"I am a Nigerian government official and I need your help ..."

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  • 05/08/2006

If you’ve heard that one, try this —

The Washington Post story on Trovan in Nigeria conveniently fails to include several pertinent facts, underscoring the victory of headlines over facts.

For example, the article claims that “… the panel said an oral form of Trovan, the Pfizer drug used in the test, had apparently never been given to children with meningitis.”

In fact,while Trovan had never been used in children with meningitis, other antbiotics of the flouroquinolones class had been tested in children with that disease with success.

Here is a summary of one such study ( Ciprofloxacin in preterm neonates: case report and review of the literature. van den Oever HL, Versteegh FG, Thewessen EA, van den Anker JN, Mouton JW, Neijens HJ. Eur J Pediatr. 1998 Oct;157(10):843-5.)

The article also implies that the Trovan trial did nothing to help address the epidemic of meningitis in Nigeria.

Despite optimal therapy, meningococcal meningitis has a 10% fatality rate and at least 15% central nervous system damage. The Post continues to ignore the fact that Pfizer’s treatment resulted in the best survival rate of any treatment then being administered in Kano. While Doctors Without Borders (DWB) treated patients with epidemic meningitis in Kano with a different medication, oily chloramphenicol, which was not approved for use in Nigeria, and succeeded in lowering the death rate to approximately 9.1 percent, Pfizer lowered the mortality rate even further to 6 percent. The rate was the same for the group who were administered Trovan and the group who received the other antibiotic that Pfizer supplied. Pfizer’s rate was also lower than the overall rate for the epidemic which ranged from 10-30 percent.

Nearly 50-100 percent reduction in mortality and Pfizer was ignoring the problem?

Finally, the head of the Nigerian “commission” who did the study has his own problems …

Dr Abdulsalami Nasidi, who chaired the commision looking at the Pfizer conduct is also head of an umbrella body for anti-AIDS groups and government agencies in Nigeria. It turns out that the his group was asking AIDS patients to pay for their drugs, which it got free. Medicins Sans Frontieres’ found nearly half of people on drug treatment in Nigeria did not receive sufficient doses due to lack of funds.

The Post fails to note that Nasidi had opposed the Pfizer trial from the outset. Moreover, the Post failed to discuss the fact that two factions in Nigeria were at war over the trial and that many observers claimed (it’s in the report the Post had) that Pfizer knew it was not wanted in Nigeria…. Indeed it is clear from the report that Pfizer was caught in the crossfire of a political feud and that much of the “testimony” regarding the handling of the study is of the “he-said, she-said” variety with one group saying the trial was conducted properly (those supporting use of Trovan) and those saying it was not (those who opposed the trial from the outset). Yet the Post story reads as if the report consistently slams Pfizer and the researchers.

It doesn’t.

And just last week The Global Fund against AIDS, Tuberculosis and Malaria at the weekend halted US $50 million in grants to Nigeria, citing the country’s failure to meet performance targets.

Fund spokesman Jon Liden said the governing board voted to suspend payment on two five-year grants after just two years because Nigeria had missed targets on anti-AIDS treatment access and other goals.

So let’s see, Nasidi is both the chair of this commission and of the AIDs group criticized for selling drugs it got for free and for missing performance targets.

Nothing like attacking a big, bad pharma company to divert attention from your own incompetence.

The Washington Post got played.

CMPI

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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