New direction for this blog

I have not ever had an editorial position for this blog. No consistent direction or unifying theme for what to say except in general terms to speak about helminthic therapy and anything that might, however distantly, relate to the health of those who approach us for hookworm, or for whipworm.

Often I have been embarrassingly guilty of writing self-indulgent garbage I should have known was of interest only to me. Things that in retrospect should not have been of interest to me.  I apologise, it won’t happen again.

I have decided that I am going to concentrate on science for a while, what it is, how it is practiced, how it is funded, who decides what gets funded, what is published and how, and perhaps how elements of that might be improved. Science has not always been like this, or even been at all.

So at some point soon I will write something to try and put science in context. Because if one does not understands what science is, where it came from, how it is practiced and has been practiced, how scientific knowledge has been disseminated, then one cannot make informed decisions about where it can and will go. Or even be able to participate in that debate. To me it is important to widen that discussion, for science and it’s practitioners as much as us, who fund and consume it’s output. As I have spent more time reading science and trying to understand how it is practiced and funded and published, I have grown more and more to see opportunities for improving science.

But to start I plan on writing a guide to reading science for the layperson. Where to find it, how to understand it, why it is in the form you find it, etc.

When I started trying to learn about helminths’ potential therapeutic use the idea of using them in that way was not called helminthic therapy, it did not have a name at all. Except in one paper I read somewhere along the way, and hope to find again soon as I reread a lot of papers to write about here.

Now “helminthic therapy” is used almost everywhere, it has spread as the name of choice for what I do for a living amongst the informed. Everywhere except to the people who do not know that “helminth therapy” is the process of killing off unwanted infections of helminths using drugs like mebendazole. Or among those who prefer the less formal, and less accurate, worm therapy.

I wrote the first copy of the article titled Helminthic Therapy on Wikipedia, so distant now from what I wrote I can not claim authorship. I started the first successful discussion group concerned with Helminthic Therapy on a public forum. I wrote the first blog post back in April, 2006, started one of the first companies, and was the first to be told that helminths are drugs by a regulatory agency and that I should stop.

Doing those things demanded a good understanding of the science behind what I was doing and what I wanted to do. Any posts online back then on the subject were met largely by an outpouring of uninformed rage. Fear, driven by a belief I was going to reintroduce a plague, kill millions (I am not making this up or exaggerating) and worse, informed that rage. To the extent an answer existed to posts and comments that angry it was to reply with information and opinion I could back up with citations. If I could not credibly claim the expertise and knowledge I could at least point to those who could.

Because back then I could not point to magazine articles, nor to any other reservoir of the interpretation of science by others. When I started none of those things existed, there were no articles I could find online in any publication that examined the subject, except what there was in scientific journals or publications.

So I had to read scientific papers, there was no avoiding it. There was no choice if I stood a chance of really understanding the subject, or of explaining it to others,  just as there had been none when I was deciding whether or not it was worth investing the time money and risk in obtaining helminths, and in trying to find a source other than from the third world.

All the time I read scientific papers, and as those devoted to helminths ran out I switched to reading about genetics and immunology, about anthropology and human history.

I came to enjoy it, it has been a source of great pleasure, and some edification I hope.

But when I started I was frightened. I wondered if I should, that I might not be capable of understanding it. That I might be being presumptuous, arrogant, that I might be guilty of hubris. Of course that is a stupid set of worries or ideas, and in retrospect I think very damaging. For me, for anyone afflicted by the attitude, but also for science and our society.

But I also think it is commonplace, as all the criticism expressed directly to me when I started reading science or suggesting I would to friends or family illustrated. People wondered how it could be possible I could understand it without having studied at university. The accusations of arrogance and hubris were especially bruising and frequent. What made me think I could, or had the right, to read science unfiltered?

I think this has come about because, or at least in part, of the more general and damaging tendency to deify scientists and science as more than human, as super intelligent, as part of a priesthood of arcane knowledge with entry only for the initiated it. As well as the tendency to rely increasingly on specialists, as we have all become more specialised in our work. Real Estate agents, furniture shops, green grocers, shoe stores, tailors and clothing stores, no one is the kind of self reliant generalist we all were just a century ago in the developed world. We used to grow our own clothes, now the idea is absurd.

So I want to make science accessible to you, to explain how I went about developing what I believe is a well developed ability to read and understand a large proportion of scientific research, and, perhaps how you can too. Where to go when you need help, and how to develop your abilities over time.

Such as where to find papers, often for free. What to read amongst those available, how to choose among the millions of papers out there. How to find older, harder to find papers that may not be online yet. What tools you can use at the beginning to make the specialised vocabulary understandable. How to examine a paper critically to understand if it is affected by bias, in questions, methods or conclusions, etc. How to find related papers, to the one you just finished to round out your understanding of the area in question.

I will go through some of the papers I read along the way over the past ten years, starting in 2004 when I first encountered the hygiene hypothesis, with a link to the full text I am discussing, of the paper I want to examine and it’s findings and weaknesses.

I do not claim to be an expert and welcome any constructive criticism, I want to be better too. Hopefully this will stimulate the interest and belief you need to explore science yourself, and to become a better, more critical consumer of it. Science clearly needs our participation in some way if we expect it to better serve us. To me it seems as though much of it has been hijacked by a minority with the money, means and interest in directing science.

I would like mine and other more disparate voices to be included in the debates science and in particular regarding about what gets studied, when, by whom and how.

Hopefully if anyone is interested we can use this site and the comments sections to discuss some of the papers and issues, and I encourage people to send me any science they would like to discuss with me privately or here.

Posted in big pharma, biome restoration, ecological medicine, ecosystem, helminthic therapy, helminthic therapy research, History of Autoimmune Therapies, hygiene hypothesis, Old Friends Hypothesis, scientific method, the body as an ecosystem | 2 Comments

Thank You Automattic for the Akismet Anti Spam Plugin

I wanted to thank Automattic, the developers of the Akismet anti comment-spam plugin for writing what is a very helpful tool for blocking comment spam on WordPress blogs.

I forgot to mention that it is free.

If you look at the screenshot below it quarantined 2,574 comments that were spam, this from early this year, around mid March I think, until now, mid September.

Most of it is in Chinese, though I did not get past the second page examining it.

If I deleted your honest post, if you submitted it and it is not published here somewhere then I deleted it, please resubmit it and I will be sure to publish. Please no marketing links, I just burn those comments.

Spam Count

2,574 comments marked as spam in less than six months

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Time to re-examine our slavish devotion to the scientific method

Someone sent me a link to some research on Psoriasis and it got me thinking again about the way science and particularly drug research is conducted, and its limitations with respect to complex systems we do not understand, like the immune system.

The subject of the direction of research in the area of immunological diseases really bothers me. I think science, because of its history and prejudices, has gone in entirely the wrong direction, and that the scientific method is part of the problem.

The scientific method works very well for simple systems like the physics of semiconductors for instance, where all but one variable can be controlled for, where all variables have been identified and understood.

That just is not possible currently for the immune system, we do not even know all of its components, or even the behaviour of any one component in all circumstances. Never mind those circumstances we create with modern drugs.

Furthermore the timescale of research required to understand the long term effects of a drug are prohibitive, not possible. Bear that in mind when you read the known side effects for a drug introduced more recently than 30 or 50 years ago. That list may be incomplete.

Given the complexity of the immune system I am convinced that barring a breakthrough in research tools or methodology akin to the discovery and development of PCR technology and techniques, which has played out over the course of 25 years, current drug development methods are not going to produce anything effective and safe except by dumb luck.

Attempting to control disease by targeting specific components of the immune system with knockout drugs will never yield anything more effective or safe than the monoclonals that we have now. They are of course neither safe, nor effective.

Crudely knocking out a major component of the immune system using proteins or other molecules that themselves can become targets of the immune system, seems to me, guarantees bad side effects and a limited period of effectiveness.

So an approach like ours where you step back so that the resolution of what you are looking at and of your thinking is reduced, and the problem and challenge are simplified, presents a more promising approach.

Understanding that immunological diseases and those involving chronic inflammation arise out of damages to the environment defined by our bodies reduces the complexity of the problem and it’s possible solutions.

Another reason why the viewpoint of science and the regulators is skewed and inappropriate, helminthic therapy has been categorised as a drug based on the definition of drugs used by agencies like the FDA. But one has to realise that using their definition of a drug would mean sunlight and food, even a kiss, could be defined as drugs as well. Given how broad and therefore useless that definition is, its use in this case creates a damaging regulatory posture, as well as an attitude of fear and conservatism amongst the public and regulators, who do not understand all the issues. That limits the development and use of a therapeutic tool that is inherently safe, clearly effective, and were it not in a ghetto created by inappropriate regulation, very, very cheap: helminthic therapy.

Regulators, because of their inability or unwillingness, to appropriately categorise helminthic therapy, ensure that millions continue to unnecessarily get sick, remain sick, grow sicker, and suffer permanent damage, and death, while paying for approved drugs that kill.

Regulation was never intended to ensure that hundreds of millions of people entered and remained trapped in severe and progressive illness by reason of that regulation. All the while being provided, at the desperate patient’s insistence absent anything better, lethal and toxic molecules identified, tested and sold on the basis of perilously sparse and incomplete knowledge of their affect, or of the systems they are meant of change. Without testing sufficient, and invariably gamed, to understand potential side effects.

I think the reason drug and therapeutics development for complex diseases, like cancer, autoimmunity and chronic inflammation, has slowed to a crawl and become astronomically expensive, is because of this complexity. Self-imposed by the fetishisation of the scientific method, its status as a holy cow, perfect and unchanging, unchallengeable and immutable.

Our inability to spend the decades waiting to work out the consequences of a particular approach using current methods also means that drugs developed under the current system have not been appropriately tested given the potential risks.
Hence also the lack of movement on helminthic therapy because of categorisation it as a drug. That and the unwillingness of the drug industry to follow any potential route to a product that does not enjoy patent protection and the artificial monopoly that regulation creates. Something that is impossible commercially given the nature of our patent system and the motivation of drug companies by profit ahead of general welfare.

Without an almost complete understanding of the immune system and all its components, as well as a computer model of it that has predictive powers, it is impossible to develop safe effective drugs.

Helminthic therapy may be categorised as a drug by a regulatory system that has clearly not adapted to current knowledge and understanding, and is likely inhibited from doing so by it’s parasitic relationship with the collection of drug companies it purports to regulate.

But it is not a drug.

——————————————
I posted this on Facebook here if you are not aware of our Facebook page and a version to the Yahoo forum.

I post small snippets and shorter material to Facebook that does not show up here, and Twitter is linked to that as well, you can follow me @wormtherapy

Posted in biome restoration, ecosystem, helminthic therapy research | Leave a comment

More evidence of the power of ecosystems

Just read at the second pass by an interesting article on the Independent.co.uk, a national newspaper in the UK concerning a recent discovery. Scientists claim to have worked out why honey is so good as an antibiotic and it has nothing to do with honey bees directly, but rather the ecosystem formed by their stomachs, as with us and helminths and the hygiene hypothesis/old friends hypothesis. Turns out they believe that bacteria living in honey bee stomachs is what confers the antibiotic properties on honey. I will leave it to your imagination how bacteria in a bee’s stomach transfer that power to the honey you enjoy. But yet another, they are stacking up fast, demonstrating that thinking of ecosystems on any level as separate or distinct from one another is not productive. Although the hippy connotations have always bothered me I think Gaia deserves another look, and hopefully a better name with less mystical associations.

From the Independent:
For millenia, raw unmanufactured honey has been used to treat infections.

Scientists believe its effectiveness could lie in a unique formula comprised of 13 types of lactic acid bacteria found in the stomachs of bees. The bacteria, which are no longer active in shop-bought honey, produce a myriad of active anti-microbial compounds.

….

Honey is an antibiotic because of bacteria in bee's stomachs

Honey has long been known, centuries in fact, to have extraordinary antibiotic properties. It’s the bacteria in the bee’s stomach…


By applying the bacteria to pathogens found in severe human wounds – including MRSA – scientists from Lund University, Sweden, found that the formula from a bee’s stomach successfully counteracted the infections.

Researchers believe that the formula works so potently because it contains a broad spectrum of active substances, unlike conventional man-made antibiotics.

My only sadness was in reading that the active ingredients had been killed by the time it is bought, honey must be pasteurised. Doing so would not just kill any bacteria but denature any ESMs left behind in the honey.

If you want the benefits you would likely have to eat raw honey. But one to store away for after the zombie apocalypse.

http://www.independent.co.uk/life-style/health-and-families/health-news/bacteria-found-in-honeybee-stomachs-could-be-used-as-alternative-to-antibiotics-9724292.html

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Things I would do if I was still sick

Or that you can, or use to try and stay healthy.

If I suffered from, any, nasty immunological disorder or any involving inflammation this is what I would do:

1. I would not rely on experts, so-called, who have managed to create a situation where all these diseases are out-of-control and increasing. Clearly “modern medicine” not only does not have the answers for these conditions, it is clear that it is part of the problem. Having said that if you are currently reliant on some modern drug to function you are going to have to continue to rely on it until you can get things under control such that it is possible to discontinue its use.

2. I would systematically make my life as close in its daily routine to that of a hunter-gatherer. This sounds wildly impractical, but if you understand what is important about each difference between modern living and the stone age in terms of health it is very easy.

So what does that mean in terms of practical advice?

These are the changes I would make to my life knowing what I know now, and to a large extent have. The more severe your disorder the more disciplined you need to be with each of these changes:

1. Eliminate carbohydrates, both simple and complex, from your diet, as close to entirely as possible. Eat vegetables, fruit, nuts and seeds, and flesh of one kind or another. No grains or their products, ever. No sugar, no rice, no bread, no crackers, no cereal, no pizza crust, no pastry, no cake, no pie, you get it. Never eat prepared food, prepare it yourself from fresh ingredients, preferably organic or grown yourself. If you cannot pronounce it, from the label, and have no idea what it is, why the hell are you eating it? If you garden you win thrice, see below.

2. Make your meals smaller and more frequent. No large set meals, snack all day. Subject yourself to periods where you don’t eat at all. Episodic hunger is good. But drink a lot of water.

3. Expose yourself to sunlight, and drop the sunblock. Yes it may increase your odds of developing skin cancer, but be smart about it. When I lived in the tropics I stayed out of the sun from 11 am to 3 or 4 pm, and never burned although I went shirtless most of the time and never wore sunblock. I am blue-eyed and had blond hair as a child. If you have to go out during those hours wear a hat and a long sleeved shirt. Our skin can produce 20,000 IUs of Vitamin D, the right kind, in a few hours of shirtless exposure to sunlight. The RDA is 200 or so IUs? Really? If we evolved to produce that much vitamin D there is a reason for it, and lack of vitamin D is implicated in a host of immunological disorders.

4. Get in the dirt every day, ideally this would mean hikes in the woods, gardening, swimming in unpolluted rivers and lakes. You need to be exposed to the bacteria and other organisms in soil. Be smart, don’t rub dirt into cuts, by exposure I mean some should end up in your digestive tract, on your skin, in your lungs. Every day. Breathing dust is good, in moderation. If this is not practical eat some small amount of dirt from natural source every day. The practice is called Pica, and not just humans, but animals, have and do practice it, and have for millennia. Go to the woods, to areas you know they don’t spread fertiliser or herbicides. Mix it up. You can bring a week’s worth back with you, just store it in an open container and don’t refrigerate it. Quantity is not important, frequency is. If you garden eat tomatoes or carrots with minimal washing out of the garden, for instance.

5. Exercise, a lot. It has an enormous impact on well being, stress, etc., and our forebears were nothing if not active. But again, be smart, walking is vastly underrated as an exercise, but requires more time to produce a given result than something more intensive. Be sure to mix it up, I am not advocating marathon running, which is a modern abomination guaranteed just about to result in damage and injury. Combine walking, running, swimming, climbing, weight lifting, dancing, wrestling, boxing, etc., and do things you enjoy. Be active for 1 hour a day at least, and mix it up. You are not competing, you are doing it for pleasure, I hope. You can make all this stuff more time efficient by combining things whenever possible, so running or walking barefoot in the woods would deal with both exercise and exposure to dirt at the same time.

6. Simplify your life, we are not meant to live in large complex societies, or deal with all these modern distractions and contrivances. The result is stress, implicated in about every immunological disorder there is. Turn off the TV, close the laptop, bring your point of view down to the level of someone living in a social group of a few hundred people, tops, and a geographical limit of fifty miles, and unplug. The world will manage to continue to screw itself up without your active participation, don’t worry about it. Why the hell is the world so upset and angry anyway? Do you really need your share of that action?

7. Stop replacing your skin’s oils and biome with artificial substitutes on a daily basis, or ever. You can shower every day, but don’t use soap or shampoo. Think about it, you strip your skin and hair’s surface of naturally occurring oils, and by extension organisms, every day, and then immediately replace those lost oils with artificial substitutes. Stop using soap and shampoo, and the things that follow their use, and I guarantee you that within a few weeks you will wonder why you ever used either of those things. I still brush my teeth and recommend you do to. No, I don’t have an odour. My skin and hair are in the best shape of my life.

8. Repopulate your intestinal tract with the organisms your modern life, either by lack of exposure or by use of antibiotics, etc., has denied it and that you have evolved to live cooperatively with. See eating dirt above. We used to live in close contact with the soil and the organisms it contains, it was in our food, on our skin, we breathed in dust every day. Food preservation was largely fermentation or drying. Eat natural yoghurt’s, seek out odd fermented foods, if necessary acquire intestinal worms, helminths, for the most important class of organisms for your immune system, helminths or worms.

If you do all those things, if you are sick with a so-called “modern disease”, things will almost certainly radically improve.

This is not a quick fix, you have spent years screwing your body up, you can expect things to improve in a time frame of months and years, and that the changes will be slow but ongoing for a very, very long time.

I originally posted this to a different blog which I am now consolidating here. It was first published in 2010 I think. There is a follow up post coming soon from the same site.

Posted in biome restoration, ecological medicine, ecosystem, helminthic therapy, History of Autoimmune Therapies, History of helminthic therapy, hygiene hypothesis, Jasper Lawrence, paleo, paleo diet, pica, the body as an ecosystem | Tagged , | Leave a comment

Another great result for Crohn’s, this time in an adult

In his words, edited to remove any identifying phrases or words:

“Today marks exactly (Jasper, while it did not take this long for him to respond, he was slow to respond as I recall, and this should be born in mind by anyone on or considering therapy) days (20 months) since I have taken immunosuppressive medication of any kind. I suffer moderate to severe Crohn’s, since 2006. I dosed with hookworm late 2010 (22 months ago), and twice in 2011. After three doses totalling 150 worms, I estimate that the hookworm alone achieves 85% symptom relief for me. I rejoice at the phenomenal benefit to my life. It would be no exaggeration to call my case a small miracle. I hope to continue to experience this degree of relief.”

No drugs, quite a result, and not atypical.

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One reason among many patent reform is needed

Patent: Further information: Association for Molecular Pathology, et al. v. United States Patent and Trademark Office, et al.

Methods to isolate and detect BRCA1 and BRCA2 (Breast cancer genes) were patented in the United States by Myriad Genetics. (So just so everyone is clear, this company has effectively patented a part of the human genome, human genes. There are lots of examples of this kind of idiocy, including famously a Texas company patenting Basmati Rice and then seeking to prevent Indian & Pakistani growers from selling their rice under the name Basmati any longer in jurisdictions covered by the patent).

This US patent has been challenged by the American Civil Liberties Union. On March 29, 2010, a coalition led by the American Civil Liberties Union ACLU successfully challenged the basis of Myriad’s patents in New York District Court. The patent was invalidated, but the decision was appealed.

On July 29, 2011 the United States Court of Appeals for the Federal Circuit made their decision and ruled that Myriads patents are valid.

Effect on Gene Testing
The conditions of Myriad’s BRCA patent require that the only laboratories legally allowed to test and sequence the genes are the ones affiliated with Myriad. This exclusive control over BRCA testing, guaranteed by the patent, has prevented peer-reviewed validation of the tests provided by Myriad.

Since the BRCA test is marketed directly to the consumer, it is not subject to government oversight by agencies like the FDA.

Without this government review, gene tests must be studied and assessed by scientific colleagues in a peer review. However, the kind of studies needed to validate the tests require access to the BRCA genes, which are protected by Myriad’s restrictive patent. (Is this funny, tragicomic, enraging, befuddling, ludicrous, or just the free-market?)

Thus, without access to the genes (meaning you cannot even study them without paying Myriad a patent license fee, assuming they are willing to grant it, in the USA – like I said, you could not make this up) or the methods used to sequence them, peer review of the test’s effectiveness is virtually impossible. (here I have to disagree, it is impossible unless you pay Myriad for the use of their patents to study their methods to determine if they are actually effective. Genius, I wish I had a patent on you.)

However, the patents have yet to be enforced in Europe, where BRCA research and testing is becoming more widely available, and several laboratories are currently offering their own BRCA testing. The UK firm NewGene offers the test at a very competitive price, to the NHS, its owner, only. (Equally surreal and non-sensical, of course. But cheaper…)

Legal decisions surrounding the BRCA1 and BRCA2 patents hold particular bearing on the field of genetic testing, as the field is relatively young. Until legal guidelines can be applied to the practice of gene testing, progress in the field will likely suffer due to uncertainty. Any decision made regarding the BRCA patents will likely become precedent for future disputes over the use of genes for testing.

via BRCA1 – Wikipedia, the free encyclopedia.

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Facebook Page for Helminthic Therapy

Hi, we have long had a well maintained and regularly updated FB page, fed in part via our Twitter account. It gets a lot of activity, daily, with links to news, etc.,

To visit go here, and if you just want the twitter feed the address is @wormtherapy (@helminthictherapy was too long, as much as I dislike the term worm therapy it was that or nothing.).

I hope you find these resources useful.

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Part 4: The Story of “A”

This is, as the title suggests, one in a series of posts, almost entirely derived from emails from her family that they send me periodically to keep us up-to-date.

At the end of this post, and in a few minutes all the others, is a standard block of text with links to each part of the story of this child, as well as some additional information.

———–

From the child’s father:

“It has been over two years now since we began treating Crohn’s disease in our daughter, “A”, using helminthic therapy.

Specifically human whipworm, from Autoimmune Therapies, and she is today doing better then ever. She was around 21 months old when we started helminthic therapy, she had been diagnosed at 14 months of age, and had not responded to any attempted treatment of the disease, except steroids.

She is now over three and a half, and is as happy, healthy, and as beautiful as any parent could want from a child.

Two years ago my wife and I could have only hoped the future should be so bright for her, and us.

A has now taken four doses of the helminths, and each time her condition has only improved.

I can assure you it was not a straight line to good health, but rather a gradual improvement. Like any good, long term investment, there were setbacks along the way. Despite our better judgment, every time there was blood or diarrhea, in the back of our minds, we would wonder if it was the beginning of a major flare, one that would require the drugs we tried so hard to avoid for her.

But the reality was that it never even came close to that. There is no doubt she is doing better now then a year ago, and certainly two years ago. She continues to gain weight, in fact she is 34 pounds, and her stools continue to improve. We have even begun introducing different foods to her diet, with fantastic results.She can play endlessly with her sisters, is as cheerful as could be, and she is even a little chubby, something we’ll take any day of the week over the alternative.

She has not taken any medication for the Crohn’s disease since shortly after she began helminthic therapy.

Suffice to say, treating our little girl with helminthic therapy was the single best decision we could have made, given the circumstance. The treatment has enabled her to live a normal life with Crohn’s disease, rather then one riddled with pain and fatigue, pills, injections, and steroids.

It is not lost on our family, the thought that today we can focus on teaching “A” to read, and swim, and good manners, rarely worrying or even thinking about the fact that she has Crohn’s disease, instead of living in the bleak future we imagined for her, and us, two and a half short years ago.

I’m proud of what we did for her, and we’re thankful to Autoimmune Therapies for the opportunity to do it.”

End of email.

As it happens I am proud too, particularly of those who work with me to do this. I talk a lot, too much perhaps in the past, of the sacrifices my family has made. Far too little has been said about the team working with me.

All, in different ways, are making very considerable sacrifices to be able to make sure people like “A” continue to get the probiotics they need. Our chief scientist, who had a very good career before I came along, has essentially sacrificed that to peruse this. That is just one easy example to identify and explain.

One day soon I hope that it will be possible to acknowledge their courage, the risks and sacrifices they have made, and to do so completely publicly. I am the figurehead for a group of people who are all intelligent, hard-working, dedicated, principled and very high-integrity individuals.

All intelligent enough to not want their name to appear on my blog.

Here’s to hoping that will one day change and their accomplishments and courage can be lauded publicly.

Links to rest of series on “A”

“A” was under 2 years old when diagnosed with Crohn’s Colitis, and the disease appears from the family’s descriptions to have been severe and aggressive. They approached us when the recommendation for treatment from the child’s Gastroenterologist was one of the biologics, either Remicade or Humira, I cannot remember which.

Below are links to each of the four posts, so far, which for the most part are just emails from the child’s dad on “A’s” progress, and his thoughts and observations.

Managing the links between the posts has become cumbersome, so I have created this standard block of links to tie the story together, explain the context if someone happens upon one of the posts and does not realise they are part of a series, and will probably make a static page to aggregate the whole thing.

Part 1: Part 1 of the story of “A”

Part 2: Part 2 of the story of “A”

Part 3: Part 3 of the story of “A”

Part 4: Part 4 of the story of “A”

Posted in Crohn's disease, Jasper Lawrence, juvenile colitis, whipworm | Tagged , , , , , | Leave a comment

What is corruption?

When I still lived in the US and Sani Abacha was the suddenly the dead ex-president of Nigeria, and it was therefore discovered he had looted billions from the Nigerian treasury, some of my friends in the US were aghast at the scale of his corruption. Apparently they did not read much international news, or much news at all perhaps.

My comment was “At least their leaders get a decent price”,  being of the view that to sell your constituent’s interests out to lobbyists in exchange for providing you the means to retain your position, as what, at the next election so you can repeat the process lacks ambition, any understanding of pricing, as well as integrity. That seems to me to be an accurate description of the relationship between lobbyists and the politicians they fund in America.

As I say, at least Mr. Abacha got a decent price for his integrity.

Which perhaps partially explains this map. One of world corruption based on the research and perspectives of those who prepared it. As the title asks, what is corruption?, so must have the map makers. How corruption is defined and measured, which varies with time and place of course, and who does the measuring. These fundamental things have an enormous impact on the results in such an exercise.

