he seemed very embarrassed about it.
They did all those ‘Culture Wars’ stuff at the ICA and I did go to a couple of those. And not only the panels, but also the audience, was completely packed. You had all these men in black shirts buttoned up to the neck with deep, deep frown lines who would stand up and say completely insane things, but it was the same form of insanity. And they were sort of scattered in the audience. And so that form of organisation, where there is a clear attempt to create an impression that you are being even-handed whilst rigging the debate – that is also what I would call a form of covert operation.
Do you think then that it is possible to trace a particular line back to Living Marxism, to LM and then to the current publication Spiked?
There is no question. They don’t make any bones about that. They are perfectly clear that Spiked came out of LM and they have also, at times, been perfectly clear that the Institute of Ideas came out of LM as well. And in previous times they were clear that LM came out of theRCP. But if you challenge any of them, as once I did challenge Frank Furedi, he said ‘Oh, no…I’ve never had anything to do with any of that’. And, of course, he was absolutely central to it. He has always written for them and all the rest of it, so it seems very odd.
And of course not all of them are old enough to go back to the RCP. I am sure that Tracey Brown [the director of Sense About Science] isn’t and Ellen Raphael [Brown’s deputy at Sense About Science] and people like that aren’t. But the original core – so in other words Hume, Furedi, Claire Fox, people like that – they go back to the RCP days.
Would you say that your article ‘The Invasion of the Entryists’ was really the article that put this stuff into the public domain?
Yes. And I don’t take any credit for this. It was Jonathan Matthews of GM Watch who had done the real research. I mean I did some research on top of his research, but he was the one who cracked the story. He found out what was happening and I was the vehicle for getting that into the media. And, of course, there was a huge amount of material. I could have filled the whole newspaper with that article, but it had to be very compressed, and I put 30 or 40 references on the end. But he had really done a very good piece of work.
I had written several pieces about them before – but not about the science. And I do think that that is the first time it had ever been exposed.
Are you at all worried about being seen as engaging in conspiracy theories?
There is no need to engage in any conspiracy theories here – collaboration is taking place. It is visibly taking place. It is overtly taking place, and these people would not deny working together. And if that means they are ‘breathing together’, ‘conspiring’ then, plainly, that definition would fit. But you don’t have to have any wild ideas to demonstrate what is an evident truth – that there is a level of organisation and a level of co-ordination taking place here.
BOB FIDDAMAN (@Fiddaman) says
Ben likes the conspiracy word.
He once tweeted the following to me:
“@Fiddaman you’re one of the angry smeary conspiracy theory people, aren’t you? ”
https://twitter.com/bengoldacre/status/413720505158348800?refsrc=email
Shame really. He comes across well but lets himself down with the labelling.
I don’t really see myself as an angry smeary conspiracy theorist, just a blogger with a gripe and some issues to settle.
Anyway…
Tracey Brown says
David, you haven’t answered or explained the misrepresentations of the AllTrials campaign pointed out by Ben. You’ve called it a footnote and moved onto other issues.
If you return to it you might read the news pages on Alltrials.net where you can see what we have done so far to build a public campaign, get organisations and individuals signed up and to influence the Clinical Trials regulations in Europe. These latter were already underway when the campaign began last year. No-one was making a fuss and the lobbying was all one way. We could have railed that the pharma lobbying effort was so much bigger than us, but instead the campaign managed to secure some good last minute additions to improve a bad lot. We got them backed by patient and consumer groups and engaged sufficient people across Europe in writing to their MEPs to affect the final regulations, see here: http://www.alltrials.net/news/europe-votes-for-clinical-trial-transparency/. They are nowhere near enough. We are also working with professional bodies to deem it professional misconduct to fail to register trials and report results, with ethical approval bodies to monitor reporting and refuse consent where previous triallists haven’t reported, with registries to make more past trial registration possible and with the media to publicise the need to rectify this gross abuse of patient trust and to publicise projects such as RIAT.
The EMA guidelines on releasing CSRs were also already under review when the campaign started. We organised a researcher-led response to challenge the moratorium on EMA releases caused by the AbbVie and Intermune cases. The guidelines are not yet published. We are pressing for maximum transparency and challenging the idea that side effects are intellectual property. Note, though, that even if the EMA comes out in favour of full transparency, their guidelines are only concerned with the CSRs they have, which are the ones that industry submitted to national regulators who then submit dossiers to EMA. This wouldn’t alone solve the bigger problem of lost and hidden trials.
But there’s a bigger point here about the context that AllTrials was created in. Which was decades of a secrecy problem that was unfixed and, worse, increasingly being justified by data privacy concerns (see please the dreadful new data protection legislation amendments that the European Parliament has just voted on to see yet another threat to CT transparency).
