By Dr. Mercola
Last year, a shocking piece of legislation was introduced in the U.S. Congress called the 21st Century Cures Act.1
Proponents of the bill claimed it would deliver faster, easier drug and
medical product approvals from the U.S. Food and Drug Administration
(FDA), which would translate into improved medical care and access to
valuable treatments for sick and dying Americans.
Industry and political backers of the bill didn't talk publicly
about the fact that the sweeping legislation also covered "biological
products," which means vaccines that are government licensed,
recommended and mandated for all Americans to use.
There are many reasons to be wary of this kind of federal legislation and, according to a public opinion poll2,3 by Harvard T.H. Chan School of Public Health and STAT, most Americans distrust it.
Fifty-eight percent of Americans oppose changing safety and
effectiveness standards to allow for fast-tracking of drugs; half of
respondents object to regulatory changes to accelerate approvals of new
medical devices.
Yet despite a lot of criticism from concerned citizens, the bill sailed through the House of Representatives last summer.
In July 2015, the bill was referred to the Senate's Health,
Education, Labor and Pensions Committee, where it stalled amid arguments
about funding and after consumer groups, including the National Vaccine
Information Center, voiced strong opposition to the gutting of already
low FDA licensing standards.4,5
This year, Senators supporting passage of the 21st Century Cures Act cut
the legislation up into seven smaller bills with hopes it will be
easier to quietly move those smaller bills through Congress without
publicity and accomplish the original goals of the 21st Century Cures
Act:
The entire 21st Century Cures House bill came in at a hefty 400 pages,
but if you want to get an overview of the long term goals of
pharmaceutical and medical trade lobbyists partnering with federal
health agencies, you can read through a 102-page Congressional Research
Service summary of it.6,7
Once you're done, you'll probably agree that the only real beneficiaries
here are the drug companies and federal health agencies, as this
legislation intends to fast-track drug and vaccine approvals, cut
corners on pre-licensure testing, severely restrict informed consent
protections in scientific research on humans, and give billions of
dollars to the National Institutes of Health (NIH) to develop more drugs
and vaccines in partnership with pharmaceutical companies.
In short, the legislation would continue to push the one-size-fits-all
type of medical care focused on expensive (and now poorly tested) drugs
and vaccines that has contributed to the U.S.' abysmal health ratings.
It will give large amounts of money to NIH to fund experimental drug and
vaccine research, while simultaneously relaxing FDA oversight — a move
that will hardly result in safer medicine. It's also a clear danger to
natural health, and as noted by Barbara Loe Fisher last year, the bill
poses a particular threat to vaccine safety.8
As passed by the House last July, this federal legislation9
intends to establish a new fund within the U.S. Treasury in the amount
of $1.86 billion per year through 2020, for a total of $9.3 billion. The
monies will go to the NIH to develop new drugs and vaccines.
This is in addition to funding from the Department of Health and Human
Services (HHS). Of the $1.86 billion per annum, $1.75 billion would go
to NIH Biomedical Research and $110 million for Cures Development.
Focus areas are: precision medicine (treatments based on genetic makeup
of the patient and/or disease), infectious diseases, antibiotics and
biomarkers (markers that gauge the biological response to a drug,
supposedly eliminating the need to wait for the results from a
full-fledged patient trial). No mention is made of research relating to
natural health or prevention.
Patient Safety Seemingly Abandoned Altogether
Harm to patients is at an all-time high in our country, with preventable medical errors and drug side effects being the third leading cause of death in the U.S.
Yet, the legislative goals of the 21st Century Cures Act that
Senators this year cut up into smaller bills apparently for the purpose
of sliding them through Congress before the public knows what has
happened, contains numerous provisions that can only worsen the
situation.
As noted by Fisher, "there are so many breathtaking ways the 21st
Century Cures Act will endanger the public health that it is hard to
know where to begin." For starters, the bill increases "regulatory
flexibility" by the FDA in reviewing and approving drugs, biologics and
medical devices. Specifically, it:
• Increases the ability of
pharmaceutical companies and device makers to have a greater voice in
the regulatory process and to streamline ways for FDA to approve their
products.
