placed it's kind of. it's kind of. like. the japanese psychiatric community had the view. that depression was a was a rare. disorder in japan and they didn't diagnose it often and what pharma did was it lobbied the japanese government in moralizing rhetoric to say that they were mistreating japanese patients and then they sponsored. campaign to try and reduce the reduce the

feelings of shame that a japanese person might have if they felt sad or they felt they felt depressed they felt something not right and they might otherwise stay home and not go to the doctor so the n.t. stigma campaign was there to help normal law and mental illness and there were. there were interviews with with celebrities and t.v. personalities and there were articles sponsored and placed in the newspapers to try and similarly arise people with the idea of depression even the very word depression in japan on silvio was a word that stood for major depression and so they built an ad campaign a slogan that would make it feel more comfortable for people because of people heard that word depression would soon be oh it meant it then something in

a hospital something someone very sick and so they came up with a slogan. which means a cold of the heart or a cold of the soul that terminology meant several things first of all catching a cold is quite common you're not one of those crazies that has to be locked up it's a cold many people have it it's so many people have it then it can't be all that bad. secondly well japanese are big consumers of and ability and stuff and they meant to them cold that's treatable. can be treated with a product and finally the soul. sort of very very pointed and. really resonated very well with the japanese.

it connected with how they felt. and so that really changed significantly the perception and created this concept of moloch depression. that physicians know started treating that big government started acknowledging because the japanese government didn't want to know that japanese were depressed for those very few japanese government realized that. there was something that was an obstacle to the productivity of japanese workers and so that all of a sudden made sense now to treat depression when you could cut it out of that arena so that he got up and died. that didn't need it. i don't know i knew we had to guess and i want to tell a. story and i am.

your son. almost one important aspect was when. when the court when the imperial court acknowledged that the. the princess actually was suffering from depression and was being treated for depression what better celebrity can you get other than the emperor himself i mean this is fantastic and this is how it all begins the drug industry here let me do that for you let me run this let me run this program for you let me do this and the stigma campaign for you let me lobby the japanese government for you let me run these clinical trials for you let me get the word out and the japanese psychiatry especially the ones who are then in the employ of the industry they believe that they're doing it they're doing the right thing only at a certain point their interests divert because from

a commercial standpoint and this is. this is natural to all businesses from a commercial standpoint they don't want to stop until every every person every last man woman and child is taking their drug is using their product whereas the psychiatrists obviously they want to get off the train before that but once the faucet is turned on it's extremely difficult to stop. people you've got to realize at least marketing to doctors is intense newbie asia salesman call ten times a week spend precious time listening to the same argument assess in a medical journal. or just

a vehicle for the same message that came in shoes. of medicine at the best universities in the comp go around giving lectures in medical schools and a positive. thing out of the tackler success of some treatment that you know that you didn't like where you know you're a fee of course hard to resist this document if we look on it you can see that it has key players in the us anti psychotic marketplace regulators payers social medical. dispensers providers manufacturers and all of these are surrounded so in patients you have friends coworkers religion advocacy groups and then regulators have legislators media and so it and every actor is to be studied how can they influence

the forward motion of the dr and the key the main key is in the science how can they how can they produce the science that will convince all of these people along the way that this is the best treatment the only treatment in fact so with eighty five percent of our clinical trials commercially funded and now ninety seven percent of the most influential clinical trials commercially funded what we find is that the odds are more than five times greater that commercially funded trials will conclude that the sponsors drug is the treatment of choice compared to non-commercially funded trials of exactly the same drugs so you see those are pretty good odds and you know we tend to think of scientific studies as being objective and not being subject to bias but what we find when we look at the.

the way the system is structured the companies sponsor the trials to help to sell their drugs the companies own the data the same way that the coca-cola company owns the recipe for coke whereas you have been particularly successful is been to get control of to co-opt doctors who have no the two industry at zero who have never been paid a cent by industry who think that they're quite hostile to industry doctors who say well we go by the evidence we want to see the evidence and we will make up our minds based on what the evidence shows nothing because we've been paid by industry not because we've been brought to meetings we will make up our minds based on the evidence the key problem for all of

