DRUG BUST by Alan Cassels
Here’s a quick question for health watchers out there: Which health-related word is becoming rarer and rarer now, passé even? “Leeches?” Nope. “Blood letting?” Wrong. Give up? It’s the word “cure.”
We hear a lot about prevention, diagnosis and treatment. There are no end of stories about causes, links, associations, disease markers and genetic predispositions. These terms litter the health sections of our newspapers and fill our TV news broadcasts. No one seems to be talking about cures these days.
Why is that? Well, there are many perspectives on this, but let me give you just one: “Cures” are unprofitable. No one makes money on cures. If the business of healthcare is about bringing better financial returns to investors, we would do best to stamp out and eliminate cures once and for all. A cure for any of the big, chronic diseases of our time – asthma, heart disease, arthritis – would have a significant, negative impact on the stock market and in turn, the economy. It would cost jobs. It would affect our competitiveness. We couldn’t have it.
You’ll never hear health care industry executives say outright that cures are anathema to their growth projections, but if you look closer, you’ll find, as I have, all kinds of very strong evidence that possible “cures” are being denied, discredited and otherwise undermined. Like inflation, or low unemployment, cures are just bad for business.
You might argue that the employees of companies making health care products – drugs and medical devices, for example – are driven by a higher calling, a very strong sense of social responsibility. The people I know who work for pharmaceutical companies are truly animated by the sense of contributing to the greater good of humankind. And that’s a good thing. At the same time, I know that it hardly matters whether your product is a computer, a car or a coronary valve. The corporation, the overwhelmingly dominant entity in our society, takes its marching orders from, in the words of Milton Friedman, a single moral imperative: “To maximize shareholder value.” Companies exist to make money. Full stop.
A biotech analyst at a St. Louis brokerage firm really captured this perspective in saying, “We sometimes joke that when you’re doing a clinical trial, there are two possible disasters. The first disaster is if you kill people. The second disaster is if you cure them. The truly good drugs are the ones you can use chronically for a long, long time.”
Let’s face it, long-term diseases – ones which sometimes mean a near-lifetime dependence on drugs, devices, medical interventions and treatments of all sorts – are among the most profitable revenue sources on the planet. To me, type II diabetes, also known as “adult onset diabetes” is the quintessential disease that engenders lifelong dependency. More than many diseases, it illustrates the corporate model of modern sickness care that is keen on having you take products over and over and over again. Your “high” blood sugar, or glucose, a condition called hyperglycemia can lead to many long-term health problems, such as eye, kidney and nerve damage. The opposite of this, hypoglycemia, is also bad news, and happens when blood sugar levels drop too low, impairing mental functioning and sometimes causing you to lose consciousness.
Taken together, hypoglycemia and hyperglycemia can be largely, but not always, regulated by controlling two things: energy expenditure (physical energy) and food intake, which happens more often in those who are overweight and who have a lowered response to insulin in the tissues of the body (insulin resistance). There are a number of known ways to improve your body’s use of insulin, but the goal of the “Diabetes Industrial Complex” involves three key things: Getting you tested (how “high” is your blood glucose?), getting you to monitor and test your blood glucose with blood test strips several times a day and getting you to take treatment (drugs and insulin).
The real “preventions” and “cures” for type II diabetes revolve around two things: better nutrition and more physical exercise.
Some might even go so far as to say that remarkable, simple cures for type II diabetes currently exist, yet they are not being tested, promoted or used. A recent study of dietary interventions compared a vegan diet to one recommended by the American Diabetes Association. It found that 43 percent of those on the vegan diet reduced their need for drugs to manage their diabetes, compared with 26 percent of the ADA diet group. OK, not stellar, but it helps about two in five patients. In terms of lowering blood pressure and cholesterol, and causing people to lose weight, you will not find a drug on the planet that would even come close to achieving a benefit equal to this vegan diet. None.
