LET PUBLIC INTEREST DICTATE RESEARCH THRUST

BANFF, Alta. - THE DECISION by Finance Minister Paul Martin in this
year's budget to triple federal spending on health research through
the proposed Canadian Institutes of Health Research was long overdue.

Canada has been a long-time laggard in spending on health
research.

But as Robert Evans, Canada's most respected health economist, warns,
there's a real danger this major infusion of money could be hijacked
by the pharmaceutical industry - with the giant pharmaceutical
multinationals not only setting the research agenda but also hiving
off the results of the research for private profit.

Evans, who was speaking at a conference organized by the Canadian
Institute for Advanced Research, is a University of British Columbia
economist and Manulife-Syd Jackson fellow in the institute's
population health program.

While Evans does not dispute the commercial value for Canada in
developing new pharmaceutical products that improve health and the
quality of life, his big concern is that the public interest, and not
pharmaceutical industry profits, should drive the research decisions
of the proposed Canadian Institutes for Health Research.

The purpose of research is to create knowledge and to spread it as
widely as possible. But as Evans argues, ``commerce is about private
advantage in society,'' which means that companies want to control
knowledge and restrict its dissemination.

``The public interest lies in health research that improves the
over-all health of the population, reduces health disparities among
social classes . . . or increases the efficiency of the system,'' he
says. ``Commercial interest lies in selling products and generating
profits irrespective of their contribution to health.''

Evans is concerned that the pharma-giants will steer the science
agenda by pushing research into areas where they can see large profits.

``The companies prefer to develop drugs for chronic conditions where
demand will be predictable and continuous, hence the relative
under-investment in vaccines. Perhaps more fundamentally, ceding
control of our research agenda to commercial interests and drug
development runs directly contrary to the emerging understanding that
health involves much more than health care.''

Socio-economic status, for example, is a key determinant of
health.

Evans is also concerned about the tendency of the pharma-giants to
limit the dissemination of scientific discoveries that may lead to
patentable and profitable products, and to silence scientific opinion
that may damage the market for their products.

He points to the lengthy effort by Bristol-Myers Squibb to block
publication of a scientific report by the Canadian Co-ordinating
Office for Health Technology Assessment, which said its
cholesterol-lowering drug was no better than others in its class.
While the assessment agency eventually won in court, the effort by the
drug company to block publication was costly and the delay in
publication boosted company profits.

The Nancy Olivieri case at the Hospital for Sick Children is another
example of what's involved when a researcher challenges commercial
paymasters. Olivieri conducted a study on deferiprone for Apotex
Research Inc., but was demoted by the hospital after Apotex complained
about her research, which showed the drug had harmful effects. A
public outcry restored Olivieri's position.

As Evans says, ``large companies have very deep pockets compared to
universities and professors; what to them is a tax-deductible legal
manoeuvre in a huge transnational economy is an expensive and
anxiety-ridden crucible for scientists and universities.''

This means the Canadian Institutes for Health Research should make
sure they are not co-opted by the pharma-giants who will want to use
taxpayer research dollars to boost their own profit potential. The
institutes should let the real health needs of Canadians determine the
research agenda, stand up for the public interest when determining who
benefits from commercialization and promote widespread dissemination
of scientific results.

There is no question that Canadians will benefit from new companies
and jobs as a result of health sciences research. But, as Evans
stresses, commercialization must not be allowed to become the
overriding driving force for the allocation of research dollars. The
public interest, not private interest, must be the determining factor
in spending taxpayer dollars.

The pharmaceutical industry would love to put us on a steady diet of
pills - but this may not make for a healthier population.

David Crane is The Star's economics editor. His column appears in the
Business section Tuesday to Thursday, Saturday and Sunday.