Combined Vol. (Eight and Ninth Monograph).ISSN 0973-1229. ISBN 81-89753-11. Rs. 250/- US $ 25/-.

Medical Practice, Psychiatry and the Pharmaceutical Industry: And Ever the Trio Shall Meet-I

Ajai R. Singh

Shakuntala A. Singh

Preface

One of the greatest happenings in the medical world today is the wide opportunity for collaboration between academic institutions, researchers and the pharmaceutical industry. While this holds great promise according to some, it portends equally great problems according to others. On the one hand is the growing commercialization of research with its effect on the ethical conduct of researchers. On the other are the advancements of scientific knowledge with its effect on the welfare or otherwise of patients. Both these are becoming areas of pressing concern. Connected to the growing clout of industry in institutions is concern about the commercialization of research and resolving the ‘patient or product’ loyalty. Issues related to conflict of interest, doctoring of data, control over publication, threats of legal tangles, patient or corporate welfare are vexing unresolved issues. Gifts, sponsorships, pliant experts acting as industry spokespersons, journals and their ethical policies are no less. Guidelines, whether clinical practice or of journal editors, are also areas of increasing activity and equal concern.

This collection of four monographs (two current, and three to follow) tackles these issues in the light of current research work done.

About the Authors

Ajai R. Singh, M.D., is a Psychiatrist who has earlier worked with the WHO Collaborating Center In Psychopharmacology In India.

Shakuntala A. Singh, Ph.D., is Principal, and Reader and Head, Dept of Philosophy, Joshi-Bedekar College, Thane, India. She has earlier worked with the Indian Council of Philosophical Research as a Post-Doctoral Fellow.

They are Founders of the Mens Sana Research Foundation, India.

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 Introduction

The Two Revolutions In Bio-Medical Research

In the field of modern medical science, we can identify certain epochs. Some of these will be our concern here, for they offer important insights into the development of modern medicine and offer equally important predictors to where it is heading in the future. In fact they are so important that they qualify to be called nothing less than revolutions.

Till the early twentieth century, medicine was an activity dependent on a small privileged elite. This changed by the mid-twentieth century into a vast publicly owned enterprise with enlightened governmental approach, support and funding. One example of this was in the 1940s, sixty five years ago, when Vannever Bush in the US, for example, persuaded the government there to divert resources allocated for the then war effort (World War II) to fund basic research in academic institutions. Similarly, in India, what was earlier dependent on the benevolence of zamindars/philanthropists and some missionaries who set up charitable dispensaries/hospitals to serve certain sections of the population was supplemented, and then overtaken, by governmental funding after independence in 1947.

The major governmental support to medical science was an important development that led to great advances in medical research and facilities all over. Such funding and consequent blooming of medical science was nothing less than a revolution, which we can legitimately consider the first revolution in modern medicine.

A second revolution was soon to follow four decades later. It was fuelled by a vast upsurge in medical research, training and therapy, with capital pouring in from private enterprise and philanthropy. This revolution is still on. It is aided by efforts like the Bayh-Dole Amendments of 1980 in the US, for example. This epoch making amendment conferred intellectual property rights to institutions and connected scientists even if they had developed their products/inventions with government funding. This was followed by incentives in tax laws that resulted in a massive inflow of venture capital into biomedical research. As a result, academia was suddenly besieged by profit seeking industry that saw immense vistas of opportunity opening up before them. Pharmaceutical majors, propped up with massive private funding by venture capital, were quick to seize the initiative. Institutions realized their commercial potential and its vast possibilities for the first time, and were not averse to jump on to the bandwagon.

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