[Ip-health] The American Conservative - Chinese Melamine or American Vioxx: Half a million dead and no questions asked

Riaz K Tayob riaz.tayob at gmail.com
Fri Apr 20 08:55:33 PDT 2012

[When asked if Vioxx would be regarded as a spurious drug in the IMPACT 
discussions, true to form, WHO officials kept mum but targeting poor 
country problems, well that is fair game ... its the Hippocratic Oath.. 
i not y! what is the loss of 500,000  people amongst friends, MNCs and 
rich country officials?]

Weekend Edition April 20-22, 2012

Valuing Human Life in China and the U.S: Take Your Pick 
Chinese Melamine or American Vioxx: Half a million dead and no questions 

In contrasting China and America, pundits often cite our free and 
independent media as one of our greatest strengths, together with the 
tremendous importance which our society places upon individual American 
lives. For us, a single wrongful death can sometimes provoke weeks of 
massive media coverage and galvanize the nation into corrective action, 
while life remains cheap in China, a far poorer land of over a billion 
people, ruled by a ruthless Communist Party eager to bury its mistakes. 
But an examination of two of the greatest public-health scandals of the 
last few years casts serious doubt on this widespread belief.

What follows is an extraordinary report by Ron Unz, publisher of the New 
American Conernative, part of his larger feature just published by the 
TAC,  "China's Rise, America's Fall. " Ron makes the charge that perhaps 
500,000 or more premature American deaths may have resulted from Vioxx, 
a figure substantially larger than the 3,468 deaths of named individuals 
acknowledged by Merck during the settlement of its lawsuit. And almost 
no one among our political or media elites seems to know or care about 
this possibility.

Ron writes to us : "I remember back in 2005, I was reading my morning 
newspapers, as I always do, and noticed those tiny, buried items about 
the unprecedented drop in the American death rate.  Hmm I said, I wonder 
if that might have anything to do with all those other stories about 
that deadly drug recently taken off the market and all the resulting 
lawsuits.  I never got around to looking into it, and apparently nobody 
in the media did either.

"Then, a few weeks ago, I was talking to Dan McCarthy the TAC Editor, 
complaining to him about how totally incompetent and dishonest the MSM 
was, and mentioned the totally ignored 2005 mortality drop as an 
excellent example.  He'd obviously never heard of it and had also 
completely forgotten about the Vioxx scandal, but said I really should 
think about writing something up.  So I decided to combine it with some 
of those other things about China I'd been complaining that the MSM 
tended to distort or ignore.

"When I went to the CDC website, it only took me about 10 minutes to get 
the public data confirming that just as I'd guessed, Vioxx had probably 
killed around 500,000 Americans, but virtually nobody in the whole 
country knew or cared.  It's a little like if a meteor destroyed 
Pittsburgh and killed everyone there, but the media never reported it, 
would anyone really notice?  From a philosophical perspective, if nobody 
knows about it, did it even really happen?"

First, consider the details of the Chinese infant formula scandal of 
2008. Unscrupulous businessmen had discovered they could save money by 
greatly diluting their milk products, then adding a plastic chemical 
compound called melamine to raise the apparent protein content back to 
normal levels. Nearly 300,000 babies throughout China had suffered 
urinary problems, with many hundreds requiring lengthy hospitalization 
for kidney stones. Six died. A wave of popular outrage swept past the 
controlled media roadblocks and initial government excuses, and soon put 
enormous pressure on Chinese officials to take forceful action against 
the wrongdoers.

China's leaders may not be democratically elected, but they pay close 
attention to strong popular sentiment. Once pressed, they quickly 
launched a national police investigation which led to a series of 
arrests and uncovered evidence that this widespread system of food 
adulteration had been protected by bribe-taking government officials. 
Long prison sentences were freely handed out and a couple of the 
guiltiest culprits were eventually tried and executed for their role, 
measures that gradually assuaged popular anger. Indeed, the former head 
of the Chinese FDA had been executed for corruption in late 2007 under 
similar circumstances.

