Giving the annual Wooldridge memorial lecture in
London on 17th November, epidemiology researcher
and best-selling author Ben Goldacre argued that public scepticism about the reliability of the information
they are given may be entirely reasonable. Unfortunately,
it can result in a resistance to accept the benefits of
treatments such as the MMR (measles, mumps and rubella)
vaccine for children.
Dr Goldacre pointed out that periodic scares about
the safety of vaccination have emerged ever since such
treatments were first introduced 200 years ago. “There
appears to be something in particular about population
level interventions that causes public anxiety,” he noted.
The patterns of these events are often quite similar. The
previous UK incident occurred only about 15 years before
the 1998 MMR panic and was focused on the whooping
cough vaccine. The causes of such events are cultural
rather than scientific, as shown by the lack of concern in
other countries where the same vaccine is being used, he
said. In France, for example, there were no worries about
the MMR vaccine, but the administration of a hepatitis B
treatment generated fears of a link with multiple sclerosis –
the only other place where the same panic emerged was in
the Francophone community in Canada, he said.
Dr Goldacre put the blame for this phenomenon on the
medical establishment, medicines manufacturers and
individual scientists for their failure to take steps that
would restore their public trust. In his ‘Bad Science’ column
that ran for many years in the Guardian newspaper, Dr
Goldacre highlighted many examples of incidents where
clinical trials had been deliberately designed to provide
misleading evidence. He also pointed out that the results of
more than half of all clinical trials are “routinely and legally
withheld from doctors and patients”.
He cited the WHO programme against polio as an
example of when this approach can go disastrously wrong.
The programme was on the verge of eliminating this long-
standing, global threat to children when campaigners in
Kano province in northern Nigeria successfully persuaded
the local population that the treatment was a conspiracy
by a US drug company to render Muslim males infertile. As a result, children went untreated and the area started
exporting polio cases around the world.
“People talk about this incident as though it was a
sudden irrational explosion of idiocy in primitive people,
in a way I find deeply offensive. The truth is that around
three years earlier in the same region, children had been
damaged in a trial of a new antibiotic drug, Trovan. When
the vaccine campaign began, people were hearing news
of the prosecution of those local officials who authorised
that first trial and were responsible for dealing with the
consequences. Just because people get some of the
details wrong doesn’t mean that people are wrong to be
suspicious,” he said.
Dr Goldacre outlined the various ways that scientific
information is consciously or unconsciously manipulated
by policymakers, industry, journalists and campaign
groups. These varied from simple manipulation of powerful visual data by truncating the Y axis in a graph, through
blurring the lines between causation and correlation, and
to the drawing of wilfully inaccurate conclusions from a
legitimate study. The Daily Mail was a regular offender in
this respect, frequently using its pages to push conclusions
that promoted its own political agenda. He noted that
publication’s obsession with factors that are supposed
either to cause or protect against cancer.
Dr Goldacre’s writings are also noted for their tireless
pursuit of charlatans. He made a particular target of the
self-styled television nutritionist Gillian McKeith, noting that
the qualifications that ‘Dr’ McKeith claims to have earned
may be bought on the internet.
To demonstrate the limited value of membership of
the American Association of Nutritional Consultants, he
mischievously signed up a new member for that body.
On receipt of the sum of $60, it provided a certificate of
membership to Hetty, who was a cat with no recognised
training in nutritional science. Moreover, she had been dead
for several years.