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HSI Newsletter, Written October 5, 2004

TURN ON THE SMOKE AND BRING ON THE MIRRORS

Dear Reader, 

It must have made for a bummer of a Friday happy hour. On Friday, September 24th, an e-mail was sent out to all National Institutes of Health (NIH) employees announcing a proposed moratorium that would ban as many as 5,000 NIH scientists from accepting any consulting money from drug companies for at least a year.

Impressive! It seems like NIH administrators are getting tough on the unseemly cash-cow cahoots between researchers and the companies that develop drugs that are studied by those researchers. But let's take a peek between the lines for a reality check.

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Moving at the speed of bureaucracy
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In the e-Alert "Back to the Island" (12/29/03), I told you about a five-year investigation into the inner workings of the NIH by David Willman, a Pulitzer Prize winning reporter for the Los Angeles Times. Mr. Willman's painstaking reporting revealed that more than $2.5 million of drug company consulting fees had been paid to top NIH officials and scientists who oversee the clinical trials of drugs.

Uh oh. Not great news if you're an NIH honcho.

In his investigation, Mr. Willman found a 1998 legal opinion that provides a loophole by which more than 90 percent of NIH officials are allowed to keep their consulting income confidential.

A pretty sweet deal... until Congress got wind of it.

This past June, NIH director Elias A. Zerhouni, M.D., told a Congressional committee that he had finally seen the light! His conclusion: The NIH ethics rules and procedures needed "drastic changes."

So here's the timeline:

* December 2003: The LA Times drops the bomb and reveals all
* June 2004: Dr. Zerhouni confirms that the situation needs drastic changes
* September 2004: NIH proposes a moratorium on drug company consulting fees

Things aren't moving along too swiftly, are they? Well, this is, after all, a huge bureaucracy. It's easier for an ocean liner to make a u-turn than it is for a "national institute" to revise a key policy.  Especially a beloved policy that's responsible for millions of dollars in perks.

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That was then...
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But things are moving along now, right?

Well... sort of. Notice that the moratorium is a "proposed" moratorium. Which means that before it can go into effect, it requires the approval of Tommy G. Thompson, secretary of the Department of Health and Human Services, AND the approval of the Office of Government Ethics (OGE). So now we've got THREE different bureaucracies involved. That ought to speed things up!

But here's the best part: Information about the proposed moratorium went out to NIH employees and the press on 9/24. And when was the proposal delivered to Secretary Thompson and the OGE? According to The Scientist magazine, as of 9/24, "NIH had not submitted the proposal, officials said, and no date for doing so had been established."

These guys are something, aren't they?

In his 9/24 e-mail, Dr. Zerhouni stated, "We have identified vulnerabilities in our system that give us pause." The key word here: "pause." Those vulnerabilities didn't make them stop. Nope. They're pausing.

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Eye of the beholder
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Any amusement we may get from this bureaucracy's double-speak and snail-like pace disappears quickly when you consider the important work of the NIH. Last year, the NIH annual budget was nearly $28 billion. And many millions of that are devoted to vital research that includes complementary and alternative medicine.

Given that, I'm not sure which makes me angrier: the fact that NIH officials and scientists are so comfortable in accepting huge "consulting" fees from drug companies, or the fact that this proposed moratorium seems to be giving drug companies plenty of notice that they need to make sure consulting fees are spread liberally before any sort of ban actually takes effect.

According to The Scientist, Dr. Zerhouni told Congress last June that in retrospect, "there was not a sufficient safeguard against the perception of conflict of interest." Once again, when we read carefully, we can see that the concern was not over a conflict of interest, but the PERCEPTION of a conflict of interest.

 It's almost as if Dr. Zerhouni were trying to tell us something.