Little has yet been disclosed about a consulting spree that has left a legacy of harm.
Your Editorial “Taking a hard line on conflicts” (Nature 433, 557; 2005 10.1038/433557a ) understates the extent of the embarrassing failure by the US National Institutes of Health (NIH), during the past year, to disclose information about NIH scientists serving as paid consultants to private companies. Having been a scientist at the NIH since 1967, as a physician, a cell biologist and now a science administrator, I must add that the habit of non-disclosure continues, making further embarrassments likely.
In November 1995, the then-director, Harold Varmus, made an unpublicized change to the rules on paid consulting by NIH scientists. The permissiveness of the 1995 rules opened the way for a spree of consulting that ended on 1 February 2005, when a stricter policy was announced. The previous decade left a legacy of harm, only part of which has come to light.
In articles published since December 2003, the Los Angeles Times has given ten specific examples of NIH scientists with financial conflicts of interest. However, details of hundreds of others remain hidden, and the extent of the damage caused since 1995 is unknown.
NIH director Elias Zerhouni told a Senate subcommittee last year that he had found no harm to patients as a result of NIH scientists' outside financial arrangements. However, he provided no evidence to support this claim and did not explain how he arrived at his conclusion.
On 2 February 2005, I attended a large meeting of NIH scientists at which Zerhouni spoke of “very disturbing” product endorsements by NIH scientists “speaking for a company on behalf of a product to entice physicians to prescribe a product at greater levels”. He provided no information about the products, the companies, the payments or the scientists.
During the past year, Zerhouni has said that achieving transparency (defined by the NIH as public availability of financial information filed by NIH employees) is “absolutely critical” and “first on the agenda”. But much of the information about past consulting, going back to November 1995, remains undisclosed.
The NIH's defensive approach — one congressman called it stonewalling — has proved a disastrous miscalculation. If the NIH does not unflinchingly seek the facts and release them, they may come out anyhow in other ways. Then the NIH's reputation, already at the lowest point in its history, will suffer further.