IT sounded like a good idea at first, at least to members of Congress, who
are always looking for that hot new thing to tout so their constituents back
home can be proud of their representatives. Every person in the country would
get a plastic identification card with a magnetic strip containing digitised
information on one鈥檚 health. You go somewhere on holiday or business, you get
hurt, and the local hospital or doctor will be able to check your card and
personal 鈥渋dentifier鈥� against a central database to better determine what ails
you. Hospitals and insurance companies liked the idea too. But then it began to
sink in: a national ID card with personal information carried by every citizen?
Could the police demand to inspect it? Employers? What happens if it gets
stolen? As it happened, Congress got a flood of negative comments from the
public. The notion that 鈥減roper regulation鈥� would take care of privacy concerns
was bounced around for a while and sank. So, no health identifier this year. And
Congress is reminded again鈥擜mericans will opt for personal freedom over
personal health nine times out of ten.
THE Department of Energy evidently feels it鈥檚 on to a good thing.
In the summer, as mentioned in this column
(29 August 1998, p 47),
with great fanfare, DoE officials announced that a drug
called gamma vinyl-GABA (GVG) might hold the
key to breaking people鈥檚 cocaine addiction. They based the claim on evidence
from brain scans done at the DoE Brookhaven National Laboratory. The scans
showed that the drug was able to bind to the same receptor in the brain as
cocaine, and in behavioural tests GVG lessened cocaine cravings. But the problem
was, as some at the National Institutes of Health were quick to point out, the
work was done in rodents and baboons, and there was no way to know whether it
would work in humans.
But the DoE wasn鈥檛 finished with GVG. This month, with even more fanfare, and
an appearance by the Secretary of Energy himself, the DoE announced that GVG
also appeared to break the nicotine habit鈥攊n rodents and baboons. The
media were underwhelmed to say the least. If the DoE wants to brag about its
scientific prowess, that鈥檚 its business. But really, helping baboons kick the
habit?
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THERE are certain forces in nature that are justifiably taken for granted. We
don鈥檛 take note of water flowing downhill. We don鈥檛 raise an eyebrow when the
tax bill arrives. And when Sidney Wolfe levels a broadside at the Food and Drug
Administration (FDA) for some dereliction on their part, as he did earlier this
month, it鈥檚 just a sign that world is not out of joint.
But recently, the world was indeed out of joint. In the past few years, Wolfe
had become positively cuddly towards his bureaucratic nemesis. Wolfe is one of
Ralph Nader鈥檚 raiders, a confirmed consumer activist who heads something called
the Public Citizen鈥檚 Health Research Group. Wolfe has never met a prescription
drug he couldn鈥檛 fault and, inevitably, it was one that the FDA had overlooked.
Wolfe argued that the FDA was more interested in protecting a good working
relationship with the pharmaceuticals industry than protecting the American
public.
That was in the good old days. Then came the Republican revolution, where
free-marketeers in Congress began questioning whether Americans needed an FDA at
all. Wolfe was shocked. As bad as the FDA was, getting rid of it was worse. So
for several years, Wolfe鈥檚 efforts seemed hell-bent on proving that the FDA was
the only thing between American consumers and uncaring megacorporations who
would foist dangerous drugs on them given half a chance.
Now that the Congressional fervour to dismantle the FDA seems to have abated,
Wolfe has reverted to his former tactics. This month鈥檚 report, 鈥淔DA Medical
Officers Report Lower Standards Permit Dangerous Drug Approvals鈥�, attempts to
show that the staff who consider new drugs for the agency are being bullied into
approving them by an agency intent on pleasing Congress, and by extension the
wealthy donors in pharmaceuticals companies who fund Congressional
campaigns.
So, the world鈥檚 back on its appointed track.