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Where do you think Health Minister Liow Tiong Lai’s wife got her RM600K MPV from huh? Think with his minister’s salary he is able to purchase that expensive vehicle and maintain it? Now you know why that back-door minister president of Gerakan still so thick skin, had to eat his words and insist on backdoor entrance? LOL !!!!

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Note that the name of the drug may be different in other countries

http://www.worstpills.org

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What the article actually says is that the flu vaccine doesn’t help people who are at highest risk of being badly affected by flu. There is no doubt that flu vaccines work to elicit immunity, but how much, or if at all, immunity is elicited depends on the health of the person’s immune system. If they are immune-compromised already (eg. elderly, sick), then vaccines aren’t going to elicit much immune response. I’m a little cautious of the author because she tends to use examples and statements obviously aimed at creating unnecessary hype within her article. Despite the words she used and how she dramatizes some aspects, if you understand the science, all she is really saying is that flu vaccines work in people who are healthy and won’t die from a flu infection anyway, but is useless for people who are at highest risk to die from a flu infection.

Immunologists in general are nice people with their hearts in the right place. The design and production of flu vaccines involves an expansive collaborative global network. They take influenza surveillance and vaccine design very seriously. It isn’t just a commercial endeavor. I’ve received flu vaccination for 3 yrs and I believe it generally works. Whether it will prevent the next flu pandemic is a matter of chance, you must understand that – Much like wearing an armour will protect you in battle, but if your opponent pierces through a gap or soft-spot in your armour, you’re still doomed.

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Phua Lai Kit’s link is very true. However, it only tells a small part of the story, and the tail-end for that matter. Problems/corruption/conflict of interest begin very early in the process of drug (medicine) discovery. Drug discovery is a long arduous journey and the foundation that allows later players to mislead/misguide the public is laid by scientists struggling to pay their bills and who will lose their jobs when the project (drug) they are working on is terminated because it is deemed not workable.

The doctors / consultants / reviewers described in Brownlee’s article (Phua Lai Kit’s link) in reality rely on scientists’ results to make their interpretation. They don’t carry out the tests themselves and usually don’t truly know the science behind treatments because they are doctors, not scientists. Doctors know the body, treatment and meds like F1 drivers know how to drive the car and have knowledge about the engineering of the car. However, it is the engineers and mechanics (scientists) who truly know every component of the car and how exactly it works. However, doctors generally have better status and reverence in society, so they become the spokespeople for pharmas. Many of these doctors publish in scientific journals, but it is because they head a lab of scientists but ultimately still rely on scientists to present and explain data to them (Like a CEO of a factory who employs engineers and technicians, but don’t really know how to manufacture the product or truly understand the technology behind the product). With their limited understanding of the science, it is easy for them to be corrupted and used by pharmas, especially when they are armed with results produced by scientists who are not just biased, but have their jobs 100% dependent on whether a potential drug will work.

Bear in mind, drug discovery is a long arduous journey: Drug design (finding & synthesising a compound that *may* work) -> Testing in tissue culture -> Testing in animals -> Human trials (Small scale; Safety / No adverse effects) -> Human trials (Small scale; Efficacy) -> Human Trials (Larger scale).

From drug design to testing in culture, a pharma may already have spent millions or at least hundreds of thousands $$. If a scientist tells them at this stage that the drug is not workable, all the millions $$ they have spent is wasted. Therefore, pharmas put lots of pressure on scientists to *make* it work or make it appear as though it works… and there are a lot of easy ways to do this – There are many ways to carry out a test to answer a question, and it is a matter of picking out the right test under the right conditions so you can show “the right answer”. The rationale behind this practice is the blind (desperate) believe that
“the drug *must* work, so we just need the ‘right’ tissue culture results so that the legislators will allow us to move to the next stage which is animal trials. Once we get to animals, it will become clear that the drug actually *does* work, it is just that there is something wrong with the tissue culture system.”

Of course, when you get to animal trials, the pharmas would have spent EVEN MORE $$. Then, if animal trials don’t quite work, the same rationale as above applies.
“We just need to get the ‘right’ results in animal trials so that we can do human trials. After all, nothing is more accurate than human trials. Once we get to that stage, it will clearly work.”

With each step, more and more $$$$ has been spent, so by the time they reach human trials, pharmas will almost do anything and everything to make it a success.

Criticising doctors/consultants/reviewers is just a part of the story. It doesn’t really address the crux that allows that to happen. Also, only focusing on tamiflu is looking through a very narrow lens. There are many drugs out there which are equally misleading or worse. I’m interested in celebrex mentioned in Phua Lai Kit’s link. A certain private hospital in Penang is prescribing *a lot* of celebrex for *a lot* of conditions and patients.

All said, there are also good medicines and there is as much or more wishful thinking in alternative medicines. It boils down to consumers being aware of what they consume. (Unfortunately, sometime difficult for medicines).

I believe that the public / society is in part to blame for govs, public health agencies n international bodies recommending stockpiling tamiflu. The majority of society (actually less in developed countries, and more so in some developing countries) have become accustomed to the idea that we need medicines for us to feel better. There are many who go to see the doctor expecting to be medicated. Patients in private hospitals in Malaysia expect to be given antibiotics, when patients with the exact same symptoms in another country may just be sent home to rest. But because patients in private hospitals are paying good money to see the doctor, they don’t feel like they are getting their money’s worth unless they walk away with some medicines (which they pay extra for).

These perceptions and over-emphasis on needing medicines, coupled with the hysteria over H1N1, I believe contributed to the recommendation by public health agencies and international bodies to recommend tamiflu even though they knew full well that tamiflu wasn’t exactly effective against H1N1. However, we are looking at societies who *need* to know that there is a cure so they can feel comforted. Partly to address public hysteria (muchly fueled by media), actions had to be taken and stockpiling tamiflu was one of them.

During the hype of H1N1, I know of someone in Penang who bought several boxes of tamiflu, supposedly from a pharmacist who had some sort of black-market supply. He can’t be the only person who was personally stockpiling tamiflu. At the same time, our gov hosps were over-run by people wanting to be tested for H1N1. Majority who didn’t need to be tested. Science, doctors and MoH gave out clear information on who needed/didn’t need to be tested. However, that didn’t stop those people (kiasu? kiasi? selfishly/irrationally afraid of dying?) from insisting to be tested and further stretching an overburdened system.

Can we 100% blame public agencies and international bodies dealing with public hysteria from offering tamiflu as a solution? Have you ever been pushed to a corner by a child, boss or loved one demanding an answer/solution that you didn’t really have? In desperation, you come up with what you hope offers some sort of remedy to waylay the problem. I don’t think anyone in public health would honestly deny that that was what tamiflu for H1N1 was all about. I’m sorry if governments and media over-played the significance of Tamiflu. In this scenario, I don’t believe the scientists and public health advisors would have misled govs that tamiflu was a cure. I strongly believe they would have pointed out the doubts, but it was the only solace so govs took it and ran with it, thereby misleading the public.

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The FDA has been reviewing reports of abnormal behavior and other brain effects in more than 1,800 children who had taken the flu medicine Tamiflu.

The symptoms have included convulsions, delirium or delusions, and in Japan, 5 deaths have been reported in children under 16 as a result of neurological or psychiatric problems.

There have also been nine deaths among older teens and adults, attributed to neuropsychiatric problems or brain infections.

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http://www.washingtonmonthly.com/features/2004/0404.brownlee.html

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