European perspective: Bird Flu–BBC Panoarama / German skeptics / Rumsfeld Tamiflu stock $5 to $25 million

Sat, 5 Nov 2005

As the media continues its senstional coverage of the “Bird Flu pandemic”, healthy skeptics are examining the evidence. Two European examinations–The BBC Panorama will air a program, Lessons from Vietnam, that interviewed healthcare workers and bird flu survivors. Panorama reports what is known about the virus was transmitted and what is known about the casualties. The reporters learned that

“In Vietnam, as in other South East Asian countries, live poultry is a common sight even in the centre of cities. In Hanoi caged birds were for sale in a market, which also sold butchered meat. People buy live animals and bring them home to slaughter them there. Because of the avian flu outbreak, the government has issued numerous directives to try and stop the selling of live birds but some parts of the country have not cracked down on the practice effectively enough.”

“Vietnam is in the process of trying to vaccinate all domestic animals in order to get rid of H5N1. The vaccine they are using comes from China and every bird has to get two shots, the second a month after the first. In Ben Tre farmers are generally happy to have their animals vaccinated to prevent H5N1 coming back. In the past few years when the virus broke out locally their ducks and chickens had to be culled.”

In light of the media and government hysteria about the bird flu, the authors of “Advance the Killer Ducks,” an article in the Novrmber issue of the German Journalists Association, Germany’s most important special interest media magazine, raise basic questions about the scienctific evidence behind H5N1.

“Are the warnings covered [sic] by scientific data? Are there independent studies proving that the H5N1-virus exists? That it is highly pathogenic in animals? And that it can jump to humans and trigger a pandemic? And is there sound proof that other factors (environmental poisons, foreign proteins, etc.) can be excluded as a cause for the illness of the birds?”

“We sent four questions to the German Ministry for consumer protection, and they turned out the following reply:

“You are inquiring about very specific issues to which the German Ministry cannot respond as quickly at the present time as it was necessary for your investigation. We thank you for your understanding" – though we didn’t even mention any deadline or any need to hurry! After we pointed out that we are not in a hurry and that it would just be nice to know when we could expect a reply, the German Ministry for Consumer Protection then only responded in reference to the scientific instances with: “Your questions about the substantiation of the pathogen city and pandemic potential of the H5N1 virus as well as the study confirming this can only be answered by the experts from RKI or FLI.”

The FLI, the authors report, sent four studies “published in an American magazine” claiming that Tamiflu (Oseltamivir) "alleviated" the symptoms.

However, the authors are understandably dissatisfied–they ask, “what power do these studies have to testify if it cannot be guaranteed that they are free from conflicts of interest?”

Perhaps the most informative, evidence-based aspect of the Bird Flu hysteria is borne out by reports about who stands to profit from the Tamiflu vaccine.

Fortune Magazine is the latest to validate earlier reports about Secretary of Defense Donald Rumsfeld’s “growing stake in Tamiflu.” Fortune reports:

“Rumsfeld served as Gilead Research’s chairman from 1997 until he joined the Bush administration in 2001, and he still holds a Gilead stake valued at between $5 million and $25 million, according to federal financial disclosures filed by Rumsfeld.”

Contact: Vera Hassner Sharav
212-595-8974

http://news.bbc.co.uk/go/pr/fr/-/1/hi/programmes/panorama/4400508.stm

Lessons from Vietnam
By Fiona Blair
Assistant Producer, Panorama

VIETNAMESE STREET MARKET

One of the reasons why the Panorama team were so keen to go to Vietnam was so that they could meet the healthcare workers who have had direct experience of treating patients suffering from the H5N1 virus, which is currently endemic in poultry in parts of South East Asia and has proved capable of jumping species and infecting humans as well.

Vietnam has had more human cases of H5N1 than any other country and in Hanoi and Ho Chi Minh the team met doctors and nurses in two infectious disease hospitals. When they visited there were no H5N1 patients in the country and the hospitals were mainly treating patients suffering from diseases like malaria, dengue fever, tuberculosis and HIV.

