The National Health Crisis and 'Health Genomics'

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The National Health Crisis and 'Health Genomics'

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Continuing crisis in the National Health Service in Britain has been hitting

the headlines almost daily. The nation desperately needs to invest in

research that can improve the health of its citizens. But research funds are

being swallowed up by 'health genomics', research that could do little else

for people's health than to enable pharmaceutical companies to further drain

the NHS in expensive patented diagnostics, drugs and therapies. Sam Burcher

and Mae-Wan Ho report.

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The crisis in Britain's National Health Service (NHS) has been deepening for

the past decade. The NHS was given 9% more cash in 2001. The annual budget

for 1999-2004 is to rise from £49.3bn to £78.7bn. But sixty percent of the

increase has already been spent with little sign of improvement. The NHS

waiting list rose from an average of 1.045 million during the last Tory

administration to 1.114 million under Labour, a 6% increase. The waiting

list to see a consultant is up 68% from 238 000 to 401 000. The government

is exporting patients abroad for treatment, after forbidding the practice

for years.

Disturbingly, old people are half as likely to receive treatment as the

young, they are more likely to be left to die. Treatment for other groups

are at the mercy of 'postal code' lottery, ie depending on where they happen

to live. Hospital acquired infections are at an all time high of 100 000 per

year, and 5000 die. Casualty waits in the emergency wards exceed 24 hours.

There is mass exodus of nurses from the NHS, already severely understaffed.

The Chancellor was forced to announce another billion for the NHS and hinted

at tax increases to come. That brings a total of 6 billion extra just for

2002, an increase of 7%. But this will be another drop in an ever-expanding

ocean. While the average European country spends 9% of their Gross Domestic

Product on health, Britain will reach 7.6% only by 2004.

Chronic under-funding is compounded by mounting costs of medical equipment

and drugs, rising faster than inflation and yielding record profits for the

pharmaceutical industry. The pharmaceutical's average 18.9%

profit-to-revenue ratio was, by far, the highest of any industry in the

United States (Box 1). Britain's pharmaceutical industry is second only to

the US.

It is not only the lack of funds, but " chaos from top down " , mismanagement

and lack of forward planning.

The lack of forward planning in national health is nowhere more evident than

in the persistent under-investment in research that promotes health instead

of reinforcing illness. Mainstream research has focussed disproportionately

on diagnosing diseases and developing expensive treatments and drugs that

allows the profit-hungry pharmaceutical industry to drain the nation's

health and life blood like a vampire.

Drugs are being regularly overused and abused in industrialised countries

with disastrous effects. Successive studies have documented a rising

epidemic of iatrogenic diseases, ie, diseases caused by medical treatments,

interventions and drugs. By 2000, doctors became the third leading cause of

death in the US killing 250 000 every year, among which are 106 000 from

non-error negative effects of drugs. The latest statistics show that older

people in care are given four times as many prescription drugs in Britain,

and deaths caused by prescription drugs have gone up five fold in the last

ten years (Box 2).

The current massive investment into 'health genomics' and related research

is explicitly aimed at identifying the maximum possible number of expensive

patented gene drugs and treatments. It has contributed almost nothing to the

health of the nation, and is unlikely to (see Genomics for Health?, this

series). On the contrary, it is taking resources away from other approaches

that can deliver genuine health to the poor as well as the rich.

A major pressure on the NHS is an increasingly aged and sickly population.

Two thirds of the NHS resources currently go to caring for the aged, and the

pressure will grow as people live longer. Yet, there is a distinct lack of

research funding into aging. Similarly, despite the growing popularity of

complementary or alternative medicine (CAM), there is almost no support for

research in that area (Box 3).

More important than documenting the clinical efficacy of CAM is to support

research into holistic models of health, and the development of non-invasive

diagnostics and effective treatments based on minimum intervention. The

rising epidemic of iatrogenic diseases is a sign that the reductionist model

that informs conventional western medicine is failing under its own weight

of maximising intervention, side-effects and costs. At the same time, there

is an urgent need to recover and revitalise indigenous herbal medicines and

health systems before they are driven to extinction by the dominant,

market-driven model.

Indeed, our health policy makers may have something to learn from countries

like Cuba that has managed to deliver health at less than one-hundredth of

what it costs us in Britain. Equality in access to primary care and

prevention are some of the key features, not expensive drugs and treatments.

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Box 1

Pharmaceutical profits top the league

The top seven pharmaceutical companies took in more profit by a wide margin

than the top seven auto companies, the top seven oil companies, the top

seven airline companies, and the top seven media companies.

One drug company, Merck, pocketed more in pure profit than all of the

airline companies in the world's 500 largest corporations, and bested the

entertainment and construction industries as well. Most significantly, the

pharmaceutical's average 18.9% profit-to-revenue ratio was, by far, the

highest margin of any industry in the nation.

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Box 2

Drugging us to death

A report released by Liberal Democrat Member of Parliament in December 2001

reveals how older people in care are given four times as many prescription

items as a person living in their home. Anti-psychotic drugs in nursing and

residential homes are vital against schizophrenia and other forms of severe

mental illness in about one in 10 residents. But research both in Britain

and overseas suggests another 2 out of 10 are given the drugs for no medical

reasons. Worse, the side-effects - constipation, dizziness, drowsiness,

fainting - may help lead to misdiagnosis of real health problems, and even

to death.

In the same month, the National Audit Office documented a five-fold increase

in deaths due to prescription drugs over the past ten years, from 250 to

1200.

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Box 3

Investment urgently needed for holistic health and complementary medicine

A report by The House of Lords Select Committee on Science and Technology in

2001 highlighted an urgent need for more research into complementary and

alternative medicine (CAM). Consumers spend £1.6 billion a year on CAM. The

medical establishment calls for more proof that alternative therapies work,

but funding in the UK for research into complementary medicine, notably in

comparison with such funding in the US, is pitiful.

CAM has been growing in popularity throughout the 1990s. By 1997, U.S.

consumers spent more than $27 billion in out-of-pocket expenses on CAM and

made more than 629 million visits to alternative providers, almost double

the 386 million visits to primary care physicians during the same period.

The first major response to the need for more research by the federal

government in US occurred in 1992. Since the, funding into CAM research has

risen from $2 million in the first year to some $50 million in 1999 and $68

million in 2000. This jumped to $89.2 million in 2001.

In Britain, less than 8p out of every £100 of NHS funds for medical research

were spent on complementary medicine. In 1998-99 the Medical Research

Council spent no money on it at all, and in 1999 only 0.05% of the total

research budget of UK medical charities went to this area.

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