Despite the era of transparency that is now emerging in many areas, in medicine it has been considered normal to hide trials and fail to report results. We were looking at a level of secrecy that had prevailed despite vehement critiques of the practices of the pharmaceutical industry. Such secrecy in the pharmaceutical industry was so normal that regulators defended it. So normal that professional bodies actively supported it, so normal that non-industry triallists were routinely sloppy about their obligations to register and report trials and so normal that side effects data has come to be seen as a commodity to be traded. So we sat down, looked at all the objections being raised against CT transparency and saw that privacy and individual patient data ‘concerns’ were being used to overcomplicate it and scare regulators and patients. These fears had trapped many sensible people in esoteric debates that could never be a rallying point for the medical profession, never mind the wider public. We needed to create a new normal, where it is unthinkable that all trials wouldn’t be registered and publicly report results. That needed the kind of international public and practitioner support that can lift threats of boycotts or other action off the written page and make them meaningful. That is what we have set about doing.
Angry screeds about the terrible behaviour of the powerful and secretive pharmaceutical industry might sound tougher. They are certainly deserved. But in the context of trying to make things really change, finally after decades, they are in fact excuses – excuses offered in advance for being ineffective against it all. And in campaigning you can have excuses or you can have results, but you can’t have both.
Tracey Brown, Sense About Science
David_Healy says
Tracey
I have never denied that AllTrials have picked these issues up. But I do think that they haven’t given others the credit they deserve. I also think the AllTrials strategy has been wrong. I’ve said from a long time ago that it risked – and it now looks like it has – backfiring. We will end up with the appearances of transparency but will have access to nothing useful. A worse situation. I think RxISK produces the results that count.
I wish AllTrials had as good a track record but I wonder if that’s really the intention of all its Coalition partners. It would be good if you could address the issues raised about Sense about Science in one of the recent comments here.
David
David
Tracey Brown says
No. A look at Sense About Science’s work would make a nonsense of it for you http://www.senseaboutscience.org
truthman30 says
In my interactions with Ben Goldacre, I have found that he fails to address anything which I have written about in my posts and he seems more concerned with discrediting any scrutiny of the link between GSK and Alltrials. Ben has yet to realize that there are many others involved in the debate about pharma, transparency, data, patient welfare and all the other related issues. I was prescribed a GSK drug- Seroxat- which harmed and injured me because I was not warned of the side effects, and also because GSK concealed them. I have been researching the pharmaceutical industry for 10 years because of my experiences, and I am as knowledgeable as Ben on most of these subjects. I don’t have his science background but I am educated and I am well informed. I would prefer if Ben began a dialogue instead of treating everyone else as if they are mindless idiots, and that he is the only authority on these issues. That’s not a dialogue- it’s dictating. Ben needs to stop being so defensive and start listening to others.
Ben Goldacre says
I’m all up for serious conversations about strategy but as I pointed out in my post, Healy is simply saying things that have no foundation in reality. That’s not a productive contribution.
https://davidhealy.org/fucked/#comment-105894
David Healy says:
“Consent processes in clinical trials were about telling you you were on a new drug that might be dangerous or might be involved in a marketing trial. Instead they have become a way for companies to justify hiding your data on the basis of a confidentiality clause they have slipped into the forms. Iain Chalmers, Ben Goldacre and AllTrials appear to have signed up to this.”
– This is complete and utter fantasy. Neither I nor AllTrials have signed up to this. David Healy will be unable to provide any evidence to show that we have. Consent forms being used to justify withholding information is exactly what I’ve campaigned against.
David Healy says:
“That what would be put in place was a mechanism that gave the appearances of transparency but in fact would lock academics into agreeing with GSK and other companies as to what the outcomes of their trials have been.”
– This is completely bizarre. AllTrials simply calls for all trials to be registered, with their full methods and results made freely publicly available, and CSRs where they’ve been created. It is impossible to argue that this “locks academics into agreeing with GSK and other companies as to what the outcomes of their trials have been”.
David has given no justification or response on these two blatant examples. Differences are one thing, they’re great, I’m always keen to discuss them. But they have to be anchored in reality. With the best will in the world, as above, David Healy is simply saying things that aren’t true, and it’s very hard to see how it’s possible to have a serious conversation with someone who does that.
David_Healy says
On the first point, we have Iain Chalmers and Patrick Vaillance’s editorial making the case for restrictions on access to the data on the basis of patient confidentiality issues. This seems to be endorsed by Tracey Brown in her comments just above. Is there a difference here Ben between you and them?
There may be distinctions between All Trials and Iain Chalmers and Sense about Science so that it may be possible to claim that AllTrials has said nothing of the sort because its mission statement says almost nothing. As a counter to criticism Tracey and Ben seem to fallback on an AllTrials minimalism. I’m with Mickey Nardo on this one. A strategy of just calling for trial registration and CSRs and not insisting on access to all trial data right now is morally wrong and likely to fail.
I think it was a terrible symbol to have BG and BMJ welcoming GSK’s offer of transparency. It was very clear from the time this offer was made that it was likely to be a marketing move primarily aimed at diverting attention from the many scandals GSK were involved in then and continue to be involved in and having AllTrials endorsement was the icing on the cake. Mistake or not?
