Holier than Thou BMJ Editor Godlee Fails to Acknowledge Merck MMR Conflict
Holier than thou BMJ editor, Godlee, fails once again to acknowledge journal's Merck conflict in the MMR affair
By John Stone
Following an editorial calling for tighter standards on Conflict of Interest by British Medical Journal editor Fiona Godlee, the journal has omitted to publish a letter pointing to its continuing failure to acknowledge its business association with MMR manufacturer Merck: BMJ Learning is in partnership with Merck’s information division Univadis, as pointed in these columns and AHRP by Martin J. Walker earlier this year (See here also). Godlee was forced into a limited admission of error in March in relation to BMJ’s recycling of allegations of fraud against Andrew Wakefield originally made by journalist Brian Deer in the Sunday Times just days after New International boss James Murdoch joined the board of another MMR manufacturePreviewr, GSK, with a brief to help look after the the group's reputation (Age of Autism James Murdoch Still Supported by GSK).
However, ultimately BMJ flunked the main issue of the Univadis/Merck connection, and only published a limited acknowledgement that they had failed to disclose the sponsorship of Merck and GSK of their annual awards ceremony, which had been mentioned by the present writer separately. This was further weakened by the fact that the disclosure, when published as a correction, only linked only to editorials in the journal and not to the articles by Mr Deer making the allegations. In her forced reply in BMJ on-line Godlee had originally explained that they had not disclosed the links “because it did not occur to us to do so”, but in the case of the links between BMJ’s learning division and Merck’s information division they still haven’t even though by now it certainly must have done.
This is not the only area of BMJ’s insensitivity over conflict of interest in the MMR affair. Associate BMJ editor, Harvey Marcovitch, signed editorials censuring Wakefield despite also being head of GMC panels and with the case still under judicial review, while also having failed to act on the conflicts of the panel chairman in the case, Surendra Kumar (Age of Autism Harvey Marcovitch and Brian Deer and the Lord High Everything Else ). These are just part of a catalogue of bizarre and often outrageous conflicts that have marked the British establishment’s pursuit of Wakefield from the beginning (Age of Autism What's Behind Ben Goldacre and Child Health Safety MMR Files Forced Open ).To put the omission in further context Marcovitch himself had recently published on the anomaly of journals being keener on the commercial conflicts of potential authors than their own. But as for BMJ, it looks as if anything goes despite the fact that both Godlee and Marcovitch are former chairs of the Committee on Publication Ethics.
BMJ’s relationship with Merck has continued despite the exposure of the pharmaceutical company’s activities in the Vioxx affair, which included the publication of fake journal articles in collaboration with Lancet publisher Reed Elsevier and a memo which talked about destroying critical scientists “where they live”.
Here is the text of my letter, so far unpublished by BMJ:-
Leadership by example?
When recently Dr Godlee acknowledged BMJ's competing interests in the
MMR affair over the publication of articles by Brian Deer and the group’s
business association with GlaxoSmithKline and Merck she announced that
they had failed to do this because "it did not occur to us to do so" [1].
Moreover, when they did do so they only did it in a half-hearted way. They
have still not acknowledged their partnership between Merck's information
division Univadis through BMJ Learning, but only the sponsorship of Merck
and GSK for their awards, and they have only linked this information to
their editorials and not Mr Deer's articles (so anyone reading those will
be none the wiser about the journal's conflicts) [2]. Nor were these
conflicts, when exposed, the subject of an international news release like
the original story.
As I also pointed out at the time BMJ can scarcely be naieve about
the implications of this dereliction, as editorial co-author Harvey
Marcovitch had written elsewhere [3]:
"It is a paradox that the professional medical association that owns
JAMA was less than open and transparent with Lundh and colleagues about
potential financial conflicts (such as their income from industry sources)
as they expect their authors to be."
All of this leaves the public at a peculiar disadvantage, if the
rules BMJ are talking about are only for other people.
[1] Fiona Godlee, 'In response to John Stone',
http://www.bmj.com/content/342/bmj.d1335/reply#bmj_el_251470
[2] Correction: 'Wakefield's article linking MMR vaccine and autism
was fraudulent' http://www.bmj.com/content/342/bmj.d1678
[3] Harvey Marcovitch, 'Editors, Publishers, Impact Factors, and
Reprint Income'
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000355
Competing interests:
Autistic son
John Stone is UK editor for Age of Autism.
