Ghost in the Machine：How Big Pharma Controls Our Perception of Drug Safety and Effectiveness
By Dr. Joseph Mercola
Drug Safety and Media Shaped by Big Pharma
In this article, we look at the"Ghost in the Machine"– the murderous forces in our health care system that harm patients instead of help them. This article will expose the deceptions that occur in almost all facets of health care today for no reason other than money. It will also expose the identities of the ghost's"puppet masters"who perpetrate health misinformation and unethical drug marketing for profit, whether it's Big Pharma or its helpers in academia, government and nongovernment agencies.
It should surprise no one that, in most cases, promotion of dangerous drugs and misleading health information is a direct result of conflicts of interest. For example, with the exception of CBS, every major U.S. media outlet keeps at least one person from the drug industry on its board, which clearly explains the dearth of reporting on Pharma dangers and corruption.
The drug industry also spends billions a year on TV ads — revenue from just nine prescription drugs was worth $100 million in one year — which also stifles negative news stories about Pharma.
這些製藥公司每年也會在電視廣告上花費數十億美元 — 僅九種處方藥一年就帶來一億美金的收入 — 這也會阻止製藥公司負面新聞的傳播。
Even so-called"public"media like PBS and NPR have accepted money from GlaxoSmithKline (GSK) and UnitedHealthcare. Similar conflicts of interest exist at medical journals, universities, medical associations, advocacy groups and government agencies, including those that are supposed to regulate the drug industry. The result is the Ghost in the Machine that we live with today — deceived patients taking expensive, often dangerous drugs and soaring health costs.
即便是那些被稱作"公共"媒體的，比如美國公共電視網和美國國家公共廣播電臺，也拿了葛蘭素史克公司（GSK）和聯合健康保險公司的錢。類似的利益衝突存在於醫藥雜誌、大學、醫學研究協會、遊說團體以及政府機構中，包括那些理應對製藥行業進行監管的機構。導致的結果就是製造業中的魔鬼來到我們生活中 — 欺騙病人們吃那些昂貴並且危險的藥品，使治療成本劇增。
Revolving Doors Between Pharma and Government
One of the most damaging conflicts of interest is the revolving door between industry and government. It allows the worst forms of cronyism, quid pro quo arrangements and approval of dangerous drugs. Both Robert Califf, former Food and Drug Administration (FDA) Commissioner, and Scott Gottlieb, the current FDA Commissioner, are shining examples of conflicts of interest.
危害性最大的利益衝突中之一就是行業和政府之間的旋轉門。它允許任人唯親的利益交換方式以及危險藥品的批准。前食藥局（FDA）委員長Robert Califf和現食藥局委員長Scott Gottlieb就是這種利益衝突的典型案例。
Before his appointment by President Obama in 2015, Califf received money from 23 drug companies including giants like Johnson & Johnson, Lilly, Merck, Schering-Plough and GSK, according to a disclosure statement on the website of Duke Clinical Research Institute. He even praised the involvement of Pharma in government affairs.
Gottlieb was named FDA commissioner this year by President Trump, despite his high-profile work as a Pharma consultant and stock trader. While serving as FDA deputy commissioner for medical and scientific affairs before becoming commissioner, Gottlieb had to recuse himself from work related to nine drug companies, including Roche, Sanofi-Aventis, Eli Lilly and Proctor & Gamble, because of his financial links.
Another example of the"revolving door"between government and industry is former director of the Centers for Disease Control and Prevention (CDC) Julie Gerberding, who left the agency in 2009 where she had overseen vaccine decisions to head Merck's vaccines division. In 2015, she sold 38,368 shares of her Merck stock valued at $2 million. Thomas Insel, former director of the National Institute of Mental Health (NIMH) also used the revolving door, leaving government for industry in 2015.