Shelley Jofre almost single-handedly has done more to get access to trial data than AllTrials have. AllTrials wittingly or unwittingly seem to have helped conceal what GSK and Roche have been up to. The recent House of Commons Select Committee Report on Clinical Trials makes a data access proposal that seems to fit in with BG testimony to the committee and likely owes something to the apparent cosy relationship between AllTrials and major companies. This AllTrials “effect”, although perhaps not intended or part of the mission statement, is however consistent with a Sense about Science corporate agenda that George Monbiot has drawn attention to. The road to Hell is paved with good intentions, and mission statements.
On the second point, calling for CSRs without the data is misguided. Having worked with several CSRs, and having worked the GSK system, and having had lots of experience with how companies like AbbVie redact CSRs, and alert to how companies are likely to write CSRs in the future knowing the use to which they will be put, I stand fully behind the view that making CSRs alone available will lock academics into endorsing the company view of their drug. To think otherwise is naive. Steve Nissen is not going to be let happen again.
I’m not the only person who can see how this can come about. If AllTrials can’t see it, then the options seem to be that those involved have little or no experience of working with CSRs or else just believe their new partners are good chaps. In the former case it might be worth while liaising more closely with Peter Doshi, Tom Jefferson, Mickey Nardo and Peter Gotzsche and perhaps recalibrating the strategy based on their input. In the latter case, well …
David_Healy says
I’ve had a lot of exposure to industry litigation support defenses.
Many of the positions being adopted by AllTrials, although perhaps not part of the core mission statement – such as the position that only academics with an approved analytic plan should be let access RCT data – play straight into how industry have been defending pharmaceutical cases for the last two decades.
I’m clear not all the AllTrials coalition are witting parties to this – the BMJ for instance – although on legal advice BMJ rarely if ever publish anything on adverse events.
There is a good deal to suggest Sense about Science may be a lot more witting – see the material below from powerbase. I’m afraid Tracey looking at the Sense about Science website doesn’t relieve my worries.
http://www.powerbase.info/index.php/Sense_About_Science
The UK lobby group Sense About Science says it is
an independent charitable trust promoting good science and evidence in public debates. We do this by promoting respect for evidence and by urging scientists to engage actively with a wide range of groups, particularly when debates are controversial or difficult.[1]
Sense About Science’s Financial Statements (year ended 5 April 2007) submitted to the Charity Commission summarise its mission as “promoting good science and evidence for the public”.[2]
Sense About Science states that it was formed in January 2002 to advance an evidence-based approach to scientific issues in the public domain. It was formalised as a Trust in August 2003.[3]
Its domain name was registered in March 2002. Within months it had begun to promote its point of view on GM crops to parliamentarians and the media, and had raised funding. The Sense About Science website states that the organisation works with “a wide network of organisations and volunteers from all areas of science”.[4]
LM connections
One of the trustees, Michael Fitzpatrick, has a longstanding involvement with the LM network and its predecessor, the Revolutionary Communist Party. Sense About Science directors Tracey Brownand Ellen Raphael worked for the London-based PR company Regester Larkin[5][6] until shortly prior to joining Sense About Science and are also part of the libertarian network which includes LM,Spiked, and the Institute of Ideas, to all of which Brown and Raphael have contributed. The domain name for the Sense About Science website – senseaboutscience.org.uk – was registered by Rob Lyons, the web master for Spiked.[7][8] Brown and Raphael are also key players in another of the network’s front groups, Global Futures. The phone number for Global Futures was the same as that for Sense About Science – see screengrabs, right.[9][10][11][12]
Royal Society connections
Royal Society former Vice Presidents Peter Lachmann and Brian Heap are respectively on the Sense About Science advisory council and board of trustees.[13][14]
Influencing the GM Public Debate
Sense about Science was created just in time for the UK’s official GM Public Debate.
In October 2002, Tracey Brown, its director, attended a meeting hosted by the UK government’s Central Office of Information (COI) about the design of the Public Debate. She was invited as part of a group of eight “social scientists familiar with the GM debate and public engagement processes”.[15] In fact, although Brown has a masters degree in the social sciences, her area of specialism was the sociology of law.[16]
Interestingly, Brown is not the only LM contributor whose advice was sought during this period. Bill Durodie describes himself as an ‘advisor’ to the Prime Minister’s Cabinet Office Strategy Unit study ‘The Costs and Benefits of Genetically Modified (GM) Crops’,[17] which formed a parallel strand to the Public Debate in the government’s assessment of the issue of GM crop commercialisation.
Public opposition to GM and farm scale trials: damage limitation
In 2003 the GM Public Debate showed an overwhelming level of public opposition to GM crop commercialisation.[18] In a double blow to GM proponents, the UK government’s farm scale evaluations (FSEs) had shown a generally discouraging environmental impact from the GM crops trialed.[19][20][21]
Sense About Science launched a media campaign in an apparent attempt to limit the damage to GM caused by these two events.
