創建者 
Ghost in the Machine: How Big Pharma Controls Our Perception of Drug Safety and Effectiveness
製造業中的魔鬼：大型製藥公司如何控制我們對西藥的安全性和有效性的認知
By Dr. Joseph Mercola
Joseph Mercola博士撰文
Drug Safety and Media Shaped by Big Pharma
由製藥公司控制的西藥安全性和媒體
In this article, we look at the “Ghost in the Machine” – the murderous forces in our health care system that harm patients instead of help them. This article will expose the deceptions that occur in almost all facets of health care today for no reason other than money. It will also expose the identities of the ghost’s “puppet masters” who perpetrate health misinformation and unethical drug marketing for profit, whether it’s Big Pharma or its helpers in academia, government and nongovernment agencies.
這篇文章中，我們討論“製造業中的魔鬼” — 存在於我們健康系統的凶殘力量，它摧毀病人的身體而非改善。這篇文章將會揭露存在於現代醫療系統中的各個面向的欺騙，它目的就是金錢。這篇文章也會揭露這些魔鬼“傀儡大師”的身份，他們利用錯誤的健康訊息和不道德的市場營銷進行牟利，不論是大型製藥公司還是它們在學術界、政府組織或非政府組織的幫手，無一例外。
It should surprise no one that, in most cases, promotion of dangerous drugs and misleading health information is a direct result of conflicts of interest. For example, with the exception of CBS, every major U.S. media outlet keeps at least one person from the drug industry on its board, which clearly explains the dearth of reporting on Pharma dangers and corruption.
這並不讓人吃驚，在大多數情況下，對危險的藥品和錯誤的健康訊息進行推廣是利益沖突的直接後果。比如，除了美國哥倫比亞廣播公司外，每一家美國主流媒體的董事會成員至少有一人來自製藥行業，這很明確地解釋了製藥公司危險和腐敗新聞匱乏現象的原因。
The drug industry also spends billions a year on TV ads — revenue from just nine prescription drugs was worth $100 million in one year — which also stifles negative news stories about Pharma.
這些製藥公司每年也會在電視廣告上花費數十億美元 — 僅九種處方藥一年就帶來一億美金的收入 — 這也會阻止製藥公司負面新聞的傳播。
Even so-called “public” media like PBS and NPR have accepted money from GlaxoSmithKline (GSK) and UnitedHealthcare. Similar conflicts of interest exist at medical journals, universities, medical associations, advocacy groups and government agencies, including those that are supposed to regulate the drug industry. The result is the Ghost in the Machine that we live with today — deceived patients taking expensive, often dangerous drugs and soaring health costs.
即便是那些被稱作“公共”媒體的，比如美國公共電視網和美國國家公共廣播電臺，也拿了葛蘭素史克公司（GSK）和聯合健康保險公司的錢。類似的利益沖突存在於醫藥雜誌、大學、醫學研究協會、遊說團體以及政府機構中，包括那些理應對製藥行業進行監管的機構。導致的結果就是製造業中的魔鬼來到我們生活中 — 欺騙病人們吃那些昂貴並且危險的藥品，使治療成本劇增。
Revolving Doors Between Pharma and Government
製藥公司和政府之間的旋轉門
One of the most damaging conflicts of interest is the revolving door between industry and government. It allows the worst forms of cronyism, quid pro quo arrangements and approval of dangerous drugs. Both Robert Califf, former Food and Drug Administration (FDA) Commissioner, and Scott Gottlieb, the current FDA Commissioner, are shining examples of conflicts of interest.
危害性最大的利益沖突中之一就是行業和政府之間的旋轉門。它允許任人唯親的利益交換方式以及危險藥品的批准。前食藥局（FDA）委員長Robert Califf和現食藥局委員長Scott Gottlieb就是這種利益沖突的典型案例。
Before his appointment by President Obama in 2015, Califf received money from 23 drug companies including giants like Johnson & Johnson, Lilly, Merck, Schering-Plough and GSK, according to a disclosure statement on the website of Duke Clinical Research Institute. He even praised the involvement of Pharma in government affairs.
