All language subtitles for First Do No Pharm

In his farewell speech to the nation in
1961, President Eisenhower warned the US

public about the dangers of the military
-industrial complex.

He also warned them about something
else.

In holding scientific research and
discovery in respect, as we should, we

also be alert to the equal and opposite
danger that public policy could

itself... become the captive of a
scientific, technological elite.

A country is as strong, really, as its
citizens.

And I think that mental and physical
health, mental and physical vigor, go

in hand.

That more people each year die of cancer
in the United States than all the

Americans who lost their lives in World
War II.

Attention to physical fitness is one of
those things that says something about a

nation and its people.

In fact, it is now conceivable that our
children's children will know the term

cancer only as a constellation of stars.

Medicine is constantly improving.

Medicare must keep pace.

So they made a deal that was a handshake
with the devil.

There's nobody on Capitol Hill who will
stand up to them.

They are now out of control as an entity
that is purely there to make money. A

psychopathic entity.

Between 2003 and 2016, fines imposed on
large pharmaceutical companies for fraud

and other illegal activity amounted to
$33 billion.

Hello. Good to see you.

Nice to see you, mate. Good to see you
again. All right.

Becoming a doctor was a calling for me.

I had a medical background. Both my
parents were general practitioners.

And that certainly had an influence on
me in terms of the career I ended up

pursuing. But also, there was a very
strong sense in my family that your

duty and responsibility is to the
community.

And my father taught me that the
ultimate purpose of knowledge is to

human suffering.

The NHS was brilliant. It was fortuitous
that the doctor I went to see,

actually, I didn't know I'd had the
heart attack at this point.

He was a young chap, a very charming
chap, and he said to me, after he'd

examined me, I think you should go to A
&E immediately.

I said, well, I can't. I've got a quiz
tonight, and I'm the maths and science

expert, so I'll go tomorrow.

And he said, well, I think if you decide
to go tomorrow, it might be the last

quiz you ever do.

And I thought, oh, that's a hint.

So off I went to hospital, and the A &E
were brilliant. It was an Irish doctor

that saw me there, actually.

They did a few tests, and it was quite
amusing there as well because she came

in with the ECG trace, and it looked
really nice. I thought, oh, that's nice.

That's reassuring.

She said, yeah, that's fine, but this
bit's upside down.

And so I thought, and she said, well,
we've got to do some more tests based on

this.

And then they went off and did a
troponin test, which looked at the

the heart. And that proved conclusively
at that point that I'd had a heart

attack. And I was carted straight from A
&E up into the ward.

And within 24 hours, a wonderful
cardiologist had had a look at me and

stent in one of my, well, circumflex
arteries.

There was an acute severe blockage found
in one of his major arteries, which we

call the circumflex.

And you can see from this angiogram,
which is a test where we inject dye,

something I did for many, many years,
looking at the coronary arteries for

blockages, this artery is almost
completely occluded.

And he had a stent put in by an
interventional cardiologist. And this is

result of the stent where you can see
the artery now is opened up.

is a potentially life -saving procedure
in the treatment of an acute heart

attack.

Something that's massively overused in
the non -acute or stable phase of

coronary artery disease.

So in those early days, in that acute
phase of the problem I had, there's no

doubt that the medical interventions
probably saved my life at that point and

was very grateful for that and for the
care I received and indeed everybody I

came across was had that mentality of
wanting the best for me but

as time went on after that it wasn't so
good so that the sort of longer term

care I started to ask questions about
what was going on and that was all

prompted by

a general decline in my overall health.
I just started to go downhill very

rapidly after about nine months.

I had massive aches in my legs. I had no
energy, no libido.

I just lost the will to live almost.

I felt dreadful. And it was that point
where I started to question what was

going on. Either I was very sick with
some other illness or my heart was going

downhill again, or it could be possibly
the medication I'd been put on. And

that's when the questions started to
arise.

One of the medications that Tony was on
that he believed caused him quite

significant side effects such as muscle
fatigue, erectile dysfunction, brain

fog, really limited his quality of life
for many, many months was a statin drug.

This is a cholesterol -lowering drug
that has been used for decades in the

management of heart disease and is
actually prescribed, estimated to be

prescribed to almost one billion people
worldwide.

Unfortunately, most patients aren't made
aware and many doctors aren't aware of

the absolute individual benefits of
statins. This is my area of interest.

my area of research.

And of course, this is at the heart of
informed or shared decision making. What

I would say ethical.

evidence -based medical practice the
first person uh in the sort of medical

realm who even sort of mentioned that
type of thing to me was a c malhotra he

was the only person that came up with
for instance numbers needed to treat

i was familiar with um and if you look
at the numbers needed to treat for

statins that gives you a very different
view as patient as to what might be the

best course of action because you get
you have to treat so many people to get

one person benefiting from this drug.
And then you look at the downside, how

many people are harmed by this drug in
some way. And if you've got that balance

as a patient, you can say, well, is it
really worth taking this chance?

But that information is very, it's
lacking.

It's generally lacking from the
conversation patients have with their

think. The NNT is shorthand for the
number needed to treat.