On the eve of the 2003 publication of the first round of the FSE results, an article, based on the preliminary findings of a survey organised by Sense About Science, of institutes carrying out GM crop trials appeared in The Times under the headline, “GM vandals force science firms to reduce research”.[22] Sense About Science’s director, Tracey Brown, was quoted in the article as saying, “The burden of trying to organise the research community to pre-empt and protect from vandalism is potentially disastrous.”[23]
Articles in the Times Higher Education (THE) and elsewhere went still further, suggesting the GM Public Debate had been ‘hijacked’ by ‘activists’ and that GM plant researchers were being subjected to physical and mental abuse, leading some to take jobs abroad. One THE article, headlined, “Scientists quit UK amid GM attacks”,[24] included claims of intimidation by Chris Leaver (a Sense About Science trustee[25]) and the late Mike Wilson (then a Sense About Science advisory panelist).[26]
Anti-GM activists accused of violence and terror
Another article, “GM debate cut down by threats and abuse”, sounded an even more sinister note. It spoke of ‘ the increasingly violent anti-GM lobby’, ‘ growing levels of physical and mental intimidation’, ‘ hardcore tactics of protesters’, ‘ intimidation by anti-GM lobbyists… mirroring animal-rights activism’, ‘ increasingly vicious protests’, ‘” a baying mob” of anti-GM activists’, ‘a string of personal threats’, etc.. It also contained a call for ‘the government to intervene to protect researchers.'[27]
Despite its use of such words and phrases as ‘increasingly vicious’, ‘violent’, ‘hardcore tactics’, ‘physical… abuse’, and so on, the article failed to cite a single instance of a researcher, or anyone else, being assaulted by anyone from the ‘anti-GM lobby’. Indeed, the only specific threat of any seriousness referred to in the article was a bomb hoax said to have occurred some five years earlier, in 1998.
The scientists claiming intimidation were once again Chris Leaver and Mike Wilson but they were joined this time by Anthony Trewavas, a highly vocal and often controversial supporter of GM, and co-author with Leaver of several letters and papers rebutting criticism of GM.[28] Chris Leaver is a member of the governing council of the John Innes Centre as of December 2009.[29] As of February 2004, Trewavas was also on the governing council of the John Innes Centre (JIC),[30] where Mike Wilson used to work. Trewavas was no longer a member of the JIC governing council in April 2005.[31] In common with Wilson (as at April 2005),[32] Trewavas (as at August 2006) was on the advisory board of the pro-GM lobby group Scientific Alliance – as were GM proponents Bill Durodie, Vivian Moses,Tom Addiscott of Rothamsted Research (retired), Mike Wilson, and Colin Berry.[33]
A month after this series of articles began with a piece in The Times, another article appeared there by the Chairman of Sense About Science, Lord Dick Taverne. The headline was, “When crops burn, the truth goes up in smoke”.[34] Taverne’s article spoke of farmers and researchers being terrorised and of ‘anti-GM campaigners’ adopting ‘the tactics of animal welfare terrorists’. No specific examples were given, yet again, other than the bomb hoax. Taverne’s article admitted that environmental groups like Greenpeace and Friends of the Earth ‘may condemn violence’ but concluded, none the less, ‘The anti-GM campaign has become a crusade. Its champions… have become eco-fundamentalists, followers of a new kind of religion… But when campaigns become crusades, crusaders are more likely to turn to violence.'[35]
Given such repeated and unsubstantiated attempts to associate those opposing GM crops with violence and even terrorism, it is ironic that the staff of the lobby group which Taverne chairs are associated with a political network, and have contributed to a publication (LM/Living Marxism), which has at times refused to condemn, or has sought to deny, acts of violence of a truly horrific character (e.g. acts of terrorism by the IRA, the genocidal massacres in Rwanda[36], Serb nationalist atrocities in the former Yugoslavia[37]).
Fiona Fox and Tony Gilland, who both sat on a Sense About Science Working Party on peer review (see below),[38] are also both LM contributors.[39] Indeed, Fox penned the notorious LM article denying the Rwandan genocide.[40] She also wrote articles that provided a platform for those opposing the peace process in Northern Ireland.[41]
A letter to the Prime Minister
At the end of October 2003 a letter was sent to the British Prime Minister Tony Blair from 114 UK scientists complaining about the lack of government support for GM during the UK’s public debate. They complained that the ‘genetic engineering of plants has been reduced to a matter of consumer preference.'[42][43]
The letter attracted considerable media coverage. Pallab Ghosh covered the news for the BBC while an article in The Times said, “More than 100 leading scientists have made a once-in-a-generation appeal to Tony Blair to save British science from a tide of neglect and abuse that is driving the brightest young brains abroad”.[44] The Times piece also referred to the signatories as ‘114 eminent researchers’. It quoted the lead signatory Prof Derek Burke as saying that the signatories provided “a measure of the concern that is out there. A cross-section of the British scientific community feels that evidence that has been carefully and painfully collected is just being swept aside”.