Dr. Neal Barnard, the researcher who ran this study, brims with enthusiasm when he describes in a phone interview that the only side effects are good ones: “They [the patients] lose weight. Their clothes don’t fit anymore.” Barnard is an adjunct associate professor of medicine at George Washington University, and president of the Physicians Committee for Responsible Medicine (www.pcrm.org), a group which promotes preventive medicine. He sums things up with: “I hope this study will rekindle interest in using diet changes first, rather than prescription drugs.” So confident is he in the dietary cure for diabetes, he’s written a book entitled Dr. Neal Barnard’s Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs. (Rodale, 2007).
While it might seem that getting people onto a vegan diet could be rather difficult, the dietary means to control diabetes seem almost “cure-like.” You can be sure the Diabetes Industrial Complex won’t like it. In fact, Dr. Barnard, and physicians like him, who propose diet and exercise to defeat diabetes, are Davids against a Goliath of mammoth proportions.
At the 19th World Diabetes Congress in Cape Town, South Africa, last month, the International Diabetes Federation announced that “…an estimated 246 million people in the world have diabetes” and that type II diabetes (about 90 percent of diabetics) afflicts almost six percent of the world’s adult population.
In the words of IDF president-elect Martin Silink, “The diabetes time bomb has been ticking for 50 years and it’s getting louder.” With a market set to expand within 20 years to affect roughly 380 million people, you can imagine the diabetes industry – the makers of drugs, monitoring devices and blood test strips – are salivating at the size and scope of this market. Any cure for this chronic disease would bring their empire to a sudden and tragic end.
What is the International Diabetes Federation (IDF), anyway? Its web material (www.idf.org) says that it is a “… global advocate for more than 240 million people with diabetes worldwide,” representing, apparently, “… over 190 diabetes associations in more than 150 countries.” Its mission is to “… promote diabetes care, prevention and a cure worldwide.” Wonderful. There’s that elusive word “cure” again.
But do the people at IDF mean it? It’s a little hard to take them seriously when you see their activities are largely funded by the very same device and drug manufacturers who stand to make a lot of money by discrediting people like Dr. Barnard and his vegan diet.
If you’re like me, you’re likely to see a continued, corrupting influence of all the money in diabetes propaganda. In the hullabaloo at the World Diabetes Congress, the IDF announced a $10 million research grant from Eli Lilly, one of the world’s largest pharmaceutical companies, and whose key products centre on treating diabetes. That grant, designed to “… close the gap between scientific knowledge and patient care” on diabetes stipulates that it can’t be used for pharmaceutical research. But, I ask, can it be used to make sure the anti-commercial word “cure” doesn’t raise any embarrassing questions around the International Diabetes Federation?
Can we even take the IDF seriously when it comes to talking about anything that affects the financial interests of the diabetes business?
Diabetes has been described as a growing health problem in our society, an epidemic that will financially burden our health care system. But I see the issues around our blood glucose to be largely social, rather than medical.
If we are fat, malnourished and sedentary high blood-pressure-cholesterol-glucose slobs, is it because we are sick or that we live in a sick society? Have we engineered the nutrients out of our food and the need for physical energy out of our lives?
My resolution for this year is to devote 2007 to diving into this, the most heavily marketed disease of the century – type II diabetes – and examine the myriad ways in which the Diabetes Industrial Complex is making your high blood sugar the hottest disease on the planet. Don’t worry, I promise it won’t be boring; there is enough intrigue, scandal and medical malfeasance to fill a whole book.
Do you have a type II diabetes story to tell? Have you any experience with treating it or “curing” it in yourself or someone close to you? Share your stories with me and if there is any evidence you think I should see, send it along to (email@example.com).
Alan Cassels is co-author of Selling Sickness and a drug policy researcher at the University of Victoria. He is also the founder of Media Doctor Canada (www.mediadoctor.ca), which evaluates reporting of medical treatments in Canada’s media.