另外一個政府和行業之間的"旋轉門"案例是關於美國前任疾病控制和預防中心（CDC）主任Julie Gerberding的。她於2009年離開了CDC，那時她負責監督默克公司的疫苗決定。2015年，她賣出了默克公司38,368份的股票份額，價值二百萬美金。Thomas Insel，前國家心理健康研究所（NIMH）主任，也利用了旋轉門，2015年他從政府部門離開到製藥行業中任職。
And who can forget former Texas governor Rick Perry, who mandated that all girls in Texas be vaccinated with Gardasil, an HPV vaccine made by Merck, after his former chief of staff became a Merck lobbyist. Stipends from industry to government also skew drug messages. Gilead Sciences, an aggressive marketer of hepatitis C drugs, likely earned the right to add the CDC's name to its ads because of its gifts to the CDC Foundation.
誰又能忘記前德克薩斯州官員Rick Perry呢？在他的前參謀長成為默克公司的說客後，他強制要求德州的女孩注射默克公司研發的子宮頸癌疫苗。行業對政府的補貼也會扭曲藥品的訊息。Gilead Sciences，一個積極營銷丙型肝炎藥品的公司，把CDC的名字加入到它的廣告中，這很可能是由於它給了CDC基金會禮物。
Pharma/Academia Partnerships Are Lucrative Thanks to Taxpayers
Academia was once a source of unbiased drug and health information, untainted by Big Pharma and Big Pharma's money. Not anymore. Universities now have a"renewed interest in partnering with pharmaceutical companies and are investing resources to ensure successful collaborations,"writes Pharma Voice. This is how Dr. Terrence Norchi, president and CEO of Arch Therapeutics, explains the profitable new partnerships.
學術界曾經是公正的藥物和健康訊息的來源，不受大製藥公司和他們金錢的扭曲。然而現在不再如此。大學現在有了"與製藥公司合作的新興趣，同時投入資源以保證合作的成功"，Pharma Voice報導。這是Terrence Norchi博士，Arch Therapeutics公司的主席和首席執行官解釋的共同獲利的新型合作方式。
"For the past 15 years, the pipelines of the big [drug]companies have been drying up … At the same time, there is a tremendous amount of pressure on academic institutions in this country and abroad. To survive, many universities will have to find creative ways to make themselves more relevant. There are opportunities to mutually solve these challenges between academia and industry."
Such Pharma/academia partnerships date back to the Bayh-Dole Act of 1980, which allowed universities to"patent discoveries that stem from government-funded research and then license them exclusively to companies in return for royalties,"wrote Marcia Angell, former editor-in-chief of the New England Journal of Medicine and Harvard lecturer, in the Boston Review.
Similar laws also allow industry to co-opt and profit from NIH-funded research, which is also taxpayer supported, says Angell. Before the Bayh-Dole Act, government-funded discoveries were in the public domain — as they should be. Between 2000 and 2011 more than half of all new drugs approved in the United States were developed by collaborations with other entities such as universities.
類似的法律也允許工業界與NIH贊助的研究合作，並從中獲利。Angell說NIH研究是納稅人的錢支持的項目。在杜拜法案之前，政府資助的研究都是在公共領域 — 這本應如此。在2000和2011年之間，美國批准的所有新藥中超過半數是與高校這樣的機構合作研發的。
Increasingly, academia does not even attempt to hide its dual allegiances. Susan Desmond-Hellmann was invited to apply to be Chancellor of the University of California, San Francisco (UCSF), which includes a medical school, while serving as president of product development at Genentech. She remained at UCSF until 2014 after which she joined the Gates Foundation, which has its own serious conflicts of interest that you will read about in the Ghost in the Machine series.
Drug Trials Now Riddled With Conflicts of Interest
The faster Pharma can get a drug to market, the more money it makes — even if safety problems emerge later. Legal settlements from injury suits are simply built into the cost of the product launch and marketing. Gag orders with injured parties keep the dangerous side effects from reaching the public and dampening sales.