The letter was followed by a parliamentary question and letter to Tony Blair, asking when he would respond, from the chair of the parliamentary science and technology select committee, Ian Gibson.[45]
Signatory Chris Leaver told the Times Higher Education, ‘The letter seems to have succeeded in shaking the creeping view – especially in government – that “we probably have to let the campaigners have this one” and hope that things might change in years to come. Also, it has given the government something to respond to other than its more regular critics in this debate, creating some unease about the state of the debate and whether we have the full picture.'[46]
In his response, published in THE, Blair emphasised his government’s support for biotechnology research and his recognition of its economic value.[47] [48]
Media reports on the letter initially stated that Derek Burke was the man behind it. The THE, for instance, reported, ‘The letter was written and coordinated by Professor Derek Burke, the former chairman of the UK government’s GM advisory committee.'[49]
But an article published in the THE just a few days later (7 November 2003) told a very different story: ‘The letter was coordinated by Sense About Science’.[50] And the THES Leader on the subject did not even mention Derek Burke but referred rather to, ‘The new organisation behind the letter, Sense About Science’. The editorial concluded, ‘Sense About Science is entitled to demand that both their [the government’s] words and their deeds are more forceful.'[51]
Derek Burke, the letter’s lead signatory, was at that time on the advisory council of Sense About Science,[52] and a significant number of the other signatories are connected to Sense about Science either via the advisory council or its board of trustees.[53] These in turn connect to the Sense About Science network of scientists and NGOs’. For instance, Professor Vivian Moses who is on the advisory council is also the chairman of the biotech-industry funded lobby group CropGen. Phil Dale from the advisory council works at the John Innes Centre with its history of multi-million pound ties ties to the biotech industry. More than 20 of the signatories had past or present connections to the JIC.
This also reflects the fact that far from representing, as Derek Burke told The Times, ‘a cross-section of the British scientific community’, the signatories were predominantly plant scientists. The THE noted this in its editorial, concluding that Sense about Science needed to start reaching out to the wider scientific community.
The claims in The Times that the signatories were ‘leading scientists’ and ‘114 eminent researchers’ also appears to be misleading. Take, for instance, signatory ‘Dr Martin Livermore Plant Scientist ; Independent Consultant’. Rather than earning his living as a plant scientist, Mr Martin Livermore trained as a chemist and now runs an agri-food PR consultancy, Ascham Associates.[54] His biography on Ascham’s website describes him as:
A senior communications/public affairs executive with a strong science background. Broad UK and international experience in leading consumer goods and science companies. Particular strengths in the agri-food and biotechnology sectors, risk, regulation and sustainability issues.[55]
The Ascham website also notes that he has worked for the agri-food companies DuPont (which also has a GM seeds business), Unilever and Dalgety.[56] It states too that “He has extensive networks in the food chain, public sector, NGO and think tank communities and is media trained.”[57]
It would be surprising if Sense About Science were unaware of any of this as in 2003 it included ‘Mr M. Livermore’ on its website amongst its financial contributors.[58]
Targeting the BMA
The public strand of the GM Public Debate had originally been expected to begin in January 2003 although it was, in fact, delayed until the summer of 2003.[59]
It’s worth noting that the GM Public Debate Steering Board at their 17 December 2002 meeting announced that the January meeting would be “open to the public to observe”.[60] Yet according to Marcus Williamson, editor of Genetically Modified Food News, this plan was changed just one day before the January meeting and it was held behind closed doors.[61]
In the light of the planned January start to the public strand of the GM debate, it is perhaps not coincidence that a series of reports which were favourable to GM appeared in the media in January. These reports seem to have emanated from either the Royal Society, Sense About Science or people closely associated with the two organisations. All appeared to be marked by inaccuracy.[62]
Among these reports was one by the BBC’s science correspondent Pallab Ghosh at the end of January stating that the British Medical Association (BMA) would be undertaking a new report on GM. The BMA’s previous report had been highly critical of the rapid introduction of GM crops and food and had called for a moratorium. Pallab Ghosh implied that Sense About Science had now persuaded the BMA to undertake a review of its policy.[63]
Sir Peter Lachmann, who is on the advisory panel of Sense About Science, was quoted as saying that the research that the BMA’s 1999 report had been based on had by now been ‘discredited’.[64]
Interestingly, in a submission to the 2003 GM science review, undertaken at the same time as the GM Public Debate, Lachmann identified Sir David Carter as the man who had made the decision to review the BMA’s position. Lachmann stated: ‘Just in the last week or two there has been renewed interest in the BMA’s “provisional report on the impact of genetic modification on agriculture, food and health” issued in 1999; and the reported decision of Sir David Carter, the Chairman of their Board of Science, to revisit the topic this year.'[65]
The BMA, however, issued a press release the same day saying its review was entirely routine and that the BBC’s account of the reasons for the review were “wrong”:
The claim that we have been persuaded by the organisation ‘Sense about Science’ to review our policy is simply wrong. We have informed Sense about Science about our plans to review the science about this subject. The BBC also states that our planned review on GM crops is happening because we have a new director of science – this is also totally inaccurate.[66]