However, this does not mean that H5N1 has gone away. Flu is seasonal. The majority of cases in Vietnam have occurred in colder weather and the hospitals they visited were gearing up for the possibility that the same would happen this year.

       Facing The Pandemic Sunday 6 November 2005 22:15 GMT, BBC One

In Hanoi the team met one doctor who had actually caught H5N1 himself. This was discovered not because he became severely ill with the flu but because they decided to screen all the medical staff in the department which treated flu patients, in order to gauge the transmissibility of the disease.

The doctor had had a cough for a couple of months, but other than that had not suffered from the virus. He believes that he caught the virus from a patient because, although his family does keep poultry, the birds all tested negative for the virus.

A health worker who catches the flu are likely to be one of the early warnings that the virus is developing into an easily transmittable ‘human’ form. As yet it has only displayed very limited ability to do so, but the more cases there are, the more chances there are for the virus to mutate into a ‘humanised’ form.

THE MEKONG DELTA

In Vietnam, as in other South East Asian countries, live poultry is a common sight even in the centre of cities. In Hanoi caged birds were for sale in a market, which also sold butchered meat. People buy live animals and bring them home to slaughter them there.

Because of the avian flu outbreak, the government has issued numerous directives to try and stop the selling of live birds but some parts of the country have not cracked down on the practice effectively enough.

A Food and Agriculture Organisation (FAO) official, based in Vietnam explained to the team that wet markets can lead to the spread of disease because of the contact between dead and live birds. There is a worry that live birds which are not sold at the end of the day will be brought home and then back to the market the next day, when they could have picked up the virus.

It also worries officials that the birds are transported live to the market, sometimes on the back of motorbikes. The droppings which carry the virus are therefore being spread on tyres and onto roads.

In Ho Chi Minh the situation was different. Markets where months ago you could easily buy live ducks and chickens were selling only butchered meat when the Panorama team visited in October. There is now a rule that all poultry should be slaughtered before it is brought into the city.

From Ho Chi Minh the team travelled South West to the Mekong delta and a province called Ben Tre. Here they travelled to the home of Nguyen Thi Thanh, a 35-year-old widow whose husband, Phan Van Luu, died from H5N1. It was the most recent fatal case of the flu in Vietnam.

Thanh has a six-year-old daughter to support who has just started school. The daughter, Phan Thi Thach Thao is pictured along with Thanh’s mother-in-law who lives with them in this roadside house. Thanh and her husband used to work together to sell a breakfast broth to village residents and people driving through. She continues this work alone now.

She believes her husband was infected by a fighting cock which he butchered. He became ill very quickly afterwards. She tried to nurse him at home but his fever kept getting worse and eventually he had to be brought to hospital. He is buried just down the road from their house.

No one else in the family caught the disease and no other bird in the area was found to be carrying it.

Vietnam is in the process of trying to vaccinate all domestic animals in order to get rid of H5N1. The vaccine they are using comes from China and every bird has to get two shots, the second a month after the first.

In Ben Tre farmers are generally happy to have their animals vaccinated to prevent H5N1 coming back. In the past few years when the virus broke out locally their ducks and chickens had to be culled.

Culling was vastly expensive for the farmer as the government only compensated them for a quarter of the market price of each bird. Animal health workers told us that during culls farmers would sometimes try and hide their flocks so they could keep them.

The FAO supports the vaccination strategy as the only way to prevent the spread of the disease in animals in Vietnam. If you can wipe out or curb the disease in poultry, then the chances of it ever mutating into a human form are greatly reduced.

Reporter Jane Corbin is pictured (right) in front of a statue of Ho Chi Minh, after whom the city formerly called Saigon was renamed in 1975 following the unification of the country. This statue is outside the ‘Peoples Committee Building’ in Vietnam. Vietnam is a communist country and we were accompanied by an official from the ministry of foreign affairs throughout our trip, who helped set up our filming.

