With friends like these… Meryl Dorey’s exploitation of Saba Button

Over the past few months I’ve come to accept that there is one Australian absolutely delighted with the fact that (then) 12 month old Saba Button suffered organ and brain damage following febrile convulsions brought on by Fluvax.

Meryl Dorey of the AVN has enveloped herself in the tragedy of the Button family, declaring long and loud she is their unofficial antivaccination representative. She claims to have twice met with them and had been, “in contact by both telephone and email many times over the intervening period…”. Finally, after 18 years of fabrication, untraceable images, offensive claims and being a danger to public health the woman who likens vaccination to “rape with full penetration” has landed her fish.

She writes in a conspiracy piece on her blog:

I can also tell you that this reaction was entirely preventable because neither they nor any other parent who gave permission for their precious child to be vaccinated in this campaign was informed that their babies were being used as guinea pigs in a trial that was paid for by the drug companies involved. Neither were they aware that those payments going to people who ostensibly worked for the government (both state and federal) and who were considered to be – but actually were not – independent.

All of this is a complete fabrication. No trials are conducted surreptitiously. Ethics requirements aside exactly what data could those conducting Meryl’s pretend trial hope to collate? By who, how and when would subjects be monitored, what tests would be carried out and for how long? Indeed Dorey is suggesting this “trial” was simply a stab in the dark to see what happened. No such trial took place and thus was not paid for by drug companies. Worse, this is knowingly exploitative of the Button family and reduces their personal tragedy and grief to yet another of the thousands of tactics Meryl Dorey has used to mislead Australians.

Morally it is no different to her claim yesterday that infants who die in a co-sleeping arrangement are likely vaccine induced fatalities. Why? Because GP’s point out the danger of this arrangement, so it must be an abuse of “natural instinct” and thus a conspiracy is in order. Or her ACTION ALERT! announcement that supporters of vaccines were mobilising to harass the author of Virus in the system – an article that recounted Saba’s experience.

CSL does carry out yearly trials following strict protocols on an informed, compliant sample, the results of which are published in peer reviewed literature. This is mentioned below. Yet I’m not here to make excuses for CSL whose conduct surrounding Fluvax, their economic handling of certain legitimate trial results and adherence to Good Manufacturing Practice leaves a great deal to be desired. Nor am I by any stretch of the imagination a fan of Dr. Rohan Hammett, head of Australia’s Therapeutic Goods Administration. One cannot however make conclusions without evidence. Unless of course, one fabricates.

As an update, one commenter below has pointed out there was a trial to gauge the epidemiological impact of the present schedule, in response to infant fatalities from influenza the year before.  I’m perhaps duty bound to note that infant fatality from flu was mentioned by Judy Wilyman at the AVN’s first Perth trip on June 30th 2010 at the State Library, W.A. Judy informed the audience that the media report such fatalities as scare campaigns to “coerce us into vaccination”. This is because, “We’re being educated by the media who have pharmaceutical interests”. I should also point out that W.A. was the only state to use seasonal influenza and H1N1 together for children under five, which can be regarded as novel and thus raise concerns about earlier trials, particularly on sample size. Yet there were no guinea pigs, or state sanctioned, profit driven guesswork.

Regarding “those payments going to people who ostensibly worked for the government…”, that too is fallacious. TGA national manager Dr Rohan Hammett was before a Senate estimates committee on October 19th, being quizzed over the very nature of Fluvax, CSL, trial results, the febrile convulsions in W.A. and payments from drug companies.

Liberal senator Concetta Fierravanti-Wells, quizzes Dr. Hammett beginning with justified concerns that the TGA knew of high fevers in 2009. Yet more disturbing is that 2005 trial data yielded fever rates of 22.5%. The 2006 fever rates were 39.5%. Despite this, CSL advised the TGA in 2009 of the 2005 figure [pp.42-43]:

Senator FIERRAVANTI-WELLS: Are you demanding an explanation? You should be.
Dr Hammett: We are. We have written to CSL.
Senator FIERRAVANTI-WELLS: It emerged that the company knew two years ago about research suggesting a sharp rise in feeders linked to its seasonal flu vaccine but omitted this from information given to doctors. We have canvassed this in these estimates. My question is: when did you and when did the government first know about this? Is this the first you have heard of it? That is really what I would like to know.
Dr Hammett: No, it is not, Senator. In 2009 a study was published which related to clinical trials undertaken in 2005 and 2006. That study was published in peer-reviewed scientific literature. We were advised by CSL of its publication at about the same time as it was actually published. You will recall that that in the years before the Fluvax incident with febrile convulsions—and, indeed, for the last four decades—seasonal flu vaccine has been regarded as an incredibly safe vaccine. In 2009, 2008, 2007, 2006 and 2005 there was no suggestion of safety problems with the flu vaccine.
In retrospect, knowing now what we know in 2010, that there was a problem with the 2010 vaccine, people are going back through clinical trials and saying, ‘With the aid of the ‘retrospector scope’, could we have picked anything?’ Indeed, in those earlier clinical trials there were rates of fever for the Fluvax vaccine that were higher than some other comparable vaccines. However, as noted in yesterday’s article, most of those fevers were mild or moderate and there was no sign of a febrile convulsion signal. Febrile convulsions were not occurring in those studies that were done.
As I have said, we have written to CSL and made inquiries as to whether there was any delay in notification of us of these issues and have sought to gain a greater understanding of what they knew when. We have not yet received a response, but we are awaiting that.
Senator FIERRAVANTI-WELLS: Can I ask you to take on notice how much money has been paid to CSL? It is an enormous amount of money that you pay them. You obviously must have a very close relationship with CSL—and I mean that simply because of the nature of the work that they do and how much they provide in terms of products to the Commonwealth. Surely, Dr Hammett, you must have been aware of what this company was doing and certainly known about its research in relation to these fevers.
Ms Halton: Let’s just back up a second. There are a couple of things. Dr Hammett is the regulator. He does not pay the CSL anything. He has a very clear role, which is as a regulator. He takes that role very responsibly and very seriously. There is a separate part of the government which purchases vaccine, including from CSL. So I think we need to make a distinction here about who is paying what for whom and what the nature of the relationship is, because I do think it is—
Senator FIERRAVANTI-WELLS: I am happy for that to happen, Ms Halton, but the point that I am getting to is, given the close relationship—whether it is on the side of the purchasing arm or on the side of the TGA—this is a serious issue. Two years ago, at a period much earlier than has been previously canvassed in these estimates, there was an issue about fever. My question is: when did the government first become aware of this?

