The Wellcome Trust convened an “Opinion Formers Conference” on “Counterfeit Medicines: Perspectives and Action” on Monday 26 October 2009. The speakers at this meeting included Dr Hans Hogerzeil, Director of Essential Medicines and Pharmaceutical Policies, World Health Organization, Aline Plançon, INTERPOL-IMPACT Project Manager, Ron Guido, VP Global Brand Protection, Johnson & Johnson, Dr Paul Newton, Head Wellcome Trust – Mahosot Hospital – Oxford Tropical Medicine Research, Brian Elliott, Executive Director of the Medicines Transparency Alliance (MeTA) Secretariat, and Dr Hezekiah Chepkwony, Director of the National Quality Control Laboratories, Kenya. According to the program, Sir Mark Walport (The Wellcome Trust) chaired the two main sessions and Andrew Jack (Financial Times) chaired a round table lunch discussion. Roger Bate, Legatum Fellow in Global Prosperity, American Enterprise Institute for Public Policy Research (AEI), presented an “overview of the counterfeiting problem” including 1) difficulties in defining counterfeit medicines; 2) the challenges for developing and developed countries; 3) actors involved and their responsibilities; and 4) overview of historic and recent developments.
Who is Roger Bate?
According to his official AEI bio (an institution that counts Richard Cheney and Raymond Gilmartin on its Board of Trustees), “Roger Bate is an economist who researches international health policy, with a particular focus on tropical disease and substandard and counterfeit medicines. He also writes on general development policy in Asia and Africa”. He holds a Ph.D in economics from Cambridge.
Bate’s profiles on Wikipedia, SourceWatch and ExxonSecrets yield a veritable treasure trove of information on his work on tobacco, climate change, ivory trade, DDT and malaria and counterfeits. According to SourceWatch, Bate served as the Director of International Policy Network (IPN) from 2001 to 2003, founded the European Science and Environment Forum (ESEF), is an adjunct fellow of the Competitive Enterprise Institute and a Board Member of Africa Fighting Malaria (he was AFM’s Chairman of the Board from 2003 to 2006).
Bate’s role as a industry-funded climate change skeptic was detailed in George Monbiot’s Guardian piece on 26 September 2006 entitled “Covert lobbying, in the UK as well as the US, has severely set back efforts to combat the world’s biggest problem” and Adam Sarvana’s exposé (28 May 2009) in Natural Resources News Service entitled “Bate and Switch: How a free-market magician manipulated two decades of environmental science”
In the Guardian piece, Monbiot detailed how AEI received $1.6 million from ExxonMobil and the Competitive Enterprise Institute received $2 million. The article noted,
Like Morris, Bate has often appeared on radio and television programmes. Interviewed by the Today programme about climate change, he argued that cutting carbon emissions has been “folly all along”. Instead, we should concentrate on adapting to climate change. In 2000, he presented a film on BBC2 called Organic Food: the Modern Myth, on which Morris also appeared. Bate has not yet answered the Guardian’s requests for a response.
The Hansard, also records the UK House of Commons’ discussion on Climate Change and the Environment which took place on 8 February 2005 when Mr Norman Baker (former Shadow Secretary of State for the Environment, Environment, Food & Rural Affairs; Lewes, Liberal Democrat) noted this about climate change skeptics, IPN and Bate:
That is not to deny that some individuals are advancing the theory that climate change is not occurring. Indeed, I shall consider some of those voices now.
One voice is that of Julian Morris of the International Policy Network, who claims that climate change is a myth. Apparently, sea levels are not rising and Britain’s chief scientist is “an embarrassment” because he believes that catastrophe is inevitable. It is worth pointing to the close links between International Policy Network and Exxon Mobil, which gave the organisation $50,000. Exxon lists that donation as part of its climate change outreach programme. There are also close links with the Washington-based Competitive Enterprise Institute.
We could also mention Dr. Roger Bate of Tech Central Station. He also criticised Sir David King, who is fast becoming an object of derision for people associated with Exxon Mobil and others. He says that
“it is especially shameful for the British to attempt limiting debate”—
apparently that is what we are doing—
“in a country that had science suppressed far too often in the past.”
I do not think that many hon. Members will recognise that description of this country. The House may be interested to know that Tech Central Station received $95,000 from Exxon Mobil last year for climate change activities.
On the ivory front, Roger Bate wrote in his piece “Culling to be Kind” for the Institute of Economic Affairs (January 2001) that,
all the evidence suggests that regulated ivory trade is sustainable, provides much-needed revenue directly to local communities and is environmentally beneficial. Sound resource management necessitates elephant culling in order to conserve other species, whilst if local people are able to benefit from the revenue they have stronger incentives to conserve stocks for the future. In addition, the ivory market in Japan is very stable. 20,000 retail outlets sell hankos, popular signature seals given to boys to mark the beginning of manhood. Plastic imitations will not do, so this demand will be constant, providing certainty to African sellers. Also, ivory stockpiles are being used up and the hankos market is hungry for supplies; without legal trade illegal sources would probably be sought.
In a piece advocating the use of DDT to combat malaria in Prospect magazine, DDT works (24 May 2008), Bate brushed aside charges of being a tobacco lobbyist countering:
John Quiggin and Tim Lambert purport to restore Rachel Carson’s reputation, trashing me and an organisation I helped found, Africa Fighting Malaria, in the process. Their article amounts to a half-baked conspiracy theory that breaks down with a cursory review of the facts. The authors’ hope is that by branding me a tobacco lobbyist and claiming the tobacco industry is bankrolling the campaign for DDT, they will convince others to dismiss DDT advocates as industry stooges. They are sadly mistaken…
Second, I was never a tobacco lobbyist. After I wrote two articles on tobacco-related topics in 1996 and 1997, I consulted for Philip Morris, at their request, on international health for a total of about a month in 1998. I never lobbied for the company or promoted cigarettes in any way. I subsequently wrote to Philip Morris asking them to provide funding for a campaign to rehabilitate the use of DDT. This letter, which is now on the web, is the source of nearly all Quiggin and Lambert’s suppositions. Yet I never even had the courtesy of a reply. Philip Morris never funded the campaign, and I haven’t spoken with the company in at least seven years.
