The Constant Gardener

Her lecture-room voice again, mordant and arrogant. "At the time of the unscientific trials, few side effects were observed. This was due also to the excessive enthusiasm of Kovacs and Lorbeer, and the determination of clinics and medical centers in Third World countries to make the trials look good. Also the trials were being favorably reported in important medical journals by distinguished opinion leaders who did not declare their profitable connections with KVH. In reality such articles were written in Vancouver or Basel and only signed by the distinguished opinion leaders. It was remarked that the drug did not suit an insignificant proportion of women of childbearing age. Some had blurred vision. There were some deaths, but an unscientific manipulation of dates ensured that they were not included in the period under review."

"Did nobody complain?"

The question angers her. "Who shall complain? Third World doctors and medical workers who are making money from the trials? The distributor who is making money from marketing the drug and does not wish to lose the profits from the whole range of KVH drugs — maybe lose their entire business?"

"How about the patients?"

Her opinion of him has reached rock bottom. "Most of the patients are in undemocratic countries with very corrupt systems. Theoretically they gave their informed consent to the treatment. That is to say, their signatures are on the consent forms even if they cannot read what they have signed. They are not allowed by law to be paid, but they are generously recompensed for their travel and loss of earnings and they have free food, which they like very much. Also they are afraid."

"Of the pharmas?"

"Of everybody. If they complain they are threatened. They are told their children will receive no more medicines from America and their men will go to prison."

"But you complained."

"No. I did not complain. I protested. Vigorously. When I discovered that Dypraxa was being promoted as a safe drug and not as a drug on trial, I gave a lecture at a scientific meeting of the university at which I described accurately the unethical position of KVH. This was not popular. Dypraxa is a good drug. That is not the issue. The issue is threefold." Three slender fingers have already gone up. "Issue one: the side effects are being deliberately concealed in the interest of profit. Issue two: the world's poorest communities are used as guinea pigs by the world's richest. Issue three: legitimate scientific debate of these issues is stifled by corporate intimidation."

The fingers are withdrawn while with her other hand she delves in her bag and unearths a glossy blue leaflet with the banner headline GOOD NEWS FROM KVH.

DYPRAXA is a highly effective, safe, economic substitute for the hitherto accepted treatments of tuberculosis. It has proved itself to be of outstanding advantage to emerging nations.

She takes back the leaflet and replaces it with a much-thumbed solicitor's letter. One paragraph is highlighted.

The study of Dypraxa was designed and implemented in an entirely ethical manner over a number of years with the informed consent of all patients. KVH does not distinguish in its trials between rich and poor countries. it is solely concerned to select conditions appropriate to the project in hand. KVH are rightly praised for their high quality of care.

"Where is Kovacs in this?"

"Kovacs is totally on the side of the corporation. She is without integrity. It is with the assistance of Kovacs that much of the clinical data is distorted or suppressed."

"And Lorbeer?"

"Markus is divided. This is normal to him. In his self-perception he has become chief of all Africa for Dypraxa. But he is also frightened and ashamed. Therefore he confesses."

"Employed by ThreeBees or KVH?"

"If it is Markus, maybe both. He is complicated."

"So how on earth does KVH come to set you up at Dawes?"