lloydtown 

Big Pharma

Great piece by David Olive in the Toronto Star on the Vioxx fiasco.

Merck has a tradition, compared to other Big Pharma companies, of balancing solid research with profits. After all, it was Merck-sponsored research that led to the Vioxx recall. On the other hand, there were earlier studies, some based on Merck data, showing the same dangers, and lawsuits had been filed as early as 2001. Yet the VP for Research at Merck responded to the new study with words like "stunning" and "astonishing" ("I'm shocked! shocked!").

Olive says all these companies have a business plan which requires new product--either brand new patent-protected prescription medication, or a new application for an existing product. (A new application should bring new customers, at a minimum; it may even bring a new patent, protected for 20 years). But the new product is not coming fast enough, so all these companies are forced (for the sake of profit) to oversell what they've got.

Vioxx should only have been prescribed for patients with both arthritis and a known problem such as
stomach bleeding--and then only for a limited time. Instead it was prescribed willy-nilly to patients with chronic pain--many of whom were responding to TV ads.

Pfizer, maker of the only other COX-2 drugs on the market, Celebrex and Bextra, has wasted no time buying full-page newspaper ads encouraging Vioxx patients to promptly switch to its offerings. John Klippel, president of the non-profit Arthritis Foundation, despairs of that, telling the Wall Street Journal that osteoarthritis, for one, "is clearly associated with being overweight and paying less attention to exercise." Pfizer's COX-2 inhibitors have not been tested as thoroughly as Vioxx in post-launch studies, and in Dr. Klippel's estimation, should be avoided unless older and cheaper over-the-counter drugs prove ineffective.

Merck and Pfizer targeted their COX-2 drugs to a wide audience, when most medical experts believe they should be prescribed narrowly to those suffering the most severe gastrointestinal problems, and should never have been aggressively marketed as a widely useful painkiller.

Pat Borders, 1992 vintage

A generally nice, funny/sad piece on Slate: Relief catcher Pat Borders blew a routine play, allowing the Yankees to advance to the ALCS. Stephen Rodrick says Borders joins the ranks of other journeymen/mediocre athletes, enjoying the gravy train of pro salaries into the twilight of their careers, who finally get some playing time and screw up.

As Rodrick says, many of the players are not stars even when they are young. They somehow fill a niche. Rodrick's line about Borders: "Without a doubt the least talented player to win a World Series MVP and score an Olympic gold medal, Borders has been playing with the house's money for a decade."

Very funny, and possibly true, but about the World Series MVP--which happened before the last decade.

It was huge for Blue Jays fans when the Jays got into their first World Series in 1992--the first non-U.S. team in the World Series, although of course with mostly American players. I was living in Minnesota, watching the ALCS against Oakland, and almost had a heart attack. I swear I dreamed a big hit by Robbie Alomar off Dennis Eckersley before it happened. Then the World Series, and Borders as MVP.

I remember Borders demonstrating on TV that he was pretty much black and blue all over. Many Blue Jays pitchers in the playoffs threw a hard breaking pitch--usually a split-fingered fastball. These pitches would tend to drop into the dirt, and Borders had to block them. (Exactly what he failed to do a few evenings ago).

Starters included Jack Morris and David Cone. Relievers included Todd Stottlemyre, David Wells, Duane Ward, and Tom Henke.

Many of us still remembered Ernie Whitt and Buck Martinez splitting the catching duties, and in different ways going beyond their real abilities. (Buck: "Martinez never fully recovered from a fractured leg and dislocated ankle sustained while blocking home plate in July 1985. After tagging out the lead runner and suffering a broken leg, he threw to third from the ground. It was a bad throw, and that runner came home too; Martinez managed to take the throw and tag him out as well.") (Ernie).

Pat Borders won our hearts in 1992; he also hit just about as well in 1993, when the pitching for both Toronto and Philadelphia was terrible.

Oil for Food Scams: Chalabi's version?

Josh Marshall posts at some length on this, yet again.

There has been a series of charges that senior UN officials, erstwhile allies of the U.S., and above all the perfidious French, profited from the oil-for-food program which was supposed to mitigate the effects of the sanctions in pre-invasion Iraq. The idea is that people who claim to be lecturing G.W. Bush about international law were previously stealing food from starving Iraqi children in order to keep living high at the Ritz or some such place.

