Cigarettes, pharmaceuticals, wikileaks, and our right to know

From preventing an update of smoking labels, to ending an independent pharmaceutical review agency, to waging war on wikileaks, corporations and governments are cracking down on our democratic right to information.

SMOKING GUN

     As I've written in other posts, cigarettes are but one of many carcinogens, and blaming smoking for the entire cancer epidemic distracts from toxic chemicals and workplaces over which people have little control, individualizes the causes of cancer, and can turn into moralizing against "bad behaviour" instead of addressing the stressful conditions of people's lives that encourage smoking. That being said, smoking is a preventable causes of death, and labels highlighting the health impacts have been shown to decrease smoking. While Canada was the first country to impose mandatory health warnings on cigarette packages, they have not changed in ten years. There was a 6-year, $4 million plan to update labels--with bigger graphics and a 1-800 national Quitline number--to be launched on May 31, World No Tobacco Day. But at the last minute the Tory government abandoned their plans, diverting focus to contraband cigarettes.
     The CBC has revealed that this decision took place after intense tobacco industry pressure:

"Health Canada's abrupt decision in September to back down from expanding warning labels on cigarette packages came after tobacco company lobbyists waged a co-ordinated, sometimes secretive lobbying campaign…The big three tobacco companies, Imperial Tobacco Canada, JTI-Macdonald Corp. and Rothmans, Benson & Hedges Inc., lobbied a combined total of 53 times in just over two years, according to the registry. When other industry associations and smaller tobacco companies are factored in, the number of 'communications' jumps to 82."

     The CBC has also revealed that many tobacco lobbyists have ties to the Tories--including Duncan Rayner (who went from director of operations for the Conservative Party to lobbyist for Imperial Tobacco), Ezra Levant (who went from Tory insider to lobbyist for Rothmans, Benson & Hedges, and now ideological defender of the carcinogenic Tar Sands), and Perrin Beatty (who went from Conservative health minister to president of the Canadian Chamber of Commerce, which lobbies on behalf of the tobacco industry).

ORGANIZED (CORPORATE) CRIME 
     Instead of enhancing labels, the Harper government is parotting the tobacco industry party line that focus should instead be on reducing contraband tobacco. According to professor Dave Hammond, who consulted Health Canada on the warning labels, "they use contraband as a blunt weapon to try and beat down anything else that might be effective." As lobbyist Beatty argues, "There is a significant share of the market that it is being fuelled by organized crime. Do we want to make it easier for organized criminals by eliminating the ability of other people to offer brands in competition?" So their efforts are not to reduce smoking, but to eliminate competition with tobacco company profits.

      Like the Harper government's decision to spend billions of dollars building prisons despite a falling crime rate, the hysteria about contraband tobacco goes against current trends. According statistics from Health Canada, sales in contraband cigarette consumption have declined since 2009, along with increases in brand name tobacco. Like the government's false dichotomy between "combat" and "non-combat troops" in Afghanistan, the dichotomy between contraband and brand-name tobacco diverts attention from the fact that cigarettes, like military occupations, are deadly regardless of what form they take. Cigarettes kill 45,000 Canadians a year, 100 times the number of people murdered. Instead of being tough on corporate crime, the government is coluding with it. As Cynthia Callard of Physicians for a Smoke Free Canada describes the tobacco lobby (shown previously in the great film, The Insider):

"There's no way of knowing conversations that take place over golf games or cocktail parties or people who float between one world and another...By and large they threaten, they bully, they cajole, they seduce and they purchase support and they've done that for decades. So it's no surprise that they've been successful this time and it's sadly no surprise why they're successful."

BIG PHARMA, BIG SECRETS

     Another recent sad victory for corporations is the killing of the Therapeutics Initiative, a publicly-funded group based at the University of British Columbia, that provides independent evidence-based reviews of pharmaceutical risks and benefits. Therapeutics Initiative helped expose the health risks of blockbuster drug Vioxx. Vioxx, an anti-arthritis medicine, was heavily marketed and made billions for Merck. But it increased the risk of heart attacks and killed killed more Americans than were killed in the Vietnam War. Thanks to the early warnings by Therapeutics Initative, it was kept it off the shelf in BC, saving 500 lives.
     Therapeutics Iniative has also called into question the costly and widespread use of levaquin to treat pneumonia, statins for primary prevention of heart attacks, gabapentin for chronic pain, and recently blew the whistle on a new blood-thinner. Dabigatran is set to replace coumadin as a blood thinner to prevent stroke, and has been approved by Health Canada based on a study funded by its maker, pharmaceutical giant Boehringer Ingelheim. Therapeutics Iniative recently alerted the fact that it appears to increase the risk of heart attacks and stomach bleeds, but the company refuses to release all its safety data. In additition to exposing health risks of Big Pharma, Therapeutics Iniative's input to which medications will be covered by the provincial drug plan has saved the government $50 million a year and given BC the lowest average per-capita drug spending.
     But despite this life-saving, cost-saving and efficiency, the BC government (under industry pressure) cut the small $1 million required to sustain Therapeutics Iniative,  refused to hire the scientists to its advisory board, and instead will base its decisions on profit-driven pharmaceutical companies. This is the latest scandal in the corrupt world of Big Pharma (for a more detailed look into the industry, see this video).

WIKILEAKS: SUPPORT  FREEDOM OF INFORMATION

     If pressuring a government to cut funds to a review agency that saves lifes and resources isn't damning enough, how about trying to sabotage a government's lawsuit against a company for its role in the death of children with meningitis. That's what wikileaks has recently revealed about the world's largest pharmaceutical giant, Pfizer, which tried to pressure the Nigerian attorney general to drop charges against Pfizer for its antibiotic's role in the death of children during a meningitis epidemic in 1996.
     Wikileaks has come under sustained attack by governments and corporations--from kicking it off internet servers to calls to assassinating its editor in chief--for the "crime" of releassing information that the public should know: about corporate corruption, military war crimes, government lies. The leak about Pfizer is just the tip of the iceberg, as wikileaks has announced it will blow the whistle on corporations after finishing the current release of diplomatic cables.
     Please sign the petition by Avaaz to defend their freedom of expression and freedom of the press. And you can donate to wikileaks through their website. There is no freedom or democracy without information, and from cigarettes to pharmaceuticals to corporate/government behaviour we have a right to know.

"Female viagra" and the medicalization of women

The pharmaceutical giant Boehringer Ingelheim has dropped its plan to market its failed antidepressant as a “female viagra” pill. The US Food and Drug Administration slammed the drug studies for failing to produce benefits, while 15% of women dropped out of the study due to side effects like depression, fainting and fatigue. “Female sexual dysfunction” is the latest pharmaceutical attempt to pathologize women, while real healthcare needs go unmet.




"FEMALE VIAGRA"
     According to a recent Globe&Mail article:

“Female sexual dysfunction” – a much-debated term that includes lack of desire and inability to reach orgasm – was entrenched when a 1999 article in the Journal of the American Medical Association announced that 43 per cent of women suffer from some form of sexual dysfunction. Problematically, the lead author was revealed to have financial ties to Pfizer.” 

Marketing this drug as a “female Viagra” is also problematic: Viagra is to achieve a physical erection, while these pills for women are trying to alter their brain chemistry to promote desire they are told is insufficient.  This does not mean taking a nihilistic attitude towards medicine but to acknowledge the impact of profit-driven pharmaceutical companies (for more on this check out the documentary Orgasm Inc.). As Ray Moynihan, co-author of Sex, Lies and Pharmaceuticals: How Drug Companies Plan to Profit from Female Sexual Dysfunction explained in the article above:

“There would be a cohort of women with nerve damage after surgery, or sexual side effects of SSRIs, for which a health professional could be extremely helpful. But to categorize the changes in desire that happen as we move through our lives and relationships as symptoms of a disorder or a dysfunction is highly controversial and questionable. I’m not sure that women going through absolutely normal changes in desire want to identify themselves as suffering from some medical disorder.”

WEAPONS OF MASS PRESCRIPTION
     Like all industries, the pharmaceutical industry is made up of rival firms in competition for market share. In the field of health this produces an inevitable pressure to pathologize. Men now face the prospect of getting treated for “andropause” (age-related decline in testosterone), “obesity” has gone from a risk factor to its own disease requiring pharmaceutical intervention (more on this in a future post), while the notion of “pre-hypertension” is pushing blood pressure medicine on people with normal blood pressure.
     Women have faced a long history of diseases created to pathologize and control their bodies. For centuries women were diagnosed as suffering from “hysteria”—a catch-all term uniquely imposed on women, based on the idea that their uterus (“hyster” in latin) was out of control. As one blogger has summarized:

“The symptoms of hysteria ranged from the erotic to the ludicrous and included fainting, insomnia, fluid retention, vaginal lubrication, ‘voluptuous sensations,’ and, natch, ‘a tendency to cause trouble.’ Sometimes disorders such as epilepsy, anorexia, postpartum depression, and menopause would be misdiagnosed as hysteria, but mostly ‘hysterics’ were just women with a libido and a disapproving patriarch in their lives.” 

“Treatment” varied from incarceration in asylums (more on the history of psychiatry in a later post), surgical removal of the clitoris, or forced orgasm.
     In the 20th century the medical establishment dropped “hysteria”, but  went on to universally medicate older women with Hormone Replacement Therapy (HRT) on the grounds that menopause was a disorder. Pressure from women’s groups helped expose the bad science behind this, culminating in the Women’s Health Initiative showing that indiscriminate use of HRT can lead to breast cancer, heart disease, strokes, and pulmonary emboli.
     Then along came “Pre-Menstrual Dysphoric disorder”. When the patent for the anti-depressant Prozac was about to expire, Eli Lilly got a new patent for it, under a different name, for the treatment of this new “disorder”. According to feminist psychoogist Paul Caplan, "It's a label that can be used by a sexist society that wants to believe that many women go crazy once a month...Any normal hormonal change in people of either sex can exacerbate migraines, thyroid problems, etc., but no one suggests calling men's hormonal changes kinds of mental illness".  Now, with "female seual dysfunction", BigPharma has pathologized women’s sexual lives in order to further push their products.

WOMEN’S HEALTH
     This does not mean dismissing the role of medicine in women’s health, but basing it on women’s needs not pharmaceutical profits. Ironically, the creation of false medical needs runs in parallel with the denial of real needs such as abortion or HIV prevention.

     An alliance between the women’s movement and the progressive medical community struck down laws against abortion, and continues to fight for access--from promoting more teaching about abortion in med schools, to challenging Canada's minority government that wants to deny abortion rights to the 70,000 women around the world who die from unsafe abortion every year. The women's movement was at the forefront of the G20 protests, exposing Harper's war on choice and leading the 40,000 strong march with a giant coat-hanger.
     Women also continue to fight for recognition and prevention of HIV. When AIDS was first discovered it was blamed on gays and Haitians and the impact on women was ignored, resulting in many women being excluded from receiving medicine, services, and disability benefits. Women demonstrated with the slogan “women don’t get AIDS, they only die from it,” demanding the definition include conditions specific to women (like invasive cervical cancer). This succeeded in 1993 and uncovered the true statistics, as the number of women with the diagnosis of AIDS tripled. But HIV continues to be blamed on gay men and promiscuity, for which the main prevention is condoms. In 1991 a group of women working on AIDS prevention in Haiti published a text countering myths about women and AIDS, a list that needs repeating almost 20 years later:

-“AIDS is a disease of men”: the data are overwhelming: AIDS was never a disease of men. Given transmission dynamics, AIDS may in fact becoe a disease predominantly afflicting women
-“Heterosexual AIDS won’t happen": Heterosexual AIDS has already happened. Indeed, in many parts of the world, AIDS is the leading cause of death among young women.
-“women’s promiscuity causes AIDS” : most women with AIDS do not have multiple sexual partners, they have never used IV drugs, they have not received tainted blood transfusions. Their major ‘risk factor’ is being poor. For others, the risk is being married and unable to control not only their husbands but also what jobs their husbands have to perform to make a living.
-“women are AIDS vectors”: ‘women are too often perceived as agents of transmission who infect men and ‘innocent babies’. Prostitutes have been particularly hard hit by such propaganda, but prostitutes are far more vulnerable to infection that to infecting; AIDS is an ‘occupational risk’ of commercial sex work, especially in setting in which sex workers cannot safely demand their clients use condoms.’
- “condoms are panacea”: gender inequality calls into question the utility of condoms in setting in which women’s ability to insist on ‘safe sex’ is undermined by a host of less easily confronted forces. Furthermore, many HIV-positive women choose to conceive children, which means that barrier methods that prevent conception are not the answer for many. Woman-controlled viricidal preventive strategies are necessary, if women’s wishes are to be respected.

To overcome the disconnect between multibillion dollar companies medicating women for manufactured diseases while millions of women are denied basic healthcare needs, healthcare needs to base itself on the needs of people not profit. Our bodies, our choice.