Sunday, June 17, 2012

The Word from Pakistan: Bioethics, for Sale to the Highest Bidder

Dr. Farhat Moazam is a most impressive Pakistani physician. She became interested in organ transplant issues in her native country and eventually came to the US to study for a PhD in ethics. Her book, Bioethics and Organ Transplantation in a Muslim Society, is a superb example both of an ethical investigation of organ transplantation, and a comparative treartment of modes of ethical thought in different cultures.

I was therefore delighted to see her views on Pharma influence in Pakistan posted on the PharmaGossip blog:

She recounts the usual sorts of skullduggery of academic physicians seeking Pharma money and doing the bidding of the industry while fondly imagining that they're not influenced. But perhaps most worrisome, especially to somebody like me whose day job includes bioethics, are these observations:

Another particularly egregious development is the increasing financial support of multinationals for bioethics centres, staff and programmes. Carl Elliot of the Centre for Bioethics, University of Minnesota, who follows this phenomenon in the US, reports a $100,000 grant established by a leading drug manufacturer for a Fellowship in Bioethics, meant to allow researchers to explore “conflicts of interest”.

The irony of this is inescapable if one recalls that not too long ago this company was involved in a deadly drug research scandal involving Nigerian children with meningitis and, according to Elliot, made to pay the largest criminal fine in 2009.

This year, another two more pharmaceuticals are to fund a “crash course in bioethics” in China which will include “meetings” with “pharma folks … expats who work for large drugmakers”. The University of Pennsylvania faculty member that is organising this course admits that he has worked “in big pharma for many years” with the key objective to “develop academic-industry collaborations”. One of the companies was cited last year for interfering in the approval of generic alternatives to its blood-thinning drug.

When US physicians eat out of Pharma's hands, one can object among other things that we ought to have enough money floating about in our bloated health care system to pay for whatever is needed without going begging to the drug industry--especially when what's at stake is not a grant to run a research project, but the funds to sponsor a luxurious dinner or reception at a swank hotel. By contrast, in a country like Pakistan, it's easier to argue that the poverty of the medical system in general leaves physicians with no options but to seek funding wherever they can. It's therefore impressive that Dr. Moazam (who directs the Centre of Biomedical Ethics and Culture at the Sindh Institute of Urology and Transplantation) is having none of that. She quite rightly demands ethical accountability and scrutiny of all such transactions--and real ethical scrutiny, not bioethics-for-hire.  If she can insist on this in Pakistan, how much more are we in wealthier nations obligated to follow her example?
(Hat tip to Dr. Barney Carroll for alerting me to this post.)

No comments: