A cikin Disamba 1953, shugabannin manyan kamfanonin taba sigari na Amurka sun yi watsi da cin hanci da rashawa. sun taru a otal din Plaza na birnin New York don fuskantar wata barazana ga masana'antar su mai fa'ida mai riba. Ƙungiyar kimiyya ta gaggawa da aka buga a cikin fitattun mujallolin likitanci ta jefa shakku kan amincin taba sigari kuma ta yi barazanar lalata nasarar haɗin gwiwa na rabin karni. Tare da su a Plaza shine John W. Hill, shugaban babban kamfanin hulda da jama'a na Amurka, Hill & Knowlton. Daga baya Hill zai tabbatar da ƙwaƙƙwaran mai ceto.
Hill ya yi kusa yayi karatu Edward Bernays, wanda aikinsa kan farfaganda a shekarun 1920 zuwa 1930 ya kafa tushen dangantakar jama'a ta zamani tare da ayyana dabarun gama gari don sarrafa ra'ayin jama'a. Hill ya fahimci cewa duk wani yaƙin neman zaɓe na al'ada ba zai gaza rinjayar al'umma ba, wanda ya ɗauki talla a matsayin ɗan ƙaramin farfagandar kamfanoni. Ana buƙatar ingantacciyar hulɗar jama'a m wajen gudanar da harkokin watsa labarai. A mafi kyawun sa, bai bar alamun yatsa ba.
Maimakon yin watsi da ko ɓata sabbin bayanan da suka sami haɗarin taba, Hill ya ba da shawarar akasin haka: rungumi kimiyya, busa sabbin bayanai, da kuma buƙatar ƙarin, ba ƙarancin bincike ba. Ta hanyar yin kira don ƙarin bincike, wanda za su ba da kuɗi, kamfanonin taba za su iya amfani da masana kimiyya a fagen fama don fuskantar babbar gardama ta kimiyya da kuma ƙara ra'ayoyin shakku game da dangantakar dake tsakanin taba da cututtuka. Irin wannan makirci zai bar kamfanoni su rufe kansu cikin shakku da rashin tabbas - ainihin ka'idodin tsarin kimiyya, wanda kowane amsa ya haifar da sababbin tambayoyi.
Yaƙin Hill & Knowlton na manyan kamfanonin taba na Amurka biyar sun lalata kimiyya da magani shekaru da yawa masu zuwa, aza harsashi ga rigingimun kudi na sha'awa a kimiyya, kamar yadda sauran masana'antu suka kwaikwayi dabarun taba don kare kayayyakinsu daga haramcin gwamnati da ka'idoji-daga baya, daga shari'ar masu amfani. Duk da yake dabarun sun bambanta a tsawon lokaci, ainihin dabarun ya canza kadan tun taba ya rubuta littafin wasan kwaikwayo, samar da menu na fasahohin da ake amfani da su a cikin masana'antu.
Don sanya kansu a matsayin kimiyya fiye da kimiyyar kanta, hukumomi suna hayar malaman ilimi a matsayin masu ba da shawara ko masu magana, suna nada su a kan allo, ba da kuɗin bincike na jami'a, tallafawa mujallolin banza, da kuma samar da malaman ilimi tare da rubutun fatalwa wanda za su iya ƙara sunayensu kuma su buga a cikin mujallolin da aka bita tare da wani lokaci kadan ko babu ƙoƙari. Waɗannan dabarun suna haifar da wata hanya ta kimiyya wacce ke nutsar da muryoyin masu bincike masu zaman kansu kuma suna yin tambaya game da ingancin bayanan bangaranci.
Don ci gaba da lalata masana kimiyya marasa son kai, masana'antu suna tallafawa a ɓoye a ɓoye da ƙungiyoyin gaba na kamfanoni. Waɗannan ƙungiyoyin sun yi tsokaci da haɓaka nazarin kamfanoni da ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararru, da ƙaddamar da yaƙin neman zaɓe ga masana ilimi masu zaman kansu, galibi suna ƙoƙarin dawo da bincikensu ko kuma a ɗauke su a matsayin matsayi na biyu kuma marasa amana ga jama'a da kafofin watsa labarai.
Don magance tasirin kamfanoni, ƙungiyoyin ilimi da na gwamnati sun yi ta juye-juye zuwa manufofin rigingimu da kiraye-kirayen nuna gaskiya da bayyana kudi. Philip Handler, Shugaban Kwalejin Kimiyya ta Kasa (NAS) a farkon shekarun 1970, gabatar da farkon rikice-rikice na manufofin amfani wanda Majalisar NAS ta amince a 1971.
Manufar ta jawo tsawatarwa daga manyan masana kimiyya wadanda suka kira ta "cin mutunci" da "rashin mutunci," ƙirƙirar tsarin da ke ci gaba a yau. A duk lokacin da wata badakala ta barke wanda ya gano kamfanoni suna yin tasiri da bai dace ba akan kimiyya, ana fuskantar kiraye-kirayen nuna gaskiya da tsauraran ka'idojin da'a tare da tabbatar da cewa dokokin yanzu suna da kyau kuma ba a buƙatar ƙarin bincike.
Duk da haka, ƙungiyar wallafe-wallafen da ke da girma ta gano cewa gardama game da rikice-rikice na kudi na gyare-gyaren sha'awa ba su da tushe, ba su da ƙarfin hankali, kuma sun jahilci binciken da aka yi nazari na tsara game da tasirin kudi. Kodayake rikice-rikice na manufofin ban sha'awa sun zama mafi yawa, abubuwan da suke ciki da mahimman buƙatun sun samo asali kaɗan tunda aka gabatar da Makarantun Kasa dokokinsu na farko.
A haƙiƙa, cece-kuce game da kula da kimiyyar kamfanoni na ci gaba da kare Makarantun. Fiye da shekaru 40 bayan gabatar da manufofinsu na farko na rikice-rikice na sha'awa, da An sake kama jami'o'in a cikin wani abin kunya, bayan koke-koken cewa mambobin kwamitin da ke shirya rahotanni ga Makarantun na da kyakkyawar alaka da kamfanoni.
Masu ba da rahoto sun gano cewa kusan rabin mambobi ne na 2011 Academies rahoton game da kula da ciwo. yana da alaƙa da kamfanoni waɗanda ke kera narcotics, gami da opioids. Wani bincike na daban na jaridar ya gano cewa ma'aikacin NAS wanda ya zabi mambobin kwamitin don bayar da rahoto kan ka'idojin masana'antar fasahar kere kere yana neman aiki a wata kungiya mai zaman kanta ta biotech. Yawancin mambobin kwamitin da ya zaba an gano cewa suna da alaƙar kuɗi da ba a bayyana ba ga kamfanonin biotech. Kamar yadda wannan bita na tarihi zai nuna, Kwalejin ba ita kaɗai ba ce wajen fuskantar rikice-rikice na sha'awa a cikin sake zagayowar ƙi, abin kunya, gyara, da ƙari.
Early Years
Damuwa game da tasirin kamfanoni akan kimiyya yana da ɗan ƙaramin zamani, tun da ya bayyana a cikin 1960s. A farkon karni na 20h, gidauniyoyi masu zaman kansu da cibiyoyin bincike sun tallafa mafi yawan binciken kimiyya a Amurka. Hakan ya canza bayan Yaƙin Duniya na Biyu, sa’ad da gwamnatin ƙasar ta fara ƙara yawan kuɗi a shirye-shiryen kimiyya. Likitan Physicist Paul E. Klopsteg yafi bayyana fargabar da masana kimiyya da yawa suka ji game da gwamnati da ke sarrafa tsarin bincike. A matsayinsa na Mataimakin Daraktan Bincike a Gidauniyar Kimiyya ta Kasa a cikin 1955, ya damu cewa tallafin da gwamnatin tarayya ke bayarwa na kimiyya na iya baiwa gwamnati damar kwace manufar jami'o'i.
"Shin irin wannan hangen nesa yana sa ku cikin damuwa?" Klopsteg ya tambaya, cikin salon magana. "Ya kamata; domin yana buƙatar ɗan hasashe don yin hoto a cikinsa wani aiki na hukuma wanda ba zai iya jurewa ba kuma babu makawa a cikin al'amuran makarantunmu na manyan makarantu."
Ana iya tantance tasirin gwamnati akan kimiyya ta hanyar nazarin lambobin kasafin kuɗi. Daga shekarar farko da ta fara aiki a shekarar 1952, kasafin kudin Gidauniyar Kimiyya ta Kasa ya karu daga dala miliyan 3.5 zuwa kusan dala miliyan 500 a shekarar 1968. Cibiyoyin Kiwon Lafiyar Jama'a na kasar sun sami karuwa mai yawa, wanda ya karu daga dala miliyan 2.8 a shekarar 1945 zuwa sama da dala biliyan 1 a shekarar 1967. Zuwa 1960, gwamnati ta tallafa sama da kashi 60 cikin dari na bincike.
A lokacin wannan lokacin, al'ummar kimiyya sun mayar da hankali kan rikice-rikice masu ban sha'awa da suka shafi masana kimiyya waɗanda ko dai suna aiki a gwamnati ko kuma waɗanda hukumomin gwamnati suka ba da kuɗi, musamman masu bincike a shirye-shiryen binciken kimiyyar soja da sararin samaniya. Ko da yayin amfani da kalmar "rikici na sha'awa," masana kimiyya sun tattauna batun kawai a cikin kunkuntar mahallin doka.
Lokacin da Majalisa ta gudanar da sauraren karar game da rikice-rikice na sha'awar kimiyya, sun damu masana kimiyya waɗanda suka kasance 'yan kwangilar gwamnati na Hukumar Makamashin Atomic ko Hukumar Kula da Jiragen Sama da Sararin Samaniya ta ƙasa yayin da suke da buƙatun kuɗi a cikin bincike na sirri ko kamfanoni masu ba da shawara.
Hakanan damuwa game da tasirin gwamnati akan kimiyya ya bayyana a cikin 1964. Wannan shekarar, duka Majalisar Amirka kan Ilimi da Ƙungiyar Ƙwararrun Ƙwararrun Jami'o'i ta Amirka sun ɓullo da manufofin rikice-rikice na sha'awa waɗanda kawai suka tattauna bincike da gwamnati ke bayarwa.
Ta hanyar nazarin bayyanar kalmar "rikicin abubuwan sha'awa" a cikin jarida Science a cikin karni da ya gabata, muna iya ganin yadda kalmar ta canza a cikin mahallin da ma'ana, yana nuna damuwar masu bincike game da ƙarfin ƙarfin waje wajen tsara kimiyya. A farkon shekarun, kalmar ta bayyana a cikin shafukan mujallar dangane da dangantakar masana kimiyya da gwamnati. A tsawon lokaci, wannan ya canza zuwa abubuwan da suka faru da tattaunawa da suka shafi masana'antu. Wannan rashin kwanciyar hankali tare da masana'antu da alama ya karu da lokaci tare da karfafa zumunta tsakanin jami'o'i da abokan hulda.
Taba Yana Ƙirƙirar Kimiyya Daidaitacce
Bayan ganawar farko da shugabannin kamfanonin taba a ƙarshen 1953. Hill & Knowlton sun ƙirƙiri ingantacciyar dabara don rufe ilimin da ke tasowa game da taba a cikin shakka. Masu shakka sun kasance koyaushe a cikin kimiyya. A haƙiƙa, shakku shine ainihin darajar kimiyya. Amma taba ta sake dawo da shakku ta hanyar cika filin bincike da kuɗi don nazarin alakar da ke tsakanin shan taba da cututtuka, da sanya masana'antar a matsayin masu ba da shawara na kimiyya yayin da suke tsarawa da haɓaka saƙon jama'a cewa haɗarin taba sigari wani muhimmin cece-kuce a kimiyyance.
tarihi Allan M. Brandt na Jami'ar Harvard ya lura, "Shakka, rashin tabbas, da kuma gaskiyar cewa akwai ƙarin sani zai zama sabon mantra na masana'antu."
Wannan kutse na Dokin Trojan ya kauce wa faɗuwar faɗuwar kai tsaye. Harin masu bincike na iya komawa baya kuma ana kallon su azaman zalunci; fitar da bayanan tsaro za a iya watsi da jama'a masu ban tsoro a matsayin masu son kai, ko mafi muni, rashin gaskiya. Amma jaddada buƙatar ƙarin bincike ya ba masana'antar sigari damar karɓo yanayin ɗabi'a wanda daga nan za su iya yin la'akari da bayanan da ke tasowa, a hankali suna jagorantar sabon bincike don tayar da muhawara mai ban tsoro. Yayin da ake yin kamar manufar kimiyya ce, kamfanonin taba za su yi sake fasalin bincike don hulɗar jama'a.
Kamfanonin hulda da jama'a na da gogewar shekaru da dama a matakin sarrafa kafofin watsa labarai don dakile bayanan da ke cutar da abokan cinikinsu. Amma ta hanyar sarrafa tsarin bincike da tsarin kimiyya, kamfanonin taba za su iya sarrafa 'yan jarida fiye da na baya. Maimakon a yi amfani da ‘yan jarida su yi fada a bangarensu na muhawarar jama’a. kamfanoni za su haifar da muhawara sannan a yi amfani da kafafen yada labarai don tallata su.
A wani bangare na shirinsu na farko, kamfanonin taba sun nemi masana don bata sunan sabon bincike wanda zai iya samun alaƙa tsakanin taba da kansar huhu. Bayan kamfanoni sun tattara bayanan jama'a na likitoci da masana kimiyya, Hill & Knowlton sannan suka samar da compendium na masana da maganganunsu. Ba a gamsu da ba da kuɗi kawai masana kimiyya da ayyukan bincike ba, Hill ya ba da shawarar ƙirƙira cibiyar bincike ta masana'antu. Wannan kira na sabon bincike ya watsa sako mai saukin kai cewa bayanan da ake ciki yanzu sun tsufa ko kuma sun lalace, kuma ta hanyar hadin gwiwa da masana kimiyya da jami'o'insu, ya haifar da ra'ayi cewa masana'antar taba ta himmatu wajen samun amsoshin da suka dace.
"An yi imani," Hill ya rubuta, “cewa ana buƙatar kalmar ‘Bincike’ a cikin sunan don a ba da nauyi da kuma ƙarin tabbaci ga bayanan Kwamitin.” Ta hanyar sanya taba sigari a matsayin mai ba da shawara kan bincike, Hill ya sanya kimiyya mafita ga yuwuwar ka'idojin gwamnati. Wannan tsarin zai haifar da kusan rabin karni na hada baki tsakanin kamfanonin taba da masu bincike na jami'a.
Kwamitin Bincike na Masana'antar Taba (TIRC) ya zama tsakiya ga dabarun Hill & Knowlton na haɗin gwiwar neman ilimi. Lokacin da aka kafa TIRC bisa hukuma, ya ƙare Jaridu 400 sun gudanar da talla sanar da kungiyar mai taken, “Bayanin Frank Ga Masu Taba Sigari.” Tallar ta lura cewa ana zargin taba da haddasa cututtuka iri-iri na mutane, duk da haka, "An yi watsi da tuhumar daya bayan daya saboda rashin shaida." The tallace-tallace sai suka yi alkawari cewa kamfanoni za su ba da kuɗi, a madadin masu amfani da su, sabon bincike don nazarin illolin lafiyar taba:
Mun yarda da sha'awar lafiyar mutane a matsayin babban nauyi, mafi mahimmanci ga kowane la'akari a cikin kasuwancinmu. Mun yi imanin samfuran da muke yi ba su da lahani ga lafiya. A koyaushe muna da kuma koyaushe za mu ba da haɗin kai tare da waɗanda aikinsu shine kiyaye lafiyar jama'a.
Babban Daraktan TIRC ya kasance WT Hoyt, ma'aikacin Hill & Knowlton, wanda ke sarrafa TIRC daga ofishin kamfaninsa na New York. Hoyt ba shi da kwarewar kimiyya, kuma kafin ya shiga kamfanin PR, ya sayar da tallace-tallace don Asabar Maraice Post. Daga baya masana'antar taba za ta ƙare "Mafi yawan binciken TIRC ya kasance mai fa'ida, yanayin asali wanda ba a tsara shi don gwada ka'idar rigakafin taba ba."
Bayan ya yi ritaya a matsayin Shugaba na Brown & Williamson, Timothy Hartnett ya zama shugaban TIRC na cikakken lokaci na farko. The sanarwar nadin nasa ya karanta:
Wajibi ne na Kwamitin Bincike na Masana'antar Taba a wannan lokacin don tunatar da jama'a waɗannan mahimman abubuwan:
- Babu wani tabbataccen hujjar kimiyya na alaƙa tsakanin shan taba da ciwon daji.
- Binciken likita ya nuna yawancin abubuwan da ke iya haifar da cutar kansa….
- Cikakken kimanta karatun kididdiga da ake yi yanzu ba zai yiwu ba har sai an kammala waɗannan karatun, an rubuta cikakkun bayanai kuma an fallasa su ga binciken kimiyya ta hanyar bugawa a cikin mujallolin da aka karɓa.
- Miliyoyin mutanen da suke samun jin daɗi da gamsuwa daga shan taba za a iya sake tabbatar musu da cewa za a yi amfani da kowace hanyar kimiyya don samun duk gaskiyar da wuri.
TIRC ta fara aiki a cikin 1954 kuma kusan kusan dala miliyan 1 aka kashe akan kudade zuwa Hill & Knowlton, tallace-tallacen watsa labarai, da farashin gudanarwa. Hill & Knowlton sun zaɓi kwamitin ba da shawara na kimiyya na TIRC (SAB) na masana kimiyyar ilimi waɗanda suka yi bita na tallafin da ma'aikatan TIRC suka tantance a baya. Hill & Knowlton ya fi so masana kimiyya wadanda suka kasance masu shakka na illolin taba sigari, musamman masu shakka wadanda suka sha taba.
Maimakon zurfafa bincike game da alaƙar taba da kansa, galibi Shirin TIRC ya mayar da hankali kan amsa tambayoyi na asali game da ciwon daji a fannoni kamar ilmin rigakafi, kwayoyin halitta, ilmin halitta, ilmin likitanci, da virology. The Tallafin TIRC na jami'o'i ya taimaka wajen kwantar da jawabai da muhawara wanda ke jayayya cewa taba na iya haifar da cututtuka, yayin da kuma ba wa kamfanonin taba damar yin hulɗa da masana kimiyya, kamar yadda wasu masana kimiyya na TIRC suka dauki matsayi mai karfi a kan taba.
Yayin ƙaddamar da TIRC, Hill & Knowlton suma sun motsa don sake fasalin yanayin watsa labarai ta hanyar haɓaka babban ɗakin karatu na tsarin giciye akan batutuwan da suka shafi taba. Kamar yadda Hill & Knowlton zartarwa ya bayyana:
Manufa ɗaya da muka daɗe muna bi ita ce mu ƙyale wani babban hari marar tushe ya tafi ba tare da amsa ba. Kuma za mu yi iya ƙoƙarinmu mu sami amsa a rana ɗaya—ba jibi ko bugu na gaba ba. Wannan yana buƙatar sanin abin da zai fito a cikin wallafe-wallafe da kuma a cikin taro…. Wannan yana ɗaukar wasu yin. Kuma yana buƙatar kyakkyawar hulɗa tare da marubutan kimiyya.
Ko da yake ba a kafa matsayinsu a cikin ingantaccen wallafe-wallafen da aka bita ba, Hill & Knowlton sun watsa ra'ayoyin ƙaramin rukuni na masu shakka game da kimiyyar sigari, wanda ya sa ya zama kamar ra'ayoyinsu sun mamaye binciken likita. Waɗannan masu shakka sun ba TIRC damar magance duk wani hari da aka yi wa taba. A lokuta da dama, TIRC ta sake fitar da sabon binciken tun kafin su zama jama'a. Wannan yaƙin neman zaɓe ya yi nasara saboda ya sace 'yan jarida na kimiyyar son jayayya da himma don daidaitawa.
"Idan aka yi la'akari da ra'ayin 'yan jarida don jayayya da yawancin ra'ayi na rashin daidaituwa, waɗannan roko sun yi nasara sosai," Brandt ya ƙarasa.
Ba a gamsu da nau'ikan sarrafa kafofin watsa labarai masu wuce gona da iri kamar talla da fitar da manema labarai ba, Hill & Knowlton sun yi ta kai farmaki ga marubuta, masu gyara, masana kimiyya, da sauran masu yin ra'ayi. Abokan hulɗar fuska da fuska sun kasance masu mahimmanci, kuma bayan kowace sanarwar manema labarai, TIRC za ta fara "tuntuɓar sirri." Hill & Knowlton sun tsara wannan zawarcin jaridu da mujallu don ƙarfafa daidaiton aikin jarida da adalci ga masana'antar taba. A yayin wannan ganawar, TIRC ta jaddada cewa, masana'antar taba ta himmatu wajen kula da lafiyar masu shan taba sigari da kuma binciken kimiyya, yayin da ta bukaci yin shakku game da binciken kididdiga na gano cutar.
A karshe, TIRC ta gabatar da 'yan jarida tare da abokan hulɗa na masu shakku "mai zaman kansu" don tabbatar da daidaiton aikin jarida. A takaice dai, bayan haifar da cece-kuce, Hill & Knowlton sai suka ha]a hannu da manema labarai don su ba da labarin muhawarar, wanda ya haifar da labarun da suka kammala kimiyyar taba “ba a warware ba.”
Duk da yadda Hill & Knowlton ke gudanar da TIRC a bayan fage don samar da ingantaccen sahihancin kimiyya, masana kimiyya da ke ba da shawara TIRC sun yi fatali game da 'yancin kai na hukumar da amincin su na sana'a a tsakanin takwarorinsu. Don kwantar da waɗannan tsoro, Hill & Knowlton sun kirkiro Cibiyar Taba Sigari a 1958, bisa ga umarnin RJ Reynolds.
An Daga baya lauyan masana'antu ya ba da labarin cewa "Kirkirar wata kungiya ta daban don bayanan jama'a an buga ta ne a matsayin hanyar kiyaye [masanin kimiya na TIRC] keta da rashin gurbatar hasumiya ta hauren giwa yayin baiwa sabuwar kungiya 'yancin yin aiki a fagen hulda da jama'a." Bayan sun kare manufar "kimiyya" na TIRC, Hill & Knowlton sun gudanar da Cibiyar Taba Sigari a matsayin ingantacciyar harabar siyasa a Washington don tinkarar sauraron sauraren 'yan majalisa da ka'idojin hukuma. Kamar yadda yake a cikin talla da kafofin watsa labarai, da Masana'antar taba ta kirkiro sabbin dabaru tare da Cibiyar Taba sigari don sarrafa yanayin tsari da yanayin siyasa.
Nasarar Hill & Knowlton ta bayyana a shekara ta 1961. Lokacin da taba ta hayar kamfanin a 1954, masana'antar ta sayar da sigari biliyan 369. A shekara ta 1961, kamfanoni sun sayar da sigari biliyan 488, kuma amfani da sigari kowane mutum ya tashi daga 3,344 kowace shekara zuwa 4,025. mafi girma a tarihin Amurka.
A 1963, a New York Times labari ya lura, "Abin mamaki shine, hasashe game da shan taba da lafiya sun kasa jefa masana'antar cikin wani mawuyacin hali, maimakon haka, ya jefa ta cikin tashin hankali wanda ya haifar da ci gaba da riba." Wani jami'i tare da Ƙungiyar Ciwon daji ta Amirka ya fadawa jaridar, "Lokacin da kamfanonin taba suka ce suna ɗokin gano gaskiya, suna son ku ɗauka cewa ba a san gaskiyar ba…. Suna so su iya kiranta da jayayya."
A lokacin wannan lokacin, masana kimiyya sun yi kama rashin damuwa da rikice-rikice na sha'awa wanda ya taso a lokacin da bincike na jami'a na tallafin taba sigari da masana ilimi suka haɗa kansu da yaƙin neman zaɓe na kamfani. Lokacin da Babban Likita Janar ya kafa kwamiti na ba da shawara kan shan taba da lafiya a cikin 1963, kwamitin ba shi da wata takaddama na sha'awa. A gaskiya ma, masana'antar taba ta kasance a yarda a nada da kin amincewa mambobin kwamitin.
Ko da yake takardun da ke ba da cikakken bayani kan dabarun taba don satar kimiyya sun zama jama'a ne kawai bayan shari'a a cikin 1990s, wannan littafin wasan kwaikwayo da aka kirkira a shekarun 1950 ya kasance mai tasiri kuma wasu masana'antu sun kwafi. Domin tarwatsa ƙa'idodin kimiyya da hana ƙa'ida, kamfanoni da yawa yanzu yi da'awar tukunyar jirgi na rashin tabbas na kimiyya da rashin hujja, da kuma karkatar da hankali daga haɗarin lafiyar samfur ta hanyar dora laifi kan alhakin mutum.
Kafin shan taba, jama'a da na kimiyya sun yi imanin cewa kimiyya ba ta da wani tasiri da bai dace ba daga bukatu na musamman. Koyaya, taba ta sake dawo da kimiyya ba don haɓaka ilimi ba, amma don gyara abin da aka riga aka sani: shan sigari yana da haɗari. Maimakon ba da kuɗin bincike don yin sabbin abubuwa, taba ta yaɗa kuɗi don gano abin da ya riga ya zama gaskiya. Masanin tarihi, Robert Proctor, na Jami'ar Stanford yayi amfani Kalmar "agnotology" don bayyana wannan tsari na gina jahilci.
Har wala yau, al’umma na fafutukar yin halitta manufofi don iyakance tasirin kamfanoni a kan fannonin kimiyya waɗanda ke ciyar da sha'awar jama'a da yin hulɗa da dokokin gwamnati. Za mu iya gode wa masana'antar taba domin kirkiro rikicin mu na zamani tare da rikice-rikice na sha'awa da nuna gaskiya na kudi a cikin kimiyya.
Labari na Zamani
Ƙarshen shekarun 1960 da farkon shekarun 1970 sun nuna lokacin dambarwar siyasa da sauyin zamantakewa a Amurka. Amincewa da gwamnati da cibiyoyin zamantakewa ya ruguje tare da Badakalar Watergate da jerin fallasa wanda ya ba da haske mai haske a kan bukatu na musamman da ke amfani da Majalisa. A lokaci guda kuma, Majalisa ta ƙirƙiri sabbin hukumomin tarayya tare da faɗo'i masu yawa don kare lafiyar jama'a, haɓaka rawar masana kimiyya a cikin tsara manufofin tarayya.
Hukumar Kare Muhalli da Hukumar Kula da Tsaro da Lafiya ta Ma'aikata, da aka kirkira a cikin 1970, an tuhumi su da haɓaka ƙa'idodin tsari don abubuwa da yawa waɗanda ke da iyakataccen bayanai don su. A lokaci guda, Dokar Ciwon daji ta 1971 ta ba da hankali ga abubuwan muhalli masu alaƙa da haɗarin ciwon daji.
A bayanin wannan lokaci, Masanin ilimin zamantakewa Sheila Jasanoff ta yi magana cewa masu ba da shawara na kimiyya sun zama "reshe na biyar" na gwamnati. Amma yayin da likitanci da kimiyya suka fara yin tasiri kai tsaye kan manufofin, lokaci guda sun shiga ƙarƙashin babban binciken jama'a, wanda ya haifar da cece-kuce game da amincin kimiyya. Kafofin watsa labaru a lokacin sun ba da labarai na farko game da sha'awar kuɗi da kuma bayyana cin hanci da rashawa game da batutuwa da dama da suka shafi muhalli, amincin masu amfani, da lafiyar jama'a.
Kafin wannan, jama'a ba kasafai ake fuskantar wata shaida game da illolin radiation, magungunan kashe qwari, da kayan abinci da kuma yadda waɗannan abubuwan ke haifar da cutar kansa ba. Duk da haka, kamar yadda masana kimiyya da likitoci suka sami ƙarin bincikar sana'o'in su, al'umma kuma ta bukaci cewa suna kirkiro manufofi don kare lafiyar jama'a.
A cikin 1970, Cibiyar Ilimi ta Kasa ta fuskanci zarge-zarge na nuna son kai ga masana'antu, bayan da aka kafa wani kwamiti don nazarin lafiyar lafiyar gubar iska. Dupont da Kamfanin Ethyl—kamfanoni biyu da suka fi samar da gubar dalma a Amurka—sun ɗauki 4 daga cikin 18 ƙwararrun kwamitin. Makarantun Makaranta kakakin ya kare kwamitin, suna jayayya cewa an zaɓi membobin a kan tushen cancantar kimiyya, kuma sun shawarci Kwalejin a matsayin masana kimiyya, ba a matsayin wakilan ma'aikatan su ba.
Shugaban Makarantun a wannan lokacin shine Philip Handler, tsohon malami wanda tuntubar da yawa abinci da kuma Pharmaceutical kamfanonin da yayi aiki a Hukumar Gudanarwa na Kamfanin Abinci na Squibb Beech-Nut. A tsawon mulkinsa, Handler ya ci gaba da fuskantar suka kan alakar masana'antar sa.
Handler yayi ƙoƙari ya zare allurar rikice-rikice na sha'awa ta hanyar nuna wajibcin Kwalejin na yin aiki tare da Ma'aikatar Tsaro don kare ƙasa. "Tambayar ba ita ce ko Kwalejin ya kamata ta yi aiki ga Ma'aikatar Tsaro ba amma yadda za ta ci gaba da kiyaye haƙƙin sa wajen yin hakan," yayi gardama. Har ila yau, Handler ya ba da shawarar samun ƙarin tallafin tarayya don ilimin kimiyya na digiri amma ya yi gargadin cewa "jami'a ba dole ba ne ta zama mai biyayya ga ko halittar gwamnatin tarayya ta hanyar dogaron kuɗi." Yayin da suke jayayya cewa tallafin gwamnati da masana'antu na da mahimmanci ga kimiyya, sai ya yi kamar ya koma gefe matsalar cewa wannan kudade na iya yin illa ga 'yancin kai na kimiyya.
Bayan kwamitin kerfuffle na jirgin sama, Handler ya ba da shawarar cewa sabbin mambobin kwamitin su bayyana duk wani rikici da ka iya tasowa yayin hidimar Kwalejin. Wannan bayanin za a raba shi tsakanin membobin kwamitin, ba jama'a ba, kuma an yi shi ne don samar da bayanai ga Kwalejin da ka iya yin illa idan ta bayyana ta wasu hanyoyi. Sabbin rikice-rikice na sha'awa dokoki sun iyakance don bayyana alakar kuɗi, amma kuma ana la'akari da "sauran rikice-rikice," waɗanda za a iya ɗauka azaman haifar da son zuciya.
Kafin aiwatar da sabon manufar, Handler ya gudanar da bincike na yau da kullun na kwamitoci da alluna a NAS. Wasu sun amsa cewa dukkan membobin suna cikin rikici, yayin da wasu suka ce masana kimiyya ba za su iya nuna son kai ba. Daya dan kwamitin ya rubuta, "Shin ba zai yiwu ba gaskiya ne cewa sai dai idan memba na kwamitin yana da wasu yuwuwar [rikicin sha'awa], ba zai yiwu ya zama memba mai amfani ba?" A takaice, lokacin da masana kimiyya suka yi tsokaci game da rikice-rikice na sha'awa da kuma yadda hakan zai iya ɓata ra'ayinsu, sun juyar da matsalar ta hanyar sake fasalin rikice-rikice na sha'awa a matsayin "ƙwarewar kimiyya."
A watan Agusta 1971, the Makarantar ta amince da wasiƙa mai shafi ɗaya, mai taken "Akan Tushen Bias Mai yuwuwa," wanda membobin kwamitin shawarwari masu yuwuwa za su cika. Wasiƙar ta lura cewa kwamitocin NAS sun kasance, zuwa "ƙara mai ƙarfi," ana tambayar su don yin la'akari da batutuwan "sha'awar jama'a ko manufofin," don haka akai-akai suna buƙatar yanke shawara wanda ya dogara kan "hukunce-hukuncen kima" da kuma bayanai. Ko da 'yan kwamitin suna aiki ba tare da son zuciya ba. wasikar ta bayyana, irin waɗannan tuhume-tuhumen na iya lalata rahotannin kwamitin da kammalawa. Don haka, mutum an bukaci mambobin su bayyana "Waɗanda [abubuwa], a cikin hukuncinsa, wasu za su iya ɗauka na son zuciya."
Da yawa daga cikin ‘yan kwamitin na kallon wannan magana a matsayin zargi ko kuma kalubalantar amincin su, tare da wasu suna kiransa "cin mutunci" da "marasa mutunci." Dokokin tarayya sun buƙaci masu ba gwamnati shawara su bayyana rikice-rikice na kuɗi kamar tallafi ko hannun jari, amma bayanin Academy shiga cikin wasu hanyoyin da za a iya nuna son zuciya kamar maganganun da suka gabata da zama memba a kungiyoyi.
Har yanzu, damuwa game da mutuncin Kwalejin ya tashi a shekara mai zuwa lokacin da aka zargi Kwamitin Kare Abinci nata da nuna son kai ga masana'antu da kuma rage haɗarin ciwon daji na sinadarai na abinci. Kamfanonin abinci wani bangare ya ba kwamitin kudi wanda ya hada da malamai, wadanda suka tuntubi masana'antar abinci. Damuwa game da tasirin masana'antu sun kuma kara zafi a 1975, lokacin da Ralph Nader ya ba wa wani tsohon ɗan jarida kuɗi Science, Philip Boffey, don bincika dangantakar Kwalejin da masana'antu da kuma yadda tallafin kuɗi na kamfanoni ya yi tasiri ga rahotannin su.
Duk da haka, sanarwar Kwalejin ta 1971 wata manufa ce ta farko a cikin rikice-rikice na sha'awa da kuma mafarin yin hakan. ayyukan Kwalejin na yanzu. Amma wani sabon abu zai shiga hoton a cikin 1980 lokacin da Majalisa ta zartar da Dokar Bayh-Dole. Wannan doka ta yarda jami'o'i don mallakar abubuwan ƙirƙira da furofesoshi suka kirkira tare da tallafin gwamnati da ƙarfafa haɗin gwiwar kamfanoni don haɓaka sabbin kayayyaki da kawo su kasuwa.
A cikin shekara guda, yawancin manyan cibiyoyin ilimi da malamansu sun sanya hannu kan yarjejeniyar ba da lasisi mai riba tare da kamfanonin harhada magunguna da fasahar kere-kere, raba ilimi a jami'o'in Amurka kan rashin kwanciyar hankali game da amincin kimiyya da 'yancin ilimi.
Shaida na Yanzu da Firamare na Kamfanonin Magunguna
A farkon shekarun 1900, Ƙungiyar Ƙwararrun Jami'o'i ta Amirka ta buga sanarwar ka'idoji don jagorantar rayuwar ilimi. A baya, wannan furucin yana da kyau:
Duk jami'o'i na gaskiya, na jama'a ko na sirri, amana ce ta jama'a da aka tsara don ciyar da ilimi gaba ta hanyar kiyaye binciken kyauta na malamai da masana. 'Yancin su yana da mahimmanci saboda jami'a tana ba da ilimi ba kawai ga ɗalibanta ba har ma da hukumar gwamnati da ke buƙatar jagorancin masana da sauran al'umma masu buƙatar ilimi mai zurfi; da… waɗannan abokan ciniki na ƙarshe suna da gungumen azaba a ra'ayin ƙwararrun ƙwararru, waɗanda aka bayyana ba tare da tsoro ko tagomashi ba, wanda ake buƙatar cibiyoyi ta ɗabi'a ta mutunta.
Ayyukan jami'a na yanzu sun yi kama da waɗannan ƙa'idodi game da kusancin yadda halayen jima'i na zamani ke lalata kyawawan ɗabi'a na zamanin Victoria. Kamar yadda juyin juya halin jima'i na 1960 ya canza dabi'ar jima'i, taba ya canza ayyukan jami'a ta hanyar ɓata iyakoki tsakanin hulɗar jama'a da bincike na ilimi. Wadannan canje-canje sun kasance mafi zurfi a cikin magani, inda haɗin gwiwar ilimi tare da masana'antar fasahar kere kere ta haifar da duka biyun warkarwa ga cututtuka da yawa da kuma a annoba na rikicin kudi na sha'awa.
A taƙaice, masana'antar harhada magunguna sun sake dawo da yaƙin neman zaɓe ta hanyar haɗin gwiwar masana kimiyya don sayar da magunguna. Wadannan rikice-rikice na kudi na sha'awar binciken ilimin kimiyyar halittu sun shiga muhawarar jama'a a farkon 1980s, biyo bayan jerin abubuwan kunya na kimiyya. A wasu lokuta, bincike ya bayyana cewa membobin baiwa sun ƙirƙira ko gurbata bayanan samfuran samfuran da suke da sha'awar kuɗi.
A lokacin, wasu muhimman dokoki guda biyu sun taimaka wa masana kimiyya da masana'antar fasahar kere kere. A cikin 1980, Majalisa ta zartar da doka Dokar Innovation Fasaha ta Stevenson-Wydler da Dokar Bayh-Dole. Dokar Stevenson-Wydler ta tura hukumomin tarayya don canja wurin fasahar da suka taimaka ƙirƙira ga kamfanoni masu zaman kansu, wanda ya jagoranci jami'o'i da yawa don ƙirƙirar ofisoshin canja wurin fasaha. Dokar Bayh-Dole ta ba wa ƙananan 'yan kasuwa damar ƙirƙira haƙƙin mallaka waɗanda aka ƙirƙira tare da tallafin tarayya, ba da damar jami'o'i damar yin lasisin samfuran da malamansu suka ƙirƙira. Dukansu dokokin sun yi niyya don yin amfani da hukumomin tarayya da kuma kudade don kawo kayayyakin ceton rai ga jama'a. Duk da haka, dokokin kuma sun tura masu ilimi a cikin ƙarin ƙawance da masana'antu.
Yayin da bambanci tsakanin binciken ilimi da tallace-tallacen masana'antu ya ci gaba da lalacewa, da New England Journal of Medicine ya sanar da farko m siyasa rikici na sha'awa ga kowace babbar kimiyyar mujallolin a 1984. A cikin edita, da Editan NEJM ya bayyana damuwa wanda ke buƙatar wannan sabuwar manufa:
Yanzu, ba zai yiwu kawai masu binciken likita su sami tallafin binciken su daga kasuwancin da samfuran da suke karantawa ba, ko kuma su zama masu ba da shawarwari masu biyan kuɗi, amma a wasu lokuta ma su kan zama shuwagabanni a cikin waɗannan kasuwancin ko kuma riƙe sha'awar adalci a gare su. Harkokin kasuwanci ya zama ruwan dare a cikin magani a yau. Duk wani sabon ci gaban bincike wanda ke da ko yana da aikace-aikacen kasuwanci yana jan hankali daga kafafan kamfanoni ko ƴan jari hujja.
Rahotanni na irin wannan ci gaba da aka fitar a taron manema labarai, da aka gabatar a tarurrukan kimiyya, ko kuma aka buga a cikin mujallu na iya sa farashin hannayen jari ya tashi ba zato ba tsammani kuma a samu arziki kusan dare daya. Sabanin haka, rahotannin sakamako mara kyau ko illa mai tsanani na iya ɓata darajar wani haja da sauri. Fiye da lokaci guda a cikin ƴan shekarun da suka gabata, buga wata kasida a cikin Jarida ita ce ta kai tsaye musabbabin hauhawar farashin hannun jari.
Bayan shekara guda, Jama ya kuma kafa manufar saɓani na sha'awa. Duk da haka, manyan jaridun kimiyya guda biyu ba su cim ma ba sai 1992 (Science) da 2001 (Nature). Bincike ya gano haka ilimantarwa na kimiyya sun kasance baya baya ga likitanci wajen magance son zuciya.
Alal misali, a cikin 1990, Makarantar Kiwon Lafiya ta Harvard ta kafa manufofin rikice-rikice na kudi na sha'awa, ta hanyar iyakance nau'ikan alaƙar kasuwanci na sashen bincike na asibiti na iya samun da kuma saita rufi akan buƙatun kuɗi. Wannan ya zama yunƙuri na farko da wata jami'a ta yi don ƙara banbance tsakanin binciken ilimi da haɓaka samfuran kamfanoni. Dukansu Ofungiyar Kwalejojin Medical na Amurka da Ƙungiyar Cibiyoyin Kiwon Lafiyar Ilimi ya biyo bayan wannan shekarar ta hanyar buga jagora game da rikice-rikice na kudi.
A cikin waɗannan shekarun guda ɗaya, Cibiyoyin Kiwon Lafiyar Jama'a sun ba da shawarar sabbin dokoki don buƙatar masana kimiyya su bayyana abubuwan da suka shafi kuɗi ga cibiyar su kuma ba su tuntuɓar ko samun daidaito a cikin kamfanoni waɗanda bincikensu zai iya shafan. A mayar da martani, da NIH ta sami haruffa 750, tare da kashi 90 cikin XNUMX na adawa da ƙa'idodin da aka tsara a matsayin masu tsatsauran ra'ayi da ladabtarwa.
Lokacin da sabbin dokokin suka fara aiki a cikin 1995, kawai suna buƙatar bayyana abubuwan buƙatun "wanda zai iya bayyana a zahiri kai tsaye kuma binciken ya shafi sosai." Abin takaici, jama'ar da za su ci gajiyar 'yancin kai na kimiyya ba kamar sun yi la'akari da wannan tsari ba, kuma cibiyoyin ilimi suna samun tallafin. ya ƙare aiwatar da ka'idoji kansu.
Koyaya, waɗannan matakan farko kamar yayi kadan tasiri wajen sarrafa tasirin da masana'antu ke samu a fannin likitanci da al'adun jami'o'i. A cikin 1999, Ƙungiyar Ƙwararrun Jini ta Amirka (ASGT) ta kasance tilasta yin shelar wasu tsare-tsare na kudi kashe-iyaka a cikin gwaje-gwajen jiyya na kwayoyin halitta, biyo bayan wani abin kunya a gwajin asibiti na farko na jiyya. Duk da haka, Tallafin masana'antu ya ci gaba da mamaye kwayoyin halitta, yanayin da ya bayyana a fili a cikin 1999 lokacin da Cibiyar Kiwon Lafiya ta Ƙasa ta ba da kuɗin dala biliyan 17.8 don yawancin bincike na asali. Sabanin haka, manyan kamfanonin harhada magunguna 10 sun kashe dala biliyan 22.7, akan bincike na asibiti galibi.
Yawancin karatu a cikin 1990s sun ci gaba da yin rikodin ikon kamfanoni akan magani. Bincike ya gano cewa kamfanonin harhada magunguna abin da ya shafi shawarar likitocin da cewa binciken na malamai masu alaƙa da masana'antu ya ƙananan inganci da kuma mai yuwuwa don fifita da nazarin samfurin masu tallafawa. Binciken mara kyau kasance da wuya a buga kuma mafi kusantar don samun jinkirta bugawa. Musamman damuwa ga masu ilimi ya kasance kafofin watsa labarai na girma sha'awa in labaran da suka tattara tasirin masana'antu fiye da magani.
Yayin da Dokar Bayh-Dole ta haifar da riba ga jami'o'i da masana ilimi, ta kuma gina ingantaccen madaidaicin ra'ayi, yana fitar da ƙarin binciken ilimi zuwa hanyar kasuwanci. Duk wani iyaka tsakanin jami'o'i da masana'antu da ya kasance a baya kamar ya ɓace bukatun ilimi sun zama kusan ba a iya bambanta su daga bukatun kamfanoni.
Amma bukatar jama'a na ci-gaba da binciken likitanci ya fusata ta hanyar rashin haƙuri na ko da wani ɓacin rai na jami'o'i yanzu sun haƙura a cikin binciken kamfanoni. A Jama edita ya bayyana wannan a matsayin gwagwarmaya "don samar da ingantaccen kayan aiki tsakanin duniya da dabi'un kasuwanci da na hidimar jama'a na gargajiya, daidaito tsakanin Bayh-Dole da ta Allah."
Rikicin sha'awa ya sake daukar hankali a cikin 2000 lokacin USA Today An buga wani bincike wanda ya gano cewa fiye da rabin masu ba da shawara ga Hukumar Abinci da Magunguna (FDA) suna da alaƙar kuɗi tare da kamfanonin magunguna waɗanda ke da sha'awar yanke shawara na FDA. Masana'antu sun musanta cewa waɗannan alaƙa sun haifar da matsala da kuma FDA ta kiyaye yawancin bayanan kuɗi a asirce.
Wani bincike na daban ya gano cewa kamfanoni sun ba da kuɗin kusan ɗaya daga cikin rubuce-rubuce uku da aka buga a cikin NEJM da kuma Jama. Masana sun kammala da cewa rikice-rikice na kudi na sha'awa "ya yadu a tsakanin marubutan rubuce-rubucen da aka buga kuma waɗannan marubutan sun fi iya gabatar da sakamako mai kyau."
A baya, 2000 ya kasance wani taron ruwa a Jama. A waccan shekarar, mujallar ta buga jerin editoci da ke nazarin yadda masana’antar harhada magunguna ke karuwa a kan likitoci tare da yin kira da a samar da shingen kare magunguna daga cin hanci da rashawa. Daya edita ya lura cewa noman likitocin masana'antar ya fara ne a shekarar farko ta makarantar likitanci lokacin da ɗalibai suka karɓi kyaututtuka daga kamfanonin harhada magunguna.
"Abin sha'awa yana farawa tun da wuri a cikin aikin likita: ga abokan karatuna da ni, an fara da baƙar fata." ta rubuta. The edita yayi nuni da nazari daya wanda ya gano cewa kamfanonin harhada magunguna suna ba da kuɗi a matsayin "likitoci masu zaman kansu" kuma bincike ya gano cewa waɗannan masanan sun fi iya gabatar da sakamako mai kyau.
A tsayayye na bincike a cikin 2000s ya ci gaba da rubuta rikice-rikice masu yaɗuwar sha'awa waɗanda suka lalata amincin kimiyya, da bincika bayyanawa azaman kayan aiki na farko domin gyarawa. Sai dai wani bincike ya gano hakan kusan rabin mujallolin likitanci suna da manufofi buƙatar bayyana rikice-rikice na sha'awa. Bincike ya kuma lura cewa kamfanoni suna daukar nauyin karatun a matsayin kayan aiki don kai hari ga samfuran masu fafatawa kuma ana iya biyan waɗannan karatun don kasuwanci ba dalilai na kimiyya ba.
Gudanar da rikice-rikice na sha'awa ya kasance marar kuskure, kuma a nazari na yau da kullun na mujallu sun gano cewa suna ƙara ɗaukar manufofin bayyanawa, amma waɗannan manufofin sun bambanta da yawa a cikin fannoni daban-daban, tare da mujallolin likitanci suna da ƙa'idodi. Dangane da wannan yanayi, Majalisar Tsaron Albarkatun Kasa ta kira taro sannan ya fitar da rahoto akan ƙarfafa ƙa'idodin rikice-rikice a cikin mujallu.
Binciken gwamnati a tsakiyar tsakiyar zuwa ƙarshen 2000s ya tilasta ƙarin rikice-rikice na abubuwan ban sha'awa a fagen jama'a. Bayan da Los Angeles Times ruwaito cewa wasu masu bincike a Cibiyoyin Lafiya na Ƙasa sun sami yarjejeniyoyin tuntuɓar masana'antu da masana'antu, Majalisa ta gudanar da sauraren karar, wanda ya haifar da tsauraran manufofin rigingimu ga ma'aikatan NIH. Binciken tarayya kuma ya fara tilastawa kamfanonin magunguna don bayyana kudaden su ga likitocin akan shafukan yanar gizo da ake da su a bainar jama'a a zaman wani bangare na yarjejeniyoyin tabbatar da kamfanoni.
Abin kunya na Merck's Vioxx ya ba da haske a kan cin zarafin masana'antar harhada magunguna na binciken likita a 2007. Takardun da aka yi a bainar jama'a yayin shari'ar sun gano cewa Merck ya canza. bincike-bincike na tsara cikin ƙasidu na tallace-tallace by karatun fatalwa ga malaman da ba kasafai suke bayyana alakar su ta masana'antu ba.
Yin nazarin labaran da aka buga, bayanin da Merck ya bayar ga Hukumar Abinci da Magunguna, da bincike na ciki na Merck, masu bincike sun gano cewa Merck na iya yin kuskuren bayanin haɗarin-amfani na Vioxx a cikin gwaje-gwajen asibiti da ƙoƙarin rage haɗarin mace-mace a cikin rahotanni ga FDA. Don gwaji ɗaya, kamfani takardun bayyana cewa rashin bayanan da hukumar sa ido kan tsaro (DSMB) na iya jefa marasa lafiya cikin hatsari.
Kada wani ya yi tunanin cewa Merck ya bambanta da hali, a Jama editan da ke rakiyar takardun ya yi nuni da irin ayyukan da wasu kamfanoni suka yi. "[M] ƙaddamar da sakamakon binciken, marubuta, masu gyara, da masu dubawa ba shine kawai manufar kamfani ɗaya ba," edita ya ƙare.
A 2009, da Cibiyar Magunguna (IOM) ta bincika rikice-rikice na kudi a cikin biomedicine, ciki har da bincike, ilimi, da aikin asibiti. Hukumar ta IOM ta ruwaito cewa kamfanoni sun biya makudan kudade da ba a bayyana adadinsu ba likitoci don ba da shawarwarin tallace-tallace ga abokan aiki, Da kuma cewa wakilan tallace-tallace sun ba da kyaututtuka zuwa ga likitocin da ke tasiri wajen tsarawa. Binciken asibiti tare da sakamako mara kyau ya kasance wani lokacin ba a buga, gurbata wallafe-wallafen kimiyya don magungunan da aka wajabta don amosanin gabbai, ciki, da kuma yawan adadin cholesterol.
A cikin misali ɗaya, nazarin mara kyau game da magungunan damuwa aka hana, haifar da meta-bincike na wallafe-wallafe don nemo magungunan sun kasance lafiya da tasiri. A na biyu meta-bincike wanda ya haɗa da bayanan da aka hana a baya sun gano cewa haɗarin sun fi fa'ida ga kowa sai dai maganin damuwa guda ɗaya.
Yin karatun gaskiya na rahoton na IOM zai sa kowane mai karatu ya yanke shawarar cewa rikice-rikice na sha'awa suna yaduwa a duk tsawon magani, gurɓataccen ilimi, kuma wani lokacin yana haifar da cutar da haƙuri. Daya gwani ya yi jayayya cewa manufofin dakatar da son zuciya da cin hanci da rashawa ba su da tasiri gaba daya, ba su bukatar komai sai dai wani canji na dabi'a a alakar likitanci da masana'antu. Har yanzu, wasu bincike ya gano cewa jama'a sun kasance ba su damu ba game da wadannan al'amura.
Na'urar Mutuwar Dawwama
Martanin tsaro da masana ilimi suka bayar game da rikicin farko na manufofin sha'awa na Kwalejin Kwalejin Ƙasa ta 1971 da ƙa'idodin 1990 da Cibiyar Kiwon Lafiya ta Ƙasa ta gabatar ya kasance gama gari har yau. Duk wani yunƙuri na sarrafa rikice-rikice na kuɗi na sha'awa da turawa don nuna gaskiya a cikin ilimin kimiyya an soki su daga al'ummar kimiyya, wanda da alama har abada sun gamsu da duk wani ɗabi'a da ke faruwa.
Misali, }ungiyoyin kimiyya sun yi tir da jagororin NIH na 1990, yana haifar da jagorori masu laushi wanda ya baiwa jami'o'i damar sarrafa kansu. Ko da waɗannan ƙa'idodi masu rauni, daga baya wani mai bincike ya rubuta, "A halin yanzu, ma'aikatan tarayya da ke aiki a dakunan gwaje-gwaje na tarayya suna fuskantar ƙuntatawa da yawa na rikice-rikice." Saboda wannan tsinkayar tsana, da Daraktan NIH ya sauƙaƙa manufofin ɗa'a don ma'aikatan NIH a cikin 1995 don haɓaka ɗaukar manyan masana kimiyya, ta barin ma'aikatan tarayya su yi shawara da masana'antu.
