Weekend Edition April 20-22, 2012
Valuing Human Life in China and the U.S: Take Your Pick
Chinese Melamine or American Vioxx: Half a million dead and no questions asked
In contrasting China and America, pundits often cite our free and independent media as one of our greatest strengths, together with the tremendous importance which our society places upon individual American lives. For us, a single wrongful death can sometimes provoke weeks of massive media coverage and galvanize the nation into corrective action, while life remains cheap in China, a far poorer land of over a billion people, ruled by a ruthless Communist Party eager to bury its mistakes. But an examination of two of the greatest public-health scandals of the last few years casts serious doubt on this widespread belief.
What follows is an extraordinary report by Ron Unz, publisher of the American Conservative, part of his larger feature just published by the TAC, “China’s Rise, America’s Fall. “ Ron makes the charge that perhaps 500,000 or more premature American deaths may have resulted from Vioxx, a figure substantially larger than the 3,468 deaths of named individuals acknowledged by Merck during the settlement of its lawsuit. And almost no one among our political or media elites seems to know or care about this possibility.
Ron writes to us : “I remember back in 2005, I was reading my morning newspapers, as I always do, and noticed those tiny, buried items about the unprecedented drop in the American death rate. Hmm I said, I wonder if that might have anything to do with all those other stories about that deadly drug recently taken off the market and all the resulting lawsuits. I never got around to looking into it, and apparently nobody in the media did either.
“Then, a few weeks ago, I was talking to Dan McCarthy the TAC Editor, complaining to him about how totally incompetent and dishonest the MSM was, and mentioned the totally ignored 2005 mortality drop as an excellent example. He’d obviously never heard of it and had also completely forgotten about the Vioxx scandal, but said I really should think about writing something up. So I decided to combine it with some of those other things about China I’d been complaining that the MSM tended to distort or ignore.
“When I went to the CDC website, it only took me about 10 minutes to get the public data confirming that just as I’d guessed, Vioxx had probably killed around 500,000 Americans, but virtually nobody in the whole country knew or cared. It’s a little like if a meteor destroyed Pittsburgh and killed everyone there, but the media never reported it, would anyone really notice? From a philosophical perspective, if nobody knows about it, did it even really happen?”
First, consider the details of the Chinese infant formula scandal of
2008. Unscrupulous businessmen had discovered they could save money by
greatly diluting their milk products, then adding a plastic chemical
compound called melamine to raise the apparent protein content back to
normal levels. Nearly 300,000 babies throughout China had suffered
urinary problems, with many hundreds requiring lengthy hospitalization
for kidney stones. Six died. A wave of popular outrage swept past the
controlled media roadblocks and initial government excuses, and soon put
enormous pressure on Chinese officials to take forceful action against
the wrongdoers.
China’s leaders may not be democratically elected, but they pay close
attention to strong popular sentiment. Once pressed, they quickly
launched a national police investigation which led to a series of
arrests and uncovered evidence that this widespread system of food
adulteration had been protected by bribe-taking government officials.
Long prison sentences were freely handed out and a couple of the
guiltiest culprits were eventually tried and executed for their role,
measures that gradually assuaged popular anger. Indeed, the former head
of the Chinese FDA had been executed for corruption in late 2007 under
similar circumstances.
Throughout these events, American media coverage was extensive, with
numerous front-page stories in our leading newspapers. Journalists
discovered that similar methods of dangerous chemical adulteration had
been used to produce Chinese pet food for export, and many family dogs
in America had suffered or died as a result. With heavy coverage on talk
radio and cable news shows, phrases such as “Chinese baby formula” or
“Chinese pet food” became angry slurs, and there was talk of banning
whole categories of imports from a country whose product safety
standards were obviously so far below those found in Western societies.
The legitimate concerns of ordinary Americans were fanned by local media
coverage that sometimes bordered on the hysterical.
However, the American media reaction had been quite different during an earlier health scandal much closer to home.
In September 2004, Merck, one of America’s largest pharmaceutical
companies, suddenly announced that it was voluntarily recalling Vioxx,
its popular anti-pain medication widely used to treat arthritis-related
ailments. This abrupt recall came just days after Merck discovered that a
top medical journal was about to publish a massive study by an FDA
investigator indicating that the drug in question greatly increased the
risk of fatal heart attacks and strokes and had probably been
responsible for at least 55,000 American deaths during the five years it
had been on the market.
Within weeks of the recall, journalists discovered that Merck had
found strong evidence of the potentially fatal side-effects of this drug
even before its initial 1999 introduction, but had ignored these
worrisome indicators and avoided additional testing, while suppressing
the concerns of its own scientists. Boosted by a television advertising
budget averaging a hundred million dollars per year, Vioxx soon became
one of Merck’s most lucrative products, generating over $2 billion in
yearly revenue. Merck had also secretly ghostwritten dozens of the
published research studies emphasizing the beneficial aspects of the
drug and encouraging doctors to widely prescribe it, thus transforming
science into marketing support. Twenty-five million Americans were
eventually prescribed Vioxx as an aspirin-substitute thought to produce
fewer complications.
Although the Vioxx scandal certainly did generate several days of
newspaper headlines and intermittently returned to the front pages as
the resulting lawsuits gradually moved through our judicial system, the
coverage still seemed scanty relative to the number of estimated
fatalities, which matched America’s total losses in the Vietnam War. In
fact, the media coverage often seemed considerably less than that later
accorded to the Chinese infant food scandal, which had caused just a
handful of deaths on the other side of the world.