Panorama’s “Bird Flu – Facing the Pandemic” is broadcast on Sunday 6 November 2005, at 22:15 GMT, on BBC One and online at bbc.co.uk/panorama where it is also available on demand and in broadband.

Published: 2005/11/04 11:33:30 GMT

© BBC MMV

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journalist (www.journalist.de;English (as well as the original German) version of the text is available on the author’s website under http://www.torstenengelbrecht.com/en/artikel_medien.html.

November 2005 (www.journalist.de)

Advance Of The Killer Ducks

Assuming we believe the media coverage of H5N1, then the world will be afflicted in the near future by a world-wide epidemic caused by a mutation of a bird flu virus with the fascinatingly eerie name H5N1. On which facts are the horror reports based?A short investigation.

ByTorsten Engelbrecht, David Crowe, Jim West

On page 1 of the German weekly newspaper Die Zeit, Germany’s most reputable print media along with Der Spiegel, we read with a shudder: "Death on quiet wings – the bird flu is on the advance.” Furthermore, what is to be understood in the article under “forthcoming attack of the killer ducks” seems as if it is about creating a title for the second part of the Hollywood’s movie shocker “Outbreak", as the paper writes: “H5N1 plays Blitzkrieg”. Der Spiegel, meanwhile, relies on the testimonies of David Nabarro, who was named the UN’s chief coordinator in the fight against the bird flu at the end of September: “A new flu pandemic can break out any moment – and it can kill up to 150 million people.” The Foreign Policy Journal quotes an expert of the US epidemic authority Centers for Disease Control (CDC), who raised the death count up to 360 million. While Reinhard Kurth, director of the Robert-Koch-Institut (RKI), cannot be topped after his interview with the Frankfurter Allgemeine Zeitung (another very reputable newspaper in Germany), saying that "a pandemic threatens potentially all six billion human beings.”

With so much sentiment of apocalypse present in the media, one has to be allowed to question the facts: Are the warnings covered up by scientific data? Are there independent studies proving that the H5N1-virus exists, that it is highly pathogenic in animals, and that it can jump to humans and trigger a pandemic? And is there sound proof that other factors (environmental poisons, foreign proteins, etc.) can be excluded as a cause for the illness of the birds?

The journalists themselves do not have any such proofs at hand. Not only the large number of experts who had a say in the matter hinted at this. An inquiry, sent to several print media, remains without result, but Die Zeit merely says: "All primary sources can be easily found through DIMDI or Pubmed and then can be ordered easily through Subito. Experts from the RKI or the Friedrich-Lˆffler-Institut (FLI) are open to questions from all journalists. And also the relevant CDC and WHO publications are freely accessible.” That is to say that Die Zeit itself does not possess concrete studies. Instead, even Die Zeit – as is usual in science journalism – relies on the statements of medical authorities.

A Time Bomb. And so thinks the media: At least the medical authorities have their statements scientifically substantiated. And thus the German Ministry for Consumer Protection, together with the respective offices from the USA, Canada, or France or the persons responsible at the world health agency WHO, firmly act on the assumption that H5N1 is a “highly pathogenic and highly contagious” virus – "a time bomb waiting to go off”, as Anthony Fauci, director of the US NIAID and grey eminence of American virus science, expresses it.

We sent four questions to the German Ministry for consumer protection, and they turned out the following reply: “You are inquiring about very specific issues to which the German Ministry cannot respond as quickly at the present time as it was necessary for your investigation. We thank you for your understanding" – though we didn’t even mention any deadline or any need to hurry! After we pointed out that we are not in a hurry and that it would just be nice to know when we could expect a reply, the German Ministry for Consumer Protection then only responded in reference to the scientific instances with: “Your questions about the substantiation of the pathogenicity and pandemic potential of the H5N1 virus as well as the study confirming this can only be answered by the experts from RKI or FLI.”

