CDC Outed as a Corporate Entity

A recent report published in the premier British Medical Journal by Jeanne Lenzer
threatens to reveal the truth about the CDC. The CDC has enormous clout due to governmental ties and its public watchdog responsibilities. It is thought to be free of industry bias, therefore doctors and healthcare workers place complete trust in their research and conclusions. Recommendations are enforced by law. Here is the CDC’s disclaimer on their site:
“The Centers for Disease Control and Prevention (CDC) includes the following disclaimer with its recommendations: “CDC, our planners, and our content experts wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products . . . CDC does not accept commercial support.”

“Despite the agency’s disclaimer, the CDC does receive millions of dollars in industry gifts and funding, both directly and indirectly, and several recent CDC actions and recommendations have raised questions about the science it cites, the clinical guidelines it promotes, and the money it is taking. Notably, the report demonstrates how the agency has been less than honest in its publication of disclaimers in its own studies when stating that “they have no financial interests or other relationships with the manufacturers of commercial products.”-BMJ

CDC director, Tom Frieden responded to the BMJ by saying, “Public-private partnerships allow CDC to do more, faster. The agency’s core values of accountability, respect, and integrity guide the way CDC spends the funds entrusted to it. When possible conflicts of interests arise, we take a hard, close look to ensure that proper policies and guidelines are followed before accepting outside donations.”

The CDC was created in 1946 but the environment changed in 1983 when the CDC was granted permission to accept “gifts” from industry or private parties. In 1992, under Bill Clinton, congress passed legislation that actually encouraged cohesion and relationships between the private industry and the CDC. They did this by creating the non profit CDC Foundation.

“The CDC Foundation raised $52m in fiscal year 2014, of which $12m was from corporations. The CDC itself in fiscal year 2014 received $16m in conditional funding from sources such as corporations, individuals, and philanthropy, including the CDC Foundation. Conditional donations are earmarked for specific projects. For example, in 2012, Genentech earmarked $600 000 in donations to the CDC Foundation for CDC’s efforts to promote expanded testing and treatment of viral hepatitis. Genentech and its parent company, Roche, manufacture test kits and treatments for hepatitis C. Numerous manufacturers give donations to the CDC Foundation. Janssen also contributed $1.5m in 2012-13,1 and in 2011-12 contributors included Merck ($915 149), Genzyme ($762 000), Sanofi-Aventis ($600 000), and Abbott Laboratories ($550 000).”-BMJ

Some interesting studies have come from the CDC recently and are inherently tied to big pharma, which raise questions about ethical standards.

For example, in 2012, the CDC issued guidelines for expanded screening for hepatitis C in certain age groups. The CDC cited new antiviral drugs as part of its rational for the screening but evidence has shown direct ties to manufacturers of the drugs. Keep in mind that these drugs cost up to $100,000 per treatment course and raise questions about industry funding. The CDC, the CDC Foundation and the Viral Hepatitis Action Coalition has collected over 26 million from the industry. Members of the coalition include Abbott Laboratories, AbbVie, Gilead, Janssen, Merck, OraSure Technologies, Quest Diagnostics, and Siemens—each of which produces its own products to test for or treat hepatitis C infection. Conflicts of interest? How is this–“no financial ties?”

“Conflict of interest forms filed by the 34 members of the external working group that wrote and reviewed the new CDC recommendation in 2012 show that nine had financial ties to the manufacturers.”-BMJ

Where is their ethics department?

The CDC told The BMJ that external advisors acted in an “individual capacity” and are not designated as “special government employees.” It said that their financial ties to industry didn’t comprise a conflict of interest as the participants “had no relationships directly related to the task-reviewing evidence as a basis for an HCV testing guideline. The reported financial activities represent activities not directly related to this work but involving commercial and non-commercial entities that could be perceived to influence involvement in the task.”

It is well known that the CDC and the CDC Foundation accepted donations from Roche, (who makes antivirals like Oseltamivir, for the flu) for their Take 3 flu campaign. Not surprisingly, the campaign told the public to take antivirals if contaminated with influenza. After much criticism for this, the CDC published marketing on its website which included a study by Dobson and colleagues which helped promote its agenda. The study was said to be independent however the study was spidered by Roche and all four authors had direct links to Roche, Genentech or Gilead (either sells oseltamivir antivirals to the public or hold the patent for it).

Despite never having proved this claim to the FDA as well as being warned by them to avoid such claims, CDC director, Frieden, still made the off-label claim, publicly stating that it could “save your life.”

What clever marketing as the CDC seems to hold hands behind closed doors with the pharmaceutical industry.

The CDC has also been criticized for its funding and collaboration with the sugar industry which has been accused of causing an epidemic of chronic kidney disease in South American workers. The CDC’s role as stated, “technical assistance and subject matter expertise,” for the studies, with the foundation serving as the “grant administrator overseeing the donor funding and facilitating the research activities.”

Per the BMJ, Researchers think that the epidemic, which has killed over 20 000 mostly young men, is most likely to be caused by “two interdependent factors: the misuse of agrochemicals and the working conditions of the labor force.” The men are exposed to banned and dangerous pesticides, some of which are known to be nephrotoxic, and the working conditions cited include “regular exposure to very hot temperatures and extreme physical effort, lead[ing] to heat stress and dehydration.”

The sugar industry has leaned on epidemiological research into the epidemic as proof that conditions in the fields are not the cause of the men’s deaths; for instance, the manager of Nicaragua’s Committee of Sugar Producers stated, “We are fully convinced that there is no direct relationship between [chronic kidney disease] and the activities conducted in the sugarcane industry.”

Yet over 20k men have died all with one thing in common. Shouldn’t the CDC re evaluate its moral code here? If human suffering is involved then an epidemiologic study should be put on the back burner. Perhaps safety measures should be put into place, rather than participating in studies that observe harm due to genetic markers. The actual root cause should be ameliorated, not studied.

“Industry funding undermines trust and introduces a bias in the presentation of results and treatment recommendations that is deplorable for a government agency. If the allegations of industry funding and influence are true, we will have to look very carefully at recommendations we are following now and those made in the future by the CDC. Industry claims their scientific methodology ensures their studies are unbiased—just as the CDC claims money doesn’t affect their recommendations. Yet multiple studies clearly—and repeatedly—show that who sponsors a study, or issues a guideline, makes a difference.”-Neil Calman, president of the Institute for Family Health in New York.

I would hope that doctors and other healthcare workers who hear of this news are able to think independently and access their own moral Hippocratic oath. The root cause of the problem within the government needs to fixed. This system has been hijacked.