在2015年他被歐巴馬總統任命以來，Califf從23家製藥公司收到錢，這些公司包括製藥巨頭公司，比如嬌生、禮來製藥、默克、先靈葆雅和葛蘭素史克公司。這些訊息來自杜克臨床研究協會網站的曝光聲明。他甚至鼓勵讓製藥公司參與到政府事務中來。
Gottlieb was named FDA commissioner this year by President Trump, despite his high-profile work as a Pharma consultant and stock trader. While serving as FDA deputy commissioner for medical and scientific affairs before becoming commissioner, Gottlieb had to recuse himself from work related to nine drug companies, including Roche, Sanofi-Aventis, Eli Lilly and Proctor & Gamble, because of his financial links.
Gottlieb在今年被川普總統任命為FDA委員長，雖然他是一名高調的醫藥顧問和股票交易員。在成為委員長之前，他擔任著FDA副委員長，處理醫藥和科學事務。而且由於他的財務關聯情況，那時Gottlieb不得不與九家製藥公司撇清關係，這些公司包括羅氏製藥、賽諾菲安萬特公司、禮來公司以及寶僑公司。
Another example of the “revolving door” between government and industry is former director of the Centers for Disease Control and Prevention (CDC) Julie Gerberding, who left the agency in 2009 where she had overseen vaccine decisions to head Merck’s vaccines division. In 2015, she sold 38,368 shares of her Merck stock valued at $2 million. Thomas Insel, former director of the National Institute of Mental Health (NIMH) also used the revolving door, leaving government for industry in 2015.
另外一個政府和行業之間的“旋轉門”案例是關於美國前任疾病控制和預防中心（CDC）主任Julie Gerberding的。她於2009年離開了CDC，那時她負責監督默克公司的疫苗決定。2015年，她賣出了默克公司38,368份的股票份額，價值二百萬美金。Thomas Insel，前國家心理健康研究所（NIMH）主任，也利用了旋轉門，2015年他從政府部門離開到製藥行業中任職。
And who can forget former Texas governor Rick Perry, who mandated that all girls in Texas be vaccinated with Gardasil, an HPV vaccine made by Merck, after his former chief of staff became a Merck lobbyist. Stipends from industry to government also skew drug messages. Gilead Sciences, an aggressive marketer of hepatitis C drugs, likely earned the right to add the CDC’s name to its ads because of its gifts to the CDC Foundation.
誰又能忘記前德克薩斯州官員Rick Perry呢？在他的前參謀長成為默克公司的說客後，他強制要求德州的女孩注射默克公司研發的子宮頸癌疫苗。行業對政府的補貼也會扭曲藥品的訊息。Gilead Sciences，一個積極營銷丙型肝炎藥品的公司，把CDC的名字加入到它的廣告中，這很可能是由於它給了CDC基金會禮物。
Pharma/Academia Partnerships Are Lucrative Thanks to Taxpayers
多虧納稅人，製藥行業/學術界合作關係的獲利是豐厚的
Academia was once a source of unbiased drug and health information, untainted by Big Pharma and Big Pharma’s money. Not anymore. Universities now have a “renewed interest in partnering with pharmaceutical companies and are investing resources to ensure successful collaborations,” writes Pharma Voice. This is how Dr. Terrence Norchi, president and CEO of Arch Therapeutics, explains the profitable new partnerships.
學術界曾經是公正的藥物和健康訊息的來源，不受大製藥公司和他們金錢的扭曲。然而現在不再如此。大學現在有了“與製藥公司合作的新興趣，同時投入資源以保證合作的成功”，Pharma Voice報導。這是Terrence Norchi博士，Arch Therapeutics公司的主席和首席執行官解釋的共同獲利的新型合作方式。
“For the past 15 years, the pipelines of the big [drug]companies have been drying up … At the same time, there is a tremendous amount of pressure on academic institutions in this country and abroad. To survive, many universities will have to find creative ways to make themselves more relevant. There are opportunities to mutually solve these challenges between academia and industry.”
