MPs told conflicts of interest put patient safety before profits

The All-Party Parliamentary Group on Pandemic Response and Recovery heard hard-hitting testimony from two experts about conflicts of interest in medicine, scientific research and the need for reform of public health agencies to make them more transparent and accountable.

Kath Sansom, founder of the campaign group Sling the Mesh, told the Group about her ten year battle to raise awareness of the serious harms caused to thousands of women, and men, by surgical mesh. Citing the failures of the Medicines and Healthcare products Regulatory Agency (MHRA), in particular the Yellow Card reporting system, she described an Agency, and a wider industry, in urgent need of reform.

Kath said: “Health scandals start with conflicts of interest, flawed evidence and inaccurate scientific literature and affect every aspect of the process: regulation, safety monitoring, prescribing and patient safety. In one case we saw how a surgeon described a pelvic mesh in a study as the gold standard which did not cause leg pain, but it was later discovered, thanks to a whistleblower, that he had not declared £100,000 he received in funding from the makers. Far too late for many. Such examples are not unique to pelvic mesh, enabled by a culture of secrecy and financial incentives. When exacerbated by a failing yellow card monitoring system that misses critical safety signals, there are terrible life-changing consequences and we see a growing list of medicines and medical devices, which must now include the Covid-19 vaccines, that have caused injury and death.

“I am calling for key reforms that I believe can better protect patients from suffering avoidable harm and fatalities. All were included by Baroness Cumberlege as recommendations in her 2020 report. Conflicts of interest must be transparently declared to ensure the integrity of evidence, research and safe prescribing. Flawed evidence permits the kind of institutional denial often faced by harmed patients. A Sunshine Payments legislation extending to all healthcare professionals, researchers and healthcare charities, together with mandatory Yellow Card reporting of suspected adverse reactions by medical professionals would be a start to improve patient safety and prevent future scandals.”

The Group also heard from Dr Kevin Bardosh, Director and Head of Research at Collateral Global, set up to research and communicate the global impacts of policy responses to the COVID-19 pandemic.

“The message from the pharmaceutical industry, and supported by government agencies, is that they did a good job during the pandemic and the intention, as endorsed by the World Health Organisation, G7 and G20 in the 100 Days Mission, is to do the same again, only faster and by redefining vaccine safety. Billions of dollars are invested in this initiative, which is beset with the same conflicts of interest, flawed evidence and the lack of transparency as we saw throughout the pandemic. It is a big problem that requires legislative, policy and multi-agency reforms. There also need to be changes in how the media approaches public health reporting, as opposed to the current position that asking important questions seems to be labelled as ‘spreading misinformation’. I think we have all seen that governments, health authorities, pharmaceutical companies and the media can not always be relied upon for accurate information.

“Through our research, we have concluded that we need to focus on decentralisation, transparency, accountability and freedom of speech. For example, in a public health agency, research and policy decisions must be kept separate. We also saw how Parliament was almost inactive for two years during the pandemic and that must not be allowed to happen again. The censorship that went on globally was a huge problem and shut down meaningful debate.”

Rt Hon Esther McVey MP, APPG co-chair commented: “It seems clear to me that the enormous amounts of funding at stake and the conflicts of interest that can give rise to, is going to hamper the MHRA from doing their job properly. Take the case of yellow card reporting, supposed to be an early warning system, ready to sound the alarm at the first sign of safety problems with drugs or medical devices. Instead, that system has let patients down, as the APPG has heard from other experts.

“I support calls from the Sling the Mesh campaign to make yellow card reporting mandatory to ensure safety signals are spotted as early as possible and then acted on. Our APPG will continue to question, demand transparency and uphold freedom of speech in pandemic and wider public health policy.”

Co-chair Graham Stringer added: “Conflicts of interest are a considerable problem in academic and scientific research. It is an issue I have become familiar with. There are often deep flaws with published research, going back years, which I think can be linked to financial incentives. Pharmaceutical companies produce some extraordinary products that keep us safe, but they also produce huge profits and wield significant influence and we need to keep that in mind. The terrible harms suffered as a result of the use of surgical pelvic mesh illustrate that all too well.

“There are no easy answers but I agree that payments from industry - to doctors, researchers, academics and charities - should be properly declared. The public should have the ability to look these payments up and gauge the impact. Such openness and transparency would help rebuild trust in healthcare.”

Biographies of the speakers:

Kath Sansom is the founder of campaign group Sling the Mesh, following her own experience being harmed by a TVT mesh medical device. Sling The Mesh provides support and advice for thousands around the globe who have been left in excruciating pain after being fitted with surgical mesh implants used to treat prolapse, incontinence, hernia repair and in some breast reconstructions following mastectomy.

Sling The Mesh was a key advocate in the Cumberlege First Do No Harm report and submitted a 240-page document of evidence of the regulatory failings, gaslighting of patients, lack of data, and what must happen to ensure the pelvic mesh scandal never happens again. Kath represented the mesh community on the APPG for Surgical Mesh and the APPG for First Do No Harm.

Dr Kevin Bardosh is Director and Head of Research at Collateral Global. A medical anthropologist, he has worked in more than 20 countries on a wide variety of infectious disease and health system projects. He has designed and implemented large-scale public health programs focused on sanitation, vector control, vaccination, food safety, and outbreak response. Much of his work prior to 2020 focused on neglected tropical diseases, Ebola, zoonotic diseases like sleeping sickness and rabies, and vector-borne diseases such as dengue and malaria.

He has co-authored more than 50 peer-reviewed scientific papers and numerous book chapters and reports. He is a regular contributor to the British online news outlet Unherd. Kevin previously held academic positions at the University of Washington, University of Edinburgh, and The Emerging Pathogens Institute, University of Florida. Prior to joining Collateral Global, he was also long-term consultant to The Carter Center’s Hispaniola program. He is currently an Evidence Informed Fellow at Kellogg College, University of Oxford.