CIHR appointment of Pfizer exec stirs outrage

So, this is what a commitment to research “innovation” is going to look like.

This fall, CIHR welcomed a new member to its governing council: Dr. Bernard Prigent, vice-president and medical director of Pfizer Canada, a division of the world’s largest pharmaceutical company.

Health Minister Leona Aglukkaq, in announcing Dr. Prigent’s appointment, suggested “his understanding of research and development partnerships will be a valuable asset”.

Clearly, the government is trying to address the much-maligned “innovation gap”, the challenge of translating basic research into useful and commercial products. Dr. Prigent’s appointment certainly addresses the latter, but perhaps not the former, and this is the problem.

I do not mean to malign Dr. Prigent’s personal credentials, which seem impeccable. Nor is it to question his character, about which I know nothing. Nonetheless, there are problems with this appointment.

Most critics are focusing on Pfizer’s ethical malfeasance, citing the recent $2.3-billion settlement Pfizer paid for illegal drug marketing. Suggesting that a Pfizer rep would be beholden to his corporation’s profit-motive, allowing Dr. Prigent to sit on the council that makes funding decisions for independent Canadian researchers represents “putting the rooster in charge of the hen house”. There is an online petition with over 3500 signatories which states, in part:

Pfizer has a well-documented history of transgressions against the integrity of science. It has been widely reported that since 2002 it has paid four substantial fines (the last being $2.3 billion) for legal/ethical violations. It is both empirically and symbolically troublesome that an official of a company renowned for its egregious behaviour would be honoured with an appointment to the CIHR Governing Council.

I think these questions and concerns are important. There is a major conflict of interest for Dr. Prigent between the CIHR mandate to support research into public health and the commercial mandate of Pfizer to develop profitable drugs. What about research directions that may undermine the value of one of Pfizer’s current products? What about research into alternative, non-pharmaceutical heath solutions? Will it be possible for the council to navigate these conflicts of interest?

The greater concern, though, is what this appointment says about the direction in which CIHR is moving. Dr. Prigent’s appointment to the governing council is motivated by the same interest that drove his recruitment to Pfizer – his understanding of how research and development is commercialized. As Dr. Prigent says about Canadian researchers, “where we are less successful is in moving health research results out of the lab and into hospitals and clinics where they can improve health outcomes.” Look, this is fine, it makes sense, we all benefit when health research translates into measurable public good. Furthermore, some might argue (and have) that it makes perfect sense to have industry input into health research policy, and that having an industry rep on the council is desirable.

The big problem is that this appointment suggests CIHR may be moving towards an industry model for research funding. Traditionally, academic health research in this country has been funded according to the academic model where progress is measured by scientific advances, publications, and training. The industry funding model is based on commercial return on investment, and rightfully so. Historically, by combining these two funding models, we ensure that high-risk research, research into non-commercial health innovations, and basic research are publicly funded and provide a pool of knowledge from which the pharmaceutical industry can draw for application development.

But CIHR wants to change that approach. In the draft strategic plan it released this summer, it stated:

In the coming years, CIHR will increasingly focus on ’solutions-based research’ that involves collaboration between researchers and users in the research process. This begins with shaping research questions that will generate solutions to pressing problems.

I had assumed that this meant individual researchers would need to collaborate with “users”, but it seems that CIHR has decided to give “users” a seat at the very head of the table. By appointing Dr. Prigent to the council and by seeking his “expertise”, the CIHR is signifying its intent to model itself after industry funding models, picking the likely winners and only supporting the research that is most likely to result in the sought-after outcome.

This short-term thinking will fail for two reasons. First, publicly administered granting agencies will not be able to duplicate the “success” (such as it is…) of big pharma in commercializing research. On the one hand, public agencies are not profit-driven and are less likely to make the hard decisions, and on the other hand, public agencies are not (and should not be) in the huge expense of marketing that makes big pharma drugs “successful”. Second, focusing on commercialization will dry up the pool of basic research that feeds the system. If everyone is working to commercialize basic research, no one is left to do the basic research in the first place.

Industry should have input into the direction of science policy in this country. But evolving the CIHR governing council to emulate the commercialization practices of big pharma makes no sense.

Everything in its right place.

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The online petition can be found here.  Other thoughtful commentary on this issue has been posted by Steven Lewis (former CIHR governing council member) and Francoise Baylis, CRC in Bioethics and Philosophy at Dalhousie University.