“在過去15年中，大型製藥公司的管道越發枯竭…同時，國內外的學術組織也面臨著很大的壓力。為了生存，很多高校不得不去尋找讓他們變得更有價值的創造性的解決方法。在學術界和工業界存在著可以共同解決這些挑戰的機遇。”
Such Pharma/academia partnerships date back to the Bayh-Dole Act of 1980, which allowed universities to “patent discoveries that stem from government-funded research and then license them exclusively to companies in return for royalties,” wrote Marcia Angell, former editor-in-chief of the New England Journal of Medicine and Harvard lecturer, in the Boston Review.
這樣的製藥/學術合作方式可以追溯到1980年的杜拜法案，它允許高校“對來自政府資助研究的結果進行專利化，並僅向授權公司開放以換取版稅，”Marcia Angell在波士頓評論中這麼描述，她是前新英格蘭醫學雜誌的總編輯和哈佛講師。
Similar laws also allow industry to co-opt and profit from NIH-funded research, which is also taxpayer supported, says Angell. Before the Bayh-Dole Act, government-funded discoveries were in the public domain — as they should be. Between 2000 and 2011 more than half of all new drugs approved in the United States were developed by collaborations with other entities such as universities.
類似的法律也允許工業界與NIH贊助的研究合作，並從中獲利。Angell說NIH研究是納稅人的錢支持的項目。在杜拜法案之前，政府資助的研究都是在公共領域 — 這本應如此。在2000和2011年之間，美國批准的所有新藥中超過半數是與高校這樣的機構合作研發的。
Increasingly, academia does not even attempt to hide its dual allegiances. Susan Desmond-Hellmann was invited to apply to be Chancellor of the University of California, San Francisco (UCSF), which includes a medical school, while serving as president of product development at Genentech. She remained at UCSF until 2014 after which she joined the Gates Foundation, which has its own serious conflicts of interest that you will read about in the Ghost in the Machine series.
學術界也越來越不會掩蓋它的雙重忠誠。Susan Desmond-Hellmann被邀請擔任加州大學舊金山分校（UCSF）的校長，該校設有一所醫學院，同時她還擔任基因泰克公司的研發主席。她在UCSF一直任職到2014年，然後加入了蓋茲基金會，這個基金會有它自己嚴重的利益沖突，你可以在《製造業中的魔鬼系列》閱讀到這些內容。
Drug Trials Now Riddled With Conflicts of Interest
藥品試驗裡充斥著利益沖突
The faster Pharma can get a drug to market, the more money it makes — even if safety problems emerge later. Legal settlements from injury suits are simply built into the cost of the product launch and marketing. Gag orders with injured parties keep the dangerous side effects from reaching the public and dampening sales.
製藥公司讓藥品越快地進入市場，就能賺更多的錢 — 即便以後會出現安全問題。那些受害者的法律訴訟費用在產品投放和市場階段就已經考慮在內。對受害方的言論壓制指示使藥品危險的負面影響不會讓大眾知道從而損害銷售。
There are many examples of drugs rushed to market before they were proven safe, such as the painkiller Vioxx , estimated to have killed over 60,000 people, and the new, expensive hepatitis C drugs that were marketed before their ability to reactivate pre-existing hepatitis B was known.
有很多未經證實安全性就在市場上著急銷售的藥品案例，比如止痛藥萬絡(偉克適)，估計它已經殺死超過六萬的人口。還有新的昂貴的治療C型肝炎的藥品，在它是否可激活現存B型肝炎病毒的能力被證實前也進入了市場。
One way in which dangerous drugs are now rushed to market is the fast work of contract research organizations (CROs) to which Pharma increasingly outsources drug trials. CROs conduct drug trial design, recruitment, enrollment and consent of subjects, as well as preparation of the final drug submission package to the FDA in turnkey operations. If and when the new drug is approved, they will also take care of marketing and branding.
