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Academia and Pharma
Industry collaboration
in academics

Dear Sir,

It was unsavory and painful to see headlines, “Academia Industry Collaboration for Research Projects should be acknowledged and promoted” in Pulse International May 15th 2021 issue.

This phrase is used for institutions who train manpower for particular industry. Medical profession is basically for patient care and welfare. The ethical practice is to acknowledge educational grant from the external funding agencies not collaboration. Unfortunately in Pakistan pharmaceutical companies are the only organizations to support Continuing Medical Education and provide support for Medical society activity. I do not entertain any doubt for good intention of universities and institutions for their recent collaborative activities. The main purpose of the industry in to promote their business. Any obligatory relationship will compromise the basic principle of ensuring patient care and welfare. It was sad that our worthy Pakistan Journal of Medical Sciences has signed the collaborative agreement with the pharmaceutical company instead of unrestricted educational grant.

Despite sunshine act pharmaceutical companies are violating ethical principles, in your same issue you have included an article from JAMA on Industry-Sponsored Speaker Programs, where a particular pharmaceutical company distributed hundred million dollar to eighty thousand physician speakers. In 2008 I gave a presentation on Doctors and Health care Industry in Pakistan Islamic Medical Association symposium I started my presentation by quoting from holy Bible,” John 8:7 He who is without sin among you, let him be the first to throw a stone........... The Bible”.

The current pattern of relationships between doctors and the pharmaceutical industry is the outcome of a long-established culture in which gratuities, gifts and the like are both expected and provided. I also disclosed my conflict of interest being supported by pharmaceutical industry for various national, international and industry sponsored symposia. Very Occasionally I received payment for attending.

Over the year there has been deterioration of medical profession. It has now become a business institution on the model of capitalistic countries. Patient is labeled as client and physician patient consult as an encounter. Most reputable organizations have formulated guidelines for Industry-Supported Graduate and Continuing Medical Education and position statement on support for medical society activity.

I am praying; Change this relationship to primacy of interest of the patients above the acquisitive interest of the doctors and unethical promotion of drugs. Let industry be partner of doctors for welfare of patients and education of doctors with no strings attached. Some excerpts from ACP-ASIM Core Principles for External funding and relationships, as approved by the Board of Regents on 15 July 2001. I request your readers to elaborate on the current situation.

 

Prof. Ejaz Ahmed Vohra FRCP
Karachi - Pakistan.

Response from the Chief Editor:

We in our publications i.e. Pulse International and Pakistan Journal of Medical Sciences have always followed honest, transparent and merit based policy. We have never hesitated to name and shame the individuals, institutions, organizations, professional specialty organizations and health officials involved in corrupt practices even at times at a great financial loss. Apart from medical journalism, the subject of Medical Ethics is very close to my heart and I keep on writing on these issues quite frequently. I was founder member of the National Bioethics Committee formed by the Government of Pakistan in 2003 and served there for ten years. I have always tried to the best of my ability to uphold professional ethics.

On a request from Prof.Rashid Jooma the then DG Health, I prepared a comprehensive document on Physicians Interaction with the Pharma Trade and Industry. These NBC Guidelines were discussed in detail by the Healthcare Committee in NBC headed by Prof. Farhat Moazzam and other colleagues for over two years and they gave very useful input. These guidelines were finally approved by the deceased PM&DC and the Federal Health Ministry but alas it has not yet been implemented. It covers all the important issues and if implemented in letter and spirit, it will take care of all these unethical practices highlighted by our friend and well-wisher Prof.Ejaz Ahmad Vohra to a great extent.

No one in the pharmaceutical industry or in the medical profession can point a figure on me and I have never asked for any personal favours though my children had to pay a very heavy price for my sins of upholding professional ethics. Our dear friend Prof. Ejaz Ahmad Vohra is himself a witness as I have been coordinating the CME activities of Pakistan Aspirin Foundation since 1995 as its Secretary and we have never forced any pharma firm to give us any donation or participate in our activities. In the beginning its CME activities were sponsored by Reckitt and Colman and these days it is sponsored by Atco Laboratories. I have never allowed any of these companies to put up a drug banner where we hold our meetings. Not only that we always announce in the inaugural session that we do not patronize any particular company or brand name to which he himself is a witness as former President of Pakistan Aspirin Foundation.

The MOU that we in Pakistan Journal of Medical Sciences have signed with PharmEvo to work together provides that PharmEvo will extend unrestricted educational grant for promoting the art of medical writing, scientific publishing, and professional capacity building of healthcare professionals through workshops, online sessions so that they can publish their research work in standard peer reviewed journals. PharmEvo Research Forum will offer research grants with emphasis on helping the young researchers, residents and faculty members. PharmEvo will have no role at all in the decision making of who will get these research grants as it will be purely decided on merit by the Members of the Advisory Board of PharmEvo Research Forum. We are prepared to collaborate with any pharma company, organization for this cause without any strings attached. I am extremely grateful to PharmEvo management for their confidence and trust in me to lead this unique initiative. I am also highly obliged to eminent medical personalities who have joined PharmEvo Research Forum on my invitation and assure my friends in the medical profession in general and members of the Advisory Board of this initiative in particular that we will always uphold professional ethics. If at any time I have a feeling that we have to compromise on this, I will not hesitate to say goodbye. PharmEvo, I wish to restate once again has no decision making role in this nor will they be allowed to influence our decisions.

I also take this opportunity to invite all kind hearted, conscious, God fearing members of the medical profession to join hands with us to initiate a campaign against the unethical healthcare professionals, office bearers of professional specialty organizations, other doctors bodies who indulge in coercion, threats and blackmail the pharmaceutical trade and industry asking for millions of rupees donations every year on different pretexts including organizing medical conferences most of which usually turnout to be social get together of doctors with their family members and there is very little scientific contents. Of course there are some exceptions. A vast majority of the participants can be seen standing in the corridors or gossiping at the stalls in the Pharma Exhibition asking them for personal favours. Attendance in most of the scientific sessions at these conferences is very disappointing. Some doctors in fact use these conferences to make quick money through different ways including selling the hotel rooms at exorbitant rates where these conferences are organized. We have highlighted all these issues time and again. It is these unethical healthcare professionals who have brought a bad name to this profession which was once known as Noble but has now become a business. Eminent physicians like Prof. Kh .Saadiq Hussain has at numerous occasions highlighted the fact that Commercialization and Corruption which he calls “CC Virus” has infected the medical profession which is indeed sad. Millions and billions of rupees are extracted from the industry every year which eventually pass it on to the poor patients in the shape of increased cost of drugs and services. Elections in these professional societies are keenly contested not because they are eager to promote academics or help their colleagues but those who get elected, it enhances their nuisance value to blackmail the pharma industry to extract personal favours. However, at the same time, there are a few who are keen to promote academics and CME but their number is very few. In fact these are the issues that medical profession has lost its respect in the society. We have always advocated the concept of self-monitoring and self-accountability. Similarly those in the pharmaceutical industry who indulge in unethical practices, bribe the medical profession just to increase their sales also need to be taken to task. SAJ