Senator Nick Xenophon later cuts to the chase addressing Hammett [p.44]:

Because time is so limited, I will put some questions on notice for you. First, can you provide details of when the TGA first became aware of the peer-reviewed article? Second, at what point was action taken? Third, did the TGA embark on other inquiries as a result of that peer-reviewed article? Fourth, do you agree with Professor Peter Collignon’s view? It is:
The TGA should be ensuring companies do update their data—it should be compulsory that the TGA should be informed of any new information, and the TGA should ensure the product information is updated to reflect that.

What really stinks coming from CSL is that the 2010 product information did not include the already documented 2009 higher fever rates. It is true these fevers are usually mild to moderate and of short duration – a factor which influenced the TGA to take no action.

It is here – and only here – that Meryl Dorey is more than welcome to raise concerns and recount poor practice or lack of insight and follow up on the part of either CSL or the TGA. However perhaps the greatest damage done by CSL is to public confidence in the safety of influenza vaccination, particularly for at risk children.

So what of actual febrile convulsion? Dorey variously claims hundreds of hospitalisations or hundreds of cases. The ABC reported “hundreds of reactions” on April 18th, 2010 with 47 taken to hospital reported on April 23. The West Australian on the same day reports 23 admissions. This led to the suspension nationwide by Commonwealth chief health officer Professor Jim Bishop.

Fluvax was given to W.A. babies resulting in a seizure rate of 3.3 per 1000. On this point MJA Insight write:

This rate of febrile convulsions [noted in 2006 trial data] (1 per 272) is similar to the estimate for the 2010 season (3.3 per 1000) which led to the unprecedented decision by Australia’s chief medical officer to suspend the use of paediatric flu vaccines.

A TGA spokeswoman told MJA InSight that a single adverse reaction report within a clinical study was not usually regarded as an adequate signal of a major safety problem. Lead author of the clinical study, Professor Terry Nolan, also told MJA InSight that the small sample size of the study meant the rates of febrile convulsions were not comparable with those seen in the community in 2010.

“We did a clinical study. It was published in a peer-reviewed journal. The serious adverse events were notified to the sponsor [CSL]”, said Professor Nolan, who is also head of the school of population health at Melbourne University.

It is not Professor Nolan’s role to inform the TGA. Nor do other members of the ATAGI receive special bonuses or payments from drug companies to influence perception of vaccines. Nevertheless Dorey manufactured a letter from a supposed “whistleblower”. A sordid tale about another W.A. based ATAGI member being handsomely rewarded by evil drug companies led her to wind up her article with:

In fact, we are told that all of our medical advisors must be paid by the drug companies because it seems to be impossible to find qualified people who haven’t been tainted by drug company cash.

This is why the AVN says that we can’t trust our government when it comes to their assessment of the safety or effectiveness of drugs and vaccines. There is a holy trinity comprised of the government, the drug companies and the doctors. This triad is protected by self-regulation (via the TGA which is completely funded by pharmaceutical licensing fees) and a complicit media which is beholden to drug company advertising.

Sounds conspiratorial? Well I’m sorry, but these are the facts.

No Meryl, that is simply fantastic conspiracy twaddle wasting good space on your blog when the real facts are far more convincing and indeed far more concerning.

But Meryl wasn’t finished with that simple post-W.A. trip tantrum, presumably to let off steam after her enormous W.A. tour flop. Last Wednesday November 16th she posted:

We read fiction:

I personally know of one 70 year old woman and a 19 year old man who were hospitalised within hours of getting the shot and who died within 7 and 2 days of that (respectively) Those deaths were never reported as being related to the vaccine.

More accusations are made about the TGA “knowing” and the CDC not buying Fluvax for this reason. No sources are cited. Then most offensively:

I will check and see how donations can be made to Saba’s fund. I know there is one that was set up for her when she was first injured. Her parents could not possibly be taking care of her in this way if it weren’t for that fund. Here’s hoping that compensation will be swift and generous for this poor victim of vaccines.

So far there is no word and I imagine no feedback will be forthcoming. In all the press surrounding Saba Button Meryl Dorey and the AVN is totally absent. Dorey has never breathed a word of the lawyer acting for the Buttons. History shows exactly what will happen to any money she would have gleefully collected and pocketed before the OLGR revoked her charitable fund raising licence for exactly that reason. Members of Stop the AVN can be proud they have this time stopped her stealing money from another family in need.

Those familiar with Dorey know if this was a death from a vaccine preventable disease her accusations would be of earlier vaccines – especially HBV leading to the death, possible antibiotic induced fatality, a lack of breast feeding or a simple media fabrication designed to scare people into vaccinating. Without sighting the medical records Dorey might well deny any disease at all. “You didn’t die from [measles or whooping cough] thirty years ago and you’re not going to die from it today”, she announced on national TV. All that’s needed is homeopathy, fresh air and clean water. Avoid doctors and hospitals.

Let’s face it. Dorey cares little for children, vaccine injured or maimed by the diseases she has helped bring back to dangerous levels. On either side they are tools to help her to offend, mislead and to cultivate fear. Snaring an innocent family with a very rational view of the world in her web of deceit can only be a negative for them. There are ample facts that assist their case. Facts Dorey is largely ignorant of. I fail utterly to see how lies and conspiracy theories manufactured by a proven threat to public health can be welcome.

Saba Button is in need of constant care via conventional medicine. Dorey is an out and proud enemy of conventional medicine. Despite the catalyst for her injuries Saba will forever be an at risk patient and need vaccination and conventional prophylactic measures to protect her from future viral threats. She will be surrounded by doctors, specialists and hospital staff perhaps for most of her life. The very people and places Dorey insists keep people sick – for profit.