目前，危險藥品被送往市場的最快的方式是合同研究組織（CROs），通過這種方式製藥公司把藥品試驗外包。CROs進行藥品試驗設計、招聘注冊和徵求受試者同意，以及提交藥品資料到FDA所需準備的一站式方案，他們也負責營銷和品牌策劃。
Another compromise in drug safety comes from the changing face of institutional review boards (IRBs), groups of medical professionals, laypeople and ethicists who monitor human safety during drug trials. Once linked to academic settings or hospital, IRBs have become for-profit ventures paid by the companies who do the research. When the financial livelihoods of members of IRBs depend on the company that hires them, that is a huge conflict of interest.
藥品安全的另一個威脅來自那些監督藥品在試驗中人類安全的機構審查委員會（IRBs）、專業醫療團體、外行人和倫理家的多變性。一旦與學術或者醫院產生關聯，IRBs就變成了由做研究的公司支付的盈利性組織。當IRBs成員的生計依賴於雇傭他們的公司時，就產生了巨大的利益沖突。
One example of the changing face of IRBs was revealed in a sting operation devised by Congress and the General Accountability Office. When they asked a Colorado review board to oversee a study of Adhesiabloc, a product designed to reduce scar tissue after surgery, it agreed to the work though neither the drug, developer nor lead researcher even existed.
IRBs多變的一個例子在國會和美國審計總署制定的一項突擊圈套中有很好的體現。當他們要求科羅拉多審查委員會監督Adhesiabloc的研究，這是一種減少術後疤痕的藥物，該委員在沒有藥物、開發人員以及首席研究員的情況下同意了這項工作。
How can human subjects be protected in such eagerness to acquire new work? To cut costs, Pharma also increasingly runs trials in poor countries where informed consent is not easily explained and subjects sometimes think they are receiving real medical care.
在如此渴望獲得新工作的條件下，如何能保護到受試者？為了削減費用，製藥公司也在貧窮國家進行更多的實驗。在貧窮國家不容易解釋知情同意，並且受試者有時會認為他們正在接受真正的醫療服務。
Conflicts of Interest Abound in Research
研究工作中的利益衝突比比皆是
In the Ghost in the Machine series, we will review conflicts of interest in publishing that skews the perception of a drug’s safety in the public’s eyes as well as among medical professionals. Research and scientific papers boosting the benefits of new drugs and downplaying their risks often appears in medical journals, ghostwritten by the drug industry with a medical professional’s name attached for credibility.
在《製造業中的魔鬼系列》中，我們審視了出版業中的利益沖突，出版業扭曲了大眾以及醫藥專家對藥品安全性的認知。學術論文鼓吹新藥的優點，對它們存在的風險輕描淡寫。為了增加論文的可信度，也常把醫藥專家的名字掛到由製藥行業的人代寫的文章中去。
For example, the popularity of the withdrawn Vioxx, the birth defect-linked Paxil, Neurontin, and the cancer and heart disease-linked hormone replacement therapy drugs all stemmed from papers ghostwritten by industry. In 2016, the National Press Club in Washington held a half-day conference for reporters, scientists and business executives to discuss how well the news covered science called “Lost in Translation: Is Science Explained Fairly in the Media?”