And it's essentially a concept of if I
give this drug to

100 people and then one person benefits,
that would be an NNT of 100.

So if you give a drug that you have to
give to 20 people and one person would

benefit, that would be an NNT of 20. The
NNT, it offers a beautiful way of

really showing people how much benefit
they stand to gain and if the

really worth it for them and if it's
something that they're willing to

Take the time and effort to take a
medication, come in for a procedure, and

on. I think that it's very useful for
patients.

But from a doctor's perspective, it may
make what they do feel

less significant. So they may not like
to see, not like to hear that the

interventions they're offering.

Aren't these amazing life -saving
interventions that are saving everyone?

think it makes us feel smaller than we
like to feel.

So if someone suffered a heart attack
like Tony, the absolute benefits of

a statin religiously over five years,
based upon industry -sponsored trials,

which means there's a caveat that this
is a likely best -case scenario, would

mean that you have to treat 83 people
who've had a heart attack for one to

benefit. in terms of saving their life
or delaying their death, and 39 have to

be treated for one to benefit in terms
of preventing a further non -fatal heart

attack. This information should be
conveyed to patients, as I always do, to

empower them in terms of making a
decision about whether the drug is right

them, but also encourages an opportunity
to discuss alternatives such as

lifestyle changes.

Remind me, how old are you now?

Yeah, coming up to 64 in a couple of
weeks' time.

Wow, that's pretty amazing. So almost
now 10 years since your heart attack,

all your cardiac medications, pre
-diabetic before the heart attack, and

completely free of even pre -diabetes.

Absolutely. And remind me what you're on
diet -wise these days.

Well, if I'm in hard training, I tend to
go fairly hard ketogenic.

If I'm not in too hard of training, I
tend to mix a sort of Mediterranean

diet with a ketogenic base.

That's how it seems to work for me
anyway.

So you generally tend to stay off the
starch and sugar most of the time.

presumably a no -no, right? Yeah, well,
certainly the processed sucrose -type

products, but I tend to avoid the
starchy carbs pretty much in the main.

very much a treat.

And how are things in terms of stress
levels and everything like that? Stress

great, nice and calm. Obviously, that's
a big driver of many diseases, so I try

and stay fairly calm.

Brilliant. Sleep good?

Absolutely brilliant, yeah. That's one
of the benefits of a lot of fasting.

And when you're fasting particularly,
you get a really good night's sleep.

Amazing. Interesting, in the pre -heart
attack period, looking back now,

when I was stood in a bar with my
friends, nothing seemed out of order.

Everybody seemed to be the same.

I think I've been lulled into this false
sense of normality through the fact

that nearly everybody was suffering from
this metabolic syndrome or metabolic

disease. And it became the norm.

So when you looked around, you didn't
see anything abnormal.

And I think this is one of the main
reasons the penny didn't drop at that

It's because society in general has
normalised these abnormal conditions.

There are 24 medical royal colleges in
the UK and Ireland.

Collectively, they form the membership
of the Academy of Medical Royal

bringing together the views of their
individual specialties to collectively

influence and shape healthcare across
the four nations of the UK.

In 2018, as part of the Choosing Wisely
campaign by the Medical Royal Colleges,

I published another article with the
then chair of the Medical Royal

who just left actually that role,
Professor Dame Sue Bailey, using the

of Tony Royal and how his case to...

give a good example to doctors of how
they can introduce lifestyle changes and

be more honest with patients about
prescription of drugs.

And that article got press released and
it made the front page of the Daily

Express. It was covered by the Mail
Online.

But on the back of that, I think because
of pressure from people related to the

statin industry, because the headline in
the Daily Express was ditch the pills

to beat heart disease.

I think that that put pressure on the
new chair of the medical colleges,

Professor Carrie McEwan, to essentially

isolate me.

And without any discussion, I received a
letter in 2018 in the summer that they

basically wanted...

me to have nothing to do with the
medical colleges and the choosing way to

campaign any further, even though it was
something that I instigated.

Dear Asim, I need to put on record the
concern that I and others have about

recent media coverage in both the Mail
Online and the Daily Express, which seem

to conflate our Choosing Wisely campaign
with your own agenda.

For the avoidance of doubt, the Academy
has no position on the use of statins

and does not wish to take one.

I also understand from colleagues that
you intend to donate proceeds from your

latest book to the Choosing Wisely
campaign.

For the reasons set out above, I am sure
you can understand that this would

cause us some difficulty and I ask that
no donation is made.

I do, of course, wish you well with your
work.

but hope that from now on you continue
it independently of the Academy or

choosing wisely.

Best wishes, Professor Carrie McEwan.

In 2023, an investigation by the BMJ
revealed that Royal Colleges in the

UK have received more than £9 million in
marketing payments from drug and

medical devices companies since 2015.

And I think that what probably happened
is one of those royal colleges, most

likely the Royal College of Physicians,
who previously made a complaint about

me, about me writing an article in the
Observer about the fact that there's a

big problem around too much medicine, I
think they had probably put pressure, in

my view, on the chair to basically
discipline me and remove me from that

organization.

