When science becomes a threat to population health

Kara Thomas 

The medical-political complex tends towards suppression of science to aggrandise and enrich those in power. And, as the powerful become more successful, richer, and further intoxicated with power, the inconvenient truths of science are suppressed. When good science is suppressed, people die.’ BMJ executive editor Kamran Abbasi

Below is a section from the Australian Medical Professionals Society’s (AMPS) submission to the Department of Infrastructure, Transport, Regional Development, Communications and the Arts Communications Legislation Amendment (Combating Misinformation and Disinformation) Bill 2023. The full submission can be viewed here. We encourage you to make a submission here by August 20.

AMPS believes granting ACMA, a government-appointed entity, the authority to label information contradicting official messaging as misinformation or disinformation establishes an alarming and precarious precedent. This becomes especially concerning considering the growing awareness of the effect of corporate conflicts of interest, leading to biased reporting within academia, biased media content, skewed therapeutic guidelines, and profit-driven public policies. History is replete with instances showcasing the consequences of authorities making decisions without being held accountable or having to be transparent about their actions. We must be cautious when policies, based on concealed health advice for instance, are determined by those in power without the requirement for empirical validation, effectively bestowing them the power to define what qualifies as true information.

The extensive sway exerted by pharmaceutical companies’ financial interests across medical academia and public policy presents a notable jeopardy to the credibility of healthcare and societal welfare. The involvement of pharmaceutical companies in financing research, regulation, education, and policy endeavours introduces an intrinsic susceptibility to bias, potentially undermining the impartiality of scientific investigation and policy development. This dynamic could result in an undue prioritisation of profit-centred incentives, overshadowing the imperative of prioritising patient well-being and the broader public health.

Professor Ioannidis describes what he calls a ‘misinformation mess’ where he claims much-published research is not reliable. Having to negotiate such a mess in deciding exactly what is misinformation offers no benefit to patients or decision-makers. It is a risk to public health.

The government must consider that many prominent journal editors have drawn attention to the pervasive influence of financial conflicts of interest on the reliability of research findings.

‘Financial conflicts can compromise the integrity of research,’ warns Dr. Fiona Godlee, editor-in-chief of The BMJ, stressing the potential bias that can result from industry funding. 

Dr. Jerome Kassirer, former editor-in-chief of the New England Journal of Medicine, notes in his book, How medicine’s complicity with big business can endanger your health, the ‘shocking extent of these financial enticements and explains how they encourage bias, promote dangerously misleading medical information, raise the cost of medical care, and breed distrust’, highlighting the distortion such conflicts can introduce into the scientific record.

Dr. Virginia Barbour, founding editor of PLOS Medicine, adds, disclosure alone is insufficient to address conflicts, emphasising the need for greater transparency and safeguards against undue influence.

Dr Maria Angell, long-time editor in chief of the NEJM resigned more than 20 years ago after 20 years as editor because of what she described as the rising influence of the Pharmaceutical industry. She said in her book, The truth about drug companies: How they deceive us and what to do about it, ‘Now primarily a marketing machine to sell drugs of dubious benefit, big pharma uses its wealth and power to co-opt every institution that might stand in its way, including the US congress, the FDA, academic medical centres and the medical profession itself.’

These editorial voices collectively emphasise the imperative of robust disclosure mechanisms and stringent evaluation of financial conflicts to maintain the integrity and credibility of research in the face of commercial interests.

AMPS would argue that the demonisation of Ivermectin during the pandemic is a prime example of how financial conflicts of interests that claimed extensive evidence demonstrating the effectiveness of Ivermectin in the treatment and prevention of Covid resulted in harm.

Our submission to the TGA’s rescheduling of Ivermectin showed how statistically significant the evidence base is to support the clinical improvements in time to clinical recovery, time to viral clearance, and reduction in hospitalisation and death from this cheap, safe, fully approved, WHO essential medicine. This medication was banned by the TGA claiming safety and efficacy concerns when their own 2013 Australian Public Assessment Reports (AusPAR) demonstrated safety and instead recommended for example the use of provisionally approved very expensive Remdesivir. Remdesivir in the WHO Solidarity Trial reported in the NEJM was found to have ‘little or no effect on hospitalised patients with Covid, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay’. In fact, in 2020 the WHO recommended against the use of Remdesivir in Covid patients. A study in the Lancet from September 2021 found, ‘No clinical benefit was observed from the use of Remdesivir in patients who were admitted to hospital for Covid, were symptomatic for more than 7 days, and required oxygen support.’ The banning of Ivermectin in favour of antivirals such as Remdesivir appears to make little evidentiary or clinical sense.

Dr Mike Magee, former physician spokesman for Pfizer, published in 2019 his book Code Blue: Inside America’s Medical Industrial Complex. He powerfully describes the corruption of the US healthcare system.

‘Cosy relationships and generous gratuities have demonstrated a remarkable ability to corrupt even those we would instinctively put on the side of the angels, including members of the biomedical research community, deans of medical schools, directors of continuing medical education programs, officers at the NIH and FDA, and even seemingly altruistic patient advocacy organisations like the American Cancer Society.’

AMPS has also written quite extensively about our concerns regarding the conflict between the government safety and efficacy claims for the Covid vaccinations and the lack of comprehensive safety and efficacy data surrounding these novel immunisations. While the accelerated development and emergency approvals were perhaps motivated by the global health crisis, some experts caution that the available data are not yet as extensive as in standard vaccine development processes.

AMPS has written about our concerns with these vaccines especially for children. According to our Therapeutic Goods Administration (TGA) AusPAR long-term safety data remains a critical gap in our understanding, emphasising the importance of continued post-vaccination pharmacovigilance. Dr. Peter Doshi, an associate editor at The BMJ, underscores the need for transparent and thorough reporting of clinical trial results to ensure the public’s confidence in these vaccines.

Financial conflicts of interest can erode trust in medical research, undermine the credibility of academic institutions, restrict access to transparent data, and ultimately result in the promotion of treatments or policies that prioritise corporate gain over the impartial pursuit of knowledge and the advancement of public welfare. Stricter safeguards and transparency measures are essential to mitigate these dangers and ensure that medical academia and public policy remain steadfastly committed to unbiased and evidence-based decision-making when seeking to define what constitutes mis-or-disinformation.

We should heed Abbasi’s warning before science itself becomes a threat to overall population health, or maybe we are too late.

‘Science is being suppressed for political and financial gain. Covid has unleashed state corruption on a grand scale, and it is harmful to public health. Politicians and industry are responsible for this opportunistic embezzlement. So too are scientists and health experts. The pandemic has revealed how the medical-political complex can be manipulated in an emergency — a time when it is even more important to safeguard science…’

Kara Thomas  is the Secretary of the Australian Medical Professionals’ Society

Originally published in the Spectator on 18 August 2023