比如，那些受歡迎的但已從市場撤回的止痛藥萬絡(偉克適)，與出生缺陷相關聯的帕羅西汀(抗抑鬱藥)、加巴噴丁(鎮頑癲)，以及與癌症和心髒疾病相關聯的荷爾蒙替代治療藥物，都來自製藥業的寫手發表的文章。2016年，國家新聞俱樂部為記者、科學家和商界高管在華盛頓舉辦了一場半天的會議，討論新聞界是如何報導科學的，名為“在轉譯中的迷失：媒體是在公正地傳播科學嗎？”
But it was clear that the conference was biased as it grew from a partnership between Scientific American magazine, Johnson & Johnson and GMO Answers, a group funded by members of The Council for Biotechnology Information, which includes Bayer, Dow AgroSciences, DuPont, Syngenta and Monsanto. The event represented a popular new trend, wrote Paul Raeburn:
明確的是，會議內容是存在偏見的，因為會議建立在美國科學雜誌、強生(嬌生)公司和轉基因答案（GMO Answers）的合作關係上。基因改造答案是由生物科技訊息理事會成員資助建立的，包括拜耳、陶氏益農、杜邦、先正達和孟山都公司。這次會議代表了一種新的流行趨勢，Paul Raeburn寫道：
“The conference was an example of what is now a widespread and growing practice in the publishing industry: the use of ‘branded partnerships’ to extended publishers’ reach and boost their income. While these arrangements might generate revenue, they also raise important questions about journalistic credibility.
“這次會議是出版業中廣泛存在並日漸流行做法的一個實例：使用“品牌合作”來擴大出版商的影響力和增加他們的收入。雖然這樣的安排可能增加營業額，但是會對新聞的可信度產生嚴重影響。
After all, how can news outlets like Scientific American, a respected — even revered — source of science news, maintain the appearance of impartiality while accepting checks from companies they cover? And should respected journalists lend their names and reputations to such conferences by participating on the panels?”
畢竟，像科學人這樣的新聞媒體，一個受人尊重 — 甚至備受尊崇 — 的科學新聞的來源，當接受被報導公司支票的時候又如何保持他們表面上的公正的態度？透過加入專家小組，受尊敬的新聞記者應該把他們的名字和聲譽來交付給這樣的會議嗎？”
Examples of branded and ghostwritten content invading publishing are not hard to find. Recently, ProPublica and Consumer Reports reported that hepatitis C drugmaker AbbVie funded a special issue of the American Journal of Managed Care on hepatitis C research, using a Stanford professor as guest editor-in-chief.
被品牌化和代筆的內容進入出版業的例子並不難發現。最近，非盈利新聞集團ProPublica和《消費者報告》報導了C型肝炎製藥商亞培公司旗下的艾伯維生物製藥資助了一個特別的研究，是美國管理保健雜誌對C型肝炎的研究，斯坦福大學的教授是該期刊的客座主編。
Even books are funded by Pharma. A 1999 textbook written to help primary care doctors diagnose psychiatric conditions was funded entirely by GlaxoSmithKline (GSK), which makes pills for psychiatric conditions. Its authors were two prominent psychiatrists, one of whom was on GSK’s speaker’s bureau; the other was investigated by Congress for undeclared GSK income.
還有很多書是被製藥公司資助的。一本寫於1999年的旨在幫助初級保健醫生診斷精神疾病的教科書是完全由葛蘭素史克（GSK）資助的，它為這些精神疾病提供了治療藥物。這本書的作者是兩位著名的精神病學家，其中一位在GSK的演講辦公室任職，另一位曾因為未申報在GSK的收入而接受國會調查。
Nonprofit Organizations Push the Pharma Agenda
非營利組織推進了製藥公司的日程安排
Recently I wrote that philanthropist Bill Gates was leading the pack as one of the most destructive “do-gooders” on the planet, and that his views on addressing poverty and disease in poor countries were shortsighted and misinformed. Why? Because the Bill & Melinda Gates Foundation (B&MGF) is one of the world’s foremost promoters of mass-vaccination efforts, which are a major part of the Pharma agenda.
