De medicalisering van Amerika

In 1997 verlaagde de American Diabetes Association in samenwerking met de WHO, de grens voor de diagnose van te laag bloedsuikergehalte van 140 naar 126 mg/dl. Plotseling waren er wereldwijd 1,7 miljoen diabeten bij, een verhoging met 15%.

In datzelfde jaar werd de grens voor hoge bloeddruk verlaagd van 160/100 naar 140/90. 13,5 miljoen mensen leden van de ene dag op de andere aan hoge bloeddruk, 35% meer dan het jaar ervoor.

De BMI index waarboven men als overgewicht werd aangemerkt werd in 1998 verlaagd van 27 naar 25. 30,5 miljoen mensen (+43%) stapten de volgende dag als patiënt uit hun bed hoewel ze nog even dik waren als de vorige dag toen ze nog als gezond werden aangemerkt.

In deze zelfde tijd liep de financiering van de WHO door de farmaceutische industrie op naar een half miljard dollar per jaar en nam het medicijngebruik met 20% toe.

In twee interessante artikelen wordt aangetoond hoe allerhande organisaties samenspannen om het gebruik van medicijnen te stimuleren en wordt tegen het licht gehouden of dit nu de mens allemaal ECHT helpt, of alleen maar de farmaceuten…

The World Health Organization,WHO, established by the United Nations in 1948 and based in Geneva, built its outstanding reputation on funding research and programs to fight communicable diseases. Today, WHO, with its 192 member nations, continues to coordinate and sponsor international efforts directed at treatment and control of worldwide health problems, such as AIDS, influenza, tuberculosis, malaria and a host of other diseases.

In the 1980’s, however, the organization expanded its attention to noncommunicable disease, although it was limited by a budget frozen at $450 million. Today, the international agency now takes in more than $500 million a year, more than it gets from all its member nations. This money comes primarily from drug companies whose fortunes are intimately connected to its donations to WHO.

Although spokesmen deny WHO is influenced by the pharmaceutical industry, the drug companies’ internal documents give another perspective. According to the Seattle Times Daphne Fresle, a former top official in the WHO office that monitors worldwide pharmaceutical use, resigned in protest in 2002, complaining of the agency’s relationships with drug makers. Unpublished documents of WHO reports first obtained by The Guardian newspaper in 2003 describe “undue influence” on guideline panels dealing with diets and food additives

Another egregious example of drug company influence is the WHO hypertension guideline, virtually a case study in itself. In 1998, the WHO set out to advise doctors worldwide on how to treat high blood pressure. The agency turned for advice to experts at the World Heart Federation. Together, the two groups named Dr. Alberto Zanchetti, a cardiologist and Professor of Medicine at the University of Milan, to examine and update guidelines for hypertension. Zanchetti, a scientific director for a 500 bed hospital doing studies funded by Bayer, AstraZeneca, GlaxoSmithKline and Bristol-Myers Squibb, appointed the other 17 members of the committee. All but one member of the group had close financial ties to drug firms.

According to the Seattle Times this guidelines committee met behind closed doors in Fukuoka, Japan, in October 1998. From the start, according to other members of the group, Drs, Zanchetti, Hansson and Mancia insisted on lower blood-pressure targets and made sweeping statements endorsing the safety of newer drugs.

For decades doctors have accepted a blood pressure of 120/80 as normal. In May 2003, however, American physicians received a shock when they received new advice from the NIH medical panel, the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). The Committee declared systolic pressure as low as 120 could be unsafe, and established a new condition, called “prehypertension,” systolic pressure from 120 to 139, (see previous newsletter) and recommended broader use of hypertension drugs to lower blood pressures. Guidelines were also issued regarding management of blood lipids, including cholesterol, and obesity. Nine of the 11 authors of the guidelines had ties to the drug companies.

Doctors, slavishly following new guidelines from JNC 7 for hypertension began prescribing more expensive, new classes of antihypertensive drugs for ever larger groups of patients. This, despite the publication of a previous study in 2002 from a different group of experts, also funded by the Government, known as ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial). This landmark study of over 44,000 patients, the largest antihypertensive trial ever, concluded that the newer blood-pressure drugs are less safe, usually no more effective and far more expensive than decades-old drugs such as Diuril© “Because of the superiority of thiazide-type diuretics in preventing one or more major forms of cardiovascular disease and their lower cost, they should be the drugs of choice for first-step antihypertensive therapy.”

The result: in 2004, patients and insurance companies spent over $16 billion for antihypertensive drugs, up 20% since 1999. Are the days of getting unbiased information over? As the drug industry welcomed the new treatment guidelines, annual spending on direct-to-consumer advertising for prescription drugs tripled between 1996 and 2000, when it reached nearly $2.5 billion. Despite this increase, such advertising accounts for only 15 percent of the money spent on drug promotion. According to just about everyone except Big Pharma, we are approaching an economic black hole in spending for health care. What to do next?

Typisch dat in deze zelfde tijd van toenemende invloed van de farmaceuten op de politiek, ook de anti-rokenhype opkwam….

Part I: The Numbers Game
Part II: Background Voices

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