製藥公司讓藥品越快地進入市場，就能賺更多的錢 — 即便以後會出現安全問題。那些受害者的法律訴訟費用在產品投放和市場階段就已經考慮在內。對受害方的言論壓制指示使藥品危險的負面影響不會讓大眾知道從而損害銷售。
There are many examples of drugs rushed to market before they were proven safe, such as the painkiller Vioxx , estimated to have killed over 60,000 people, and the new, expensive hepatitis C drugs that were marketed before their ability to reactivate pre-existing hepatitis B was known.
One way in which dangerous drugs are now rushed to market is the fast work of contract research organizations (CROs) to which Pharma increasingly outsources drug trials. CROs conduct drug trial design, recruitment, enrollment and consent of subjects, as well as preparation of the final drug submission package to the FDA in turnkey operations. If and when the new drug is approved, they will also take care of marketing and branding.
Another compromise in drug safety comes from the changing face of institutional review boards (IRBs), groups of medical professionals, laypeople and ethicists who monitor human safety during drug trials. Once linked to academic settings or hospital, IRBs have become for-profit ventures paid by the companies who do the research. When the financial livelihoods of members of IRBs depend on the company that hires them, that is a huge conflict of interest.
One example of the changing face of IRBs was revealed in a sting operation devised by Congress and the General Accountability Office. When they asked a Colorado review board to oversee a study of Adhesiabloc, a product designed to reduce scar tissue after surgery, it agreed to the work though neither the drug, developer nor lead researcher even existed.
How can human subjects be protected in such eagerness to acquire new work? To cut costs, Pharma also increasingly runs trials in poor countries where informed consent is not easily explained and subjects sometimes think they are receiving real medical care.
Conflicts of Interest Abound in Research
In the Ghost in the Machine series, we will review conflicts of interest in publishing that skews the perception of a drug's safety in the public's eyes as well as among medical professionals. Research and scientific papers boosting the benefits of new drugs and downplaying their risks often appears in medical journals, ghostwritten by the drug industry with a medical professional's name attached for credibility.
For example, the popularity of the withdrawn Vioxx, the birth defect-linked Paxil, Neurontin, and the cancer and heart disease-linked hormone replacement therapy drugs all stemmed from papers ghostwritten by industry. In 2016, the National Press Club in Washington held a half-day conference for reporters, scientists and business executives to discuss how well the news covered science called"Lost in Translation：Is Science Explained Fairly in the Media?"
But it was clear that the conference was biased as it grew from a partnership between Scientific American magazine, Johnson & Johnson and GMO Answers, a group funded by members of The Council for Biotechnology Information, which includes Bayer, Dow AgroSciences, DuPont, Syngenta and Monsanto. The event represented a popular new trend, wrote Paul Raeburn:
明確的是，會議內容是存在偏見的，因為會議建立在美國科學雜誌、強生(嬌生)公司和轉基因答案（GMO Answers）的合作關係上。基因改造答案是由生物科技訊息理事會成員資助建立的，包括拜耳、陶氏益農、杜邦、先正達和孟山都公司。這次會議代表了一種新的流行趨勢，Paul Raeburn寫道：
"The conference was an example of what is now a widespread and growing practice in the publishing industry：the use of ‘branded partnerships' to extended publishers' reach and boost their income. While these arrangements might generate revenue, they also raise important questions about journalistic credibility.
After all, how can news outlets like Scientific American, a respected — even revered — source of science news, maintain the appearance of impartiality while accepting checks from companies they cover? And should respected journalists lend their names and reputations to such conferences by participating on the panels?"
畢竟，像科學人這樣的新聞媒體，一個受人尊重 — 甚至備受尊崇 — 的科學新聞的來源，當接受被報導公司支票的時候又如何保持他們表面上的公正的態度？透過加入專家小組，受尊敬的新聞記者應該把他們的名字和聲譽來交付給這樣的會議嗎？"
Examples of branded and ghostwritten content invading publishing are not hard to find. Recently, ProPublica and Consumer Reports reported that hepatitis C drugmaker AbbVie funded a special issue of the American Journal of Managed Care on hepatitis C research, using a Stanford professor as guest editor-in-chief.