最近我寫了慈善家比爾蓋茲領先成為了地球上最具有破壞性的“行善之人”之一，他的關於在貧窮國家解決貧困和治療疾病觀點是短視的，並且具有誤導性。這是為何？因為比爾和梅琳達蓋茲基金會（B&MGF）是世界上最重要的進行大規模疫苗接種的推手，這是製藥公司議程的一個主要部分。
Two of the B&MGF’s research heads were hired right out of Pharma — one from GlaxoSmithKline, with whom the B&MGF had a long-standing collaboration, and the other from Novartis. In 2002, B&MGF began buying billions in drug stocks and subsequently added huge amounts of Monsanto stock as well. Not surprisingly, the foundation is also a leading international promoter of GMO crops and technology.
兩名B&MGF的研究首席是直接雇傭於製藥公司 — 一名來自葛蘭素史克公司，他與蓋茲基金會有長久合作關係；另一名來自諾華製藥。2002年，B&MGF開始以數億美元買入醫藥股份，隨後又買入大量孟山都股票。不足為奇的是，蓋茲基金會也是基因改造農作物和技術的主要國際推動者。
“The Bill & Melinda Gates ‘Foundation’ is essentially a huge tax-avoidance scheme for enormously-wealthy capitalists who have made billions from exploiting the world’s people,” writes Ruben Rosenberg Colorni. “The foundation invests, tax free, money from Gates and the ‘donations’ from others, in the very companies in which Gates owns millions in stocks, thus guaranteeing returns through both sales as well as intellectual-property rights.”
“對於那些透過剝削世界人民賺取億萬財富的資本家來講，蓋茲基金會本質上是一個巨大的避稅方案。” Ruben Rosenberg Colorni描述道。“基金會投資蓋茲家族免稅的錢以及來自其他公司的‘捐贈’，在這些公司中，蓋茲家族擁有價值百萬股票，這樣就保證了銷售和知識產權的回報。”
In a 2011 Forbes interview, Bill Gates admitted the new profitability of vaccines. “Ten or 15 years ago, nobody in the drug business would have held up vaccines as profit centers,” he said, conceding that “vaccines are so tough, particularly because of liability issues.” But now, “people are making money in the vaccine business,” he noted. His statements characterize the Ghost in the Machine well.
在2011年福布斯訪談節目中，比爾蓋茲承認了疫苗新的獲利能力。“十年或十五年前，沒有製藥企業會把疫苗當做利潤中心。”他承認“疫苗由於責任問題而非常艱難。”但是現在，“疫苗業務正給人們帶來大量金錢”他強調到。他的言論很好地描繪了製造業中的魔鬼特徵。
There Is a Final Irony to the Ghost in the Machine
製造業中的魔鬼存在最終的諷刺
While mainstream medicine, which is dominated and influenced by Pharma, assails natural, nonprescription treatments that are less expensive and usually safer as worthless and untrustworthy, many Pharma companies are trying to enter the vitamin and supplement industry themselves. It is easy to see why. Supplements and natural products often treat or prevent the conditions on which Pharma makes most of its money.
當受製藥公司主導和影響的主流藥品攻擊那些既便宜且安全性高的但被認為無價值和不可信的天然非處方療法的時候，製藥公司它們自己也正在進入維他命和膳食補充劑的行業。原因很明顯，膳食補充劑和天然產品經常用來治療或預防製藥公司用來賺錢的大部分症狀。
They are used by the most desirable customers to Pharma — patients who say they have “excellent” or “very good” health and have high discretionary income. Such patients often prefer natural treatments like probiotic-rich fermented food for heartburn instead of Pharma’s dangerous proton pump inhibitors. They are not deceived by the Ghost in the Machine.
它們被製藥公司最理想的客戶使用 — 那些宣稱擁有“優秀”或“非常好”的身體狀況並且擁有較高的可支配收入的人們。這些病人通常更喜歡自然治療，比如食用益生菌豐富的發酵食物來減緩胃部灼燒感，而不是食用製藥公司危險的質子泵抑制劑。他們不會被製造業中的魔鬼所欺騙。
原文:
翻譯:Yaxi
校正:Uma
本文出處網址: https://www.golden-ages.org/2018/04/12/20180412-01/
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