It’s time Meryl Dorey did at least one morally correct thing and just left the Button family alone.

Legal synthetic drugs leading to arms race of prohibition

Few things underscore the failure of the war on drugs quite like the, well… failure of the war on drugs.

Two mornings ago I read in the press Synthetic drugs banned ahead of schoolies.

Attorney-General Paul Lucas said a further 19 cannabinoids, which are used to make fake illicit drugs such as the synthetic cannabis Kronic, have been outlawed. Mr Lucas said anyone caught selling them now risked between 15 and 20 years in jail.

Ten hours later I read Synthetic drugs seized ahead of schoolies, as police raided business across the Gold Coast to remove the obvious supply of, but not the demand for, synthetic drugs. No problems. Kids can go back to buying regular pot supporting organised crime in the time honored fashion. Perhaps amphetamine type stimulants (ATS) like ecstasy (or their safer legal cousins) will soon be managed identically, literally placing kids lives at risk.

Trying to terrify a nation Detective Superintendent Steve Holahan lies, “They’ve contained pesticides, crushed glass – extremely dangerous for human consumption.” Then, even though kids will now buy from organised crime figures with corrupt connections, zero accountability, no business to legally maintain and nothing in mind but an easy quick dollar we get Poe’s Law:

“Anything that you don’t know what it contains, should sound alarm bells straight away,” he said. “I really can’t emphasise enough, don’t ingest something that you don’t know what it contains.

“People need to understand they’re taking a very real risk both for their personal health…”.

In this 60 Minutes clip examining the status of “legal highs” – synthetic drugs that do not fall under the various misuse of drugs, or drug misuse and trafficking acts – vision of police savaging illegal cannabis growers struck me like never before. The recognition of futility, posturing and wasted public money was there. Yet more and more the anger I used to feel has given way to vague annoyance toward these pitiful people dressed up in action costumes to engage in what is a demonstrably futile endeavour.

Perhaps my annoyance peaked when NSW Drug Squad Chief, Nick Bingham angled to plead tough on “legal” drugs. He first admits to the difficulty of policing drugs that are not illegal then offers:

We have enough legal drugs on the market. We have tobacco, we have alcohol, we have your benzodiazapines. Why do we want to open up an avenue of all these synthetic substances to make them legal as well?

Er, firstly benzodiazapines area a prescription medication. Why not just rattle off the entire edition of MIMS there Nick? Next, there is no safe level of tobacco consumption. Which leaves alcohol – the most abused mind altering drug in the developed world clocking up a cost to public health that is approximately 15 times that of illicit drugs and once again wasting public money in policing violence. Lastly, regarding drugs that can’t be legally seized without legislative change there is no evidence anywhere of “opening up an avenue… to make them legal as well”.

Readers may remember back in June I covered the inaccurate “anecdotal” claims made by Steve Fielding on June 22nd in Questions without notice as he hassled Attorney-General Representative, Senator Joe Ludwig over what he intended to do nationally about Kronic. Fielding’s hysteria aside we still have no evidence to back his horror stories about what NSW health minister, Kevin Humphries told ABC Lateline was a “synthetic psychotic drug”. Indeed, despite years of sensational press and conservative panic the risk of chronic psychosis in people genetically predisposed to schizophrenia is roughly around one in 15,000 of regular smokers of illegal cannabis.

Of course, Fielding’s frown and Ludwig’s lament did nothing. It turns out Kronic derivatives remain legal and misunderstood. Colin Barnett, perhaps Australia’s most daring and dashing politician on the topic of illicit drugs banned Kronic in June promising maximum sentences of 25 years. Rather than understand the drugs and manage any issues we have simply enforced ignorance and expanded the supposed problem.

Surely now is the time for education and sensible regulation. In all the hype essential facts are lost and urban myths begin to emerge. “Synthetic cannabinoids” aren’t in many cases, cannabinoids. The European Monitoring Centre for Drugs and Drug Addiction notes:

Although often referred to simply as synthetic cannabinoids, many of the substances are not structurally related to the so-called ‘classical’ cannabinoids, i.e. compounds, like THC, based on dibenzopyran. The cannabinoid receptor agonists form a diverse group, but most are lipid soluble and non-polar, and consist of 22 to 26 carbon atoms; they would therefore be expected to volatilize readily when smoked. A common structural feature is a side-chain, where optimal activity requires more than four and up to nine saturated carbon atoms. The first figure shows the structure of THC, while the others show examples of synthetic cannabinoid receptor agonists, all of which have been found in ‘Spice’ or other smoking mixtures. The synthetic cannabinoids fall into seven major structural groups…

This clip spends ample time allowing Matt Bowden, NZ’s incredibly successful legal drug producer to chat with Liz Hayes. With ATS we all know the status of mephedrone as illegal in Australia. Yet smart chemists have enough formulas for both ATS and cannabinoids to keep the production-ban-production-ban arms race going for some time. Slowly the rhetoric is changing. Less and less are we terrified with stories of mashed neurons, instant madness and blokes who ripped off their scrotum. It’s pretty simple. Impairment. Drugs, like alcohol, cause impairment. And no, we don’t want those we care about going about their business impaired.

We need open and honest discourse. Proper scientific understanding and advice strikes me as the only sensible, critical next step. Users do not deserve to be scared witless to the point of hiding and lying about what is in essence simple human behaviour. More to the point the action to ban synthetic cannabinoids announced the presence of such legal drugs to Australians sending sales to unprecedented levels.

The history of banning previously legal substances is one of failure. Perhaps we might like to not repeat this particular aspect.

Drug Free Australia manipulate, misrepresent data to discredit Insite

In April 2011 the Lancet published an article written by authors from the British Columbia Centre for Excellence in HIV/AIDS, the UBC Faculty of Medicine, the UBC School of Population and Public Health and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.

