The Avandia Case, and a Warning About How Bad Things Can Get

We have posted frequently about the controversy about rosiglitazone (Avandia, by GlaxoSmithKline). Some of the distressing aspects of the case were various efforts made to keep information and opinions unfavorable to Avandia away from physicians, the patients, and the public, including efforts involving obfuscation, deception, and intimidation. (For example, see this post about the "spinning" of Avandia and the ridiculing of Avandia critics, and this post about attempts to silence an early Avandia critic.)

This month, the British Medical Journal printed a news article about the US Senate report that claimed that the critic, Dr John Buse, was intimidated by top GSK executives.

Perhaps with deliberate irony, on the same page was another news article, headlined, "One in 20 East German doctors spied on patients or colleagues." It was based on a study by the Hannah Arendt Institute for Research on Totalitarianism,

About 5% of doctors in the former East Germany spied on their colleagues or patients as unofficial members of the East German secret police (the Staatssicherheit or Stasi), a new report has shown.

The study, by the Hannah Arendt Institute for Research on Totalitarianism, Dresden, and commissioned by the German Medical Association and the German medical journal Deutsches Ärzteblatt, showed that the percentage of unofficial members of the Stasi among doctors was higher than in the East German population as a whole.

'Doctors were one of the main targets of the Stasi because they were thought to belong to a reactionary class and were thought to be especially interested in escaping to West Germany,' said Francesca Weil, author of the study....

Of those doctors who were unofficial spies, about a quarter passed on information not only about colleagues but also about their patients' health and private lives. Psychiatrists and sports medicine experts were the most common specialists among the unofficial spies, and a third of them held a leading position in a hospital. The Stasi also recruited medical students.

Reasons for spying varied. Some doctors were trying to advance their career or were afraid that their careers would suffer if they did not participate; others were committed socialists; and another group liked the economic advantages, which ranged from monthly cash payments to fast tracked delivery of a car or other luxuries.

In my humble opinion, physicians in the West should not view the latter article as affirmation that we do not have things so bad. Rather it is a warning about how bad things can get.

Post Title → The Avandia Case, and a Warning About How Bad Things Can Get

Axis of What? - Pfizer CEO to Go to North Korea

Here is a curious juxtaposition that nearly made it under the radar. Last month, the Nigerian government brought civil and criminal charges against Pfizer Inc, the world's largest drug company, for the actions it took during a controversial antibiotic trial 10 years ago. For example, per the Washington Post,

Officials in Nigeria have brought criminal charges against pharmaceutical giant Pfizer for the company's alleged role in the deaths of children who received an unapproved drug during a meningitis epidemic.

Authorities in Kano, the country's largest state, filed eight charges this month related to the 1996 clinical trial, including counts of criminal conspiracy and voluntarily causing grievous harm. They also filed a civil lawsuit seeking more than $2 billion in damages and restitution from Pfizer, the world's largest drug company.

This story first came into public view due to the Post's reporting in 2000. At that time, the Post noted,

The experiments raise questions about corporate ethics and profits on a frontier of globalization where drug companies wield enormous influence, and where doctors paid by U.S.-based corporations sometimes perform experiments on ill-informed patients in authoritarian societies.

A Nigerian physician who said he was present during the Kano experiment, for instance, felt it was "a bad thing," but he did not object because Pfizer's test appeared to have backing from the government. 'I could not protest,' said the physician, Amir Imam Yola. 'The system you have in America and the system we have here, there is a wide gap. Freedom of speech is still not here.'

At the time, Nigeria was run by a military government that had one of the world's worst human rights and corruption records.

Fast forward to 2007, and here is the report that sailed in barely over the radar,
via the Chosun Ilbo news service out of South Korea,

The CEO of pharma giant Pfizer, Jeffrey Kindler plans to visit North Korea. According to Pfizer’s Korean subsidiary on Tuesday, Kindler will arrive in South Korea for a two-day visit on Wednesday and plans to go to a hospital in the inter-Korean Kaesong Industrial Complex in the North.

The CEO plans to visit the hospital in the Kaesong Industrial Complex with 40 executives on Thursday if he gets approval from the North Korean government through the South Korean Unification Ministry.

A Pfizer’s spokesman said Kindler was invited by Kim Dong-keun, the chairman of the Kaesong Industrial Complex committee. The CEO will inspect medical services in the industrial complex but has no plans to invest in or support North Korea.

North Korea, of course, has been branded part of the"axis of evil" by US President George W Bush for allegations of state sponsorship of terrorism.

The point of the visit by the CEO and 40 executives of Pfizer to a North Korean hospital is not clear. It seems that Pfizer's international operations have a curious affinity for dictatorial governments not known for protecting human rights, to put it very politely.

And pharmaceutical companies wonder why the public views them as "shifty?" Memo to the CEO, if you do not want your company to be viewed as shifty, avoid appearing too friendly to military dictatorships or governments labelled as supporting terrorism by the US government.

Post Title → Axis of What? - Pfizer CEO to Go to North Korea