The FLI, which according to the German Ministry for Consumer Protection "possesses virus isolates of H5N1", sent us four studies, which were published in an American professional magazine, as an answer to our questions. These papers discuss pathogenicity or pandemic potential, but they do not go into if other factors like toxins might come into question for the cause of the sickness of the birds. And concerning the request for substantiation of pandemic potential, the FLI conceded: "There is no scientific forecasting method that could support the possibility that an influenza virus can induce a new pandemic at this time."

Pure Material. And not even in regard to the existence and pathogenicity of H5N1 can the studies presented by FLI really deliver substantial facts. If a virus exists that can cause that kind of disease, it must be detectable. In trade language: There must be pure virus material present. But exactly this is not the case in these studies.

But if the existence, the pathogenicity, and the pandemic potential of H5N1 is unproven, and if it cannot be excluded that other factors made the birds sick, then the requirement for a possible conclusion is missing. Die Zeit demands: “It is high time that Germany buys a sufficient amount of medication", but at the same time the newspaper confines: "The antiviral drugs do not prevent the illness, but they alleviate its course.” That is correct in the opinion of established medicine; but in general however it is not even sure that the drugs – a main focus is Tamiflu (Oseltamivir) – "alleviate" the symptoms. In fact, there are studies, which support this view. But what power do these studies have to testify if it cannot be guaranteed that they are free from conflicts of interest?

Illness of Reverence. Often the “Spanish flu" of 1918/19 is, in a way, being brought into play as a reference for an H5N1 panic. Also in this case one is referred to statements of experts and studies, published, for example, in Science. But whoever concludes quickly that the “Spanish flu” was caused by only one virus and that this virus alone can be made responsible for the deaths of 25 to 50 million people, makes it too easy. There are in no case any facts for such a thesis.

In addition, mass mortality occurred at the end of the World War One – at a time when innumerable people were exhausted, malnourished, and stressed after four years of war. Moreover, many drugs at that time contained highly toxic substances like heavy metals, arsenic, formaldehydes, or chloroform, which can cause heavy flu symptoms. And many chemicals intended for military purposes could be found wandering around in the civil sector (agriculture, medicine) without the necessary controls.

The only fact that exists in relation to the bird flu virus, as Reuters reported on July 20th 2005, is that in the course of the H5N1 panic prefacing the worldwide flu precautions, the Tamiflu manufacturer and pharmaceutical giant "Roche reported a big win". More specifically: "Global Tamiflu sales increased in the first six months of 2005 by 363 percent up to 580 mio. Swiss Francs" – also thanks to German tax payer. According to Die Zeit, the German federal state Nordrhein-Westfalen "announced in July that it will store drugs amounting to 30 Mio. ’Ǩ".

Results. But which editorial staff checks to see if the Tamiflu studies are free from conflicts of interest and are de facto meaningful? By searching the Internet you can easily detect if Roche funds Tamiflu (Oseltamivir) studies or not. Key words like "Roche funded pubmed Oseltamivir” result in proud 128 hits.

Nothing unusual: Just recently the UK parliament asserted in a comprehensive investigation that three quarters of all clinical studies published in the leading scientific magazines like Lancet, NEJM, and JAMA are financed by pharmaceutical firms. And even studies of "highest standard" are being deterred. Nevertheless in 2002, for example, the NEJM changed its guidelines so that reviews and editorials are also allowed to be written by experts who take in payments of up to 10,000 dollars per year – although the payments largely also come from companies whose products are mentioned in the articles in question. The fundamental reasoning from NEJM’s in regards to the change in guidelines: One is just plain not in the position anymore to find enough top experts who have no connection to the pharmaceutical industry.

Torsten Engelbrecht works in Hamburg (www.torstenengelbrecht.com)
David Crowe works in Calgary
Jim West works in New York City

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