• Lowers FDA licensing standards
for drugs, medical devices and biological products, the latter of which
includes vaccines, which means companies will be able to forgo large
case-controlled clinical trials to evaluate safety and effectiveness.
In lieu of large-scale clinical trials, drug companies would be allowed
to use biomarkers and other endpoint measures to prove the vaccine's
effectiveness. But what about safety?
Public Trust in FDA at Historic Low
It's interesting to note that all of this is happening at a time when
public trust in the FDA is already at a historic low. According to a
2014 paper10
in JAMA Internal Medicine, 37 percent of respondents in an online poll
agreed the FDA is "intentionally suppressing natural cures for cancer
because of drug company pressure."
Some have even suggested the 21st Century Cures Act is the beginning of
the end for the FDA, and that the agency will eventually be eliminated
altogether. As noted by ProPublica:11
"The legislation has its roots in a longstanding push by
conservative groups to liberate drug and device development from red
tape. 'Now, I don't want to get your hopes up, but Phase Three, maybe
we'll take out FDA,' said Newt Gingrich during the Republican Revolution
of 1994, when he also called the agency the nation's 'leading job
killer.'
More recently, the deregulatory crusade against the FDA has been led
by conservative think tanks such as the Goldwater Institute and
Manhattan Institute, which launched its 'Project FDA' to reform the
agency so that it provides a 'more predictable, transparent, and
efficient pathway' for new medications and devices."
Enter 'Good Enough Science'
When assessing the safety and effectiveness of a drug or vaccine, the
FDA would even be allowed to accept such flimsy evidence as Bayesian
statistical analyses — a novel data analysis method based on
probabilities and "best guesses" — and clinical experience, including
anecdotal evidence!12
"It's interesting that clinical experience and anecdotal evidence
will constitute 'good science' for the purpose of demonstrating a
vaccine is safe before its licensed, while clinical experience and
anecdotal evidence have never been enough to demonstrate that a vaccine
is unsafe after its licensed," Fisher says.
Political scientist Daniel Carpenter, Ph.D. who specializes in the
FDA, calls the legislation "the 19th Century Fraud Act," saying, "This
is a part of the bill that threatens to take us back more than a
century."13
Even the FDA commissioner Dr. Robert Califf has stated that unless the
legislation is "carefully crafted, [it] could pose significant risks for
FDA and American patients. Innovative therapies are not helpful to
patients if they don't work, or worse, cause harm."14
Disturbingly, the legislation would also allow clinical testing of
experimental drugs on people without first obtaining their informed
consent, provided "the proposed clinical testing poses no more than
minimal risk." It's unclear what constitutes "minimal risk," and who
would have the right to make such a determination. This seems like a
monumental step backwards, considering the legal protections put in
place across the world to prevent covert medical experimentation on
humans.
The legislation also outlines provisions related to the delivery of
health care, including interoperability of electronic health information
technology, and includes a number of proposed Medicare and Medicaid
changes to offset costs. Oddly, it also calls for a drawdown in the
nation's strategic petroleum reserve, presumably to help pay for it all.
Lowering Licensing Standards Is a Really Bad Idea
The 21st Century Cures Act legislation now embodied in seven separate
Senate bills seeks to bring more medicines to people with rare disorders
for which few treatments are available. But by tying together funds for
increased research and loosened regulatory controls across the board,
the risks will be carried by ALL people.
If you have a debilitating and lethal disease, you may be willing to
take risks you'd never take under normal circumstances. If this law
takes effect, medicine will be increasingly risky for everyone.
As noted by STAT:
"There is no question that more research funding is necessary and
that finding legitimate ways to get medicines to patients faster is
crucial. But Congress ought to separate the debate over research funding
from the rest of the legislation. Loosening regulatory standards would
only create problems for which real cures will be needed."
