David H. Freedman

Two recently released European reports have raised the possibility that scientists who helped fuel world fear of an H1N1 flu crisis were motivated by ties to drug companies enriched by the ensuing rush to stockpile medications. The reports, which were from credible parties, including a Council of Europe committee and the British Medical Journal, noted that several of the World Health Organization scientists behind that agency’s pressuring of governments to take dramatic action in response to the flu had received consulting or other fees from the drug companies, but that WHO hadn’t bothered to identify these potential conflicts of interest. (Though the scientists in question had previously identified these ties in research-journal papers). With H1N1 turning out to fall far short of the devastating pandemic WHO and others predicted, many of the world’s governments have ended up with vast unused stores of antiviral and other medications snatched up at WHO’s urging.

There’s no evidence that the scientists ginned up the warnings in order to channel sales to drug companies that had been good to them, and it seems unlikely that’s the case. Scientists widely agreed there was plenty of reason to fear that H1N1 could become widespread and deadly. And we surely want our scientists, institutions and governments to err on the side of caution in these matters. It may even be that the rapid action taken by governments at WHO scientists’ prodding was at least partly why H1N1 appears to have been something of a dud, so that the wasted drugs are in a way a sign of WHO’s competence rather than its failure. (WHO actually continues to warn there’s still a real danger of H1N1 getting out of hand.)

Still, science is supposed to be tough on biases, and especially blatant conflicts of interest. It has long been standard to insist that scientists openly and clearly state any ties they have to any corporations when there is any chance that their work could be seen as benefiting those corporations. But there’s little question that conflict of interest remains a big problem in medical research. A 2003 Journal of the American Medical Association review of conflict-of-interest meta-studies involving some 67 conflict-of-interest studies and 398 other research reports confirmed a strong correlation between industry sponsorship and positive findings. (I provide sources in Wrong for that last and the following points).  And the problem may be worse than it looks, because companies often disguise that they are behind certain findings by paying university researchers to put their names to studies actually conducted and written up by the companies–so-called “ghost authorship,” a problem that infects about three-quarters of industry-backed drug trials, one study found According to another study, at least 30 percent of published medical researchers have been in a potential conflict-of-interest situation, and as few as 2 percent of researchers fully disclosed that fact. Every single one of the 170 psychiatric experts contributing to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) used to diagnose psychiatric disorders had financial ties to manufacturers of psychiatric drugs.

Remember this situation every time you hear of research that concludes a drug works well, or a new type of test is effective, or, yes, an infectious disease is about to wreak havoc on the world unless governments buy up all the treatments they can get their hands on. That’s not to say the specific research is likely to be wrong–but it’s another reason why we need to be wary consumers of research conclusions.