Wednesday, November 24, 2004

More info

I heard while in the car. Like most human interactions, the issues are complex, and this points a few more of them out.
From The Tavis Smiley Show, Dr. Ian Smith, from Wed. Nov. 17th. Dr. Ian Smith, Race Specific Drugs

Of particular note is the fact that this FDA approval request will extend the patent - and therefore the high price -- on this drug. Imagine that, a pharmaceutical company finding a way to increase profits on a drug that already exists. A secondary issue that the good Mr. Jennings missed.

Without the FDA approval, Doctors could prescribe it off-lable. But once the patent runs out it becomes a cheaper co-pay, or lower cost generic.

This is an interesting in depth examination: How a Drug becomes Ethnic:

Monday, November 08, 2004

Peter Jennings is a Big Weenie

Tonight, because I was too lazy to get up and change the channel to West Wing, the administration we should have, I found myself wallowing in the murky world of the ABC Evening News. I never watch mainstream news on television, for reasons that will become obvious in a moment, preferring to read progressive papers and magazines, or watch Democracy Now.

So suddenly Peter Jennings interrupts my hard-drive-utility-upgrading by asking if researchers were unfairly using "race" to get a drug through the FDA process. "...race-consciousness offered a faster way through the FDA's regulatory maze." It seems that African Americans in particular respond to something this new drug does for those who have had heart failure. This is wonderful news for people who suffer from heart disease at a high rate.

Unfortunately, I didn't really get a good sense of what the drug does from this bit of news, because that wasn't actually what the piece was about. This piece of journalistic integrity was about calling it a "race-based therapy," and how it is wrong to target a group of people like this. It seems they fear that it might make us think that there were genetic differences between people and isn't that racist. The implication was that this single study could serve to reinvigorate a particular kind of racism that pops up in certain ultra-conservative circles every decade or so and explicitly exists in neo-nazi and white supremacist circles -- the idea that there is a definitive genetic or biological category of African American or Black folks.

Of course, that wasn't really what they meant, what they meant was "whine whine whi are we spending money on something that won't help mee ee ee." whine whine whimper.

Plus and besides which, the concept of biological racism has nothing to do with actual science, and although it comes and goes in the conservative intellegencia's publishing cycle, it's main stream America still holds on tightly to notions of white supremacy. Afterall, it's foundational to our nation.

Plus and besides which also, no other group of people have ever been studied to the detriment of others (assuming "detriment" is even the case here).

Oh wait, they have.

White men have been used to represent "average people" in medical studies for years. Not only have we extrapolated the impact of myriad of drugs from white men to white women, and men and women of color, we have also consciously limited research to white men.
A quick Google search found this on the second page of results, "Now a team of researchers including members from Washington University School of Medicine has evidence that drug developers might have better luck focusing their leptin-related efforts on white men." (http://www.biostat.wustl.edu/overview/Leptin.html ) They then did so. Study white men that is. Of course, that didn't show up on the ABC Evening News, although I bet it could have, being on the second page of a google search and all.

The report didn't examine or even reference the veneer of racism that colors the lenses of doctors, the vast majority of whom are white, who don't percieve illness or treatment the same way in people of color as in white men. (Another quickly Googled search found a study in the New England Journal of Medicine that indicated "that the odds that Blacks and women presenting with chest pain would be referred for cardiac catheterization were 60 percent of those of whites and men. The disparity was most dramatic for Black women, whose odds of being referred for catheterization were 40 percent of those of white men"
http://www.pww.org/past-weeks-1999/Medical%20treatment.htm )


So this ABC news piece wasn't about how fantastic it is that a group of suffering people have had some attention by the medical and pharmaceutical establishment. It wasn't so much about the science, which was articulated in a peer-reviewed article in the New England Journal of Medicine published on the web today, and in print on the 11th,(
http://content.nejm.org/cgi/content/abstract/NEJMoa042934 ) as it was about piggybacking on a perspective piece in the same journal about "Race-Based Therapeutics." http://content.nejm.org/cgi/content/abstract/NEJMp048271
That opinion piece stated, "Proponents of exploiting these biologic differences to create new race-based therapies often say this appoach treats race as a placeholder -- a crude marker for genetic variations, not yet discovered that lead to differences in responsiveness to drugs." This simple statement is likely true. The socially constructed category of race is a crude marker for anything. The social category of race is a lousy, socially created gobbledeegook. It is used to pre-judge and limit and oppress. It's been used in recent history to produce genocidal science like the Tuskegee Syphilis Experiment. It is also a reality that race is used all the time in determining what subjects to use for research. Every time research is done on white men, it is race-based research.

But it's wonderful that someone has connected the existance of certain genetic markers in some individuals who fit into that arguably crude category of African Americans, and the possible receptiveness of those genes to this particular medicine is fabulous!

To minimize the science because saying "race as a placeholder" is so much more sexy for television is unacceptable journalism. Sure, they found a couple of talking heads to blurb a sentence or two in disagreement with that idea, those pink elephants of the invisible negative*, so what will people remember? They'll remember that studying black folks is racist and bad for America, and bad drugs will be wisked through the FDA without proper study.

If you're not with me yet, imagine this scenario:

"Proponents of exploiting these biologic differences to create new gender-based therapies often say this appoach treats gender and sex as a placeholder -- a crude marker for genetic variations, not yet discovered that lead to differences in responsiveness to drugs."

..."Sex-consciousness offered a faster way through the FDA's regulatory maze."

Can you spell V - I - A - G - R - A ?

I mean, really, popping Viagra has been a boon to women and children all over the United States. Golly, it is a good thing that they didn't study it for a particular group of people or rush it through the FDA.

Oh wait, they did.


So one minute I'm tweaking my computer, and the next thing I know Cranky Cindy is starting a blog. I should never watch mainstream news.

Keep an eye out for Happy Cindy, my other blog. I haven't written anything there yet, but it could happen...

* I frequently mock self help books, except when I find them helpful myself. I must admit to finding this one helpful so far. Drop the Pink Elephant: 15 Ways to Say What You Mean...and Mean What You Say, http://www.wiley.ca/WileyCDA/WileyTitle/productCd-1841126373.html