ChildHealthSafety told us:-
"UK government officials were complicit in this in launching a known dangerous vaccine in the UK when the Merck vaccine was available at 25% of the price of Pluserix.
GSK is considered an important British company to the UK government. Its children their lives and health are far far less important to UK health officials."
State procurement systems in the UK are SUPPOSED to ensure the BEST VALUE for British taxpayers. If you are correct about Pluserix costing 4x as much as the Merck alternative in 1988, then the Government vaccine choice of Pluserix was a CLEAR breach of the UK rules on public finance.
British companies are NOT given automatic tendering preference in the UK. An exception COULD have been made if Pluserix had been proven to be a better, safer alternative to the Merck vaccine, but in view of the fact that Pluserix (under another name) had already been banned in Canada, and the UK Government had already been warned about it, then this can only have been a corrupt decision on the part of those making it.
An interesting comparison can be made with the HPV vaccine. In the UK, Cerverix was chosen over Gardasil because this was a cheaper alternative.
Posted by: Jenny Allan | August 21, 2011 at 01:54 AM
Murdoch is slipping and so will all those involved with him Deer et-al.
I was going to post on Murdoch`s control of the Movie market and how he is going to lose this lucrative market (what a shame never mind).Then 2 more came up,one on Milly Dowler the schoolgirl killed by a Pedo, someone pretending to be Milly using her cell phone number after she was dead for 6 days..and another Mulclaire being ordered by court to spill the beans on who told him to hack where,what, and when ..
My point being this is, where lying has got them , deceit, ignorance of facts , gets them a short rush of money and a lifetime and generations of family shame to come..Godlee`s shame is in the pipeline no doubt lying for all she is worth..
http://www.telegraph.co.uk/search/?queryText=phone+hack&Search=
Posted by: Angus Files | August 20, 2011 at 05:47 PM
Jenny,
What no one knows is whether any cozy deals go on behind the scenes between members of UK Government advisory committees and drug companies. We do not know but we can know if codes like the Joint Committee on Vaccination and Immunisation [JCVI] Code of Practice is adhered to. Of course nothing of the kind will ever happen - until someone is caught in the act:-
http://tinyurl.com/3pkcwbm
The BMJ Editor can get away with whatever she wants so we have to assume that other medical professionals will behave the same way.
The JCVI Code of Practice adopts the ‘Seven Principles of Public Life’ set out by the UK Committee on Standards in Public Life (the Nolan Committee).
JCVI members should be required to open up their finances and assets to scrutiny under the Principle of Accountability. This is particularly the case because they do what they do just for expenses and are not paid - so we have to ask "What's in it for them?".
The Principle of Accountability: "Holders of public office are accountable for their decisions and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office."
Under the Principle of Honesty: Holders of public office have a duty to declare any private interests relating to their public duties and to take steps to resolve any conflicts arising in a way that protects the public interest.
Under the Principle of Openness: Holders of public office should be as open as possible about all the decisions and actions that they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands.
The Code of Practice for Scientific Advisory Committees (COPSAC) is also relevant:
http://tinyurl.com/3srjz7n
Posted by: ChildHealthSafety | August 20, 2011 at 09:52 AM
Jenny Allan | August 20, 2011 at 02:23 AM
The UK Government did not ban Pluserix.
Pluserix was withdrawn worldwide by Smith Kline Beecham [now GSK] urgently on short notice acting on legal advice on 11th September 1992. The UK Department of Health was given hardly one week's notice and was forced by GSK's action to remove the product from pharmacy shelves the next week.
The UK government did not even revoke the product licence for Pluserix meaning it could continue to be sold and was sold. They did not revoke the licence claiming if they did it would cause a worldwide vaccine crisis.
The reality is this was a commercial battle between GSK and Merck for supremacy in the commercial vaccine wars. UK government officials were complicit in this in launching a known dangerous vaccine in the UK when the Merck vaccine was available at 25% of the price of Pluserix.
British children's lives are unimportant to UK health officials when it comes such commercial struggles between pharmaceutical giants.
GSK is considered an important British company to the UK government. Its children their lives and health are far far less important to UK health officials.
