Sex and corruption in medicine

 

The recent sex and corruption case at the Central Narcotics Bureau has certainly woken many people up. But there is really nothing new here other than the titillating stories of trysts  and late night sexting between two very gatal (itchy) people. Sex sells. And all through history women have used their wiles to charm their way into position, power and wealth. So was this corruption, or just two very gatal people acting out their fantasies? We won't know for some time, and Gigamole will not speculate.

Nonetheless, Gigamole is reminded that the medical and health industry is not immune to such sex and corruption issues. Just that many do not get flagged out.

The WHO has estimated that the about US$4.1 trillion is spent globally on health services and of this, US$750 billion was on pharmaceuticals. It is a massive industry. The pharma companies aggressively compete for this market, and many (if not all) resort to unsavoury methods to market their wares.

Recently GSK was fined US3 billion for illegal marketing of its products. Part of these charges relate to providing junkets for doctors and various other kickbacks. J&J also had to pay up US78 million to settle charges of bribery and kickbacks it had provided.

Does this happen in Singapore? For sure. But perhaps not so obvious, because of our CPIB. But bribery and kickbacks in some form definitely occurs. Our doctors (especially)  go on junkets all the time. Not to mention kickbacks of various sorts. These are supposed to be regulated and notified to senior management, but nobody really scrutinizes anything, and consultants regard these as the perks of their practices. Medicines Australia reported that the annual spending by Pharma companies in wining and dining doctors and healthcare workers amounted to about A$24 million. How much "hospitality" spending in Singapore? Gigamole doesn't know. In fact the authorities don't really want to know.The public should insist that this be reported and made known publicly.

Any sex involved? Gigamole cannot prove anything. But suffice to point out that the industry is much bigger than selling the odd IT systems. Anybody stopping to point out that the sales reps for pharma companies are invariably attractive young ladies in short skirts?

This is not a problem that affects just pharmaceuticals. Medical devices suffer the same corruptibility. The susceptibility also extends up all levels of the health care chain....all the way from the prescriber, procurer and possibly even the regulator. Can we trust that we have only the best medical information, drugs and devices? Possibly not.

We need to look at this more carefully. The trouble is that the medical industry is seems rather "protected" and few want to stir the pot to root out these problems within the industry.

Nigerian frauds and big pharma.....

One normally associates Nigerian frauds with those sob story emails that you get from time to time, but the recent Wikileaks exposés showed up another kind of fraud that happened some time ago in Nigeria.

Back in 1996, there was an epidemic of meningitis in Nigeria, and big pharma Pfizer, with a new antibiotic trovafloxacin (Trovan) in hand, seized the opportunity to conduct a clinical trial on Nigerian children who came down with symptoms of the disease. All well and good except that the study did not receive ethics approval as was legally required under Good Clinical Practice. Pfizer claimed the study received approval to proceed, and an approval letter was produced supposedly from the ethics committee. The trouble was that there was no such ethics committee at that time. The lead investigator of the trial, Dr. Abdulhamid Isa Dutse, subsequently admitted that the letter could have been drafted 1 year after the study started and then backdated.

If this is true, this is fraud, plain and simple. Clinical trials fraud. Pfizer has however denied culpability and Dr. Abdulhamid Isa Dutse apparently is now the Chief Medical Officer of the Aminu Kano Teaching Hospital.

Strange.

The incident would have been consigned to the history books if not for the recent Wikileaks revelations, which pointed a finger at Pfizer trying to manipulate legal proceedings by uncovering unsavoury details about corrupted practices by Nigerian Federal Attorney General Michael Aondoakaa, so as to pressure him to drop the legal suits against the company.

If these revelations are true, they do show that even big companies who are supposed to be ethical are not above playing dirty. More recently, some more Wikileaks exposés, this time about New Zealand, show the shadowy hand of big pharma in trying to unseat Helen Clark who was Health Minister at that time.

I hope our Singapore government can keep big pharma at arms length. Sometimes I feel they have become to close to big pharma because of the need to cultivate their engagement in our attempts to grow the life sciences and biomedical industry. They have to be careful not to let big pharma have too big a voice in shaping our national strategies.