The title was Reduction in overdose mortality after the opening of North America’s first medically supervised safer injecting facility: a retrospective population-based study, by Brandon D L Marshall, M-J Milloy, Evan Wood, Julio S G Montaner, Thomas Kerr was followed by a media release from The University of British Columbia which included:

Researchers compared nearly 300 case reports from the British Columbia Coroners Service documenting all illicit drug overdose deaths in Vancouver between January 1, 2001 and December 31, 2005.

Compared to the 35 per cent reduction in overdose deaths in the immediate vicinity of Insite following its opening in September 2003, overdose deaths in the rest of Vancouver declined only nine per cent over the same period. No overdose deaths have been recorded at Insite since the facility’s opening. The researchers also noted that there was no evidence of significant changes in drug supply or purity during the study period.

“This study provides the first unequivocal scientific evidence of the benefits of supervised injection facilities, and clearly demonstrates that facilities such as Insite are saving lives and playing a vital role in reducing the harms associated with illicit drug use,” says co-author Dr. Julio Montaner, director of the BC-CfE and Chair of AIDS Research at the UBC Faculty of Medicine.

The Abstract can be read here. Insite which opened in September 2003 has also been the subject of more than 30 studies in 15 peer reviewed journals. These have cited a number of benefits including increased access to rehabilitation services, detoxification, reduced syringe litter, reduced public injecting and most importantly reduced needle sharing which serves to reduce blood borne virus spread.


In 2006 the new Conservative government which did not support the initiative threatened to let the site’s legal exemption lapse before the project was complete. On September 1st 2006, Health Minister Tony Clement cited a need for more research as he deferred his decision to extend the site’s legal exemption. On the same day the Government cut all funding for future research. In August 2007 two addicts and the Portland Hotel Society filed suit in the B.C. Supreme Court arguing violation of rights – “security to the person”. What followed was from a legal and human rights perspective remarkable including the May 2008 strike down of sections of the Canadian criminal code on drug trafficking and possession as a breach of the Canadian Charter of Rights and Freedoms.

The struggle between progression and conservatism continued with the federal government appealing this legal advance in human rights. The B.C. Court of Appeal dismissed this in a 2-1 ruling. The government announced a further appeal to the Supreme Court of Canada. There were nine interveners in the Supreme Court Case. Only one supported the stance of the conservative government to close Insite. That group was the socially conservative, anti-women’s rights lobby group REAL Women of Canada.

National vice president of REAL Women…, Gwen Landolt, argued against the Canadian Medical Association and other supporters. She claimed that Insite would allow users to get “worse and worse until they die” and that such facilities “are assisting in the suicide of drug addicts.” The government had to admit it had no credible research to show Insite was not working. There were no valid data to show Insite was not reducing drug related harm. In essence the government and REAL Women of Canada were mounting non evidence based claims.

The Supreme Court of Canada ruled unanimously on September 29th, 2011 to uphold Insite’s exemption from the Controlled Drugs and Substances Act. This allowed the site to stay open indefinitely. The ruling was highly critical of Health Minister Tony Clement’s application of the CDSA to Insite stating it was grossly disproportionate and undermined “the very purposes of the CDSA, which include public health and safety”.

Drug Free Australia’s Bogus Critique

Drug Free Australia (DFA) is a conservative right wing prohibitionist lobby group of loosely affiliated extremists masquerading as a quasi-official body critical of Australia’s illicit drug policy. Regarding Injecting Facilities they have a discredited history (indeed presence) in maintaining the highly flawed opinion piece Case For Closure attacking Sydney’s Medically Supervised Injecting Centre. The Drug Misuse and Trafficking Amendment (MSIC Bill) was passed in October 2010 with considerable support from then Premier Kristina Keneally, The Australia Medical Association and the Royal Australasian College of Physicians. All three along with countless other individuals, MPs and organisations rejected the efforts of Drug Free Australia under the auspices of Secretary Mr. Gary Christian to sabotage over a decade of trial success.

On September 17th 2011, perhaps in a final effort to sway the Supreme Court of Canada (at that time yet to hand down it’s decision) DFA presented a media release claiming to have “exposed major, inexcusable errors” alleging “research fraud and professional misconduct” in the Lancet paper by Marshall et al. They cited an article headed Analysis of the 2010 Lancet study on deaths from overdose in the vicinity of Vancouver’s Insite Supervised Injection Facility published in the Journal of Global Drug Policy and Practice (JGDPP).

The authors were familiar names. Dr. Greg Pike co-author of the Case for Closure, and already profiled here. Dr. Stuart Reece and Dr. Joe Santamaria, also both co-authors of the Case for Closure of the Sydney MSIC. Prohibitionist Robert DuPont, former “White House Drug War Czar” under Richard Nixon and present board member of Drug Free America Foundation and finally Dr Colin Mangham, Director of Research, Drug Prevention Network of Canada. Their coordinator was anti-Harm Reduction campaigner Gary Christian.

In a comprehensive response the Lancet authors note their methodology and data was subjected to extensive scientific peer review and that this independent process “confirmed the appropriateness of the data and methods that we employed”. They further note Mr. Christian’s source has not been subject to peer review nor published in any scientific journal.

Nevertheless this formed the basis of a complaint by “research coordinator”, DFA Secretary Mr. Gary Christian to the University of British Columbia. The media release included:

The international team’s analysis has been sent by the Drug Prevention Network of Canada to the Ethics Committee of the agency which funded the Lancet study with questions regarding research fraud and professional misconduct.

Mark Wainberg, professor of medicine and director of the McGill University AIDS Centre was called upon to independently review the matter. Wainberg reviewed DFA’s analysis, the Lancet paper and the author’s response. He concluded in part:

In my view, the allegations that have been made by ‘Drug Free Australia’ are without merit and are not based on scientific fact. In contrast, it is my view that the work that has been carried out by the team of Thomas Kerr et al is scientifically well-founded and has contributed to reducing the extent of mortality and morbidity in association with the existence of the safer injection facility. . . . The University of British Columbia should be proud of the contributions of its faculty members to the important goal of diminishing deaths due to intravenous drug abuse.

The JGDPP analysis and complaint were found to be entirely without merit and the complaint was dismissed.