Throughout these events, American media coverage was extensive, with 
numerous front-page stories in our leading newspapers. Journalists 
discovered that similar methods of dangerous chemical adulteration had 
been used to produce Chinese pet food for export, and many family dogs 
in America had suffered or died as a result. With heavy coverage on talk 
radio and cable news shows, phrases such as "Chinese baby formula" or 
"Chinese pet food" became angry slurs, and there was talk of banning 
whole categories of imports from a country whose product safety 
standards were obviously so far below those found in Western societies. 
The legitimate concerns of ordinary Americans were fanned by local media 
coverage that sometimes bordered on the hysterical.

However, the American media reaction had been quite different during an 
earlier health scandal much closer to home.

In September 2004, Merck, one of America's largest pharmaceutical 
companies, suddenly announced that it was voluntarily recalling Vioxx, 
its popular anti-pain medication widely used to treat arthritis-related 
ailments. This abrupt recall came just days after Merck discovered that 
a top medical journal was about to publish a massive study by an FDA 
investigator indicating that the drug in question greatly increased the 
risk of fatal heart attacks and strokes and had probably been 
responsible for at least 55,000 American deaths during the five years it 
had been on the market.

Within weeks of the recall, journalists discovered that Merck had found 
strong evidence of the potentially fatal side-effects of this drug even 
before its initial 1999 introduction, but had ignored these worrisome 
indicators and avoided additional testing, while suppressing the 
concerns of its own scientists. Boosted by a television advertising 
budget averaging a hundred million dollars per year, Vioxx soon became 
one of Merck's most lucrative products, generating over $2 billion in 
yearly revenue. Merck had also secretly ghostwritten dozens of the 
published research studies emphasizing the beneficial aspects of the 
drug and encouraging doctors to widely prescribe it, thus transforming 
science into marketing support. Twenty-five million Americans were 
eventually prescribed Vioxx as an aspirin-substitute thought to produce 
fewer complications.

Although the Vioxx scandal certainly did generate several days of 
newspaper headlines and intermittently returned to the front pages as 
the resulting lawsuits gradually moved through our judicial system, the 
coverage still seemed scanty relative to the number of estimated 
fatalities, which matched America's total losses in the Vietnam War. In 
fact, the media coverage often seemed considerably less than that later 
accorded to the Chinese infant food scandal, which had caused just a 
handful of deaths on the other side of the world.

The circumstances of this case were exceptionally egregious, with many 
tens of thousands of American deaths due to the sale of a highly 
lucrative but sometimes fatal drug, whose harmful effects had long been 
known to its manufacturer. But there is no sign that criminal charges 
were ever considered.

A massive class-action lawsuit dragged its way through the courts for 
years, eventually being settled for $4.85 billion in 2007, with almost 
half the money going to the trial lawyers. Merck shareholders also paid 
large sums to settle various other lawsuits and government penalties and 
cover the heavy legal costs of fighting all of these cases. But the loss 
of continuing Vioxx sales represented the greatest financial penalty of 
all, which provides a disturbing insight into the cost-benefit 
calculations behind the company's original cover-up. When the scandal 
broke, Merck's stock price collapsed, and there was a widespread belief 
that the company could not possibly survive, especially after evidence 
of a deliberate corporate conspiracy surfaced. Instead, Merck's stock 
price eventually reached new heights in 2008 and today is just 15 
percent below where it stood just before the disaster.

Furthermore, individuals make decisions rather than corporate entities, 
and none of the individuals behind Merck's deadly decisions apparently 
suffered any serious consequences. The year after the scandal unfolded, 
Merck's long-time CEO resigned and was replaced by one of his top 
lieutenants, but he retained the $50 million in financial compensation 
he had received over the previous five years, compensation greatly 
boosted by lucrative Vioxx sales. Senior FDA officials apologized for 
their lack of effective oversight and promised to do better in the 
future. American media conglomerates quietly mourned their loss of heavy 
Vioxx advertising, but continued selling the same airtime to Merck and 
its rivals for the marketing of other, replacement drugs, while their 
investigative arms soon focused on the horrors of tainted Chinese infant 
food and the endemic corruption of Chinese society.

