Thursday, December 23, 2004

The Anechoic Effect and Conflicts of Interest at the NIH

The articles published by the Los Angeles Times about serious conflicts of interest affecting senior NIH scientists have not yet received much notice. A Google News search reveals two lonely reactions, one a web duplicate of the main LA Times story, and one an audio report on NPR last night.
Last year, when the LA Times published "Stealth Merger: Drug Companies and Government Medical Research," the response was also very slow. It took about a month for major-market east coast newspapers to pick up the story. This seemed to be an example of what my colleague, Russ Maulitz, dubbed the "anechoic effect." Stories about the mismanagement of health care organizations tend to vanish without an echo.
Of course, once the Congressional investigations of the NIH started last year, media interest picked up. But, as the investigations faded away, so did attention to them. The bitter irony is that one reason the investigations waned is that their leaders left government to take prominent positions in the industry whose interactions with government they had tried to plumb.
Rep James Greenwood, who lead the House Energy and Commerce Subcommittee on Oversight and Investigations, accepted the Presidency of the Biotechnology Industry Organization. Rep. W. J. "Billy" Tauzin, chair of the House Energy and Commerce Committee, now is President and CEO of the Pharmaceutical Research and Manufacturers of America.
Finally, NIH Director Elias Zerhouni did announce a future temporary one-year moratorium on NIH officials consulting with industry, but that ban has apparently not yet taken effect. A future one-year moratorium seems hardly adequate as a response to the sorts of conflicts recounted in yesterday's Los Angeles Times articles.
Today, a Times editorial, "The Sick NIH " alleged "the appearance of corruption" at the NIH, and called for Zerhouni to resign.
One explanation for the anechoic effect is that we revere some of our health care institutions so much we are reluctant to criticize any aspect of them, particularly their leaders. Of course, if we truly revere them, we should defend them from inadequate or worse leadership. Some less than honorable leaders may realize this tendency, and cloak themselves in their organization's revered mantle to avoid justifiable criticism.
In my humble opinion, it is a tragedy and disgrace for the country's and perhaps the world's premier biomedical research organization to be tainted by leaders with the gross sorts of conflicts of interest reported in yesterday's articles. It will take drastic measures to cleanse it. But until it is cleansed, can anyone fully trust its actions?

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