Drug Free Dishonesty

Along with the Lancet author’s response and the independent review there are a number of elements which render this amateurish attack particularly offensive. As noted above the “analysis” is not peer reviewed nor published in any recognised scientific journal. It was published in the JGDPP which is a collection of non peer reviewed articles and opinion pieces. Described as a “glorified blog” by The Media Awareness Project, the JGDPP is run by DFA’s parent body Drug Free America Foundation (on whose board sits DuPont). It was initially funded by the US Department of Justice which is presently under investigation for corruption. It has an international reputation for hosting articles seeking to sabotage human rights oriented policy initiatives successful in controlling the spread of blood borne viruses. Many authors hold extreme and archaic religious and/or anti-science views.

Essentially the JGDPP piece argues that the 35% reduction in overdose deaths in a delineated area following the opening of Insite and documented in the Lancet by Marshall et al. is flawed. Tactics by which this is done obfuscate context and manipulate the import of data in such a way as to misrepresent it to the reader. By using flawed population analysis and failing to state the nature of deaths across a much larger area it seeks to claim overdose deaths increased. The JGDPP team also suggest the Lancet authors should have dismissed an entire year as irrelevant because doing so decreases the overall decline in mortality. Thus it was, in their minds, only included by Marshall et al. to skew results.

The Lancet authors note the JGDPP report:

[U]ses crude Vital Statistics data, which included all accidental poisonings to define its estimate of overdose deaths, and it did not exclude deaths unlikely to be affected by a supervised injecting facility (e.g., suicides, adverse effects of drugs in therapeutic use). We note that the REAL Women/DPNC (JGDPP) critique seeks to call into question the Lancet paper’s findings using these crude data, and then goes on to argue that the Lancet paper’s findings cannot be relied upon because they use similarly unrefined death counts. We would argue that you cannot have it both ways.

The JGDPP article also fails to admit it used crude death counts and not population-adjusted mortality rates. This fails to account the relevance of death rates in a changing population. The Lancet study used annual population estimates from Statistics Canada to conclude on overdose mortality. Most shocking however was the increase by the JGDPP authors in area consulted by around a factor of 10. The Lancet studied mortality in 41 city blocks. The JGDPP article refers to mortality in a 400 block area. This further obscures the fact that the greatest reduction in overdose is within 4 blocks of Insite and significantly decreases outside that area.

The area in green is that studied by the Lancet authors showing a 35% reduction in overdose mortality. The area in red is that used by the JGDPP authors to misrepresent the Lancet finding.

The JGDPP article was written as an analysis for REAL Women of Canada and the Drug Prevention Network of Canada (DPNC). It is demonstrably a collation of highly selective, misleading, out of context and academically discredited material. The “analysis” relies time and again on a 2007 “critique of [the Insite] parent philosophy” written by co-author Dr. Colin Mangham of the DPNC. The DPNC holds a highly partisan irrational anti Harm Reduction position claiming it “leads to terror, degradation and the eventual death of the addict”, refers to supporters of HR as “enablers” and presents a grossly distorted misrepresentation of HR on it’s website.

They are dedicated to:

…advance abstinence-based drug and alcohol treatment and recovery programs, to promoting a healthy lifestyle free of drugs and to opposing legalization of drugs in Canada.

Their Mission Statement freely includes, Lobbying in the media, at the community level and in government for the support of our stated principles. At no point does the DPNC propose to hold to an evidence based approach or accommodate advances in scientific consensus. Not surprisingly the previous 2007 article by Mangham is critical of research which supports harm reduction and Insite. Even less surprisingly it too is published in Journal of Global Drug Policy and Practice.

Along with accusations of fraud, professional misconduct and research errors directed at the Lancet authors, the media release From Gary Christian also expanded on the supposed impact of the work of Marshall et al:

The article was influential in the Canadian Supreme Court hearings of May 12 this year, where the court reserved its decision on whether the Canadian Government is rightfully able to close the facility. The Canadian government has been trying to close Insite since 2006, but has been hampered by court action by harm reduction activists.

This is extraordinary. The JGDPP analysis that has so emboldened Mr. Christian was written for REAL Women of Canada and the DPNC. REAL Women of Canada were interveners in the Supreme Court in favour of the Canadian Government. The JGDPP analysis relied significantly upon material critical of Insite produced by the DPNC in 2007. The same DPNC with a mission statement to lobby community and government. Surely the time for accusations and presentation of evidence was in the Supreme Court itself. Yet the reasons why the government could produce none of this flawed “evidence” are manifestly clear.

The JGDPP piece cites the 2007 critique of Mangham in formulating the claim that changes in policing, “could account for any possible shift in overdose deaths from the vicinity of Insite”, arguing this was intentionally ignored by Marshall et al. Mangham is also cited as refuting Insite as having any impact on public crime or public disorder. Yet the Royal Canadian Mounted Police who had commissioned Mangham’s 2007 report claimed it, “did not meet conventional academic standards”.

Although every injection within Insite is sterile and safe from contraction of blood borne viruses, Christian’s JGDPP analysis further cites Mangham 2007 in arguing:

Added to this [the impact of policing] are the spurious claims by Insite researchers that the facility has impacted HIV and HCV transmission, despite the claim being possible only if ALL injections by those HIV or HCV positive are hosted by Insite, which has rarely been the case.

Unsurprisingly Mangham’s 2007 report was ignored by Canada’s Expert Advisory Committee on Injecting Site in formulating their own report. This doesn’t stop the JGDPP piece from citing data from Canada’s Expert Advisory Committee on Injecting Site that Insite statistically saves only one life per year. It’s argued that “this would not be detectable at the population level. This estimate is backed by the European Monitoring Centre’s methodology and avoids the error of naively assuming overdose rates in the facility match overdose rates in the community.”

At first blush this sounds compelling but is in fact a rogue construct manipulating entirely different methodologies, which yield entirely unrelated data sets, to imply naivety on behalf on Marshall et al. Regardless of what is “detectable at the population level”, neither study is relevant to the other. Citing the European Monitoring Centre’s methodology is simple weasel wording applied to distract the reader from the straw man of “one life per year”.