us is increasingly compared with the nine hundred sixty s. industry now controls the evidence industry runs the clinical trials all of them when i was a fellow between one thousand nine hundred eighty two we would spend hours and hours dissecting clinical trials and looking for statistical problems and outcome measures that didn't measure that didn't reflect what the study had been designed to do and we saw plenty of problems but i can't remember a single time that we saw a problem that we assumed had to do with a commercial bias and of course science is imperfect it's always imperfect but the we didn't see that and our professors had no relationship with the drug companies it was unheard of for a professor to have a relationship with a dark drug company it was just a nonsensical thought. now we see that. articles have problems all the time and

if you could put on truth goggles and you watch the prestigious press professors coming down the hospital. corridor in their white coats they look like formula one drivers and instead of saying pennzoil and mobil gas it would say merck and pfizer and then german genzyme because they're getting sponsored by all the professors a financial relationship with the journey was to become a little bit of a question mark which member will put up. some of. those aren't invited to do was on should suggest all of the piece that they'll respond enough to think it was aunt valleys of admits. to this that he feels he delimited i think what the internet does that it allows patients allows you know every day people to go to the web and to feel empowered by getting all the medical information they could possibly ever want right they can get access directly to medical journals if they want they can go to any number of websites where data is presented where information is presented

about diseases they could consult with their friends they can consult online on bulletin boards of other people suffering from these diseases and get lots of information and there's the idea that not only is it does it feel empowering but it's actually a requirement for being a good patient right being a good patient requires that you know all of this information before you even go to the doctor and that you've done your own research and that you are you're approaching your approaching your doctor not from not to just listen to his authority but that you'll be in negotiation with him to create to come up with your own treatment plan but there's of course a catch here is that the internet in particular is. it is able to hide where the information comes from. it was

a. very hard to take. care. that you ever had sex with that. perfect there now let's let's play. list the i'm plenty. plenty. of. speak the language. programs in documentaries in arabic in

school here on the t.v. reporting from the world talks about seventy ip interviews intriguing story for you . then try. to find out more visit our big. dog called. one of the new will come and watch and the new knowledge base just like you know. players. pleasure to have you with us here on t.v. today i rollers who should. be interviewed. her.

ability to. play. i have an example for you you know i just saw my doctor and found out most about the sore back i've had three years. does any good from the time my back hurts every morning. that bit more we. takes me an hour to loosen up that showering isn't enough. and i watch the world cup on t.v.

you my saw a commercial for franklin book we musician no money said i might have spondylitis it was old. and it can be traded i'll buy so when i'm home what do i do. well i look it up on the internet when i'm down that way you know i went to the site they suggest it was miss rehab is it because the name is easy to recall as happened to me. just. the less clear title to top when it's not on a truck you can't they study up till. i

keep watching the film human left because he's talking about back. to when he's describing all these symptoms so accurately defense song places like being tired and sore at night. in the morning and you must know we need to i'm creaky left and i have the same symptoms i've lost so i click there's a doctor. at all. but ok to the decepticons schottische don't get up walk walk all the level this is you discover all to. the bottom i'm a six year old. i think you could that but even if you're just i'll just say so he sure sounds trustworthy. but i'm surprised seekers reza see this man. a prominent medical professor. standing in front of the pfizer locos. is a modest person lisa logos are strategically located about what so what because one

of my friends is a marketing specialist and percentage of marketing mix because if they leave he told me that those are key places. around a talking head in the middle. so maybe it's no accident to see if you know the picture is composed that way. does the doctor tell me. well. to sum it up. one hundred fifty thousand people reported every year they're young people the signs are easy to ignore. the symptoms are so common. that this professor calls it young people's back. he may be scarce me he says this backache may disable me i don't see it may become a serious disability. scares me but he reassures me ok maybe it's not very common but. it can be very painful maybe but it can be treated may

and the treatment is fully covered by you to go to school you know steve i think i do every single day out. of the game missed it by close issue we should all disposable did. you know why should the us. public unfortunately the drug has adverse side effects. its long term effects are still unknown. but there's good reason to think it effects the cardiovascular system. and may also be a factor in cancer forgot to mention treatment cost one thousand eight hundred euros. i don't know how close and have our. watching the pharmaceutical industry how they lobby how de market medicine how do you

try to influence the public the doctors the government the media etc and we want to reduce the influence so we have more rational use of medicine to get our all straight out with sather up fake disease to show how pharmaceutical companies said of this is over and that's kind of paying to market their medicines we approached market research agency we said we are working for a pharmaceutical company who's coming up with a new truck against flatulence and we want to do market research and see how big this problem is. a knob the few canadian those have lost from winter fact from days a mentor have to. look at plaster on. the campus of miss and god.