Posted by: ChildHealthSafety | August 20, 2011 at 09:16 AM
To put it another way round, if these associations are not important why is BMJ so uptight about even acknowledging them? I also didn't mention in the article above that it took some weeks of agitation before they even put a link to the "correction" on the on-line versions of the editorials to which it referred.
Posted by: John Stone | August 20, 2011 at 05:34 AM
Hi Jenny
But the British government have already admitted that MMR causes brain damage:
http://childhealthsafety.wordpress.com/2009/07/09/mpsmisledovermmr/
John
Posted by: John Stone | August 20, 2011 at 05:02 AM
When is it OK to describe someone as "crooked"?
Posted by: ChildHealthSafety | August 20, 2011 at 04:22 AM
I sent a copy of my letter to the Science and Technology Committee to UK Government Health Minister, Andrew Lansley. You might be interested in this excerpt from the reply from an official in the 'Customer Service Centre':-
"Although the MMR vaccine is known RARELY to cause some temporary neurological disorders such as FEVER FITS, there is no CONFIRMED evidence that the MMR vaccine can cause any long term brain industry in children who experience a fever fit. There is also NO EVIDENCE that the MMR vaccine causes non-febrile seizures (seizures withgout a fever). There remains NO EVIDENCE that the MMR vaccine causes brain damage." (Capital letter highlighting-MINE)
I found this interesting, because as we all now know, the Urabe Mumps component in Pluserix, the first UK MMR vaccine, DID cause widespead convulsions, non fevered meningitis, and encephalitis. This was all COVERED UP by the UK Government at the time.
I was also intrigued by the COMPLETE LACK of references to either autism or bowel disease!! The rest of my S&T letter dealt PURELY with the Wakefield/Deer BMJ articles and Godlee's Editorials. I have concluded that the UK Government IS presently concerned about Pluserix, and the way it was introduced in the UK in 1988 in spite of being banned in Canada for causing EXACTLY the same havoc. It took the UK Government 3 years to bann this dangerous vaccine. They sold the excess stocks of it to South America-with predictable consequences.
Posted by: Jenny Allan | August 20, 2011 at 02:23 AM
Thanks everyone. It is just fascinating to watch the British establishment dig themselves in ever deeper. Over the last 8 years we have seen them time after time acting in this affair with absolute disregard for rules with the apparent certainty that no action will ever be taken: no conflict is too absurd or brazen, no discrepancy too great to be temporarily papered over. You sometimes wonder whether they are hiding even bigger secrets than we ever even imagined such is the continued recklessness of the defence.
Posted by: John Stone | August 19, 2011 at 06:27 PM
Well, only in Britain, I think, could Godlee still be earning a whack of money every year, fronting an outfit (the BMJ ),and actually not fronting an outfit , but convincing enough of the public on behalf of pharma that she has,when all the time Deer has called the shots on behalf of the Pharma mob FOR NO PAY.....phew!
A message for Dr Godlee
We exist. And you will listen to us.
Posted by: Angus Files | August 19, 2011 at 05:35 PM
For those who may be too young to remember .. the infamous French "Dreyfus Affair" is worth recalling:
In November 1894, French Army Captain Alfred Dreyfus was sentenced to life for allegedly having communicated French military secrets to the German Embassy in Paris. Two years later, evidence came to light identifying a French Army major as the real culprit. High ranking military officials suppressed the new evidence .. and .. a military court unanimously acquitted the real culprit after a two day trial. Drunk with power .. the French military then added new charges against Dreyfus based on false documents fabricated by a French counter-intelligence officer .. who was seeking to re-confirm Dreyfus's original conviction. Eventually the cover-up was exposed in a book "J'accuse" .. and .. in 1906 Dreyfus was exonerated and reinstated as a major in the French Army .. where he served honorably throughout WWI.
Someday .. trust me on this .. the U.K. will be as infamous for the "Wakefield Affair" .. as the French have become for the "Dreyfus Affair".
After all, there are only two (minor) differences:
Wakefield was injustly persecuted by high-ranking U.K. public health officials .. instead of high-ranking French military officials
and
instead of a French counter-intelligence agent .. U.K. public health officials were aided and abetted by the BMJ's editor Fiona Godlee .. who was determined to prove Wakefield guilty.