Even books are funded by Pharma. A 1999 textbook written to help primary care doctors diagnose psychiatric conditions was funded entirely by GlaxoSmithKline (GSK), which makes pills for psychiatric conditions. Its authors were two prominent psychiatrists, one of whom was on GSK's speaker's bureau; the other was investigated by Congress for undeclared GSK income.
Nonprofit Organizations Push the Pharma Agenda
Recently I wrote that philanthropist Bill Gates was leading the pack as one of the most destructive"do-gooders"on the planet, and that his views on addressing poverty and disease in poor countries were shortsighted and misinformed. Why? Because the Bill & Melinda Gates Foundation (B&MGF) is one of the world's foremost promoters of mass-vaccination efforts, which are a major part of the Pharma agenda.
Two of the B&MGF's research heads were hired right out of Pharma — one from GlaxoSmithKline, with whom the B&MGF had a long-standing collaboration, and the other from Novartis. In 2002, B&MGF began buying billions in drug stocks and subsequently added huge amounts of Monsanto stock as well. Not surprisingly, the foundation is also a leading international promoter of GMO crops and technology.
兩名B&MGF的研究首席是直接僱傭於製藥公司 — 一名來自葛蘭素史克公司，他與蓋茲基金會有長久合作關係；另一名來自諾華製藥。2002年，B&MGF開始以數億美元買入醫藥股份，隨後又買入大量孟山都股票。不足為奇的是，蓋茲基金會也是基因改造農作物和技術的主要國際推動者。
"The Bill & Melinda Gates ‘Foundation' is essentially a huge tax-avoidance scheme for enormously-wealthy capitalists who have made billions from exploiting the world's people,"writes Ruben Rosenberg Colorni."The foundation invests, tax free, money from Gates and the ‘donations' from others, in the very companies in which Gates owns millions in stocks, thus guaranteeing returns through both sales as well as intellectual-property rights."
"對於那些透過剝削世界人民賺取億萬財富的資本家來講，蓋茲基金會本質上是一個巨大的避稅方案。"Ruben Rosenberg Colorni描述道。"基金會投資蓋茲家族免稅的錢以及來自其他公司的‘捐贈'，在這些公司中，蓋茲家族擁有價值百萬股票，這樣就保證了銷售和知識產權的回報。"
In a 2011 Forbes interview, Bill Gates admitted the new profitability of vaccines."Ten or 15 years ago, nobody in the drug business would have held up vaccines as profit centers,"he said, conceding that"vaccines are so tough, particularly because of liability issues."But now,"people are making money in the vaccine business,"he noted. His statements characterize the Ghost in the Machine well.
There Is a Final Irony to the Ghost in the Machine
While mainstream medicine, which is dominated and influenced by Pharma, assails natural, nonprescription treatments that are less expensive and usually safer as worthless and untrustworthy, many Pharma companies are trying to enter the vitamin and supplement industry themselves. It is easy to see why. Supplements and natural products often treat or prevent the conditions on which Pharma makes most of its money.
They are used by the most desirable customers to Pharma — patients who say they have"excellent"or"very good"health and have high discretionary income. Such patients often prefer natural treatments like probiotic-rich fermented food for heartburn instead of Pharma's dangerous proton pump inhibitors. They are not deceived by the Ghost in the Machine.
它們被製藥公司最理想的客戶使用 — 那些宣稱擁有"優秀"或"非常好"的身體狀況並且擁有較高的可支配收入的人們。這些病人通常更喜歡自然治療，比如食用益生菌豐富的發酵食物來減緩胃部灼燒感，而不是食用製藥公司危險的質子泵抑制劑。他們不會被製造業中的魔鬼所欺騙。