The circumstances of this case were exceptionally egregious, with
many tens of thousands of American deaths due to the sale of a highly
lucrative but sometimes fatal drug, whose harmful effects had long been
known to its manufacturer. But there is no sign that criminal charges
were ever considered.
A massive class-action lawsuit dragged its way through the courts for
years, eventually being settled for $4.85 billion in 2007, with almost
half the money going to the trial lawyers. Merck shareholders also paid
large sums to settle various other lawsuits and government penalties and
cover the heavy legal costs of fighting all of these cases. But the
loss of continuing Vioxx sales represented the greatest financial
penalty of all, which provides a disturbing insight into the
cost-benefit calculations behind the company’s original cover-up. When
the scandal broke, Merck’s stock price collapsed, and there was a
widespread belief that the company could not possibly survive,
especially after evidence of a deliberate corporate conspiracy surfaced.
Instead, Merck’s stock price eventually reached new heights in 2008 and
today is just 15 percent below where it stood just before the disaster.
Furthermore, individuals make decisions rather than corporate
entities, and none of the individuals behind Merck’s deadly decisions
apparently suffered any serious consequences. The year after the scandal
unfolded, Merck’s long-time CEO resigned and was replaced by one of his
top lieutenants, but he retained the $50 million in financial
compensation he had received over the previous five years, compensation
greatly boosted by lucrative Vioxx sales. Senior FDA officials
apologized for their lack of effective oversight and promised to do
better in the future. American media conglomerates quietly mourned their
loss of heavy Vioxx advertising, but continued selling the same airtime
to Merck and its rivals for the marketing of other, replacement drugs,
while their investigative arms soon focused on the horrors of tainted
Chinese infant food and the endemic corruption of Chinese society.
This story of serious corporate malfeasance largely forgiven and
forgotten by government and media is depressing enough, but it leaves
out a crucial factual detail that seems to have almost totally escaped
public notice. The year after Vioxx had been pulled from the market, the
New York Times and other major media outlets published a minor
news item, generally buried near the bottom of their back pages, which
noted that American death rates had suddenly undergone a striking and
completely unexpected decline.
The headline of the short article that ran in the April 19, 2005 edition of USA Today
was typical: “USA Records Largest Drop in Annual Deaths in at Least 60
Years.” During that one year, American deaths had fallen by 50,000
despite the growth in both the size and the age of the nation’s
population. Government health experts were quoted as being greatly
“surprised” and “scratching [their] heads” over this strange anomaly,
which was led by a sharp drop in fatal heart attacks.
On April 24, 2005, the New York Times ran another of its
long stories about the continuing Vioxx controversy, disclosing that
Merck officials had knowingly concealed evidence that their drug greatly
increased the risk of heart-related fatalities. But the Times
journalist made no mention of the seemingly inexplicable drop in
national mortality rates that had occurred once the drug was taken off
the market, although the news had been reported in his own paper just a
few days earlier.
A cursory examination of the most recent 15 years worth of national
mortality data provided on the Centers for Disease Control and
Prevention website offers some intriguing clues to this mystery. We find
the largest rise in American mortality rates occurred in 1999, the year
Vioxx was introduced, while the largest drop occurred in 2004, the year
it was withdrawn. Vioxx was almost entirely marketed to the elderly,
and these substantial changes in national death-rate were completely
concentrated within the 65-plus population. The FDA studies had proven
that use of Vioxx led to deaths from cardiovascular diseases such as
heart attacks and strokes, and these were exactly the factors driving
the changes in national mortality rates.
The impact of these shifts was not small. After a decade of remaining
roughly constant, the overall American death rate began a substantial
decline in 2004, soon falling by approximately 5 percent, despite the
continued aging of the population. This drop corresponds to roughly
100,000 fewer deaths per year. The age-adjusted decline in death rates
was considerably greater.
Patterns of cause and effect cannot easily be proven. But if we
hypothesize a direct connection between the recall of a class of very
popular drugs proven to cause fatal heart attacks and other deadly
illnesses with an immediate drop in the national rate of fatal heart
attacks and other deadly illnesses, then the statistical implications
are quite serious. Perhaps 500,000 or more premature American deaths may
have resulted from Vioxx, a figure substantially larger than the 3,468
deaths of named individuals acknowledged by Merck during the settlement
of its lawsuit. And almost no one among our political or media elites
seems to know or care about this possibility. A recent Wall Street Journal
column even called for relaxing FDA restrictions aimed at avoiding
“rare adverse events,” which had been imposed after the discovery of
“unanticipated side effects of high-profile drugs like Vioxx.”
There are obvious mitigating differences between these two national
responses. The Chinese victims were children, and their sufferings from
kidney stones and other ailments were directly linked to the harmful
compounds that they had ingested. By contrast, the American victims were
almost all elderly, and there was no means of determining whether a
particular heart attack had been caused by Vioxx or other factors; the
evidence implicating the drug was purely statistical, across millions of
patients. Furthermore, since most of the victims were anyway nearing
the end of their lives, the result was more an acceleration of the
inevitable rather than cutting short an entire young life, and sudden
fatal heart attacks are hardly the most unpleasant forms of death.
But against these important factors we must consider the raw numbers
involved. American journalists seemed to focus more attention on a
half-dozen fatalities in China than they did on the premature deaths of
as many as 500,000 of their fellow American citizens.
The inescapable conclusion is that in today’s world and in the
opinion of our own media, American lives are quite cheap, unlike those
in China.
Published by permission of the The American Conservative. Copyright, The American Conservative.