In truth the “one life per year” comes from person to person intervention in a clinical facility. It actually underscores the safety of the Insite environment in averting dynamics which may predicate a potentially fatal overdose. Community overdose rates considered by Marshall et al. cover 41 blocks surrounding Insite. The Lancet authors seek to quantify the impact of Insite’s presence on these rates.

Canada’s Expert Advisory Committee on Injecting Site is in no way at all dismissive of the “one life per year”. They write plainly [bold mine]:

INSITE staff have successfully intervened in over 336 overdose events since 2006 and no overdose deaths have occurred at the service. Mathematical modelling (see caution about validity below) suggests that INSITE saves about one life a year as a result of intervening in overdose events.

Marshall et al. write in their abstract [bold mine]:

We examined population-based overdose mortality rates for the period before (Jan 1, 2001, to Sept 20, 2003) and after (Sept 21, 2003, to Dec 31, 2005) the opening of the Vancouver SIF. The location of death was determined from provincial coroner records. We compared overdose fatality rates within an a priori specified 500 m radius of the SIF and for the rest of the city.

Furthermore it is interesting that the EMCDDA 2004 report notes such rooms can be expected to reduce high-risk behaviour beyond the consumption room setting itself and reduce exposure to and transmission of drug-related infectious diseases [p.25]. On public order and crime the same report lists two main objectives of 1.) to reduce public drug use and associated nuisance and 2.) to avoid increases in crime in and around the rooms [p. 61].

It should be noted each of these four points is in dissonance to the position of the JGDPP authors and every point they cite from Mangham 2007. More so, as noted during the Supreme Court Case the Canadian Government and the government’s only supporting intervener REAL Women of Canada, chose not to produce Dr. Mangham’s 2007 report. They effectively admitted they had no evidence to support their case to close Insite. As such it is remarkable Mr. Christian relied so heavily on Mangham to argue there were, “questions regarding research fraud and professional misconduct.”

Mr. Christian’s problem is not that the Canadian Government, “has been hampered by court action by harm reduction activists” since 2006. It is the simple reality that despite having had five years in which to produce convincing evidence in a court of law to close Insite, the Canadian Government has been unable to do so all the way to the Supreme Court of Canada. Apart from criticising Clement for undermining the purpose of the Controlled Drugs and Substances Act the ruling also acknowledged the dysfunctional nature of the prohibitionist mindset, stating:

…the potential denial of health services and the correlative increase in the risk of death and disease to injection drug users outweigh any benefit that might be derived from maintaining an absolute prohibition on possession of illegal drugs on Insite’s premises.

Other shonky tactics employed by Christian’s team include intentionally misrepresenting the findings and recommendations of other research. In attacking cost effectiveness of sterile injecting the JGDPP report states:

The 2009 Andresen and Boyd cost-benefit study calculated savings to government from 35 supposed HIV/AIDS transmissions averted by Insite annually, despite the most authoritative international review to date not finding any demonstrated effectiveness of clean needle provision reducing HIV transmission via needle exchanges.

This is a misrepresentation of the cited IOM review. Preventing HIV Infection among Injecting Drug Users in High Risk Countries: An Assessment of the Evidence, states:

The report provides evidence-based recommendations regarding drug dependence treatment, sterile needle and syringe access, and outreach and education. The report urges high-risk countries to take immediate steps to make effective HIV prevention strategies widely available.

Page 2 of the report brief includes [bold mine]:

Avenues for making clean injecting equipment more widely available—and thus reducing drug-related HIV risk—include needle and syringe exchange; the legal and economical sale of needles and syringes through pharmacies, voucher schemes, physician prescription programs, and vending machines; supervised injecting facilities; and disinfection programs….. Multi-component HIV prevention programs that include sterile needle and syringe access are effective in reducing drug related HIV risks such as the sharing of needles and syringes.

Gary Christian also claimed in his media release as part of the allusion that policing, not Insite had caused a reduction in mortality:

These researchers cannot truthfully claim they knew of no policing changes in the immediate area around Insite when some of their number produced an indignant study condemning the changed policing.

Yet in their response the authors indicate that the police initiative referred to ended “within weeks” of Insite opening. It was not ongoing during the study – which is what Christian’s team had falsely suggested. More so if the crackdown was the cause of a reduction in mortality after Insite opened then it was the cause of an increase in overdose deaths in the area prior to Insite opening. Even more crushing for Gary Christian, is that this means the decline in drug related overdose clearly demonstrated in the Lancet occurred because the policing initiative ended.

Perhaps most scurrilous as mentioned above is the suggestion by Gary Christian’s JGDPP team that the Lancet authors included 2001 in their methodology in order to skew results in favour of overdose reductions. The JGDPP report suggests a review from 2002 onwards would show an increase. Yet the Lancet authors had written an earlier report in 2009 showing stable use from 2001 to 2005:

As shown in a figure from that report (below), although the proportion of IDU reporting daily heroin use declined from 1998 to 2001, the proportion of IDU reporting daily heroin injecting remained stable from 2001 to 2005 (i.e., the period considered in our Lancet study).

Figure showing that daily heroin use from 2001 to 2005 remained stable

Whilst this is a look at the most prominent manipulations and misrepresentations authored by Gary Christian’s team a quick reading of the Lancet author’s response – below – reveals a more comprehensive overview. Accusations of careless assessment are put to rest and a read of the original paper shows the lengths gone to in the Discussion to acknowledge other factors that may contribute to a reduction in drug induced mortality. There are also many other absurdities presented in the JGDPP article (such as “recommended reading” and citing a speech by “Christian voice in politics”, Gordon Moyes) that must condemn Christian and his team even further.

Of course like an antivaccination lobbyist Christian has not budged an inch, still insisting he is completely correct and that peer review and science itself is flawed. Now, in the shadow of their complete demolition we can review the hypocrisy and misplaced confidence of Mr. Christian in his ability to scam the public and academics alike.

 Activists are never likely to provide objective science and there are dozens of other Insite studies that must now be under a cloud as a result.

Drug Free Australia has never produced any science and peer reviewed research. This shows their inhumane prohibitionist world view as without merit, and data supporting Insite as entirely safe.

