The annual conference of the Israel Association of Public Health Physicians on Monday at Kfar Maccabiah was full of content. Under the title “Public Health: Between Science and Politics,” there was a wide range of meetings and lectures running simultaneously. Doctors and leading researchers, health-care executives and policy makers were among the participants, along with academics and experts from public health programs and medical schools.
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The public health field covers an enormous spectrum of issues – including pollution, smoking and lifestyle, obesity, vaccinations, contagious diseases, pandemics and preventative medicine – and all are at the heart of media coverage of this field.
Up to this point, this article could be seen as free advertising for the conference. But anyone reading the fine print discovered that the big pharmaceutical companies sponsored this important event, whose very essence is public health. Pfizer was a “gold” sponsor while Sanofi, MSD and GlaxoSmithKline were “silver” sponsors.
This sponsorship begs a reaction – did you figure out what it is? Don’t be nave. Every professional medical conference, including that involving Israel’s public health physicians, is underwritten by the drug giants. There are no medical confabs without them. The complex and problematic dependence of the public health system on the pharmaceutical industry is well known, and this arrangement does not only involve funding conferences. The close relations also include conducting clinical trials in Israeli institutions and hospitals, and prescribing innovative drugs coming straight from the development front to patients with serious illnesses. The deal involves clear commercial interests that do not necessarily match public health interests.
The relations between the drug companies and the country’s health system are anchored in a pact between the ethics board of the Israel Medical Association – the organization that hosted this week’s event – and drug company representatives. One can thus find pharmaceutical industry money and interests in every step Israel’s medical system takes. Openly, consciously and by agreement.
So why get annoyed by a conference of the Association of Public Health Physicians, which apparently is no different than any other professional gathering? Because it is different. If there is professional and ethical justification for the title “public health physician” or for the existence of the Association of Public Health Physicians, or for academic tracks and research in schools of public health – then public health should remain an untainted island in which the public interest is not only its vision but also its substance.
The conference’s own program proves the basis for this demand. Topics like anti-smoking policy, air pollution or nutrition – which touch on the soft underbelly of many corporations that are not sponsors – are debated in depth. Each one is certainly of prime public importance, but note what topics are not being discussed.
You won’t find at this conference debates on the worrying trend of drug abuse. Or on the phenomenon of adverse drug reaction deaths (which average 100,000 annually in the United States alone, more than diabetes and AIDS, but about which there is no data for Israel). Nor will you find a session discussing the advantages of medical cannabis (used sometimes at the expense of prescription medications), or about whether the turbulent regulatory changes the industry is undergoing are good or bad for Israeli patients. This is a current topic that interests the Israeli public and is relevant to many patients. Moreover, you won’t find discussions on the surge in use of painkillers in the country, or about the exorbitant price of oncological drugs or their effectiveness. And this is just a partial list.
Is it just a coincidence? Maybe, but why take the risk? The Israeli public and the professionals truly dedicated to the issue out of a sense of duty (and there are some) deserve an unadulterated approach to public health. If there is going to be public health, then go all the way with it, without compromise. We don’t have to be nave or detached from reality to strive for this.