John, Jenny and Mark .. your courageous, staunch refusal to abandon Dr. Wakefield in the U.K. .. should be remembered in history with the same admiration as the French now remember Emile Zola .. the author of .. "J'accuse".
Posted by: Bob Moffitt | August 19, 2011 at 05:07 PM
Like John Stone, I also tried to respond to the recent Godlee article, “Turning the tide on conflicts of interest”. My response (below) has failed, without explanation, to achieve a posting, despite polite inquiry on two occasions.
"Tied up in industry knots"
On 5 January 2011, Godlee et al published an editorial claiming that Andrew Wakefield's 'Early Report' published in the Lancet in 1998 was fraudulent. [1] The claims of fraud had been alleged by Brian Deer, an "investigative" journalist funded by The Sunday Times of London, a News International publication. Deer's subsequent reports in the BMJ were declared as "commissioned and paid for by the journal". In March 2011, Godlee et al published an online correction to their editorial, declaring that the BMJ should have declared industry ties to Merck and GSK *, both manufacturers of the MMR vaccine. [2] No corrections appeared on the Deer series of articles.
* It should be noted that in February 2009, James Murdoch, Chairman and Chief Executive of News Corps, Europe and Asia, became a non-executive director of GSK, to "serve as a member of GSK's corporate responsibility committee", with a brief to "review ... external issues that might have the potential for serious impact upon the group's business and reputation."
http://www.guardian.co.uk/business/2009/feb/03/glaxosmithkline-james-murdoch
[1] Editorial: Wakefield's article linking MMR vaccine and autism was fraudulent. Fiona Godlee, editor in chief, Jane Smith, deputy editor, Harvey Marcovitch, associate editor. BMJ 2011; 342:c7452 (Published 5 January2011). http://www.bmj.com/content/342/bmj.c7452.full
[2] Correction: Wakefield's article linking MMR vaccine and autism was fraudulent. BMJ 2011; 342:d1678 (Published 15 March 2011).
http://www.bmj.com/content/342/bmj.d1678.full
Competing interests: None declared
Posted by: Mark Struthers | August 19, 2011 at 12:55 PM
It's very disheartening isn't it!!? But we should not despair -as long as we have the Internet. The effectiveness of AoA and John's letter writing is demonstrated by Godlee's forced responses to Andrew Wakefield's questions being posted on AoA's comment thread, and her forced (but admittedly circumspect and incomplete) admittance of BMJ's pharma conflicts of interest.
This was Godlee's responses to the UK Government Science and Technology Committee. The topic was specialist journal articles 'peer review':-
http://blogs.nature.com/news/2011/05/medical_journals_are_the_marke_1.html
A leading medical editor has warned that journals are rightly seen as the marketing arm of the pharmaceutical industry and they must go further to be open about where their money comes from.
Fiona Godlee, editor in chief of the BMJ group, told a select committee of the UK Parliament that “We have to acknowledge that the publishing industry has a number of different revenue streams, one of which is the pharmaceutical industry.”
Speaking before a committee hearing into peer review, Godlee was asked about the practice of many publishers producing sponsored publications – where companies can pay for special publications covering certain diseases or topics.
Such publications could be confusing to readers and it was not always clear what industry involvement was, she noted. And even traditional fully peer-reviewed medical journals should not be viewed as pure.
“It has been said that journals are the marketing arm of the pharma industry and that is not untrue; to a large extent that is true,” Godlee told the Science and Technology Select Committee.
Godlee called for more efforts towards transparency in medical publishing, especially around centralised systems for declaring conflicts of interest and making explicitly clear when industry funding has been involved.”
Thie following is from my letter to the S&T Committee. I got a reply stating that it would be copied to committee members. Whether or not they read it is open to question!!
"You will have to forgive me for finding Dr Godlee’s pious responses to the Committee (which I verified by listening to the proceedings),very hard to digest, in view of the fact that Deer’s articles were plainly commissioned by the BMJ’s pharmaceutical ‘paymasters’ and solely intended to preserve the interests of the MMR vaccine manufacturers GSK and Merck!!
However, Godlee DID admit to the Committee that journals ARE ‘the main marketing arm for the pharma industry’!! The vaccine industry makes £billions worldwide and Government indemnities in the UK and US means the manufacturers have few problems with litigation liabilities!!"
Jenny
Posted by: Jenny Allan | August 19, 2011 at 03:03 AM