Roger Bate wrote a letter to Philip Morris on 4 September 1998 requesting them for funds to work on the DDT malaria campaign. The letter is addressed to David Greenberg of Philip Morris.
In Bate’s pitch to Philip Morris, he implored Philip Morris to support his work on malaria on the basis of its “humanitarian, scientific and public policy interest”. He noted that funding this would would enable Bate to build a network of contacts on the African continent among politicians and scientists. According to Bate, these African contacts would be crucial in shaping UN/WHO policy in the malaria debates on the use of DDT as evidenced by the “debate and policy shift on ivory trading”. Bate further buttressed his request to Philip Morris by noting that funding would afford him and several colleagues to write a series of opinion pieces and books on the “disparity between current and correct roles for environmental public health” in “usual first world targets, such as FT [Financial Times] and WSJ’ [Wall Street Journal] in addition to the African media. In his solicitation, Bate also proposed that he work on projects for Philip Morris on an ad hoc basis including the tobacco leviathan’s work “influencing the WHO on their tobacco protocol”. In particular Bate proposed he could work on a paper on the Montreal Protocol on Substances That Deplete the Ozone Layer (a protocol to the Vienna Convention for the Protection of the Ozone Layer) and its relevance to the “proposed tobacco protocol”; this paper would involve three to five days work. In his conclusion, Bate cited his going rate for previous work for Philip Morris Corporate Services (PMCS) Brussels was 800 pounds sterling a day.
According to SourceWatch, an email written by John Roberts on 21 October 1998 to Matthew Winokur and David Bushong of Philip Morris stated:
“I think Bate is a very valuable resource and have strongly recommended that he play some role at UN level. I recall that we paid him up to GBP 10,0000 per month … There is one additional person I would recommend as deserving of consideration too and that is John Bowls. Where Bate’s principal interest Is Malaria, Bowls’s is mental health, I believe them to be complementary resources. Best wishes, John”
Bate approached R.J Reynolds in 1996 for a a grant worth £50,000 to fund a book on environmental risk including chapters on environmental tobacco smoke, pesticides, radiation, metal, science policy and and social science but according to SourceWatch, the grant request was denied.
A PLoS ONE article (May 7, 2008) that Bate wrote with Philip Coticelli, Richard Tren and , Amir Attaran entitled “Antimalarial Drug Quality in the Most Severely Malarious Parts of Africa – A Six Country Study” had a competing interests section which declared that
[i]n the past five years Roger Bate and Amir Attaran received travel grants from pharmaceutical company Novartis, and Amir Attaran received a consulting fee. No funding was received in respect of this research. Amir Attaran also received consulting and/or travel fees from the WHO and World Bank, and is a member of the WHO Global Malaria Programme Technical and Research Advisory Committee. No member of the study team received any funds from a competing interest for the performance of this study.
In a piece published in the Malaria Journal on 25 Feburary 2009 Bate authored with Richard Tren, Kimberly Hess and Amir Attaran on the “Physical and chemical stability of expired fixed dose combination artemether-lumefantrine in uncontrolled tropical conditions”, the competing interests section stated that Roger Bate “received a travel grant within the past four years from Novartis AG”.
From his perch at AEI, Roger Bate has taken aim at substandard counterfeit medicines with pieces in the AEI’s Outlook series (June 2007) “Bad Medicine in the Market” and Foreign Policy (September/October 2008) entitled The Deadly World of Fake Drugs among others. In his AEI Outlook piece, Bate employed the term “pseudo-generic drugs” lamenting,
Although WHO has done much to prevent the spread of fake drugs, it has actually encouraged the use of substandard drugs through the promotion of products it considers to be generics–but which have unverified quality. As documented in a recent paper, this has been a significant problem for HIV drugs. Unfortunately, the Global Fund to Fight AIDS, Tuberculosis and Malaria has exacerbated the problem by not requiring 93 percent of the drugs on its approved antimalarial compliance list to have bioequivalence registration with a competent agency. Most of the drugs purchased are of the approved variety, but sources inform us that nearly 20 percent of total purchases–well over 450 transactions–are for non-approved drugs. European and Indian companies have also exploited loopholes in domestic legislation which allows them to copy drugs for export without undertaking significant quality testing. Belgium and Italy in particular have allowed drugs produced in their countries to compete for Global Fund awards without having them tested.
It is uncertain how damaging substandard, pseudo-generic drugs may be for patient safety. Their use–and hence impact–is set to grow even faster than the market for fake drugs. This is disquieting, since the Global Fund does not see this as a problem. It continues to use funds from the Bill and Melinda Gates Foundation and the G8 countries to purchase such drugs. The Global Fund mistakenly assumes that because the drugs are cheaper, more lives will be saved, which is only true if the copies are as good as the originals. Meanwhile, the Fund continues to show antipathy toward the research-based pharmaceutical industry. Board members voted to increase access to antimalarials of unproven quality to prevent Novartis, the producer of the best drug on the market, from increasing its dominance, even though Novartis sells the drug at lower than cost.
With such a breadth of experience in fighting for causes such as ivory trading, tobacco and raising doubts on climate change, the audience at Wellcome Trust’s Opinion Formers Conference on Counterfeit Medicines: Perspectives and Action no doubt waited with bated breath for Roger’s master performance.