The fully referenced version of George Monbiot's excellent Guardian piece. Highly recommended.
The Sleaze Behind Our Science
The conflicts of interest revealed by the MMR story are everywhere.
By George Monbiot. Published in the Guardian
24th February 2004
Pity Andrew Wakefield. The doctor who suggested that there might be a link between the MMR vaccine and autism, causing thousands of parents to refuse to let their children have the jab, is being paraded through the nation with the label "cheat" hung round his neck. The General Medical Council is deciding whether to charge him with professional misconduct, MPs have called for an inquiry, and the newspapers are tearing him to bits.
There's little doubt that he messed up. Some of his findings have been disproved by further studies, and we now know that when he published his paper he failed to reveal that he was taking money from the Legal Aid Board. The board was paying him to discover, on behalf of parents hoping to sue for damages, whether or not the jab was harmful.
It looks like a conflict of interest, and his failure to disclose it was wrong. But the crime for which the new Dr Evil is being punished is everywhere. The scientific establishment is rotten from top to bottom, riddled with conflicts far graver than Dr Wakefield's. Such is the state of science today that if, for example, there HAS been a genuine rise in the incidence of autism, and if that rise is linked to an environmental pollutant or the side-effects of a valuable drug, it's hard to see how we would ever find out.
Just as Wakefield was being burnt in effigy over the weekend, a much bigger story passed by almost unnoticed. The Union of Concerned Scientists released a report showing how American science has been systematically nobbled by George Bush.1 Whenever scientific research conflicts with the needs of his corporate sponsors or the religious fanatics who helped him into office, he has sought to suppress it.
Last year, the White House tried to force the Environmental Protection Agency to alter its findings on climate change. It ordered the agency to dump its temperature records and replace them with a discredited study partly funded by the American Petroleum Institute. It told the EPA to delete the finding that "climate change has global consequences for human health and the environment".2
It went on to suppress the agency's findings on mercury pollution from power stations, and to block the publication of a study showing that antibiotic-resistant bacteria are leaking from pig farms.3 When the U.S. Centers for Disease Control revealed that Bush's "abstinence-only" sex-education programme appears to have caused an increase in teenage pregnancies, the CDC was told to stop gathering data.4 The National Cancer Institute was instructed to claim, quite wrongly, that there is a link between abortion and breast cancer. 5 Independent scientists have been purged from the government's expert panels and replaced with corporate stooges and religious nutters. One learned professor hoping for a seat was asked how he had voted in the presidential election. He gave the wrong answer, and wasn't appointed.6
But Bush has simply systematised something which has been taking place informally, all over the world, for years. The religious component is mostly new, but the corporate distortion of science is almost universal.
One study, published in 2001, found that only 16% of scientific journals had a policy on conflicts of interest, and only 0.5% of the papers they published disclosed such conflicts.7 The same researcher found that 34% of the lead authors of the scientific papers he studied were compromised by their sources of funding.8 In other words, the great majority of the scientists with conflicts of interest are failing to disclose them.
Wakefield's paper (and therefore his conflict) was consequential - measles, mumps and rubella are likely to have spread as a result of the vaccine scare - but no more consequential than the daily deceptions practised by the most eminent scientists. A study of research papers examining the side-effects of a class of heart drugs called calcium channel blockers found that 96% of the researchers who said they were safe had financial relationships with the manufacturers, as opposed to 37 per cent of those who raised concerns.9 Other studies have found similar relationships between the financial interests of researchers and their reporting of the dangers of passive smoking and the side effects of contraceptive pills.10
It gets worse. In 2002, the Guardian revealed that British and American scientists are putting their names to papers they have not written.11 The papers are "ghosted" or co-written by employees of the drugs companies, then signed, for a handsome fee, by respectable researchers. In some cases, the researchers have not even seen the raw data on which the papers' conclusions are based. A pharmacologist who has studied the practice told the Guardian, "it may well be that 50% of the articles on drugs in the major journals across all areas of medicine are not written in a way that the average person in the street expects."12
Among the papers he had questioned was one suggesting there was no link between SmithKline Beecham's anti-depressant drug seroxat and an increased risk of suicide. Last year, the government managed to extract the company's original data. This showed that the drug trials revealed a clear increase in suicidal tendencies.13 Earlier this month a further leak, to the Panorama programme, revealed that the drug didn't even work.14 How many suicides might have been avoided if those scientists had not put their names to SmithKline Beecham's report? And why haven't THEY been hauled before the General Medical Council?
It's left to non-scientists to try to drag the data we need to see into the public domain. Friends of the Earth are currently being sued by the biotech company Bayer to prevent them from exposing its data on the environmental and health effects of glufosinate ammonium, the herbicide used on the GM maize the government wants to approve for planting in Britain.15 By all accounts the figures make grim reading. But if Bayer gets its way, neither we nor the government will be allowed to see them before the decision is made.
Three years ago, eleven of the biggest medical journals drew up a code on conflicts of interest. It is plainly not working. Since it was published, an analysis in the Journal of the American Medical Association revealed that 87% of the scientists who write the clinical guidelines used by doctors for prescribing drugs have financial links to drugs companies. Over half of them are connected to the companies whose drugs they are reviewing. Of the 44 papers analysed, only one carried a declaration of conflicting interests. 16
So, given that undisclosed conflicts of interest in science are everywhere, why is it only Dr Wakefield whose bloody remains are being dragged through the streets? The obvious answer is that his alleged co-option works against the interests of the drugs companies, while almost everyone else's works in their favour. Why? Because in science, as in all fields of human endeavour, you get what you pay for. There is more corruption in our university faculties than there is in the building industry. But, though the mobs are baying for Wakefield's blood, hardly anyone in Britain seems to give a damn.
The references for this and all George Monbiot's recent articles can be found at www.monbiot.com.
1. The Union of Concerned Scientists, February 2004. Scientific Integrity in Policymaking: An Investigation into the Bush Administration's Misuse of Science. UCS, Cambridge, MA.
7. S. Krimsky and L.S. Rothenberg, 2001. Science and Engineering Ethics 7, 205-218, cited in Frank van Kolfschooten, 28th March 2002. Can You Believe What You Read? Nature Vol 416, 360-363.
8. S Krimsky et al, 1996. Science and Engineering Ethics 2, 395-410, cited in Frank van Kolfschooten, ibid.
9. Henry Stelfox et al, 8th January 1998. Conflict of Interest in the Debate over Calcium-Channel Antagonists. New England Journal of Medicine, Vol. 338, No. 2
10. Liz Lightfoot, 14th February 2000. Scientists 'Asked to Fix Results for Backer'. Daily Telegraph.
11. Sarah Boseley, 7th February 2002. Scandal of Scientists Who Take Money for Papers Ghostwritten by Drug Companies. The Guardian.
12. David Healy, cited in Sarah Boseley, 7th February 2002, ibid.
13. Sarah Boseley, 3rd February 2004. Company 'Held Back' Data on Drug for Children. The Guardian.
14. Sarah Boseley, 3rd February 2004, ibid.
15. Phil Michaels, Friends of the Earth lawyer, 23rd February 2004. pers comm.
16. Cited in Alison Tonks, 16 February 2002. Authors of Guidelines Have Strong Links with Drugs Industry. British Medical Journal, 324:383.