The cancer at the heart of medicine is its need to serve two masters: the patient and the pharmaceutical company's shareholders. In an ideal capitalist system, this does not necessarily present a problem. The very best drugs will become the most popular because they are the most beneficial, and so the company and its shareholders are rewarded.
Unfortunately, medicine does not operate as a free market. The patient-or consumer, to use market-speak-does not have a choice. Instead, the doctor, as the expert, makes the purchasing decision-often based on the flimsiest evidence or none at all.
And because this expert channel to the market exists, the drug company exploits it. It funds 'research' that is little more than PR, it arranges 'conferences' in exotic locales, it 'sponsors' the doctor's surgery with free PCs and other gadgetry. It also pays the doctor to participate in 'early-stage marketing trials'-a good way to get a new drug launched.
Truth and the scientific method become distorted. Ultimately, they are harnessed to enhance a drug's sales and so reward the shareholders. Truth plays second fiddle to profits in a market that is controlled. The best product doesn't always win, but the one that is best supported just might.
When you have billions of pounds and dollars of drug company revenues at stake, you have a problem. When you have two powerful industry groups involved, you have a black hole from which truth cannot escape-so great is the pull for profit.
This has happened with the cholesterol theory, the subject of our cover story this month. It claims that if you eat a diet that is high in fats, you will increase the level of LDL or 'bad' cholesterol in your system. This 'bad' cholesterol will stick to your artery walls until they become clogged, thus causing a heart attack.
This theory has created two massive markets: statin drugs, the most profitable drug sector in the world; and the low-fat industry, which also generates billions of pounds and dollars every year.
The cholesterol theory is not true; it has been disproven many times by the scant amount of independent research that is allowed to see the light of day. Worse, new research is demonstrating that 'bad' cholesterol isn't bad at all-it plays a key role in healing inflammation and, ironically, in preventing heart attacks.
As we age, cholesterol becomes even more important. It helps to build muscle and keeps our brains sharp. The attack on 'bad' cholesterol could be behind the rise in dementia in the elderly, and may be causing the very thing it is supposed to protect us from.
But when it comes to profits or people, guess which comes first.