Politikere og regeringer undertrykker videnskaben. De gør det i offentlighedens interesse, siger de, for at fremskynde tilgængeligheden af diagnostik og behandlinger. De gør det for at støtte innovation, for at bringe produkter på markedet i en hidtil uset hastighed. Begge disse grunde er delvis plausible; de største bedrag er grundlagt i sandhedskorn. Men den underliggende adfærd er bekymrende.
Videnskaben undertrykkes for politisk og økonomisk gevinst. Covid19 har frigivet statskorruption i stor skala, og det er skadeligt for folkesundheden1. Politikere og industri er ansvarlige for dette opportunistiske bedrageri. Det er også forskere og sundhedseksperter. Pandemien har afsløret, hvordan det medicinsk-politiske kompleks kan manipuleres i en nødsituation - en tid, hvor det er endnu vigtigere at beskytte videnskaben.
Kommentar: Delvist oversat af Sott.net fra Covid-19: Politicization, "corruption," and suppression of 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
Comment: See also: SAGE conflicts of interest and UK's ex-SAGE member speaks out against 'circuit breaker' lockdown
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.10 11
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.12 13 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.17Government 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.
References
1. Geoghegan P. Cronyism and clientelism. London Review of Books 2020 Nov 5. https://www.lrb.co.uk/the-paper/v42/n21/peter-geoghegan/cronyism-and-clientelism
2. Scally G, Jacobson B, Abbasi K. The UK's public health response to covid-19. BMJ2020;369:m1932. doi:10.1136/bmj.m1932 pmid:32414712
3. Iacobucci G. Pandemic preparedness: Government must release 2016 report, says information commissioner. BMJ2020;371:m3953. doi:10.1136/bmj.m3953 pmid:33046458
4. Department of Health and Social Care. Policy paper. Annex B: Exercise Cygnus report. 5 Nov 2020. https://www.gov.uk/government/publications/uk-pandemic-preparedness/exercise-cygnus-report-accessible-report
5. Public Health England. Disparities in the risk and outcomes of COVID-19. 2020. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/908434/Disparities_in_the_risk_and_outcomes_of_COVID_August_2020_update.pdf
6. Khunti K, Platt L, Routen A, Abbasi K. Covid-19 and ethnic minorities: an urgent agenda for overdue action. BMJ2020;369:m2503. doi:10.1136/bmj.m2503 pmid:32576558
7. Horton R. Tweet, 15 Oct 2020. https://twitter.com/richardhorton1/status/1316711967554506753
8. Boseley S. Antibody tests bought by UK government "less accurate than maker claims." Guardian 2020 Nov 12. https://www.theguardian.com/world/2020/nov/12/covid-antibody-test-bought-uk-government-less-accurate-than-makers-claim
9. Iacobucci G, Coombes R. Covid-19: Government plans to spend £100bn on expanding testing to 10 million a day. BMJ2020;370:m3520. doi:10.1136/bmj.m3520 pmid:32907851
10. Iacobucci G. Covid-19: mass population testing is rolled out in Liverpool. BMJ2020;371:m4268. doi:10.1136/bmj.m4268 pmid:33144291
11. Iacobucci G. Covid-19: rapid test missed over 50% of positive cases in Manchester pilot. BMJ2020;371:m4323. doi:10.1136/bmj.m4323 pmid:33158908
12. Ranya M, Jones HE, Sian T-P, et al. Accuracy of UK rapid test consortium (UK-RTC) "AbC-19 rapid test" for detection of previous SARS-CoV-2 infection in key workers: test accuracy study. BMJ2020;371:m4262.
13. Dipender G, Ponsford MJ. Testing for antibodies to SARS-CoV-2. BMJ2020;371:m4288.
14. Armstrong S. Covid-19: Government buried negative data on its favoured antibody test. BMJ2020;371:m4353. doi:10.1136/bmj.m4353
15. Cohen K, Kupferschmidt K. The "very, very bad look" of remdesivir, the first FDA-approved COVID-19 drug. Science 2020 Oct 28. https://www.sciencemag.org/news/2020/10/very-very-bad-look-remdesivir-first-fda-approved-covid-19-drug
16. Transparency International. Corruption and covid-19 — the story so far. 8 Jul 2020. https://www.transparency.org.uk/corruption-coronavirus-covid-19-latest
17. Ennals E. Government test tsar has £770,000 shares in drugs firm that sold us £13million of "pointless" antibody screening kits — after it emerged that Sir Patrick Vallance has a financial interest in company racing to find vaccine. Daily Mail 2020 Sep 26. https://www.dailymail.co.uk/news/article-8776339/Test-tsar-770-000-shares-firm-sold-13million-pointless-antibody-screening-kits.html
18. Armstrong S. Covid-19: Government faces legal action over £75m contract for antibody tests. BMJ2020;371:m4427. doi:10.1136/bmj.m4427
19. Mahase E. Covid-19: Vaccine candidate may be more than 90% effective, interim results indicate. BMJ2020;371:m4347. doi:10.1136/bmj.m4347 pmid:33168562
20. Bollyky TJ, Kickbusch I. Preparing democracies for pandemics. BMJ2020;371:m4088. doi:10.1136/bmj.m4088 pmid:33097482
Kommentar: Good on the BMJ for finally calling out the blatant corruption and suppression of science, it's about time! For more information see the articles below: