In an editorial, USA Today wrote, automobile air bags save about 2,300 lives each year, so when they instead turn deadly — exploding and spewing shrapnel into drivers’ bodies — you’d expect urgent action to get the defective products off the road. Instead, air bag maker Takata and its biggest customer, Honda, conducted glacial, piecemeal recalls that have left drivers in jeopardy.
Air Pollution Set to Soar as Vehicle Population Grows Exponentially in Indian Cities
International Business Times reports that the vehicle population on Indian roads will increase air pollution three to five times over, says a report from The Energy and Resources Institute (TERI), University of California, San Diego (UCSD) and the California Air Resources Board (CARB). Under current trends of vehicle population, and existing fuel and emission standards, particulate matter smaller than 2.5 micrometers will increase by a factor of three, while nitrous oxide emissions will rise by a factor of five.
2014 Sets New Record as Year of the Most Automobile Recalls Ever
A Ford announcement today recalling more than 200,000 of its vehicles for everything from gas leaks to stalling problems helped solidify 2014′s place as the year of the most-ever automobile recalls. Automakers have issued more than 550 recalls for more than 52 million vehicles, according to the Associated Press. The previous record, set in 2004, was 30.8 million recalled automobiles.
Toyota Recalls Mount as Automaker Faces Increasing Scrutiny
Automotive News reports that Toyota Motor Corp. made its fourth global recall involving more than a million vehicles this year, as the world’s largest automaker begins operating with stricter supervision over safety from U.S. regulators. The carmaker is calling back 1.75 million vehicles, including 759,000 Toyota and Lexus sedans to repair fuel pipes that could leak and raise fire risks.
GM Eligible Death Claims Will Rise: Feinberg
CNBC reports that Kenneth Feinberg, the attorney who is overseeing the General Motors compensation fund for victims in crashes linked to defective ignition switches, has linked 19 deaths to the faulty switches and expects the death toll to go higher. In the five weeks the fund has been operating, it has received 125 death claims and 320 injury claims. Feinberg has found 31 claims eligible for compensation. “Already there are more deaths than GM said from day one,” Feinberg said.
Climate Change, Food and Health: Taking Action to Address Root Causes
The “good” news is that three of the world’s most serious threats —human-induced climate change, accelerating epidemics of chronic diseases, and growing food insecurity — have common causes and therefore potentially common solutions. The 2014 Climate Summit at the United Nations later this month provides an opportunity for scientists, government leaders, activists and concerned citizens from around the world to examine these common causes and identify the actions we can take to modify the underlying causes of these intersecting crises.
What are these common roots? Our economy’s continued dependence on fossil fuels ensures that carbon continues to accumulate, accelerating rising global temperatures and their impact on weather, climate and human well-being. The global energy industry from Exxon to BP to Gazprom uses its economic and political power to thwart widespread implementation of alternatives. Evidence shows that coal plays an especially important role in climate change yet countries like China, the United States and others continue to support coal production. According to Greenpeace, the fossil fuel industry is planning 14 massive coal, oil and gas projects that would produce as much new carbon dioxide emissions in 2020 as the entire US, and delay action on climate change for more than a decade.
Hyperconsumption describes lifestyles and health behaviors that put people at risk of premature death and preventable chronic illnesses. Each year the tobacco, alcohol and processed food industries spend billions of dollars aggressively promoting their products around the world, despite the World Health Organization’s finding that increased consumption of tobacco, alcohol and unhealthy food are primary drivers of growing rates of chronic diseases, today’s leading global killers. The production and distribution practices of the food, alcohol and tobacco industries contribute to global warming and also magnify global health inequalities.
Autocentrism is the irrational promotion of automobiles as the main mode of human transportation. Despite growing evidence that active transportation like walking and bicycling and mass transitcontribute to more physical activity, better health, fewer emissions of carbon and other pollutants, and people-friendlier cities and towns, the automobile industry and the governments that support it resist pursuing alternatives at a scale that can achieve their benefits.
Industrial agriculture describes the transformation of food production from small and medium size farmers and manufacturers to a system where giant multinational corporations like Monsanto, Cargill, Coca Cola, McDonald’s, Nestle and Walmart control every stage of our food system from patented seeds, monoculture farming, and integrated distribution to global marketing and retail outlets. Industrial agriculture insists that the bottom line is their profit, not human need. Its practices on fertilizers, transportation, meat production and global trade contribute to carbon emissions, diet-related diseases and food insecurity.
One reason that climate change, chronic disease and food insecurity have worsened in recent decades is that the industries involved and business and international trade associations they have created have coordinated a massive effort to roll back regulations that protect public health and the environment and discredit the science that documents the dangers the world faces.
Underlying these trends has been the growing concentration of wealth and power in the hands of corporations and the moneyed interests that own and control them. The synergistic impact of these developments has been a rise in inequality and declines in democracy, developments that make it harder to propose and mobilize public support for alternative policies.
Some who agree on the magnitude of the threats and the evidence on common causes of climate change, premature deaths from chronic diseases and growing food insecurity are reluctant to act because they believe the problems are too big and complex and the perpetrators too powerful to make change possible. But the acceleration of each of these problems results from human decisions made over the course of the last few decades. And what people decide in one time, they can change in another.
To the chorus of the powerful that there is no alternative to the status quo the response of the majority must be that another world is possible. By encouraging public discussion of the common roots of climate change, chronic diseases and food insecurity, we can begin to shine a light on the actions that will lead us to that other world.
Every generation is judged by the world we leave our children and grandchildren. The decisions we make in the years to come will determine whether our legacy is shortened lifespans, growing hunger, and further deterioration of the environment that supports life. Or we can decide that our gift will be better health, food security and a more sustainable planet. The choice is ours.
Another World is Possible
For more information, read the recent Lancet summary on climate change and health and Chapter 7 on food security and Chapter 11 on Human Health from the Intergovernmental Panel on Climate Change, 2014.
Good News for Auto Companies is Bad News for Breathers
U.S. August auto sales were unexpectedly strong, reports the Chicago Tribune, thanks in part to heavy discounting by the manufacturers, with the industry selling at an annualized pace not seen since early 2006. The lowest gasoline prices in four years helped GM and Chrysler Group, a unit of Fiat SpA , achieve double-digit gains in sales of full-size pickups, which provide the bulk of profit. The best-selling pick-ups and SUVs pollute more and contribute more to global warming.
Back to School Books on Corporations and Health
For those who make a living teaching about health, August means getting ready for returning to the classroom and introducing new students to what we think is important. A basic premise of Corporations and Health Watch is that every health professional should understand something about the ways corporations influence health and what can be done to prevent or modify corporate practices that harm health.
To help CHW readers contribute to that goal, I suggest five books to add to public health, medical, nursing, social work or related course readings and discussions. These books have been published or updated in the last year or so, are available for less than $30, and can be used in a variety of courses including introductory public health, health policy, social and behavioral health, epidemiology or social epidemiology and more specialized courses.
I suggest books –in addition to the texts and journal articles we usually assign—because they give students an opportunity to read in more depth on a single topic, evaluate the range of evidence that authors present, and react to the opinions the authors draw from this evidence. The brief descriptions of each book are those provided by the publisher.
Corporations Are Not People: Reclaiming Democracy from Big Money and Global Corporations
By Jeff Clements, Updated Edition, 2014, Berrett and Kohler
Describes the new fabrication of rights and power for corporations and money, at the expense of the rights of human beings and of democracy itself. A resource for everyone who want to join the historic work to overcome partisan divides and re-engage in self-government by all Americans — community by community, state by state, and, ultimately, in Washington itself. This 2014 edition is updated throughout with surprising information and analysis about the impacts of unlimited money in federal, state, and even local elections; the spreading “corporate capture of the courts” resulting from the dangerous fabrication of “corporate rights” in the Constitution; and the growing, historic response from people of all political viewpoints to defend democracy and rebuild government of the people. A completely new chapter—“Do Something”- shows how thousands of so-called ordinary people are working to build the “most dynamic, grass-roots movement in the United States,” and offers “portals” for people to connect and act.
The Gun Debate What Everyone Needs to Know
Philip J. Cook and Kristin A. Goss, Oxford University Press, 2014
No topic is more polarizing than guns and gun control. From a gun culture that took root early in American history to the mass shootings that repeatedly bring the public discussion of gun control to a fever pitch, the topic has preoccupied citizens, public officials, and special interest groups for decades. The Gun Debate: What Everyone Needs to Know® delves into the issues that Americans debate when they talk about guns. With a balanced and broad-ranging approach, noted economist Philip J. Cook and political scientist Kristin A. Goss thoroughly cover the latest research, data, and developments on gun ownership, gun violence, the firearms industry, and the regulation of firearms. The authors also tackle sensitive issues such as the effectiveness of gun control, the connection between mental illness and violent crime, the question of whether more guns make us safer, and ways that video games and the media might contribute to gun violence. No discussion of guns in the U.S. would be complete without consideration of the history, culture, and politics that drive the passion behind the debate. Cook and Goss deftly explore the origins of the American gun culture and the makeup of both the gun rights and gun control movements.
Lethal But Legal Corporations, Consumption, and Protecting Public Health
Nicholas Freudenberg, Oxford University Press, 2014
Decisions made by the food, tobacco, alcohol, pharmaceutical, gun, and automobile industries have a greater impact on today’s health than the decisions of scientists and policymakers. As the collective influence of corporations has grown, governments around the world have stepped back from their responsibility to protect public health by privatizing key services, weakening regulations, and cutting funding for consumer and environmental protection. Today’s corporations are increasingly free to make decisions that benefit their bottom line at the expense of public health. Lethal but Legal examines how corporations have influenced — and plagued — public health over the last century, first in industrialized countries and now in developing regions. It is both a current history of corporations’ antagonism towards health and an analysis of the emerging movements that are challenging these industries’ dangerous practices. The reforms outlined here aim to strike a healthier balance between large companies’ right to make a profit and governments’ responsibility to protect their populations. While other books have addressed parts of this story, Lethal but Legal is the first to connect the dots between unhealthy products, business-dominated politics, and the growing burdens of disease and health care costs. By identifying the common causes of all these problems, then situating them in the context of other health challenges that societies have overcome in the past, this book provides readers with the insights they need to take practical and effective action to restore consumers’ right to health.
Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
by Ben Goldacre (New paperback edition, 2014) Macmillan Publishers.
We like to imagine that medicine is based on evidence and the results of fair testing and clinical trials. In reality, those tests and trials are often profoundly flawed. We like to imagine that doctors who write prescriptions for everything from antidepressants to cancer drugs to heart medication are familiar with the research literature about these drugs, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by the pharmaceutical industry. We like to imagine that regulators have some code of ethics and let only effective drugs onto the market, when in reality they approve useless drugs, with data on side effects casually withheld from doctors and patients. All these problems have been shielded from public scrutiny because they are too complex to capture in a sound bite. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct in the medical industry affects us on a global scale. With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system in need of regulation. This is the pharmaceutical industry as it has never been seen before.
Food Politics: How the Food Industry Influences Nutrition and Health by Marion Nestle, University of California Press, Revised and Updated Paperback, 2013
We all witness, in advertising and on supermarket shelves, the fierce competition for our food dollars. In this engrossing exposé, Marion Nestle goes behind the scenes to reveal how the competition really works and how it affects our health. The abundance of food in the United States—enough calories to meet the needs of every man, woman, and child twice over—has a downside. Our overefficient food industry must do everything possible to persuade people to eat more—more food, more often, and in larger portions—no matter what it does to waistlines or well-being. Like manufacturing cigarettes or building weapons, making food is very big business. Food companies in 2000 generated nearly $900 billion in sales. They have stakeholders to please, shareholders to satisfy, and government regulations to deal with. It is nevertheless shocking to learn precisely how food companies lobby officials, co-opt experts, and expand sales by marketing to children, members of minority groups, and people in developing countries. We learn that the food industry plays politics as well as or better than other industries, not least because so much of its activity takes place outside the public view.
For previous Corporations and Health Watch Back to School posts see:
Corporations and Health Watch Goes Back to School: 10 Recent Articles for Fall 2013 Courses
Bringing Corporations and Health into the Public Health Curriculum
Corporations and Health Watch Goes Back to School: 10 Ways to Bring the Health Impact of Business Practices into the Classroom
After Deadly Blast in China, GM Doesn’t Plan to Change Supply-Chain Safety Process
General Motors Co said it has no immediate plans to review how it manages safety standards further down its supply chain, three days after a deadly blast at a supplier’s contractor in China, reports the Wall Street Journal. The auto maker will continue the prevailing industry practice in which car makers rely on their direct component suppliers to monitor the safety standards of indirect suppliers further down the chain, the company’s president said.
“Hide No Harm” Bill Will Tip the Balance in Favor of Science and Safety over Corporate Profits
Cross-posted from The Equation
On July 16, Senators Richard Blumenthal (CT), Tom Harkin (IA) and Robert Casey (PA) introduced S. 2615, the “Hide No Harm Act.” Their legislation would impose criminal penalties—fines and even imprisonment—on corporate executives if they knowingly failed to warn the public about life-threatening dangers in their products.
Senator Blumenthal introduced the “Hide No Harm Act” because it is time to hold executives accountable when public health and safety are at stake.
The bill was prompted by revelations that executives at General Motors had ignored red flags about the ignition switch in many GM models, a switch that could suddenly shut down power to the car, including its air bags. The product defect has been implicated in at least 13 deaths and many injuries. After GM learned about the defective part, the company took years to warn consumers or address the problem.
But the “Hide No Harm” bill addresses a more fundamental problem than one company’s mishandling of a significant product hazard. It aims to give the public and regulatory agencies timely access to public health and safety information, so that deaths and serious injuries can be avoided.
The bill requires that corporate officers and executives—the people running companies—disclose information about these dangers to the appropriate government agency, and warn employees and consumers. They must issue these warnings promptly, not years after the company detects the problem. The bill also makes clear that corporate managers may not retaliate against any conscientious employee who discloses these dangers.
The science connection
What does this legislation have to do with scientific integrity? Quite a bit. In numerous cases, scientists, engineers, and technicians working for corporations have raised concerns about product safety, only to be ignored by corporate accountants, marketers and lawyers.
If corporate executives know that they can be held directly accountable for their actions, it may persuade them to pay more attention to the potential harms a product may cause, and may tip the balance in favor of the scientific evidence that raises red flags. Whistleblowers are invaluable in helping to identify problems before they create deaths and injuries.
In GM’s case, Courtland Kelley, then the head of an inspection program for GM products throughout the country, raised concerns about safety problems he was finding in GM models in 2002. He tried to take his concerns to company managers, but was rebuffed. He sued the company to help prompt corrective action, using Michigan’s whistleblower law. But his efforts sandbagged his career at the auto company, with the company downgrading his duties.
The way that engineer was treated affected others at GM, who kept quiet when in 2004, reports were surfacing about another safety defect in ignitions. The recall of millions of cars, not to mention the loss of lives, could have been prevented if GM managers welcomed safety concerns and did not punish whistleblowers.
No spinning science
Vioxx was a huge money maker, a painkiller that reportedly was easier on the stomach than older pain pills such as aspirin. But as early as 2000, in a clinical trial of 8,000 patients comparing Vioxx to the painkiller naproxen, researchers found that five times as many Vioxx patients had heart attacks as those on naproxen.
Merck did disclose the findings of the clinical trial to the Food and Drug Administration and to the media, but it spun the message. It stressed that Vioxx caused fewer digestive problems than naproxen, and concluded that naproxen must have some property that protects the heart, thus explaining away any possible harm Vioxx might do.
In truth, Merck’s scientists were concerned about the clinical trial, wondering whether the drug was truly safe. Some corporate scientists were so worried that they proposed withdrawing the drug until their questions could be answered.
Merck failed to address its scientists’ concerns. The company did not try to determine what caused this uptick in heart attacks. Was naproxen really protective for the heart, or did Vioxx potentially cause heart problems?
Instead, the company opted to monitor clinical trials looking at other aspects of Vioxx to see if any disturbing trends turned up. It continued to insist on the safety of its drug even after the Journal of the American Medical Association (JAMA) in 2001 published the findings of two Cleveland Clinic cardiologists who re-analyzed data from several Vioxx clinical trials and concluded that the drug did raise the risk of heart attack and stroke.
Even worse, despite all these unresolved questions and emerging red flags, the company sold the drug to doctors for a use that the FDA had not yet approved—to treat rheumatoid arthritis.
At Merck, the marketers and bean counters prevailed over the scientists who wanted more answers. Merck took four years to voluntarily withdraw the drug from the market. Withdrawal occurred only after a much larger clinical trial established the damage Vioxx could do. As a consequence, tens of thousands of patients who took Vioxx suffered fatal heart attacks.
Accountability is important
Merck ultimately sold Vioxx to 25 million Americans. Global sales of the drug totaled $2.5 billion the year before it was withdrawn. (The FDA also has earned justifiable criticism for its lax regulation of Vioxx and its efforts to suppress the warnings of Dr. David Graham, an FDA scientist who also sounded the alarm about the painkiller).
After misrepresenting the science, Merck was able to celebrate billions of dollars in profits off a drug that was directly linked to thousands of heart attacks.
The government did punish the company, levying a $950 million fine in 2011, which also resolved civil suits in several states. In 2007, Merck paid more than $4.8 billion to settle 27,000 lawsuits by those who claimed they or their relatives suffered injury or death due to Vioxx.
But Merck executives were not held accountable by the U.S. Department of Justice. The DOJ’s charges concerned illegal marketing, and not the more fundamental wrongdoing of failing to adequately or promptly warn patients of the potential dangers of the drug, and not taking action for four years, while the evidence of serious concerns about Vioxx’s safety continued to mount. Indeed Merck’s press release announcing the negotiated deal made just that point: “As part of the plea agreement, the United States acknowledged that there was no basis for a finding of high-level management participation in the violation. The government also recognized Merck’s full cooperation with its investigation.”
It is time for corporate executives to be held personally accountable for subsuming the concerns of their scientists and others in the scientific community for the sake of profits and share price. Fines, even large ones, can be offset by the astounding money that can be made from an unsuspecting public.
As Erik Gordon, an assistant professor of business at the Ross School of Business at the University of Michigan told the New York Times: “It’s just a cost of doing business until a pharmaceutical executive does a perp walk.”
Celia Wexler is a senior Washington representative for the Scientific Integrity Initiative at UCS. A former award-winning journalist, Wexler is the author of Out of the News: Former Journalists Discuss a Profession in Crisis, published in 2012 by McFarland. At UCS, Wexler’s issue portfolio includes food and drug safety, protections for scientist whistleblowers, and government transparency and accountability. See Celia’s full bio.
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