Marshall reminds us that we really seem to be hearing only the Ahmed Chalabi version of this story. Chalabi, as far as we know, has refused to share what he says are the key documents with anyone in authority, and he has refused to cooperate with the UN investigation led by Paul Volcker. Yet we keep hearing the Chalabi version with no debate or qualifications--even though Chalabi is a proven liar and fraud.

Republicans in Congress seem to be repeating Chalabi news releases with absolutely no scepticism. Same with Instapundit. This has all come up now as a "new" but backward-looking justification for invading Iraq in March 2003. Good heavens: Saddam was practicing corruption; some of the western allies who are supposed to be Boy Scouts were not; so Uncle "Dudley Do-Right" Sam had to step in. This has to come to the forefront now, of course, because there were, er, no weapons, and no link to Al Qaeda.

Marshall, to his credit, pretty much sticks to raising good questions.

There's a separate question about why U.S. firms on the list aren't being identified, only foreigners. But, setting that aside, has any independent body yet reviewed those documents? And if not, why are they being given such credence considering Chalabi's record as a convicted criminal, forger of documents, producer of phony intelligence and, in all likelihood, someone who passed on American intelligence to Iran?

Childhood Then and Now

A little hint from Glenn Reynolds--possibly something he's posted on before: in "science nerd" stories set in the 1960s and 70s, kids "seem a lot more independent and free-ranging than kids today."

I've had many conversations about this: can't we boomers all remember just wandering around with no adult supervision--especially in the summer? "Street" games were the rule, not the exception (they weren't something "lower class")? But for kids only? (I think I'm talking more about the 50s and 60s than the 60s and 70s, but still).

So I went looking for an article I read a few years ago--about how childhood has changed since the 50s. Here's some of what I remembered:

This is true, of course, for adults, too, as the line blurs between us and our children. Toys, as it turns out, are us. We display the same desires for instant gratification as our kids. We even play some of their computer games. We ferry them to their ballet lessons and sit for hours watching their exploits on the hockey rink or soccer field. When they score, we score.

For middle-class kids, this meshing of adult and child worlds is surely one of the biggest differences between today's childhoods and those of earlier times, say the 1950s.

Our parents never saw us play ball. They never knew that sometimes we hung out in the rail yards, or stole apples from neighbors' trees. They didn't know the games we played because they were ours. On summer mornings, we disappeared into neighborhood - kid enchantment, emerging only briefly for lunch before plunging back into our conspiracies. We had no play dates. It was assumed we'd return before dinner ? safely.

Now, middle-class parents feel the need to be all over their kids' lives. Rarely do you see middle-class kids playing unattended in city parks. Kids are tightly scheduled: ballet, swim team, computer camp. Postman writes about a scuffle that broke out among parents at a massive kids' soccer tournament, and then, afterward, about how parents congratulated one another for a wonderful event.

But Postman's question was this: What were 4.000 kids doing at a soccer tournament? Surely they couldn't have organized such an event themselves, for their own enjoyment. He concludes that kids' sports have less to do with children's fun than parents' gratification. Play has become serious business. As childhood disappears, so does a child's idea of play. And of innocence.

Afghanistan and Pakistan

First the good news on Afghanistan: John Simpson of the BBC via Instapundit.

Simpson expects the election to go smoothly--at least in Kabul--and says the Americans are not unpopular-at least in Kabul. Kabul is not Baghdad, is actually the way he puts it. This passage is especially striking.

Three years after the Taliban were chased out, Kabul has returned to the real world. The streets are jammed with cars, the shops are full of goods. Last year Afghanistan's economy grew by 30 per cent. The weirdest thing about Kabul under the Taliban used to be its unnatural silence. Now it's as noisy as anywhere on earth.

According to some reports, drugs constitute up to half of the Afghan economy and they finance much of the private construction, particularly in the capital. The interweaving of Taliban and al Qaeda politics with drug-related crime networks could create a deadly base for a continuing insurgency for years to come. As we've learned elsewhere, the only way to fight the drug trade is to eat into its profit margins--by legalizing the stuff in the West, or in the producing country, and taxing it appropriately--which is, of course, politically unacceptable.

Radek is right, of course. It cannot be repeated enough. Not only is the war on drugs counterproductive at home, but it also provides a mechanism by which the terrorists can find an invaluable source of funding. The Bush administration seems incapable of recognizing this simple fact, but Kerry, we know, would be no better.

Pathetic.