Sake mayar da waɗannan ka'idodin ya haifar da binciken da ba makawa a cikin hanyar bincike na 2003 da hukumar ta yi. Los Angeles Times wanda aka bankado manyan masana kimiyyar NIH suna tuntubar kamfanonin harhada magunguna, inda daga baya ma'aikatar shari'a ta gurfanar da wani mai bincike a gaban kuliya. Sauraron zaman majalisa da binciken cikin gida sannan ya tilasta NIH don gabatar da ƙarin ƙaƙƙarfan ƙa'idodin ɗabi'a ga ma'aikata waɗanda suka taƙaita ikon mallakar hannun jari da tuntuɓar kamfanonin harhada magunguna.
Da yake sanar da sabbin takunkumin, da Daraktan NIH ya bayyana bukatar "kiyaye amanar jama'a" da kuma magance ra'ayoyin jama'a game da rikice-rikice na sha'awa. Amma kamar yadda a baya, wasu masana kimiyya sun ga wannan zagaye na biyu na dokokin a matsayin hukunci da wuce gona da iri, suna jayayya cewa hakan zai hana hukumar damar daukar manyan masana kimiyya.
Lallai, masana kimiyya sun dage wajen shigar da kansu cikin binciken da suka gwada samfuran kamfaninsu akan marasa lafiya. A cikin 2008, Kwamitin Kudi na Majalisar Dattawa ya gano cewa a Mai binciken Jami'ar Stanford yana da dala miliyan 6 a cikin daidaito a cikin kamfani kuma shine babban mai bincike na tallafin NIH wanda ya ba da kuɗin binciken majiyyaci akan magungunan kamfaninsa. Stanford ya musanta aikata ba daidai ba yayin da yake riƙe da sha'awar kuɗi a cikin kamfanin. The NIH daga baya ya ƙare gwajin asibiti.
Binciken da Kwamitin kudi na majalisar dattawa ya kuma bankado misalai da dama na malaman da suka kasa bayar da rahoton alakar kuɗi ga kamfanonin harhada magunguna lokacin karɓar tallafin NIH. Wannan ya kai ga sake fasalin da ake bukata mafi tsananin rikice-rikice na sha'awa dokokin don masu ba da NIH da ƙaddamar da Dokar Biyan Kuɗi na Likitan Sunshine. Dokar Sunshine, wadda na taimaka wajen rubutawa da zartarwa, ta buƙaci kamfanoni su ba da rahoton biyan kuɗi ga likitoci, kuma an yi irin wannan dokar a wasu ƙasashe da yawa.
Duk da nasarar da majalisar ta samu, maraba a makarantun ilimi ya fi sanyi. A wani misali, Jami'ar Tufts ba a gayyata ba na bayyana a wajen wani taro kan rigingimun da aka gudanar a harabar su, wanda ya sa wani mai shirya taron ya yi murabus. Tun da aka aiwatar da waɗannan canje-canje, masana'antu da ilimi sun yi ƙoƙarin birgima duka tanadi na Dokar Sunshine da sabbin dokokin NIH.
Hukumar Abinci da Magunguna ta sami daidaitattun martani ga rikice-rikice na sha'awa. A cikin 1999, gwajin canja wurin kwayoyin halitta a Jami'ar Pennsylvania ya kashe majinyacin sa kai Jesse Gelsinger. Dukansu mai bincike da ma'aikata suna da bukatun kudi a cikin samfurin da aka gwada. The FDA sannan ta kafa ƙarin tsauraran rikice-rikice na buƙatun bayyana sha'awa ga masu bincike kuma sun hana waɗanda ke mu'amala da marasa lafiya riƙe daidaito, zaɓin hannun jari, ko tsare-tsare masu kama da juna a cikin kamfanonin da ke ɗaukar gwajin.
"Don haka, ɗana, yana yin abin da ya dace, wani tsari ne ya kashe shi kuma mutane suna cike da rikice-rikice na sha'awa, kuma an gano ainihin adalcin yana da rashin ƙarfi. Daga baya mahaifin Gelinger ya rubuta.
Ƙaddamar da wani ɓangare ta hanyar abin kunya na Vioxx, FDA ta ba da izinin nazarin 2006 ta Cibiyar Magunguna. Wannan rahoton ya sami rikice-rikice masu yawa na sha'awa a kan bangarorin shawarwari na ƙwararrun FDA waɗanda ke nazarin sabbin magunguna da na'urori. The rahoton shawarar cewa kada mafi yawan masu gabatar da kara ba su da wata alaka da masana'antar. Rahoton ya kammala da cewa, "Gaskiya FDA ita ce mafi mahimmancin kadarorinta, kuma damuwar kwanan nan game da 'yancin kai na membobin kwamitin shawarwari… sun haifar da inuwa ga amincin shawarwarin kimiyya da hukumar ta samu," in ji rahoton.
A cikin 2007, Majalisa ta amsa, ta zartar da sabuwar doka wacce ta sabunta Dokar Abinci, Drug, da Kayan kwalliya wanda sanya ƙarin buƙatu masu tsauri kan yadda FDA ta magance rikice-rikice na sha'awa. A cikin salon al'ada, daga baya wani babban jami'in FDA ya nuna rashin amincewa da cewa dokokin suna cutar da ikon hukumar na nemo kwararrun kwararru don bangarorin shawarwari.
An sake soke waɗannan da'awar a cikin wani wasika zuwa ga Kwamishinan FDA, yana nuna shaidar cewa kusan kashi 50 cikin XNUMX na masu ilimin kimiyya ba su da alaƙa da masana'antu kuma kusan kashi ɗaya bisa uku na waɗannan masu binciken sun kasance cikakkun furofesoshi. Duk da haka kukan FDA ya bayyana tasiri kuma Lokacin da Majalisa ta sabunta dokar FDA a cikin 2012, sabuwar dokar ta kawar da buƙatun da suka gabata cewa FDA ta ƙarfafa kula da rikice-rikice na kudi.
Hatta mujallolin da kansu sun shiga koma bayan da ake fama da su wajen magance rikice-rikicen sha'awa. Bayan aiwatar da manufar rikicin farko na sha'awa a cikin 1984, da NEJM ya sabunta manufofinsa a cikin 1990, Hana marubutan edita da kuma bitar labarai daga samun duk wani sha'awar kuɗi tare da kamfani wanda zai iya amfana daga magani ko na'urar likitanci da aka tattauna a cikin labarin.
Sabbin dokokin sun haifar da tashin gobarar zanga-zanga, tare da wasu suna kiran su "McCarthyism" da wasu suna magana da su a matsayin "censorship." Daga ƙarshe, ƙa'idodin sun raunana. Karkashin sabon edita a cikin 2015, da NEJM ya buga jerin kasidu wanda ya nemi ya musanta cewa rikice-rikice na sha'awa sun lalata kimiyya.
A ƙarshe, wata hanya don bayyana ɓoyayyun rikice-rikice na sha'awa tsakanin masana'antu da masana kimiyyar jama'a ita ce ta buƙatun buƙatun bayanai. Dokokin 'yancin bayanai na tarayya ko na jiha ba da damar ’yan jarida masu bincike da sauransu don neman takaddun da suka danganci ayyukan da jama'a ke ba da kuɗaɗe iri-iri, gami da binciken kimiyya. Amma a shekarun baya-bayan nan. wadannan dokokin sun fuskanci hari ta Ƙungiyar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararru. Kwararru kan dokokin 'yancin bayanai sun yi watsi da wadannan yunƙurin a matsayin batattu, tare da wani malami suna nufin su "gibberish."
Ko da bin ka'idodin bayanan jama'a na yanzu ya kasance cikakke, adadin 'yan jarida da ke amfani da wannan kayan aikin ba su da yawa kuma yana raguwa. A cikin 'yan shekarun nan, da yawa 'yan jarida ma tafi aiki ga masana'antu sun taba bayar da rahoto. Kuma kamar magani, aikin jarida ya yi fama da rikice-rikice na matsalolin sha'awa, tare da yawancin kafofin watsa labarai da ba su da takamaiman manufofi ga manema labarai da majiyoyin da suka kawo.
Dokar Biyan Kuɗi na Likitoci an yi amfani da shi don gano likitoci, wadanda kuma 'yan jarida ne kuma wadanda suka karbi diyya daga masana'antar harhada magunguna. Kuma kamar yadda a cikin kimiyya, Pharmaceutical, abinci, Da kuma Masana'antar biotech sun ba wa 'yan jarida kudade a asirce don halartar taro kan batutuwan da suka shafi su don karkatar da fahimtar jama'a.
Neman Magani mara iyaka
Wannan ɗan taƙaitaccen tarihin rikice-rikice na kuɗi na sha'awa kawai ƙoƙari ne don bincika zuriyar kai tsaye wanda ya fara da taba, yana gano shi zuwa matsalolin zamani a cikin biomedicine. Akwai wasu misalan waɗanda kamfanoni ke neman lalata amincin kimiyya don samun kuɗi, amma akwai ƙaramin shaida cewa waɗannan ƙoƙarin sun ci gaba har zuwa gaba. Tarihi yana da mahimmanci domin ya bayyana dalilin da ya sa aka fara waɗannan kamfen, yadda aka aiwatar da su, da dabarun da suka yi amfani da su.
Har ila yau, hikimar tarihi ta bayyana cewa, a ko da yaushe ana adawa da yunƙurin gyare-gyare, da gurɓata lokaci, sannan kuma a sake aiwatar da su ta hanyar fuskantar sababbin badakala. Yayin da nake rubuta wannan babin, da Ana aiwatar da makarantun kasa sabbin ka'idoji na rikice-rikice na sha'awa don magance badakalar da ta shafi bangarori biyu na su da suka cika tare da masana kimiyya waɗanda ke da alaƙa da masana'antu.
Bugu da ƙari, Cibiyar Kiwon Lafiya ta Ƙasa ta kasance cikin wani rikici, tare da Jami'an NIH suna neman gudummawa daga masana'antun giya don tallafawa binciken dala miliyan 100 kan illar shaye-shayen kiwon lafiya. Farashin NIH daga baya ya ƙare haɗin gwiwa. Sakamakon suka da alama ya hana NIH daga haɗin gwiwa tare da masana'antar harhada magunguna akan shirin haɗin gwiwar bincike na opioids wanda ya kai kusan dala miliyan 400, wanda masana'antar za ta ba da rabin farashin.
The Rahoton Cibiyar Magunguna ta 2009 ya lura cewa tushen shaida na yanzu don rikice-rikice na manufofin bincike ba su da ƙarfi kuma ƙarin bincike kan lamarin zai iya taimakawa wajen jagorantar dokoki ko ƙa'idodi na gaba. Hukumomin tarayya ba su yi tsalle kan wannan shawarar ba.
Bangaren shari'a na iya zama mai ban sha'awa. Matsugunan tarayya tare da kamfanonin magunguna sun tilasta musu bayyana kudaden su ga likitoci kuma shari'a ta sirri ta bankado takaddun da ke nuna son zuciya a cikin binciken kimiyya mai zaman kansa. The Majalisar dattijai ta gabatar da Dokar Sunshine a Shari'a, wanda zai buƙaci alkalai su yi takaddun jama'a waɗanda ke gano samfuran na iya cutar da jama'a, amma ba a zartar da wannan doka ba.
Ƙananan ci gaba suna ci gaba kamar yadda PubMed sanar a cikin 2017 cewa zai haɗa da rikice-rikice na maganganun ban sha'awa tare da taƙaitaccen binciken, kuma bincike kan batun ya ci gaba, koda kuwa ana watsi da sakamakon sau da yawa. Neman PubMed don kalmar "rikici na sha'awa" a cikin 2006, wani bincike ya gano 4,623 shigarwar tare da kawai 240 bayyana kafin 1990, kuma fiye da rabi bayan 1999.
Yawancin gyare-gyare don rikice-rikice na sha'awa sun haɗa da wasu nau'in bayyana kudade. Amma ko da waɗannan na iya zama marasa tasiri da jan hankali saboda bayyanawa ba ya warware ko kawar da matsalar. Dole ne kuma cibiyoyi kimanta da aiki da wannan bayanin ta hanyoyin da suka hada da kawar da dangantakar ko hana masana kimiyya shiga wasu ayyuka.
Duk da haka, wasu masana har yanzu suna ƙoƙarin kawar da matsalar tare da rikice-rikice na sha'awa, ta sake maimaita kalmar a matsayin “confluence of interest.” Wasu rage al'amarin ta hanyar ɗaga abin da ake kira "rikicin hankali na sha'awa" kamar yadda yake da daraja. Cibiyar Magungunan ta yi watsi da irin wannan ra'ayi a hankali, tana mai cewa, "Ko da yake wasu bukatu na biyu na iya yin tasiri ga yanke shawara na ƙwararru kuma ƙarin kariya ya zama dole don kare kai daga irin wannan bukatu, an fi gano buƙatun kuɗi da kuma daidaita su." Hukumar IOM rahoton ya ƙare, “Irin waɗannan rikice-rikice na sha'awa suna barazana ga amincin binciken kimiyya, rashin sanin ilimin likitanci, ingancin kulawar marasa lafiya, da kuma amincewa da jama'a ga likitanci.
Yawancin masana kimiyya ba su iya fahimta da yarda da cewa rikice-rikice na kudi na sha'awa sun lalata kimiyya saboda sun yi imanin cewa masana kimiyya suna da haƙiƙa kuma sun sami horo sosai don samun tasiri ta hanyar ladan kuɗi, kamar sauran 'yan adam. A wani misali, masu bincike sun bincika mazaunan likita kuma ya gano cewa kashi 61 cikin XNUMX sun ruwaito cewa za su yi ba a rinjayi kyaututtuka daga kamfanonin harhada magunguna, yayin da suke jayayya cewa kashi 84 na abokan aikinsu. zai a rinjayi. Wani malami wanda ya yi bincike game da rikice-rikice na sha'awa ya girma sosai tare da masana kimiyya sun musanta ilimin kimiyyar tasirin kudi ya rubuta parody domin BMJ wanda ya jera yawancin musun da suka saba yi.
"Abin da na fi samun takaici shi ne yadda manyan likitoci da masana kimiyya waɗanda sana'arsu ke da alama suna buƙatar sadaukar da kai ga wani nau'i na tushen shaida ba su da masaniyar mafi kyawun shaida kan nuna son kai." ya rubuta. "Wannan wallafe-wallafen yana da ƙarfi kuma yana da kyau." Lalle ne, lokaci ya yi da masana kimiyya su yi daina zama marasa kimiya game da kimiyya akan rikice-rikice na sha'awa da kuma daina musanya ra'ayinsu na kashin kansu don bincike-bita na tsara.
Hanya mai yawa sauran masana'antu sun yi nazari a hankali littafin wasan kwaikwayo na masana'antar taba. A sakamakon haka, sun kara fahimtar tushen tasiri a cikin ilimin kimiyya da kuma darajar rashin tabbas da shakku wajen karkatar da ka'idoji, da kariya daga shari'a, da kuma tabbatar da gaskiya duk da tallace-tallace da aka sani da cutar da lafiyar jama'a. "Ta hanyar yin wasan kwaikwayo na kimiyya a yakin da ake yi na hulda da jama'a, masana'antar taba ta kafa wani tsari mai lalacewa wanda zai shafi muhawarar da za a yi a nan gaba kan batutuwan da suka hada da dumamar yanayi zuwa abinci da magunguna," malamai sun lura.
A zuciyar al'amarin akwai kudi. Har zuwa 2000, ƙwararrun masana sun yi tambaya game da ikon cibiyoyin ilimi don daidaita rikice-rikicen kuɗi na bukatun lokacin da suka dogara sosai kan biliyoyin daloli a kowace shekara daga masana'antar. A cikin 2012 taron tattaunawa kan rikice-rikice na sha'awa da aka gudanar a Makarantar Shari'a ta Harvard, shugabannin ilimi sun lura cewa matsalar ta kara girma kuma tana daɗaɗaɗaɗawa cikin lokaci. Shugabannin jami'o'i sun guji ko da tattaunawa game da wajibcin daidaita rikice-rikice na kudi saboda suna tsoron rasa kudaden shiga.
Jajirtattun masu tsara manufofi dole ne su shiga tsakani kuma su samar da dokoki don guje wa abin kunya na gaba da kuma ci gaba da rasa kwarin gwiwa a kimiyya. Mafi mahimmanci, dole ne su kare jama'a.
Asalin wannan rubutun ya fito a matsayin babi a cikin "Mutunci, Gaskiya da Cin Hanci da Rashawa a Kiwon Lafiya & Bincike akan Lafiya.” Littafin ya ba da bayyani game da fannin kiwon lafiya da gwagwarmayar sa don samun ingantaccen tsarin gudanarwa na kamfanoni, kuma yana fasalta kasidu ta manyan masana ilimi da 'yan jarida waɗanda ke dalla-dalla game da yanke bincike da kuma abubuwan da suka faru na ƙwararru.
-
Paul D. Thacker mai ba da rahoto ne mai bincike; Tsohon mai bincike na Majalisar Dattijan Amurka; Tsohuwar Cibiyar Da'a ta Safra, Jami'ar Harvard
Duba dukkan posts
