When good science is suppressed by the medical-political complex, people die
Politicians
and governments are suppressing science. They do so in the public
interest, they say, to accelerate availability of diagnostics and
treatments. They do so to support innovation, to bring products to
market at unprecedented speed. Both of these reasons are partly
plausible; the greatest deceptions are founded in a grain of truth. But
the underlying behaviour is troubling.
Science is being
suppressed for political and financial gain. Covid-19 has unleashed
state corruption on a grand scale, and it is harmful to public health.1
Politicians and industry are responsible for this opportunistic
embezzlement. So too are scientists and health experts. The pandemic has
revealed how the medical-political complex can be manipulated in an
emergency—a time when it is even more important to safeguard science.
The
UK’s pandemic response provides at least four examples of suppression
of science or scientists. First, the membership, research, and
deliberations of the Scientific Advisory Group for Emergencies (SAGE)
were initially secret until a press leak forced transparency.2
The leak revealed inappropriate involvement of government advisers in
SAGE, while exposing under-representation from public health, clinical
care, women, and ethnic minorities. Indeed, the government was also
recently ordered to release a 2016 report on deficiencies in pandemic
preparedness, Operation Cygnus, following a verdict from the Information
Commissioner’s Office.34
Next,
a Public Health England report on covid-19 and inequalities. The
report’s publication was delayed by England’s Department of Health; a
section on ethnic minorities was initially withheld and then, following a
public outcry, was published as part of a follow-up report.56 Authors from Public Health England were instructed not to talk to the media. Third, on 15 October, the editor of the Lancet
complained that an author of a research paper, a UK government
scientist, was blocked by the government from speaking to media because
of a “difficult political landscape.”7
Now, a new example concerns the controversy over point-of-care antibody testing for covid-19.8 The prime minister’s Operation Moonshot depends on immediate and wide availability of accurate rapid diagnostic tests.9 It also depends on the questionable logic of mass screening—currently being trialled in Liverpool with a suboptimal PCR test.1011
The incident relates to research published this week by The BMJ,
which finds that the government procured an antibody test that in real
world tests falls well short of performance claims made by its
manufacturers.1213
Researchers from Public Health England and collaborating institutions
sensibly pushed to publish their study findings before the government
committed to buying a million of these tests but were blocked by the
health department and the prime minister’s office.14
Why was it important to procure this product without due scrutiny?
Prior publication of research on a preprint server or a government
website is compatible with The BMJ’s publication policy. As if to prove a point, Public Health England then unsuccessfully attempted to block The BMJ’s press release about the research paper.
Politicians
often claim to follow the science, but that is a misleading
oversimplification. Science is rarely absolute. It rarely applies to
every setting or every population. It doesn’t make sense to slavishly
follow science or evidence. A better approach is for politicians, the
publicly appointed decision makers, to be informed and guided by science
when they decide policy for their public. But even that approach
retains public and professional trust only if science is available for
scrutiny and free of political interference, and if the system is
transparent and not compromised by conflicts of interest.
Suppression
of science and scientists is not new or a peculiarly British
phenomenon. In the US, President Trump’s government manipulated the Food
and Drug Administration to hastily approve unproved drugs such as
hydroxychloroquine and remdesivir.15 Globally, people, policies, and procurement are being corrupted by political and commercial agendas.16
The
UK’s pandemic response relies too heavily on scientists and other
government appointees with worrying competing interests, including
shareholdings in companies that manufacture covid-19 diagnostic tests,
treatments, and vaccines.17
Government appointees are able to ignore or cherry pick science—another
form of misuse—and indulge in anti-competitive practices that favour
their own products and those of friends and associates.18
How
might science be safeguarded in these exceptional times? The first step
is full disclosure of competing interests from government, politicians,
scientific advisers, and appointees, such as the heads of test and
trace, diagnostic test procurement, and vaccine delivery. The next step
is full transparency about decision making systems, processes, and
knowing who is accountable for what.
Once transparency
and accountability are established as norms, individuals employed by
government should ideally only work in areas unrelated to their
competing interests. Expertise is possible without competing interests.
If such a strict rule becomes impractical, minimum good practice is that
people with competing interests must not be involved in decisions on
products and policies in which they have a financial interest.
Governments
and industry must also stop announcing critical science policy by press
release. Such ill judged moves leave science, the media, and stock
markets vulnerable to manipulation. Clear, open, and advance publication
of the scientific basis for policy, procurements, and wonder drugs is a
fundamental requirement.19
The
stakes are high for politicians, scientific advisers, and government
appointees. Their careers and bank balances may hinge on the decisions
that they make. But they have a higher responsibility and duty to the
public. Science is a public good. It doesn’t need to be followed
blindly, but it does need to be fairly considered. Importantly,
suppressing science, whether by delaying publication, cherry picking
favourable research, or gagging scientists, is a danger to public
health, causing deaths by exposing people to unsafe or ineffective
interventions and preventing them from benefiting from better ones. When
entangled with commercial decisions it is also maladministration of
taxpayers’ money.
Politicisation of science was
enthusiastically deployed by some of history’s worst autocrats and
dictators, and it is now regrettably commonplace in democracies.20
The medical-political complex tends towards suppression of science to
aggrandise and enrich those in power. And, as the powerful become more
successful, richer, and further intoxicated with power, the inconvenient
truths of science are suppressed. When good science is suppressed,
people die.
Footnotes
Competing
interests: I have read and understood BMJ policy on declaration of
interests and have no relevant interests to declare.
Provenance and peer review: Commissioned; not externally peer reviewed.
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