save the present have faced little plaster also come to the market of make ahead session save the patient is not better has are to waste for something that i've had problems as i'm to help deliver a maybe same can but i can only never fight it out of hand. so we made this folder or the nice lady with balloons we thought it fits well because flatlands with the air and looks nice. it's the same way pharmaceutical companies do it because they using happy patients because the problem is solved. we went to doctors and asked if it put this leaflet in the waiting rooms and they agreed. they thought it was a great campaign and they didn't ask who was behind this campaign and all of it was from a pharmaceutical company or

a patient's organization they didn't care or the they liked the flyers so we could just sprout the leaflet with a poster in the waiting rooms. and also we had some fear dio's or of people suffering from federal and for example we used my daughter as a fake patient who get called names by classmates and the teacher is telling her that no good to fart in the classroom and so on poli and well but now the doctor has gave. just a simple pill and. it's over. and we approached some t.v. programs. a soap opera us but also informed of programs and we

asked them if it's possible to have attention for flatulence yes it was. for her. one show oprah a very popular program in the netherlands good times bad times we had to pay fifty thousand euros and one of the. maybe persons. and the soap discuss. with his wife that he has a really problem with flatlands. she would advise him to go to the doctor and in the waiting room well they would fill him in the ways and for the doctor there would be our post office of the flatlands campaign.

a polyp was announced in a special issue of the british medical journal in two thousand and three. in the preface by the editor suggested that this was the single most important article the b.m.j. had ever and possibly would ever publish and this is impressive given that the polypill at that time was an entirely theoretical intervention and the authors of this article suggested that rather than systematically screening the population for blood pressure for cholesterol for diabetes and for a number of other preventive concerns that might require pharmaceutical intervention why not simply give the entire population over a certain age a pill that contains interventions designed to treat all of these things at the same time and so the poly pill in its theoretical form contained

a thighs i direct contained a beta blocker. it contained a. an ace inhibitor. and i think folate acid and aspirin and the idea was that one could model each of these interventions carried with it a possible risk of side effect each conferred a possible benefit of prevention and by modeling those risks against each other the the the authors suggested that one could achieve a reduction in cardiovascular mortality by about eighty eight percent. by it simply administering these pills to the entire population over the age of i think fifty and for what seems like quite an orwellian intervention the poly pill generated immediate enthusiasm hundreds of people wrote in to the to the b.m.j.

website suggesting that if a polypill existed they would take it immediately others suggested will why just one poly pill why not make a poly pill for men they contained a prostate medication nepali pill for women that contained to mock safin to reduce the risk of breast cancer don't club so you're on board for a lifetime of treatment. you know what it's wallowing it doesn't pills a day back to prevent rule diseases or illnesses. you have a one percent chance of getting. the q what's going on here i mean how much has meds become you know they've just lost any sense of what's a reasonable risk you know to take and what isn't. if you want to introduce the french element into all this is of course the famous quote from. now about the

art of medicine. you know it's great to be able to give a drug to treat an illness but it's an even greater rock to know when not. that's the thought that we've lost since the outcome is lost because the market doesn't understand that. enough seats in students' amongst. the policemen to listen to. it's going to problems that it seems to. be could still be to confuse one system.

coming up with. the feel better some. of the. pain from the young girls cammo for the future hunter. her son between two and three hundred million guns united states so you can act like they're not here and keep kids away from them with. the plaza sound is a large you know i mean this teaches them a lot of rough spots ability to simply come to faith through the eyes of children

if we can do it for our children for our future what is the time for the soul. dramas that can't be ignored. stories others through a few still noticing. things since changing the world lights never. so picture of today's leaves. from around the globe. and local. t.v. . twenty fourteen call muslims will ultimately be an exhilarating winter and i'll take it you still need

anything now and i'm a criminal and i'm the last of all let me take you staying for sochi twenty four take. on oxy. speak your language anything about the war not a damn. good news programs and documentaries and spanish matters to you breaking news a little turn a tip angles keep the story. here. all to spanish find out more visit i to allahabad all tito is calm. please please. please

. the united states agrees to provide medical treatment. to the mother. look at how the. limits. through legislation that would have enshrined in law the right to discriminate against gays.