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The Cancer Letter Inc.
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publication date: Mar 25, 2013

Congressional Republicans asked the HHS Office of Inspector General to investigate the appropriateness of funding a prominent scientist whose publications found a link between tobacco companies and the Tea Party conservative movement.

A letter signed by Rep. Jack Kingston (R-Ga.), chairman of the House Appropriations Subcommittee on Labor, HHS and Education, asked HHS Inspector General Daniel Levinson to review three NCI grants to Stanton Glantz, a professor in the Department of Medicine at the University of California San Francisco, as well as a member of the Helen Diller Family Comprehensive Cancer Center and director of the Center for Tobacco Control Research and Education.

The letter also challenges a grant the National Library of Medicine gave to Catherine Gallagher, a Cochrane Collaboration leader and a criminology professor at George Mason University, who studies health problems of young prison inmates as well as gun violence.

“I would appreciate your review of these grants to determine if the lobbying prohibition was in fact violated,” Kingston wrote to Levinson.

“Please ensure your review also examines if and when NIH updated its procedures and guidelines to ensure NIH-supported activity does not violate any lobbying restrictions,” wrote Kingston.

The letter to Levinson was not officially released, but a copy was obtained by The Cancer Letter.

Kingston’s request for an investigation appears to be a part of a broader strategy by Republicans to push NIH and other HHS agencies away from public health research and public health programs that may influence policy.

Several science advocates say that this latest episode in America’s ideological war threatens to undermine the foundations of peer-reviewed research:

• “There are people interested in finding truth and saving lives; there are people interesting in hiding truth and making money—and the latter cohort often attacks the former, and is often funded by big tobacco,” said Otis Brawley, chief medical and scientific officer of the American Cancer Society.

“While a federal grant should not be used to lobby, and I have no information that this grant money was—the study of how big tobacco manipulates public health intervention is fair game. Anyone truly interested in public health research must support Glantz at this time.” ACS has funded Glantz’s work in the past.

• “The need to protect the NIH peer review process and integrity is critical even when very controversial topics are handled,” said David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies; and a professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health.

“The issue of the politics, of course, is also a sensitive one that can be used to undermine the freedom of scientists to conduct their work once approved by NIH peer review, which is process that is the admiration of the entire world.” The Schroeder Institute is a part of Legacy, the foundation that established Glantz’s endowed chair and has funded his work.

• “To lobby is to try to influence a public official to take a certain action on behalf of a constituency; to publish in a peer reviewed journal is to advance a claim for knowledge based on a methodology that meets the standards of a discipline,” said Sheldon Krimsky, the Lenore Stern Professor of Humanities & Social Sciences at Tufts University.

“To conflate the two can only be viewed as a step toward the censorship of science.” Krimsky is the author of an upcoming book, “Biotechnology in Our Lives: What Modern Genetics Can Tell You About Assisted Reproduction, Human Behavior, Personalized Medicine, and Much More.”

 

NIH Director Collins Grilled at Congressional Hearing

While the controversy over the boundaries between research and politics isn’t new, the challenge from Republican legislators has intensified in recent weeks.

At an appropriations hearing last week, self-described Tea Party member Rep. Andy Harris (R-Md.) confronted NIH Director Francis Collins with the findings in Glantz’s recent paper that appeared in Tobacco Control, a peer-reviewed journal published by British Medical Journal Group.

Collins didn’t defend the Glantz paper, saying instead that he was “troubled” by it (The Cancer Letter, March 8).

Kingston is asking the Office of the Inspector General to expand what appears to be the agency’s ongoing investigation of HHS grantees using federal funds for lobbying.

OIG is involved in a related investigation of the Communities Putting Prevention to Work Program, funded by the Centers for Disease Control and Prevention. The program is funded through the American Recovery and Reinvestment Act and the Patient Protection and Affordable Care Act. The investigation was prompted by House Republicans and is included in the OIG work plan for 2013.

 Though Kingston’s letter asking OIG to focus on Glantz and another researcher was dated Feb. 25, it’s not clear whether Collins would have known about it at the time he was confronted at the appropriations hearing.

“I can confirm to you that we did receive that letter,” said Donald White, a spokesman for OIG. “We are giving the letter from the Chairman very careful review. The next step, after review, it will be assigned, as appropriate, to a component within the Office of Inspector General if there is going to be further action taken.”

White said he could neither confirm nor deny the existence of a broader investigation of lobbying by HHS grantees noted in Kingston’s letter. However, other sources said that the investigation is ongoing.

 

Peer Review Called the Study "Flawless"

Glantz first learned about the Kingston letter from The Cancer Letter.

“We welcome a careful review of our work,” Glantz said. “We wrote a well-documented academic paper in a peer-reviewed journal.”

Gallagher, director of the Cochrane Collaboration College for Policy and an associate professor of Criminology, Law and Society at George Mason University, was also singled out by Kingston. Her grant, which pays $50,000 a year for up to three years, focuses on health problems of young prison inmates.

“The preponderance of evidence portrays adults and adolescents under the control of the criminal and juvenile justice systems as disproportionately shouldering the burden of nearly every type of negative health condition, from premature death to representing the single largest infectious disease carrying population,” a summary of the grant states.

“As such, the tens of millions of people currently involved in the criminal and juvenile justice systems are critical to the public health of their larger communities, while also representing an overwhelming loss of human potential. Despite these facts, there remains a dearth of coherent policy specifically designed to address the health of, and the health service delivery for, this population.

“The lack or rational policy and evidence-based guidelines may be viewed as the failure of the scientific community to rigorously organize the knowledge base on health prevalence, interventions and outcomes, and to disseminate findings in a manner conducive to guideline development that will resonate with care providers.”

Like Glantz, Gallagher was unaware of Kingston’s letter.

“This piece of research almost got a perfect score in the NIH peer review,” said Gallagher. “You want a 10. I got a 13. It was called ‘flawless.’ All of the independent scientists said it’s written flawlessly; it’s compelling, it’s organized. You don’t get a 13— it’s a once-in-a-lifetime score. If NIH has people having a problem with a grant that got 13, where are we?”

Gallagher said she is unaware of any specific incident that could have singled her out to House Republicans. However, she has conducted Congressional briefings on juvenile justice and gun violence. Gallagher said she has no position on gun control. “I have no position how to fix it,” Gallagher said. “What I have a position on is what it does to kids and what it dies to their futures and their lives, but that’s all from research. It’s not me saying people shouldn’t have a gun. I am looking at prevalence and correlates.

“You are taking someone who works with Cochrane, the most independent research organization around the globe, and saying that somehow they are going to be lobbying,” Gallagher said. “The goal is to ensure that we are bias-free, and that we report bias, and we reduce bias.”

The letter from Kingston focuses on a phrase from the NIH abstract, which states that her project “is intended to engage the medical, public health, criminal justice, policy, legal, and advocacy communities by uniting diverse disciplines around a common issue.”

Gallagher said she had to deal with advocacy communities, because the cohort she is studying is in prison. “They are locked up,” Gallagher said. “It may have been better to say ‘to involve patient populations and patient representatives.’ That may have been the politically correct language to use. I don’t know. It just seems very silly.”

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