This is particularly true for vaccines, which are given to healthy
infants, young children and adults. Moreover, once a vaccine is licensed
by the FDA and recommended for all children by the CDC, it often is
mandated by state health officials for school attendance, and that's
true whether the vaccine is fast-tracked or not.
The risks to public health, however, are FAR greater with a
fast-tracked vaccine and there are literally hundreds of experimental
vaccines in the pipeline, including vaccines for HIV/AIDS, hepatitis C,
genital herpes, syphilis, norovirus and tuberculosis, just to name a
few.
"The 21st Century Cures Act is being sold as a way for the FDA to
quickly license experimental pharmaceutical products for people
suffering with rare or life threatening diseases, whether or not those
products have been adequately tested.
However, greasing the FDA's licensure skids to make
experimental drugs available for the sick and dying who voluntarily
choose to use them is one thing, while greasing the skids to bum rush
experimental vaccines to licensure that government will legally require
healthy children and adults to buy and use is quite another," Fisher says.
Ignoring the Basics Can Have Serious Consequences
While precision medicine with its focus on genetic makeup is a goal
worthy of research, the Cures Act legislation completely ignores far
more basic differences between individuals, such as age and sex. As
noted by The Washington Post:15
"Throughout the 20th century, most medical research was conducted on
relatively young, healthy men. In recent years, researchers have
realized that treatments often affect women and older patients
differently than men or younger patients.
These differences can affect safety and effectiveness ... [T]he
21st Century Cures Act is based on the assumption that there will be
more cures if drugs and devices are studied more quickly by testing them
on fewer patients — in some cases, on just a handful.
Unfortunately, such studies would be too small to allow safety and
effectiveness findings to be broken down for subgroups such as men,
women, young adults and seniors. This embrace of smaller, more
preliminary studies could drastically lower scientific standards. When
fewer people are studied, it is more likely that a drug will seem safe
and effective even if it has dangerous side effects for many patients —
who may not have been included in those small studies.
Worse, the bill specifies that after studying only small groups of
patients, drug manufacturers could sell a new treatment to anyone, even
if the patient was not among the types studied. In fact, hospitals would
be paid extra to make it financially feasible to prescribe more
expensive new drugs to Medicare patients, even if the drugs were never
studied on patients older than 65 ..."
The 21st Century Cures Act legislation actually undermines other recent
laws calling for more stringent research into drug effects based on age
and sex differences. Three years ago, a law was passed directing the FDA
to make sure all age groups and both sexes are included in testing to
ascertain safety and efficacy. Just last year, the General
Accountability Office also concluded the NIH needs to make analysis of
sex differences a priority.16
Fast-tracking, which requires only minimal testing, has other pitfalls
as well. Like vaccines, the bill would allow antibiotics to be
fast-tracked based on limited data from test tubes and animal studies.17
This makes no sense at all, as research shows these kinds of tests
don't always translate into safety and effectiveness in humans.
Considering the fact we're facing a proverbial avalanche of antibiotic-resistant disease,
issuing ineffective antibiotics is foolhardy in the extreme. It may
simply add fuel to the fire of drug resistance, while simultaneously
failing to help patients.
Members of Congress Spend Most of Their Time Raising Funds for Reelection
Americans have not only lost trust in the FDA. A mere 14 percent of
Americans think Congress is doing a good job. CBS' 60 Minutes recently
aired a segment discussing the inordinate amount of time Congress spends
raising money for their own elections and the party — about 30 hours a
week! — and Florida Republican David Jolly's call to quit "dialing for
dollars" and get down to real business.
According to 60 Minutes:
"Nearly every day, they spend hours on the phone asking supporters
and even total strangers for campaign donations — hours spent away from
the jobs they were elected to do. The pressure on candidates to raise
money has ratcheted up since the Supreme Court's Citizens United
decision in 2010. That allowed unlimited spending by corporations,
unions and individuals in elections.
So our attention was caught by a proposal from a Republican
congressman that would stop members of Congress from dialing for dollars
... Rep. David Jolly: 'You have six months until the election.
Break that down to having to raise $2 million in the next six months.