Back to Dogs Again

In the Political Science department at the University of Alberta, where I got my BA, one professor had a cartoon up on his door. A seedy-looking intellectual type is hunched over a typewriter (Dan Rather-era technology); the page in the machine is blank, and no manuscript is in sight. He is obviously blocked. He is also surrounded by dogs, and his wife is nearby. The caption is his wife saying: "Write about dogs."

I've actually been meaning to post on this for a while: two articles in [link=http://www.shopanimalnetwork.com/product.asp?0=206&1=299&3=794]Dog World[/link] magazine, July 2004.

"How to Choose a Stud Dog--and How Not To".

Good breeders determine the "inbreeding coefficient" for their bitch--more or less an indication of whether all her relatives are very closely related. The big question is whether to breed once again to a male who is closely related--which promises to produce more puppies in a distinguished line of heredity, making them worth a high price. Of course the hope is the puppies will also show the best working or show qualities of the line--but the risk is that with a lot of inbreeding, bad qualities will be reinforced along with good ones.

A good breeder will determine if the bitch's inbreeding coefficient is already quite high--that is one risk factor. Then a search of available males in the same line is carried out. If none of these males truly bring qualities that are not available elsewhere, this is a strong argument for using a stud that is not closely related, and in fact for giving preference to less inbred combinations.

A bad or careless breeder will simply think the more of a famous line you use, the better off you are--not realizing that some famous dogs have also been infamous for such things as bad feet, shy temperaments, even carrying a recessive disease.

The good breeder will ask stud owners for specific information. If one tells her there are no problems, but produces no documentation, she crosses that stud off her list; if another admits to some hidden problems, she keeps the information to herself so that other breeders will trust her in the future. A bad breeder tends to believe any good news she hears, and if she hears bad news, she repeats it, so no one is inclined to be honest with her.

There are a lot of other contrasts--price, whether the stud owner wants a pup, how to be careful in placing a pup, whether with a breeder or not, etc.

The other article is "A Breeder's Challenge: Do you breed to the standard, or breed to the winner?"

Here the complication is that "physical perfection and the ability to replicate it are by no means mutually inclusive." Mendelian genetics shows that each individual animal is the result of a random selection of genes from a hereditary pool; a sibling who is not as impressive may have offspring who are far more impresive. For breeding, it is essential to look beyond an individual animal's show records to a pedigree.

The other interesting wrinkle is that judges are human, and judged events (just like at the Olympics) sometimes yield strange results. "...a dog comes along that is more caricature than substance when compared to the official document [the breed standard]. Still, the dog is an arresting figure." (In figure skating: "granted, she fell on her ass three-or was it four?--times, but she has been a great champion, with a smile that lights up the world, and the judges won't forget that. She's got a medal in the bag!")

The article also quotes a very successful breeder to the effect that in the old days, in contrast to today, "mediocre dogs simply were not admitted into the protected gene pools." I take this to mean: there is great disparity today between the best dogs and the worse within the same gene pool.

All of this just to repeat my point. Dog breeding must be a unique business in that it produces consumer goods--puppies--largely for ill-informed urban and suburban people. Rural folk, especially small family operations, have generally fallen on hard times, and breeding dogs can seem like a good way to make money. Unfortunately, the big money may come faster with unethical practices: knocking off puppies that are practically identical genetically, just because they have the "look" (from a movie, say) that people want. Ignoring the overall quality of the gene pool, or the risk that inbreeding will multiply hereditary defects. Putting a focus on championships, and that crazy world of the shows, which is related to, but somewhat distinct from, good ethical breeding.

Of course defenders of the status quo, whether the issue is diet or whatever, always say dogs live longer now than ever. How can there be a proliferation of health problems? Well: there are certainly more people willing to pay big money for dogs--for vet care along with boarding, exercise, and everything else--than ever before. Vet care prolongs the lives of dogs. That doesn't mean the incidence of hereditary diseases is not on the increase at the same time, and this may be driven by a somewhat corrupting relationship between breeders and consumers.

Responsible dog lovers, like the editors of Dog World, seem to be aware of some significant problems, although they deal with them diplomatically as well as firmly. Where does their money come from? Besides subscriptions to dog lovers, they sell ads to breeders, and suppliers of the increasing variety of products that vets and pet supply stores can sell. There are people who don't want the whole lucrative boat to be rocked.

Are There Two Approaches to Iraq?

Let's stipulate, as the lawyers say, that neither Bush nor Kerry really knows much about Iraq: who the leaders or most important groups are, what it would take to win them over, how to tell friends from foes.

Bush seems to stand for fighting on relentlessly, with roughly the troop strength that is there now.

Kerry promises to negotiate with a lot of people, to send more troops if necessary (how?), and to somehow get out sooner than Bush would.

Lots of people think neither one, as president, will have the option of pulling out unless there is a fairly stable government that asks them to leave, or is able to keep control. I still think that if either of them reached the point where they wanted out, Bush would actually have more flexibility to leave, since he has established his toughness. Kerry might find himself stuck like Johnson.

Johnson apparently told people that if he pulled out of Vietnam, American Catholics would raise a stink. "It would make China (in 1949) look like chickenshit."

It's unfortunate that Kerry keeps blurting out that Bush should have given someone--France or the UN--some kind of veto over U.S. action. The statesmanlike thing may have been simply to ... wait. One hopes Kerry means that, but he can't bring himself to say it was up to the president to either unilaterally wait or unilaterally go in.

If I am right, the best argument for invading Iraq was that it was a promising staging area for a democratic movement--i.e. there would be a quick military victory, and a population basically willing to build a new country. I still suspect a lot of people around Bush knew very well there were few or no WMDs, and they didn't care about any connection to Al Qaeda.

They decided they couldn't sell this to the public. They needed to harp about weapons, violated UN resolutions, etc., as an excuse. With the inspectors at work, they couldn't take the risk that Iraq would be found to be free of WMDs, so they rushed in.

Not the smartest move, but arguably noble. From what we have seen, the absence of any knowledge on the ground, or any real planning, is amazing.

The Debate

Is Ann Althouse a good example of a swing voter? I don't know. She's already swung pretty hard for Bush, before the debates even began.

On last night's debate: she first said Bush, while sometimes struggling (faltering?) for words, showed genuine emotion--he was irritated at having to deal with Kerry, who doesn't understand what's at stake, while Bush himself has so much busy and important work to do. Kerry's emotion is all plastic; he doesn't really feel anything. Later she said Bush seemed tired--the poor man works so hard, it's unfair to expect him to campaign.

Brother. Has she become Bush's big sister, constantly sticking up for the guy who is tongue-tied when he's in a tough spot?

If Bush speaks smoothly, as he did at the convention and I guess with O'Reilly, his defenders say he has a great message and he sticks to it--it's not a message any more, it's part of him. (The kind of thing that was said about Reagan). When he has trouble with syntax, and even with the meaning of ordinary words, they say his genuine passion is boiling over, or he's tired.

Sharon a Great Success?

This article caught my eye when it was referred to in "In Other Magazines" in Slate:

Sharon has been very successful in fighting terrorism. Hamas is operating much less openly and effectively today than it was a year or two ago; the areas of Israel that were hardest hit by suicide bombers have become much safer; and Palestinians themselves are increasingly treating Arafat as a pariah.

In other words, in this case the use of force (including the wall) did not simply generate a worse and worse backlash.

Of course, Israel is also more of a pariah than it used to be.

What can Bush or Kerry learn from this? Apparently the use of force must be targetted, so that it can usually be proved that it was in fact the bad guys who were taken out. Labour-intensive security measures, such as erecting a wall and conducting careful searches, go a long way. Perhaps above all, have the flexibility to reach out to at least some former enemies: in recognizing the need for a Palestinian state, Sharon broke with his own Likud party, and showed some freedom from the "hard right" label that is usually attached to him.

Now if he can just succeed in getting Israelis out of Gaza, he will deserve the Nobel Peace Prize.

Tactics and Strategy in Iraq

U.S. News (via Slate): the U.S. continues to rely on air strikes to keep down casualties on both sides. They are forced to do so, as well, insofar as they can't tell friend from enemy. Air strikes kill indiscriminately, and spread the notion--especially via Arabic-language TV--that the U.S. treats Iraqi civilians as enemies.

I guess everyone's sick of the Vietnam analogies--the neo-cons see themselves as a breath of fresh air for constantly appealing to Britain (not Washington) in 1939--but the phrase "hearts and minds" does arise in this article.

Perhaps one can say: the shorter a time a war lasts, the more likely these tactics are to succeed, i.e. it will be generally accepted that the killing was necessary for stability. The longer it goes on, however, the more likely it is that the sophisticated killing itself becomes a source of instability.