Teresa Forcades on Justice and Healthcare
A rebel nun has lost her faith! Sr Teresa Forcades is a Spanish nun but she is also a doctor, with a Ph.D. in public health, who has lost her faith… in the pharmaceutical industry. In a hard-hitting chapter in her new book, Faith and Freedom (published by Polity), Forcades uses medicine’s own literature to expose the abuses of the drugs industry as well as the failings of governments and the World Health Organisation.
For the purposes of medicine, only chapter four of this publication, Public Health, is relevant but don’t despair; Forcades is arrestingly hard-hitting in her earlier and lengthier publication Crimes and Abuses of the Pharmaceutical Industry (available here as a pdf).
In this chapter she explains that the main problem with medicine is not that it’s moved away from a certain wisdom of the past (knowledge of herbal remedies) but it’s “commodification under capitalist market conditions: turning the care of the sick and the prevention of disease into stock market transactions; allowing huge profits and financial operations to depend on the selling of medical products, the delivery of medical treatment, or more particularly, the medical insuring of the healthy or ill.” (p. 50)
Forcades refers to a WHO published list (in 2000) of its 191 member countries, ranked by the quality of their medical systems. It was evident from this list that the countries with universal public health systems have the best outcomes and spend the least per capita. Privatisation has had a deleterious effect on health care (“Tony Blair had to recognize the urgent need to put a brake on Thatcher’s privatising policies in the domain of public health.”).
Who Owns WHO?
Privatisation today affects not only hospitals and national public health systems but also on the world’s biggest health authority, she says (p. 52). Since the late 1990s, the WHO has come to depend more on extraordinary donations from private foundations (most notably the Bill and Melinda Gates Foundation) than on the ordinary contributions of member states. The result is that: “This situation severely compromises the independence of the WHO and its capacity to confront big economic powers in order to defend public health.”
Forcades develops this criticism further by referring to her lecture at the Johns Hopkins Bloomberg School of Health, presenting evidence that during the 2009 flu pandemic, the WHO largely ignored the interests of the public in favour of those in the major pharmaceutical corporations. The lecture was subsequently published as “Flu Vaccination: the gap between evidence and public policy.”
In her address, she says data shows the lack of science behind seasonal flu campaigns and asks why the evidence and recommendations from epidemiologists at top-tier institutions has not been heard. She concludes by quoting the conclusion of Dr Margaret McCartney, in the BMJ at the start of the 2014 influenza season, in answer to the question “what use is mass flu vaccination?”:
in view of the available evidence, the current policy is impossible to justify.
Drug Efficacy and EMA
It is no surprise when Forcades says:
Currently, in the UK as in the rest of the Europe, studies on the safety and efficacy of drugs remain in the hands of pharmaceutical companies that have been accused on numerous occasions of betraying the trust placed in them: moreover, the office that grants licenses to commercialize drugs – the European Medicines Agency – receives over 50 per cent of its funding from these same companies. (see How medical fat cats cream it)
In 2014 the EMA was embarrassed into implementing new regulations – scientists would have to get access to all relevant data on medicines. As of yet, this has not happened and may not happen due to pressure from Big Pharma and the possible introduction of TIPP, a free trade agreement.
She discusses the redefinition of the term “medicalization” and the resulting consequences as well as the pathologisation of society – creating new diseases for old drugs – which should be read by every citizen.
Forcades reassures us that because we are living longer it does not mean this medicalization of society is therefore beneficial. She points out that life expectancy in Japan is consistently higher than in the UK and the US, despite the latter two countries being more medicalized than Japan. The US is by far the most medicalized country but is far from being the healthiest, according to the WHO statistics she supplies.
“Me-too Drugs” or “Follow-on Drugs”
Public health policies, she warns us, are increasingly drafted to suit drug companies’ interests rather than help their patients. For example, it is not illegal, she explains (61) to commercialize a drug produced by introducing a minor change in the chemical structure of the active molecule of an already existing drug without altering its efficacy. Such drugs are called “me-too drugs” or “follow-on drugs” and represent the vast majority of new drugs being developed by the pharmaceutical industry.
This amounts to a cheap way for a drug company to hold on to a patent for another twenty years because the “me-too drug” can be patented as new.
Marketing and Lobbying, not Researching
Drug companies spend millions on marketing rather than research. Me-too drugs are only profitable if they are prescribed instead of the older ones in generic form. This is why, the author tells us, the main activity of pharmaceuticals today is advertising and lobbing instead of research.
Publicly funded researchers, like university departments and large hospitals, etc. can innovate but lack the financial muscle to develop their findings commercially, consequently, they have to sell their findings to private industry. These findings are then submitted to the rule of profit maximization.
Is this for the good? Not necessarily, as we are told companies often use such innovation to obtain “defensive patents.” Defensive patents are a means of blocking a competitor from turning such research into a beneficial medicine for the sick and thereby making a profit.
This is why, she explains, Peter Gotzche correctly used the word “corruption” in the title of his book, Deadly Medicine and Organised Crime: How Big Pharma has Corrupted Healthcare. Corruption, according to the Oxford English Dictionary, means “destruction of dissolution of the constitution which makes a thing what it is.” So now Forcades is justified, along with Gotzche, in using the word corruption in relation to drug companies:
Healthcare is made what it is by its capacity to take care of the medical needs of the population. To orient healthcare towards increasing the private profits of a few corporations is to corrupt it. (64)
Part of the corrupting of me-too drugs is the unspoken side-effects not identified in drug trials that led to the drug’s approval.
With an admonition, Forcades concludes:
Private companies cannot corrupt the health system by themselves; the collusion of governments is necessary…
Crimes and Abuses
The scope of this book, Faith and Freedom, prevents the author sharing the criticism of the pharmaceutical industry she explored in Crimes and Abuses of the Pharmaceutical Industry. This free booklet tackles “crimes” and “abuses” such as female sexual dysfunction, drugs used to combat AIDS in Africa, wealth and power against the poor (how the wealth and power of large pharmaceutical companies is being used), how innovation in treatment is being replaced by advertising and finally, how to dismantle the system.
These criticisms of the pharmaceutical industry aren’t the whole story (e.g. see Unhealthy Business) but they come from a doctor who is also an authority on public health, not a “quack”, “conspiracy theorist”, “pseudo-scientist” or any of the other abusive labels so-called sceptics use to attack homeopaths with.