The Constant Gardener

(Handwritten note from Tessa: These unbiased opinion leaders are one and all contracted to KVH by highly paid "roving commissions" to spot promising biotech research projects worldwide.)

Extract from a book entitled Clinical Trials by Stuart Pocock, written out in Tessa's handwriting as her preferred means of committing it to memory. Some passages blazoned in red in contrast to the writer's sober style:

There is a tendency for students, and indeed many clinicians, to treat the medical literature with undue respect. Major journals such as the Lancet and the New England Journal of Medicine are presumed to present new medical facts which are not to be disputed. Such a naive faith in the "clinical gospels" is perhaps encouraged by the dogmatic style that many authors adopt, so that the uncertainties inherent in any research project often receive inadequate emphasis…

(Tessa's note: Articles are constantly planted by pharmas, even in the so-called quality rags.)

As regards talks at scientific meetings and advertising by pharmaceutical companies one needs to be even more skeptical… the opportunities for bias are enormous…

(Tessa's note: According to Arnold, big pharmas spend zillions buying up scientists and medics to plug their product. Birgit reports that KVH recently donated fifty million dollars to a major U.S. teaching hospital, plus salaries and expenses for three top clinicians and six research assistants. Corruption of university Common Room affiliations is even easier: professorial chairs, biotech labs, research foundations, etc. "Unbought scientific opinion is increasingly hard to find." — Arnold.)

More from Stuart Pocock:

… there is always the risk that authors are persuaded toward a greater emphasis on positive findings than is really justified.

(Tessa's note: Unlike the rest of the world's press, pharma journals don't like printing bad news.)

… Even if they do produce a trial report of their negative findings it is likely to be in an obscure specialist journal rather than in the major general journals… consequently this negative rebuttal of the earlier positive report could not be made available to such a wide audience.

… Many trials lack essential features of design to achieve an unbiased assessment of therapy.

(Tessa's note: Are geared to prove a point, not question it, i.e., worse than useless.)

Occasionally, authors may deliberately dredge the data to prove a positive…

(Tessa's note: Spin it.)

Extract from the London Sunday Times, headed "Drug Firm Put Patients at Risk in Hospital Trials." Heavily scored and underlined by Tessa and presumably reproduced or faxed to Arnold Bluhm since it bore the superscription: Arnie, have you SEEN this?!

One of the world's largest drug companies placed hundreds of patients at risk of potentially fatal infections by failing to disclose crucial safety information to six hospitals at the start of a nationwide drug trial.

Up to 650 people underwent surgery in Britain in the experiment organized by Bayer, the German pharmaceutical giant, despite the company having conducted studies which showed its drug reacted badly with others, seriously impairing its ability to kill bacteria.

This prior research, obtained by The Sunday Times, was not revealed at the start of the study to the hospitals involved.

The trial, whose flaw has never been revealed to the patients or their families, resulted in nearly half of those operated on at one test center in Southampton developing a variety of life-threatening infections.

Bayer declined to reveal overall numbers for postoperative infections and fatalities, on the grounds that the data remained confidential.

"The study was approved by the competent regulatory authority and all local ethics committees prior to initiation," said a spokesman.

Full-color, full-page advertisement torn from a popular African magazine, captioned: I BELIEVE IN MIRACLES! Center stage, one pretty young African mother in low white blouse and long skirt, smiling radiantly. Happy baby sits sideways across her lap, one hand to her breast. Happy brothers and sisters cluster round, handsome father towers over all. Everyone including mother is admiring conspicuously healthy child on her lap. Along the bottom of the page, the words THREEBEES BELIEVE IN MIRACLES TOO! Speech bubble issuing from pretty young mother's mouth reads: "When they told me my baby had TB, I prayed. When my GP told me about Dypraxa, I knew my prayer was heard in Heaven!"

Justin returns to the police file.

Extract from officers' report on their interview with PEARSON, Ghita Janet, locally employed member of Chancery, British High Commission, Nairobi: