This post stands in stark contrast to EU-nuch in the Humira-m.
There could not be a greater contrast between the way companies now sell drugs globally and the way they attempt to restrict the reporting of adverse events. The infographic below from Kayla brings out the point.
Sales are now global. AbbVie’s plans for Humira and the plans other companies have for their Biologicals will now include the middle classes of Africa, India and China in a way they would not have done only a few years ago. It is this that will make Humira the biggest selling drug of all time.
Adverse event reporting needs to be global also.
Better die than offend
In addition to company efforts to sabotage adverse event reporting, they can avail of another factor to hide problems. Adverse event reporting did not happen in the West before Thalidomide and the 1960s. Thalidomide and Western democracy almost go hand in hand in this sense.
In the 1960s people got out on the street and tore down the hierarchies that had separated us – women demanded they be seen in their own right, the young refused to bow to the wisdom of their elders, a range of ethnic groups challenged notions of ethnic supremacy. The disabled, none more than the Thalidomiders, demanded to be seen and heard on an equal footing with the able-bodied. All of this is necessary to adverse event reporting.
In hierarchical societies, decent people smile sweetly and talk ingratiatingly to those higher up the hierarchy but can be bullies to those just below them. Status is everything. This was commonplace in the West until quite recently in a way that would seem unimaginable to most people now.
The problem with status is that you cannot have an adverse event to something given to you as a gift from someone higher in the hierarchy. Better die than offend.
We need to spread democracy
For this reason, adverse event reporting will be very slow to take off in Africa, or India – at least among an older generation. Good adverse event reporting is likely one of the best indicators there is of genuine democracy – a state where everyone feels they have a stake in or can contest the reality in which they live. Fostering adverse event reporting is a way to foster democracy.
While Western societies are less hierarchical than they once were, there is always the risk of slipping back into Fascism. The push to democracy in healthcare that began in the 1960s is now under siege. We are ruled by Brand Fascists – whose central goal is to deny adverse events.
One of the big problems this brings is that our New Rulers have co-opted many well-meaning doctors to their purposes. Doctors have a new Status as scientists. They are deafened by the trumpet of controlled trials and cannot hear the quiet voices of their patients. We need to spread Democracy.