However, on 9 March 2004 – the day that the Blair Government announced its decision to commercialise GM maize in the face of strong public hostility – the Daily Mail ran the headline, “Doctors 100% behind GM decision”. The accompanying article stated, ‘In an apparent U-turn over its policy to GM foods, the British Medical Association said there was no reason not to go ahead with commercial planting of GM maize’. Sir David Carter was reported to have said it was necessary to ‘move away from the hysteria that has so often been associated with GM foods’. Asked if he would be 100% behind a decision to allow GM maize, Sir David said: ‘I would say so.'[67] On the following day, 10 March 2004, The Times ran the headline, “GM: Doctors say it’s no problem to health”. The accompanying article read:
Doctors’ leaders have given their approval to the Government’s decision over GM crops. In a reversal of the position that it had previously taken in 1999, the British Medical Association (BMA) said that there was no reason not to go ahead with the commercial planting of GM maize.[68]
The timing of the press conference and Sir David’s remarks could not have been more helpful to the Government if it had been planned that way. Yet Sir David’s remarks were not only out of line with the BMA’s cautiously worded new report, which stated that “the evidence for real benefit is not yet sufficiently persuasive to grow GM crops at the expense of conventionally derived alternatives that can be grown at least as effectively”.[69]
Sir David’s remarks were even further away from what the BMA last had to say publicly on the issue. Then, in its submission to the Scottish Parliament’s health committee back in November 2002, the BMA argued for a moratorium on GM crop trials as a “precautionary measure” to safeguard public health. Its submission said that “insufficient care” had been taken over public health and that the grounds for concern were “serious enough” to justify an immediate end to GM trials.[70]
The BMA’s stance in Scotland was completely consistent with the position it adopted in its report on this issue in 1999.[71] It was, however, completely at odds with that of the Royal Society of Edinburgh, which had told the committee that there were no grounds for concern. The BMA’s position had brought an immediate backlash. In a letter to The Times in early December 2002, Sir Peter Lachmann and others strongly attacked the BMA’s stance. They wrote:
Why does the BMA, with no expertise in plant science, single out GM crops, rather than any other novel crops? There is no merit in advocating inaction for its own sake. Such a precautionary approach, if allowed to take hold in policy, would have a deadening effect on progress.[72]
Sir David is not only a leading Fellow of the Royal Society of Edinburgh (elected 1995 and current as at December 2009)[73] but its former Vice President (appointed November 2000[74]). He is connected to Sense About Science, as the Daily Mail reported after the BMA’s change of heart: ‘Tony Blair’s Government has embarked on an orchestrated PR strategy designed to break down public opposition to GM… Yesterday, on the day [Government minister] Mrs Beckett backed GM, the British Medical Association announced a remarkable U-turn on the issue and effectively abandoned its opposition. The BMA’s decision was driven by Professor Sir David Carter, who it emerged is a supporter of a pro-GM lobbying group.'[75]
The Mail was referring to the fact that (as at 1 Feb 2005) Sir David was on Sense About Science’s advisory council.[76] Others on the council include such well-known GM proponents as Sir Peter Lachmann, Vivian Moses (CropGen, Scientific Alliance[77]), Michael Wilson (Scientific Alliance,[78] HRI), Phil Dale (John Innes Centre), Matt Ridley (links to Institute of Economic Affairs (IEA), Julian Morris etc.), Derek Burke, and Roger Turner.[79] Also on the Sense about Science advisory panel is Julian Ma.[80] Ma also signed Lachmann’s letter to The Times criticising the BMA. Of the two remaining signatories to that letter, one was Dame Bridget Ogilvie, the Vice Chair of Sense About Science.
According to the Daily Mail report, “Leaked documents recently hinted at a plan to use scientists from various backgrounds to talk positively about GM.”[81] The timing of the BMA’s press conference on the very day the Government announced its decision may have been no chance affair.
Working Party on peer review
Sense About Science established a special Working Party on peer review which includes ‘an investigation into the social consequences of unfounded research claims’. This was said to have as its target audiences, amongst others, parliamentarians, Government and policy bodies, as well as the media. It reported early in 2004.[82]
Tracey Brown is not the only one on the Working Party on Peer Review with strong LM connections. Another is Tony Gilland, an LM and Spiked contributor, as well as the science and society director of the the Institute of Ideas (I of I). Another member is Fiona Fox, who heads the Science Media Centre, which operates out of the Royal Institution. Fox contributed several articles to LM, including highly controversial material on Ireland and the Rwandan genocide. Fiona Fox’s sister, Claire Fox, heads the Institute of Ideas where Gilland works.
The project enjoys strong support from the Royal Society. It has not only met at the Royal Society but is chaired by the former Vice President of the Royal Society, Sir Brian Heap. The Society’s current Vice President and Biological Secretary, Patrick Bateson, has been assigned to liaise with the Working Party, as has Bob Ward, a Senior Manager for Press and Public Relations at the Royal Society. Several members of the Working Party are leading Fellows of the Royal Society, including Professor Sir Peter Lachmann FRS.
One ironic omission from the report, given the convergence of the topic of peer review and the special interest in GM of many of the working party members, is the fact that GM crops are authorised on the basis of tests carried out by the GM companies, that are usually neither peer reviewed nor published at the time of authorisation and which have historically been kept secret under ‘commercial confidentiality’ rules, prior to the intervention of civil society groups and their lawyers.[84][85]
A second irony is the involvement in this working party of Peter Lachmann, who was identified by The Guardian newspaper as having made an aggressive phone call to the editor of The Lancet to try to prevent publication of the research of Arpad Pusztai, which had found ill effects in rats fed GM potatoes – in spite of the fact that the study had passed a more stringent peer review process than was usual (see Peter Lachmann for details).
