Whistleblowers in Health Science

Researchers at Baylor University in Texas found that when people are too generous, they are punished for their generosity. People are also punished if they’re too stingy. The trouble is nonconformity and what one of the researchers called “the power of norms.”

This made me think of Tom Jefferson, an English epidemiologist who works in Rome on infectious disease. He was asked by the drug company Roche to evaluate the research on its Tamiflu product in the build-up to a swine flu epidemic that never materialized. An honest scientist, Jefferson asked Roche for all of the clinical trial data. When Jefferson refused to sign a confidentiality agreement, Roche denied him access to the proprietary data.

So Jefferson went ahead with data that was the publically available and found that there was no evidence that Tamiflu improved the outcome for flu patients. This launched him on a path that questioned quite a bit about the seasonal hysteria and very big business of flu vaccination. Because of these important discoveries, he was an outcast within the infectious disease research community. That is, he was punished for his failure to conform.

To judge by a big article in the New York Times about Dr. Jefferson’s colleague and collaborator Peter Doshi, the punishment hasn’t stopped either of them. The topic of the article is not just the critique of vaccination but the ability of researchers to get hold of all the clinical data held by drug companies like Roche, companies that have denied access on the grounds that the data is proprietary and would put them at a commercial disadvantage. While drug companies haven’t yet lost, more and more of them are releasing previously sequestered data to researchers—which also means to the public.

Although I’m sure that they don’t think they’re whistleblowers, I think Dr. Jefferson and Dr. Doshi qualify. They reveal the misconduct and dishonesty of drug companies and public agencies when these organizations tell us that, for example, Tamiflu is very effective or that 36,000 people die each year from the flu and that if only they had been vaccinated those who died would have survived.

For this they are punished. Not with life in prison or self-exile to foreign soil, yet they’re still punished for revealing misconduct and dishonesty.

As admirable as the work of these medical whistleblowers might be, it leaves us at the mercy of “the power of norms.” Tom Jefferson and Peter Doshi are nonconformists of a fairly mild kind: they’re working diligently to make the drug companies and the CDC and the FDA honest.

But that leaves us stuck in the world of drugs. There are alternatives. As alternatives to drugs, there are herbs and homeopathic remedies. From the standpoint of the dominant system of health care, these are very, even wildly nonconformist. And we see that plainly in how they are punished. No self-respecting or career-respecting researcher would propose—let along get funding for—a research project that honestly compared the efficacy of pharmaceutical, herbal, and homeopathic treatments.

Yet even this is quite limiting, in my opinion. It traps us in a universe of alternative forms of magic. What pill makes you larger. What pill makes you small.

Research on how viruses make us sick show that not only influenza but other viruses such as West Nile and Dengue highjack aspects of the hosts immune system, specifically several varieties of interferon. Interferon is an element in the innate immune system, which is our general-purpose first line of defense against invading organisms. So when the innate immune system is weak, the body is more vulnerable to viral attack.

The dominant mode of health care against viruses is vaccination, which exposes the body to the virus in a dose that will provoke an immune response. Unfortunately, this is a response of the adaptive immune system—in other words, it creates antibodies.

What I just said is that the dominant approach—the norm—to viral infection is all wrong. Innate immunity should be the focus of attention. To that extent, herbal and homeopathic remedies are likely superior. But that’s not the path I want to follow.

If supporting innate immunity protects against viral infection, what supports innate immunity? Not vaccination. Vaccination uses adaptive immunity. Not a drug.

What supports innate immunity is social justice.

A recent study in the open access journal PLoS One found that social injustice and inequity in income, education, and race (all manifestations of the “power of norms”) weaken a child’s innate immune system and increased the incidence of infectious disease not just for the child but for the adult into which the child grew.

Let me say this more strongly. Social injustice and inequity cause the flu and other viral infections.

So if the CDC is serious about preventing viral epidemics, it should make sure that our children are well-fed, well-educated, well-housed, and free from discrimination.