And your job, new member of Congress, is to raise $18,000 a day. Your
first responsibility is to make sure you hit $18,000 a day.'"
Jolly has quit making fundraising calls — a move that might cost him his
position, but it's a risk he's willing to take. He's also introduced a
bill called the "Stop Act," which would ban all federal elected
officials from soliciting donations directly. It's a good start, but
truly, we need comprehensive reform.
Corporate donations play a huge role in the kinds of legislation brought
forth, and it's hard to look at the 21st Century Cures Act legislation
as anything but another gift to the big political spenders — the
pharmaceutical industry that has developed a public-private business
partnership with federal health agencies — at the direction of Congress!
And it was Congress that bailed out the vaccine manufacturers in 1986
by shielding them from product liability for injuries and deaths caused
by government licensed, recommended and mandated vaccines.18
Congressman Rick Nolan (D-Minnesota), who is co-sponsoring the Stop
Act, agrees that the influx of corporate money has had a dramatically
negative influence on Congress.
Anonymous Congressman Writes Tell-All Book
The 86 percent of Americans who have lost faith in Congress will likely
not be shocked by "The Confessions of Congressman X," a brand new
tell-all book written by an anonymous Democrat. He too reveals that his
main job as Congressman is to raise money for reelection, leaving no
time to actually read any of the bills he votes on. (Apparently, it also
leaves precious little time to write, as the book is a mere 84 pages.)
According to The Daily Mail:19
"The anonymous spleen-venter has had a lot to say about his
constituents, however. Robert Atkinson, a former chief of staff and
press secretary for two congressional Democrats, took notes on a series
of informal talks with him — whoever he is — and is now publishing them
with his permission.
'Voters claim they want substance and detailed position papers, but
what they really crave are cutesy cat videos, celebrity gossip, top 10
lists, reality TV shows, tabloid tripe, and the next f***ing Twitter
message,' the congressman gripes in the book ...
'Fundraising is so time-consuming I seldom read any bills I vote
on,' the anonymous legislator admits. 'I don't even know how they'll be
implemented or what they'll cost. My staff gives me a last-minute
briefing before I go to the floor and tells me whether to vote yea or
nay. How bad is that?'
And on controversial bills, he says, 'I sometimes vote 'yes' on a
motion and 'no' on an amendment so I can claim I'm on either side of an
issue. It's the old shell game: if you can't convince 'em, confuse 'em'
... 'Our party used to be a strong advocate for the working class,' he
says. 'We still pretend to be, but we aren't. Large corporations and
public unions grease the palms of those who have the power to determine
legislative winners and losers' ...
'Most of my colleagues are dishonest career politicians who revel in
the power and special-interest money that's lavished upon them,'
Atkinson recorded his mystery collaborator saying. 'My main job is to
keep my job, to get reelected. It takes precedence over everything.'"
Long-Term Public Health Sacrificed for Short-Term Goals
Our political process is in shambles, and the fact that corporations are
running the show has become increasingly self-evident. The 21st Century
Cures Act legislation is just one of the latest clues. For an excellent
summary of the many shortfalls of this bill, see this previous Health
Affairs' article.20
If made into law, it will make newly approved drugs and medical
devices LESS safe and likely LESS effective, while further increasing
costs in a country that already has the highest medical expenditures on
the planet while lagging far behind other industrialized nations when it
comes to health statistics.
Modern medicine is the third leading killer of Americans, and we need increased patient safety,
not more fast-tracked drugs and vaccines with limited safety and
effectiveness testing. Recent research shows many of the drugs approved
by the FDA are already tainted by massive corruption, allowing worthless
and/or dangerous drugs on the market.
We need stronger drug licensing requirements, not more lax
ones. As noted by Health Affairs, "many of the provisions appear to be
favorable to the pharmaceutical, biotechnology and medical device
industries, while not providing benefits to patients." This just isn't
right.
If you agree, I urge you to contact your senators and share your
views on this bill. You can also find your senators' contact information
by calling the Capitol Switchboard at 202-224-3121.
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