Stephen Fry extended interview

Stephen Fry talks to Tony Jones of ABC Lateline about his many interests, passions, convictions and roles.

He discusses his vice-presidency of the auspicious conservation group Flora and Fauna International, a responsibility Sir David Attenborough convinced him to assume. He expresses his love for “indifferent nature” and evolution and ponders his interest in saving the planet, in view of the fact that as a gay man he isn’t prone to leave genes behind. He offers his views on gay marriage, the “teenage years” of the gay rights movement and the human yearning to love and to be loved.

This brings up Molly Lewis’ open letter to Stephen Fry in which she sings her offer to act as a surrogate mother to pass on his genes. He touches on his friendship with and the mortality of Christopher Hitchens, whose academic genius and brilliantly expressed atheism has contributed to his rising stature over the past decade.

…one of the things that was most perhaps galling, if I can put it like that, for him is that his life seems to be on the verge of being snatched away from him at a time when he has most achieved.

An atheist himself Fry offers his more gentle appraisal of religion in general yet reserves no particular escape clause for the folly of theistic belief and theology. In view of the real world struggle for life in nature this seems to strike him as incomprehensible. Although fond of the art religion has inspired, he agrees with Jones that, “…there’s no proof contained in this of the existence of God”;

And no, I don’t believe in God. To me there is no difference between someone who believes in Allah or Yahweh, or God, the Christian God, or Christ, than someone who believes in Pan and Hephaestus and Zeus and the gods of the Greek myth.

They’re wonderful constructs and they allow for marvellous art because they tell great stories of the human collective unconscious at a time before we had science to articulate an expression and an explanation of the world.

We can’t disprove the existence of God anymore than we can disprove Bertrand Russell’s celestial teapot:

On the other hand, it is absurd to believe that it exists. And it’s more than absurd to predicate a whole system of moral codes on the basis of that unprovable thing. It is actually wicked to do so.

So, yes, you can never disprove God. Of course you can’t. And you can’t disprove the teapot, but to all intents and purposes, if there is a god, it is clear that he’s capricious, wilful, mean, treacherous, a liar, unkind, prepared to see suffering of the most shameful kind.

Whilst life is “beautiful” it is also “unbelievably cruel. It’s only about passing on the genes”:

And so, you have to dispense with any sort of Victorian idea of this benign, loving god, this brown-eyed Jesus, this Holman Hunt knocking at the door…

…by all means say that there is a god, but don’t tell me he loves me. I mean, that’s just silly.

There’s no shortage of the charm, wit and warmth we’ve come to associate with this admirable, adorable and wonderful chap. May he delight us all for many years to come.

Measles: A Gift from a Goddess?

One of the more ridiculous falsehoods spread by Meryl Dorey in her promotion of disease as better than vaccination, is that in ancient Sanskrit “measles” means “gift from a goddess”.

She further claims that this is so because robust health and “huge” growth follows measles. Which is not exactly what I’d expect to see in a child who’d been bed ridden, suffering fevers perhaps seizures, diarrhea, exhaustion, malnourishment, drowsiness, muscle pain, photophobia, dry cough, bloody nose, possible brain damage, etc, etc and of course the chance of death. This entire claim is utterly bogus and toweringly irresponsible given that some listeners will be influenced by it.

From page 26 of Dorey’s Iverell Forum presentation slides (AVN seminar teachings)

In fact the Sanskrit मसूरिका or “masuurikaa” translates variously as measles, lentil, eruption of lentil shaped pustules, procuress (female procurer) and smallpox. So, with apologies to Sanskrit we shall move on to examine exactly what relationship a Goddess may have with this disease and why. As with many early cultures and belief systems, significant phases in life are assumed controlled by divine power. Diseases are believed to come in response to divine retribution, anger, punishment or even the working of an evil witch or sorcerer.

With respect to this Merylism we at least have enough to visit the beliefs of rural Indian folk. Here we find the goddess Sitala Mataji also known as Shitala, Sheetala or just Sitala. Broadly speaking Sitala Mataji is the Hindu pox goddess, worshipped in Pakistan, Nepal, Bangladesh and particularly in Northern India and Western Bengal. With Bengal situated in the north-east of the Indian sub-continent geographical proximity supports a common anthropological view of infectious disease.

Sitala Mataji loves cold and coolness and this is reflected in her name. She likes cold food offerings cooked the day before. One derivation Shitala Devi means the Cold Goddess. Measles is caused by the anger of Sitala Mataji. When we talk about measles and this goddess it’s important to realise this is understanding measles in strictly religious terms. Hindus may refer to measles as choti mai or choti mata (the smaller mother) whilst smallpox is bari mai or bari mata (the larger mother). Before the eradication of smallpox in the 1970’s Sitala was associated with smallpox.

According to legend Sitala is one of seven sisters who live in the neem tree and who bring epidemic diseases. She is often in the company of Gheṇṭukarṇa, the god of skin diseases, Jvarāsura, the fever demon, the Cauṣaṭṭī Rogas, (the sixty-four epidemics), Olāi Caṇḍi/Olāi Bibi, the goddess of cholera, and Raktāvatī, the goddess of blood infections. The measles rash represents “heat” and “dirt” that must come out lest the child die. Child talismans of goat, lion or bear hair warding off the fear which measles brings, and indeed the way measles “frightens” children strongly reflect links to the spirit world.

Shrines to Sitala Mataji can be found near neem trees. Other talismans against evil spirits and fear include spreading neem leaves and rose petals across a child’s bed in the case of Punjabi Christians who also spread neem leaves on the floor and use them to brush the measles rash. Hindus place neem leaves over the entryway to the house and under the infected child’s bed.

They would also keep a can of wet cow dung at their door or child’s door so that people entering – who may be “impure” – can put their feet or leg in the wet dung which is “pure”, before entering to visit the victim. A herb kala dana which is also used for Evil Eye infections should be burnt as it’s smoke is good for measles, assisting the rash to “come out”. Some herbal teas assist in promoting fever which is viewed as assisting the heat and rash to leave the body.