The Working Party on Peer Review looked at the Arpad Pusztai case. Although the Royal Society has been amongst Pusztai’s sternest critics over the issue of speaking out about his findings prior to peer review,[86] working party member Brian Heap has admitted that biotech companies often release their findings to the mass media before undergoing peer review in order to help keep up their share price.[87]
In a letter to Tracey Brown, leaked to GMWatch, the Wellcome Trust sets out why, after careful consideration, it is declining to be part of the Working Party or to provide any funding. Amongst the series of concerns listed is the fact that, ‘The proposed make-up of the Working Party is extremely narrow’. The Working Party, the letter says, ‘runs the risk of being seen as a closed and defensive strategy’, and the letter talks of the project being based on ‘many assumptions’ and very little ‘direct evidence’.[88]
The Wellcome Trust quotes its Medicine in Society Panel as having commented on the Sense About Science initiative as follows:
The key issue being addressed by the study is the erosion of trust by the public in authority. The peer review process is only a part of this problem – much of the confusion is about risk and probability, compounded by Government using scientific information as if it were a definitive truth (for example in the case of BSE) to make policy.[89]
ETC ETC
JUAN GÉRVAS says
About the BMJ and statins side effects, a short tale.
Hope you will enjoy it.
“DR.CHOLESTEROL” AGAINST “THE BRITISH MEDICAL JOURNAL”. DO NOT MEASURE YOUR CHOLESTEROL, BE HAPPY.
Juan Gérvas, MD, PhD, retired general practitioner, Equipo CESCA (Madrid, Spain) @JuanGrvas
jjgervas@gmail.com mpf1945@gmail.com http://www.equipocesca.org
Children sit down and be quiet, silence please!
Mara and Andrew, move to the the front row. Your parents are doctors and I do not want any trouble. I want you to write down word by word what I say. Tonight, when you get home, I want you all to read it, before dinner, and for your parents to sign it.
[That’s so unfair!]
[I have nothing to write with]
[Mara pushed me … ! ]
[Can we not just type it on the computer?]
[We are with grandma, our parents are divorcing…! ]
Everyone write down! Remember it is utterly important to copy exactly what I say.
The UK is an island country, member of the European Union.
[Both in capitals? “Union” and “European”?]
[Not so fast , you are going too fast…!]
[Tessa threw me a paper ball!]
[My aunt has gone to live in the UK, she says that everyone speaks English!]
The UK has a very old and very tolerant democracy.
In the UK there are doctors who are general practitioners whom everyone respects a lot.
[Are there no paediatricians? Great! That means they are not vaccinating and weighing children all day!]
[Are they rich, the general practitioners?]
[I saw a movie and a doctor was a very bad person!]
[I’ve been to London and I have never seen a general practitioner]
[My grandfather was a rural general practioner]
In the UK there are also medical specialists.
General practitioners and specialists together form the British Medical Association .
There are more than 150,000 physicians.
Drop the pens just now and come over the computer to see what a nice building they have, it is in central London, in Tavistock Square.
[Oh yes! It is beautiful]
[It has a clock and a flag! Is it the doctors’ flag?]
[There is a large gate, do they fear getting robbed?]
[Are British doctors rich?]
[My father has a friend who is a doctor there, was born in Pakistan and is working in a village. We went to see him. He had a very large house, a fatty dog, a Siamese cat and six children]
Doctors at the British Medical Association have many journals and scientific activities.
But there is a fantastic scientific journal, which knows all the doctors in the world .
It’s called “British Medical Journal”.
I’ll write on the blackboard the name of the journal.
[Very easy name, I know the “New York Times”]
[Is it in English?]
[Is it free?]
[Peter threw me a bogey, that’s yucky!]
The “British Medical Journal” is very popular because it publishes many papers that help clinicians to treat their patients better.
The journal is free for doctors from poor countries and the most important papers are also free to all doctors in the world, available online .
Since 2005 the editor of the “British Medical Journal” is a general practitioner, Fiona Godlee, who studied medicine at Cambridge, became general practitioner in London and then she went to the U.S. to Harvard.
Fiona is married and lives with her husband and two children.
She is 52 years old.
I will write down these names on the blackboard and we will go online to see some pictures of Fiona.
[When I grow up I will be the editor of the “British Medical Journal”]
[Does Fiona earn a lot of money?]
[Why did she go to Harvard? Is she an U.S. spy?]
[She is very old! Do you have to be old to be an editor?]
[I have to pee. Can I go…?]
[I am tired of writing, why don’t you just tell us and we will tell our parents?]
Last year, 2013, the “British Medical Journal” published two articles about cholesterol .
The two studies showed that cholesterol is not a problem.
As a Spanish general practitioner says: “Do not measure cholesterol. Be happy”
In those two papers there was a little error because they noted that cholesterol drugs harms 18 % of patients.
Actually it was 17.4% and the authors published a correction, also they stated that this result was only a study done in the United States and perhaps elsewhere would be different.
But in the UK there is a “Dr. Cholesterol” that meets up with his friends everyday and scares everyone talking about cholesterol, about food, about sitting and watching football games on TV and all, he thinks about all day is to sell more and more drugs for cholesterol.
