protection from dangerous drugs hangs by a thread
DRUG BUST by Alan Cassels
Electing a government may be about a lot of things, but what seems to dominate the speeches of candidates is how they plan to spend our tax dollars. Those decisions determine our priorities and shape what kind of country we’ll have now and in the future so whatever underpins those priorities is worthy of some careful thought. After nearly a month of political campaigning, I can only discern one distinct refrain in the various Harper pronouncements: fear. When the PM says, as he does in his broken-record way, “Let me be perfectly clear,” he is about to remind us, once again, that the world is a big, fearful place and that the government’s main job is to make us safe.
Fear is the backdrop to the “tough-on-crime” prison-building, border-tightening, fighter-jet procuring policies of the Harperites. In a manner similar to a simplistic, US Republican way of thinking, Harper’s platform makes you think that axing the entire civil service and shovelling tax cuts to corporations are our two tickets to paradise. And there are a lot of people who support that view. I wonder, however, if those who are scared of the big, fearful things in the world – criminals and terrorists – ever stopped to think deeply about how the likelihood of those harms compare with a whole range of other dangers?
This question arose for me last week when I read a new US report that stated almost two million patients per year were being injured, some fatally, by adverse drug reactions in US hospitals, a figure that has grown by 54 percent between 2004 and 2008. In Canada, we know the prescription drug death toll is proportionately similar and growing. It translates to about 200,000 Canadians hurt every year by hospital-administered medicine. Most of us think going to a hospital will improve our chances of survival if we’re very sick, but there is a growing reality it can also be a dangerous experience that may end in death and governments are doing practically nothing to protect us.
Let’s consider something a little closer to home: your kitchen. Imagine a world in which you could never eat your breakfast in peace without the threat that, at any moment, your toaster could explode in your face. Or that the sausages you’re eating may be contaminated or your water may be laced with disease-causing pathogens. It’s hard to imagine that world because behind the consumer products we use everyday there are people who test and regulate them and identify problems when they arise and inform people how to avoid potential danger. They are, of course, undermanned, undergunned and probably underpaid, but they perform an essential, and some would say lifesaving, public service.
Some people think it is only the invisible hand of the market that ensures products are safe in the hands of consumers and that those businesses selling exploding toasters would not be commercially viable for long. They think government just needs to ‘get out of the way’ of the market and allow it to work unfettered by intrusive regulations. The opposite view holds it is not the invisible hand of the market, but rather the invisible hands of regulators and regulatory systems that work everyday behind the scenes to ensure our toasters don’t explode. Without regulators monitoring the safety of consumer products, drugs and food, our lives are just a little bit more endangered.
Regulation is vital, but beyond the immediate actions of regulators is a much more important terrain: it is where a whole bunch of people from what is called “civil society” work to keep governments and corporations accountable. Without the actions of non- profit groups of patients, activists and advocates who keep an eye on the erosion of rights, while also challenging the business-friendly, profit-at-all-costs ethic of politicians, we’d never be able to protect the rights of Canadians. Nor would we be able to ensure they are not exposed to excessive dangers from the marketplace.
So how’s the state of civil society in Canada? In a nutshell, terrible and getting worse – especially since the Conservatives have been running things. Don’t believe me? Maybe listen to those people who make up civil society, those who have concrete evidence of the myriad ways our democracy in Canada is being debased, defunded and eroded. Voices-voix (voices-voix.ca) is a huge, non-partisan collection of “organizations and individuals defending democracy, free speech and transparency in Canada.” Its website contains some shocking examples of what the Harper government has been silently enacting, including cutting off funding of groups that provide those essential services which the invisible hand of the market can’t provide, such as protecting women’s and immigrants’ rights, international aid and so on. What does this have to do with the election? The Prime Minister said he’d fund his government’s vision with $11 billion worth of savings made from “efficiencies” within the federal government. Pray tell, what does that mean?
No one seems to know, but in the televised leader’s debate, NDP leader Jack Layton was the only one who delivered any insight when he asked (I’m paraphrasing here) if the $11 billion in savings was going to come through laying off food inspectors? It isn’t at all clear where one can find an easy $11 billion worth of cuts, but we can be reasonably assured the easy targets are the regulatory people and the laws they protect. After all, what better way to save money than by feeding federal consumer product testers and drug evaluation and medical device regulators into the maw of the downsizing mill?
If you think Canada already has robust ways of keeping unsafe drugs and dangerous toasters out of the hands of Canadians, you’ve obviously never heard of Vioxx, the biggest prescription drug disaster in our lifetime, which could have easily been prevented with proper government oversight of the evaluation, sale and marketing of pharmaceuticals.
A few years ago, Canada’s Auditor General did a report on Health Canada’s activities around the medical device industry. These are the developers and marketers of heart and hip implants, lasers, blood test kits, complex medical imaging machines and home use glucose monitors, among many other things. The report essentially stated Health Canada carried out very little testing of products after they had come on the market; it communicated inadequately with consumers when they found shoddy goods; and it didn’t even have a strategy to communicate risks of medical devices. The key recommendation? More funding so Health Canada could properly regulate medical devices and keep Canadians safe.
You can imagine how much extra money our health regulators got since the Harper Government has been slashing and burning the public service and the civil society actors who endeavour to keep government accountable. If you are feeling safer now, you should know that discretionary money is financing prisons and jets instead of the federal bureaucrats who oversee complicated medical devices and tests, verify to see if there is lead in your baby’s teether or salmonella in your cabbage. And you are likely deluding yourself. Scary stuff indeed.
Right now, we’ve got a government that answers every question with a corporate tax cut. And to fund its agenda of fear, we need “efficiencies” created by cutting federal jobs and programs and getting rid of those invisible hands representing thousands of public servants and civil society groups whose job it is to keep our food, water and health care safe and who protect and uphold our laws. What do we think of this? I give the last word to my friend Wendy Armstrong of Edmonton, one of the strongest voices for consumer protection in Canada. She says we are getting what we pay for. “The cost of regulating, overseeing and challenging the activities [of industries] in order to ensure the health and safety of Canadian consumers, workers, and the public at large, is a critical element in any market economy. In the end, we all pay for regulatory failures… just ask the Japanese.”
Alan Cassels is a drug policy researcher at the University of Victoria and is currently working on a book on medical screening. Have you been screened for something and have a story to tell? Let him know at email@example.com. Read his other writings at www.alancassels.com