Although Sitala looks out for children and mothers she is simultaneously destructive and protective. In An anthropology of infectious disease: international health perspectives, Inhorn and Brown (1997) cite a number of authors, writing:

Although Sitala is by nature cool when she is angry she becomes heated and attacks with pox diseases, overheating her victims as well. Excess heat in the body then causes the skin rash to appear. The idea is that the disease of measles is the goddess and that when measles occurs the goddess herself is within her victims, burning them. From this it follows that measles victims themselves are in something resembling a “godlike” state and it is appropriate for them and their families to follow a restricted “purification” diet while the disease is in progress [p. 308].

In order to placate Sitala Mataji parents wait until about the fifth day and having wrapped their child tightly in a white cloth take them for a blessing at the temple. The tight wrapping also increases perspiration and the progression of the rash. On returning from the temple wet cow dung is used to make symbols resembling on the wall of the house or house compound.

Cotton wool is spaced out evenly stuck to the dung. Red ceremonial worship powder is dabbed onto the cotton wool as Sitala is further encouraged to chill out (no pun intended) with prayers said in the child’s name. The symbols also serve to warn others away.

As expected in areas of counterfeit vaccines/medication and where less than half of “allopaths” are properly qualified there are stories of families following doctors orders to the letter only to loose the child. Others who sought to placate Sitala Mataji and went to the temple found their child recovered. Some Hindu women suggest these beliefs and strong relationship between measles and Sitala are a “carryover” from when smallpox was a major killer.

The legend of the vengeful burning arises from the story of a poor daughter in law ordered by her cranky mother in law to prepare sweets and food for the Sitala Satam celebrations, which were the next day. The daughter in law did but exhausted and having fed her child about 11pm, fell asleep. At the stroke of midnight Sitala Mataji came by and was burnt by the stove which had not been put out. Sitala cursed this woman and said “As I was burnt so let your child be burnt”.

On waking the woman realised her folly and saw her child was burnt. Other villagers pointed out it was the young mother’s fault that Sitala had been pained by the hot stove, become angry and thus, that her child had become burnt. The woman got permission to seek Sitala in the forest and eventually came upon an old woman with dandruff and “some tiny microbes” in her hair. The old lady asked where she was going and if she could spare time to clean her hair of insects and such. The young mother being a rather selfless type complied, handing her baby to the old woman.

After about an hour the baby revived and cried and the mother suddenly realised the old woman was Sitala Mataji in disguise. Showing devotion she fell into the holy lotus position and begged forgiveness for her mistake. This made Sitala very happy who forgave the young mother and promised to always be helpful to her – as long as no stoves were left on on that particular day. The next year the young mother’s jealous sister in law purposely left her stove on so her child would be burnt by Sitala Mataji. She journeyed into the forest but ignored the old woman and returned with a dead baby.

Devastated, crying, seeking forgiveness from the young mother and praying with true devotion to Sitala Mataji she begged the goddess “to make the dead child alive”. Sitala Mataji then blessed this child and later the jealous daughter made a confession and asked for forgiveness. So, the festival became one celebrated with devotion. All sweets and food are prepared the day before. Stoves are turned off and sprinkled with water. Devotees have a cold bath in the morning, and it is women and small children who worship mostly seeking blessing from the goddess Sitala Mataji.

The impact of this legend may be rightly gauged as profound. The life and death of a child is solely down to offending or proper appeasement of the goddess Sitala Mataji. In some North Indian villages as reported by Inhorn and Brown [p. 311] 74% of mothers believe measles cannot be prevented “whether through immunisation or otherwise”. It is a dangerous yet essential part of life. 70% believe no doctors should be seen lest the goddess – who resides within measles – is offended. Of 18 cases among Sikhs in India none were taken to a doctor. Three died [p. 313].

Apart from increasing perspiration, wrapping also prevents “measles-associated pneumonia” – a widely held fear. It is believed pneumonia is caused by cold. Even after recovery, isolation and wrapping continues to prevent “breathing problems”. Sitala has a brother god who causes the gasping for breath seen in pneumonia which suggests measles-pneumonia is also a part of Hindu mythology. In families with severe poverty and illiteracy other children die of dehydration from measles induced diarrhea, which is also seen as a means of removing the heat inflicted by Sitala Mataji.

In simple terms, in the cultures Dorey was misrepresenting, measles is seen as a curse from a goddess. One who demands in response such absolute devotion that children die as their superstitious parents fear offending her with medicine and instead smear cow dung on the walls of their home, pray and burn ritual herbs. In a fit of anger she attacks and burns small children through the fault of the mother who must then carry the burden of hit and miss spiritual appeasement. It is these very beliefs and others like them that will for a long time prevent significant reduction of measles in developing nations.

Clearly there is no gift from any goddess. No “huge” growth spurt. Only a pitiful struggle for survival and the fear of Sitala’s brother god. Ken McLeod on page 24 of Meryl Dorey’s trouble with the truth part 3: lies and fraud offers [bold mine]:

In a Sanskrit dictionary the word “masuri ” means “small-pox,” and the Sanskrit equivalent of the English word “measles” is “masurika मसूरिका”, from ‘a kind of herb’, ‘lentil’ or ‘pillow’, as in “an eruption of lentil-shaped pustules.” There is no etymology involving gifts from goddesses. The World Health Organisation tells of a superstition in the Indian subcontinent that smallpox resulted from a wrathful kiss by the Goddess of Smallpox, Shitala Mata. That is quite the opposite to Dorey’s claim.

One must pause and wonder if Dorey has any remote appreciation of the harsh living conditions and unbridled suffering such villagers may endure. Or if she understands their struggle as she sprouts her own cow dung over the simple truths that control their quality of life. If she is so inclined then why not smear cow dung on her own walls or offer a can full at the next pox party?

Strange isn’t it. We won’t see the antivaccination devotees stepping in wet cow dung before crossing the threshold to visit a sick child. Nor would we see devotees of Sitala Mataji giving their children the saliva of children already infected with measles. All things considered I’m pretty sure who is the most misguided.

Gift from a Goddess? I call cow dung.