Wednesday, January 26, 2005

The NIH Response to Whistle-Blowing: "Overwhelm with Force"

A follow-up from Associated Press about the case of Dr. Jonathan Fishbein, who complained about questionable practices at a Ugandan site for a National Institute of Health (NIH) run study on nevaripine for the prevention of transmission of HIV. Fishbein had been praised by the Director of the AIDS Division of NIH, Dr. Edmund Tramont, and recommended for a $2500 bonus to recognize his performance in his first year on the job. But after AP reported his concerns about the Uganda site, (see my post on this here), his immediate supervisor emailed Tramont "how hard would it be to terminate him?" Tramont's response was to fire him, "In Clauswitzian style, we must overwhelm with force."
Science, and therefore science based medicine, of course, requires the free communication of research data and results, and the free analysis, interpretation, and discussion of them. The very last place in the world I would have expected to see someone who publicly discussed questionable research methods "overwhelmed with force" is the NIH, formerly one of the world's foremost biomedical research organizations.
This story, coupled with previous stories about major conflicts of interest affecting NIH leaders (see previous posts here and here and here) suggests the NIH badly needs new leadership who will respect its mission.

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