This story of serious corporate malfeasance largely forgiven and 
forgotten by government and media is depressing enough, but it leaves 
out a crucial factual detail that seems to have almost totally escaped 
public notice. The year after Vioxx had been pulled from the market, the 
New York Times and other major media outlets published a minor news 
item, generally buried near the bottom of their back pages, which noted 
that American death rates had suddenly undergone a striking and 
completely unexpected decline.

The headline of the short article that ran in the April 19, 2005 edition 
of USA Today was typical: "USA Records Largest Drop in Annual Deaths in 
at Least 60 Years." During that one year, American deaths had fallen by 
50,000 despite the growth in both the size and the age of the nation's 
population. Government health experts were quoted as being greatly 
"surprised" and "scratching [their] heads" over this strange anomaly, 
which was led by a sharp drop in fatal heart attacks.

On April 24, 2005, the New York Times ran another of its long stories 
about the continuing Vioxx controversy, disclosing that Merck officials 
had knowingly concealed evidence that their drug greatly increased the 
risk of heart-related fatalities. But the Times journalist made no 
mention of the seemingly inexplicable drop in national mortality rates 
that had occurred once the drug was taken off the market, although the 
news had been reported in his own paper just a few days earlier.

A cursory examination of the most recent 15 years worth of national 
mortality data provided on the Centers for Disease Control and 
Prevention website offers some intriguing clues to this mystery. We find 
the largest rise in American mortality rates occurred in 1999, the year 
Vioxx was introduced, while the largest drop occurred in 2004, the year 
it was withdrawn. Vioxx was almost entirely marketed to the elderly, and 
these substantial changes in national death-rate were completely 
concentrated within the 65-plus population. The FDA studies had proven 
that use of Vioxx led to deaths from cardiovascular diseases such as 
heart attacks and strokes, and these were exactly the factors driving 
the changes in national mortality rates.

The impact of these shifts was not small. After a decade of remaining 
roughly constant, the overall American death rate began a substantial 
decline in 2004, soon falling by approximately 5 percent, despite the 
continued aging of the population. This drop corresponds to roughly 
100,000 fewer deaths per year. The age-adjusted decline in death rates 
was considerably greater.

Patterns of cause and effect cannot easily be proven. But if we 
hypothesize a direct connection between the recall of a class of very 
popular drugs proven to cause fatal heart attacks and other deadly 
illnesses with an immediate drop in the national rate of fatal heart 
attacks and other deadly illnesses, then the statistical implications 
are quite serious. Perhaps 500,000 or more premature American deaths may 
have resulted from Vioxx, a figure substantially larger than the 3,468 
deaths of named individuals acknowledged by Merck during the settlement 
of its lawsuit. And almost no one among our political or media elites 
seems to know or care about this possibility. A recent Wall Street 
Journal column even called for relaxing FDA restrictions aimed at 
avoiding "rare adverse events," which had been imposed after the 
discovery of "unanticipated side effects of high-profile drugs like Vioxx."

There are obvious mitigating differences between these two national 
responses. The Chinese victims were children, and their sufferings from 
kidney stones and other ailments were directly linked to the harmful 
compounds that they had ingested. By contrast, the American victims were 
almost all elderly, and there was no means of determining whether a 
particular heart attack had been caused by Vioxx or other factors; the 
evidence implicating the drug was purely statistical, across millions of 
patients. Furthermore, since most of the victims were anyway nearing the 
end of their lives, the result was more an acceleration of the 
inevitable rather than cutting short an entire young life, and sudden 
fatal heart attacks are hardly the most unpleasant forms of death.

But against these important factors we must consider the raw numbers 
involved. American journalists seemed to focus more attention on a 
half-dozen fatalities in China than they did on the premature deaths of 
as many as 500,000 of their fellow American citizens.

The inescapable conclusion is that in today's world and in the opinion 
of our own media, American lives are quite cheap, unlike those in China.

Published by permission of the New American Conservative. Copyright, New 
American Conservative.

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