I think they missed most of the endemic corruption woven into western economies, of the type above and below. Corruption, after a great deal of practice in the developed world, has been refined to either a state of invisibility through familiarity. Or one of a pantomime everyone uses to pretend to themselves that this is just the way things are, or for a minority, to ensure they remain so.

But in any case it is legal when practiced on any scale worth studying, or mapping, in the light yellow or orange countries on that map. But if it is legal then it does not appear on this map. A kind of Catch-22, or of corruption all of itself really.

When thinking of really big examples the Bush sponsored Medicare Prescription Drug Improvement Act still comes to my mind first.

An Act that on the one hand makes prescription drugs cheaper and more available to seniors enrolled in Medicare. Old lady’s arthritis pills, what is not to like there? Within a contorted system of plans and rules it should be noted.

An Act that also expressly forbids the United States Government, the largest buyer of prescription drugs in the US, from negotiating lower drug prices from drug companies. Take a moment, let that sink in. Within a very simple system it should be noted.

This seems, to me, like it might be an example of corruption.

But not according to this map.

Senator Hillary Rodham Clinton (Democrat, New York) announced that she is working on legislation to improve the Medicare drug benefit by creating a regulatory structure to find and remove less-efficient private drug plans.  She also said that the government should have the authority to negotiate for lower drug prices in Medicare (which is strongly opposed by the pharmaceutical companies) and that pharmacists should be reimbursed for filling prescriptions for Medicare beneficiaries who were unable to prove eligibility because of computer glitches; and the February 15 deadline for reimbursing states offering Medicaid coverage to address coverage gaps should be extended - Link to source

When the custom was to speak plainly I think this was referred to as price rigging. But as with IQ tests, or SAT scores, or law enforcement, test results tend to provide as comfortable outcome as possible for those designing or administering the rules or laws, and more so as time passes. Intelligence declining according to historic measures? Grades and scholastic aptitude measures in decline? Too many of your friends prevented from expressing their desires by unreasonable limits imposed by a different interest group?

Don’t cheat, don’t break the rules or laws, that is corrupt. Change them, that is democracy.

In the more specific example below, as shown in the accompanying screenshot from my unsubscribe form submission with WebMD Professional, you can see mention of this type of legal corruption that few seem to see because it is part of the fabric of life. In this case it was a piece of that fabric I had not seen before, so it was shocking.

After unsubscribing I was asked the reasons for my leaving, and other questions WebMD thought might provide useful answers.

The most interesting to me was: “Do you only participate in programs sponsored by pharmaceutical companies when an honorarium is offered”.

I did not know that it was common, and legal, practice to pay doctors to listen to drug companies make presentations, did you?

I suspect that this information is presented either alongside, or perhaps even as, research or continuing education requirement courses offering credit to doctors who have to submit evidence they are keeping abreast of academic advances in their field. After all what else but interest or compulsion would make you travel across the country and stay in a hotel with a bunch of doctors, and attend a conference and it’s presentations and discussions?

Honorarium, far more mellifluous a word than any accurate alternative. Some examples? Substitute “bribe” or “inducement” in place of “honorarium” and the question would be as accurate, and more honest.

Paying someone to attend, no mention is made as to whether honorariums on average defray, meet or exceed the expense of attending for instance. Or that they are only offered if the party paying expects to profit from the act in some way. That might be by gaining a reputation as a sponsor of worthy causes I suppose. But these are drug companies paying doctors after all, and drug companies are first for-profit, not for-health, enterprises. What do you think the odds are that this practice is so widespread that it is regulated?

How large are honorariums, how do they vary, is there any correlation between the size of the payment and the market potential of the drug in dollar terms, how large are they compared to the expense of attending in specific drug categories, and on average, etc., etc.

That would be an interesting little project.

how drug companies bribe doctors

Unsubscribe screen shot composite from WebMD “Professional”

Posted in big pharma, corruption, drug companies, Medicare Prescription Drug Improvement Act, Price rigging, Uncategorized | Tagged | 1 Comment