[Can I get a drink? I’m so thirsty…!]
[Does “Dr. Cholesterol” make a lot of money?]
[Charles is bothering me!]
[There’s a pigeon on the window!]
[Is “Dr. Cholesterol ” like a pig? My mother says that pork is full of cholesterol]
[I think that the more cholesterol things have the more I like them. Specially my grandmother’s bacon bites. She has promised to make them tonight, Yummy!]
[My aunt says that cholesterol is terrible and she’s all day taking blood tests]
“Dr. Cholesterol” went to visit Fiona and told her that she must delete those two papers, which were really bad for cholesterol drugs.
Fiona explained that the mistake had been corrected and that he could write a letter to the “British Medical Journal” if he disagrees about cholesterol not being a problem.
“Dr Cholesterol” was outraged and left Fiona’s office and went straight to see the tabloid journalists.
[What is it, what is a tabloid journalist?]
[My father says Ben Goldacre is a tabloid journalist, but my uncle, my mother’s brother, said he is very good and very brave]
[Perhaps “Dr Cholesterol” has a high cholesterol because he was so angry. To be stressed is bad for the heart]
There are many friends of “Dr Cholesterol” making money with cholesterol drugs, and they want Fiona fired.
Cholesterol drugs are called statins and are very good when given to you after you have had a heart attack.
But statins are worthless if you have no coronary artery disease (heart disease).
You do not need to check your cholesterol. You just have to be happy.
[As my parents are divorcing my mother said she is very unhappy. She goes to visit the doctor who orders her blood tests and tells her: “you have have high cholesterol you need pills”. Would it be better to find her a boyfriend so she will be happy?]
[My father says that he finds happiness in Buddhism, he is silly]
[Happy doctors earn more money?]
[A friend of mine says her father eats everything he likes and then a pill for cholesterol so that way he does not get ill]
[My aunt wants everything cholesterol free and low in calories]
[Peter is bothering me again]
Coronary artery disease (heart disease) is a frequent problem amongst poor people who suffer it because they are unhappy, eat poorly, have no money, smoke a lot, have a lower level of education and do not know what are their future expectations. Coronary artery disease (heart disease) it is mainly a social and psychological problem, not a biological one.
Do not measure your cholesterol.
Be happy.
You have to enjoy life, even with its drawbacks.
The cholesterol drugs, statins, are only for those who have had coronary artery disease (heart disease).
Statins sometimes produce serious harms, even deaths.
My mother died because she took Lipobay (cerivastatin), she had high cholesterol but without coronary artery disease (heart disease).
Lipobay “ate” my mother’s muscles away and “collapsed ” her kidneys, and she died.
Then Lipobay was banned but by then my mother was already dead.
Statins harm the muscles, the liver and pancreas and they can cause diabetes.
You do not need to check your cholesterol, just be happy
[You are crying. Is it for you mother?]
[My mother died , and I cry when I remember her. One day she was drowned on the beach]
[Do not cry, we love you very much!]
[We’re going to be good and you will be very happy and that way your cholesterol will not rise]
[Tonight I will read this to my grandmother, she will appreciate it very much]
NOTE
This problem relates to power, money and censorship. This problem is about scientific freedom that seeks to put limits to Medicine. This problem relates to industries that put the profit of shareholders before the health of patients and populations. It is a problem that concerns us all.
To know more:
Adverse effects of statins as weapons against British Medical Journal
http://www.nogracias.eu/2014/05/21/adverse-effects-statin-weapons-british-medical-journal/
http://www.bmj.com/content/348/bmj.g3306?tab=responses
On the problem of cerivastatin , which had to be removed in 2002 after causing hundreds of deaths (funny enough, not one in clinical trials)
http://www.healthyskepticism.org/global/news/int/hsint2002-06
About the excesses of statins. Statins prevent domestic and traffic accidents, in addition to burns and wounds
http://www.ncbi.nlm.nih.gov/pubmed/19349320
James Bradley says
one of the interesting things about Bad Pharma was the romantic notion that somehow the capitalist greed of the pharmaceutical companies could be reined in by accommodation through transparency. Just about every aspect of the book seemed to point towards a culture that could not and would not be curtailed. Where did this optimism that good science could trump corporate greed (with its Nuremberg like mantra of shareholders-uber-alles) come from? The whole thrust of the book appeared to argue for the dismantling of the system. But somehow Goldacre couldn’t follow the trajectory of his own argument. I diagnose a case of wooly English Liberalism. It was a very disappointing end to an otherwise excellent and powerful book. But it might, as well, explain the defensiveness on display in these comments. Martin Amis wrote at the end of his underrated novel The Information that the protagonist was like Tasman, the voyager who discovered Van Diemen’s Land (rebranded Tasmania in 1853) but somehow managed to miss the entire bulk of mainland Australia. Sums up Goldacre’s work?
John Stone says
I think perhaps BG is a woolly second generation Australian and not particularly liberal – anyhow, I am sure he knows figuratively speaking that Australia is there (unlike Tasman).