And only recently it came out through a
BMJ investigation.

that the Royal College of Physicians,
and even I was shocked by this, had

approximately one million pounds from
Pfizer.

And this is the drug company that is
responsible or behind one of the most

lucrative drugs in the history of
medicine, that is Lipitor, also known as

atorvastatin.

Between 1997 and 2022,

Pfizer sold $172 billion of the statin
drug Lipitor.

Controversy with me probably started
many years ago.

Probably I became sort of, I broke into
the mainstream.

uh around sort of 2011 initially because
i wrote an article which was a front

page commentary in the observer
newspaper which is part of the guardian

the uk basically as the cardiologist was
saying you know why are we serving junk

food to my patients in hospitals uh and
that was after i'd met with jamie oliver

who i'd written to so that's i kind of
started campaigning on the issues around

obesity at that point um and not shortly
uh after not long after that joe i then

um

had sort of went into a deep dive to try
and understand why we had an obesity

epidemic, so what was driving that, what
was the role of cholesterol in heart

disease, overprescription of statin,
saturated fat, and essentially that

culminated in me publishing a piece in
the British Medical Journal in 2013,

October.

basically, which was titled Saturated
Fat is Not the Major Issue, and

we should be focusing on sugar. We got
it wrong on saturated fat. We're over

-medicating millions of people on
statins.

Cholesterol is not that bad as a risk
factor for heart disease.

And that's really where I sort of broke
into the mainstream. And that was, you

know, BMJ Press released it. It was
front page of three British newspapers.

I was on Fox News Chicago, CNN
International.

And that's really when I started my kind
of activism.

to try and fight back against medical
misinformation and a kind of deep

understanding that what was driving poor
health for many, many people was

biased and corrupted information that
was coming from two big industries, big

food and big pharma.

I think what is wrong with the food
system, it has stopped being a food

Food is supposed to nourish you. Food is
supposed to be healthy.

Food needs to become you. It becomes
your blood, your cells, your brain.

And yet what we call food, which I call
anti -food, is doing the opposite

of food should do. What food should do,
it is creating disease because it is

creating disharmony and dysbiosis
everywhere in the system.

A perfect example of this was shown by
Dr. Kevin Hall at the NIH, where he took

20 normal volunteers.

admitted him to the Clinical Research
Center at the NIH for four weeks.

For two weeks, they were fed an ultra
-processed food diet, and for two weeks,

they were fed a real food diet in random
order.

They got the same amount of protein, the
same amount of carbohydrate, the same

amount of fat, the same amount of
everything, except one was ultra

and one was not unprocessed. And it
turned out that on the ultra -processed

diet, people ate 500 calories per day
more and gained weight, whereas

when they were on the real food diet,
they ate 500 calories less and

lost weight.

Now, ultra -processed food could be
causing depression, anxiety and might

be related to early death.

That's according to a study by the
British Medical Journal which found that

-produced products such as sugary
breakfast cereals and microwave meals

linked to 32 damaging health.

We're still here with journalist and
author Ella Whelan, alongside

Asim Malhotra. Now, Asim, you have been
on this for a long time. I've known you

a long time. You've been campaigning
hard to get this debated.

Talk to us about what's going on.

Well, I think let's look at it in
context first. So if we think about

poor diet now.

is responsible for more disease and
death globally than physical inactivity,

smoking and alcohol combined.

So it's a low -hanging fruit that needs
to be addressed head on, the most

important factor, which I would also say
is probably driving increased strain on

the NHS.

So within poor diet, what are the major
culprits? Well, what this study has

shown, which involves...

10 million people.

It's an analysis of analyses, if you
like, and it's shown that the

of ultra -processed food is linked to 32
health conditions.

The strongest bit of evidence comes from
increasing death rates, types of

diabetes, and even things like mental
health problems, heart disease, that's

speciality.

It's a big problem in this country
because 57 % of the calories consumed by

Brits come from ultra -processed food.
People don't necessarily know what ultra

-processed food is.

So in order to understand ultraprocess,
first we have to define it. What are we

talking about?

My colleague and your colleague, Carlos
Montero at the University of Sao Paulo,

did us all a very great service. He
constructed a labeling system

called the NOVA system.

And it doesn't look at what's in the
food. It looks at what's been done to

food, which is much more appropriate and
much more relevant.

to its health consequences.

Nova is divided up into four classes.

The easiest way would be an example.

So let's take an apple.

So Nova Class 1 would be an apple picked
off the tree.

Nova Class 2 would be apple slices, de
-stemmed, de -seeded, de -skinned

possibly.

Nova Class 3 would be apple sauce,
macerated, cooked.

possibly preservative added, maybe even
a little bit extra sugar.

Nova Class 4 would be a McDonald's apple
pie.

So the question is, does that Nova Class
4 look anything like the Nova Class

1? And the answer is, not even remotely.
You can't even tell what's the apple in

a McDonald's apple pie.

That's ultra -processed food.

It begins with...

How we grow the food, and this is the
beginning of industrial agriculture,

-war agriculture, which was really
taking all the chemicals created to kill

people during Hitler's Germany and
converting them into agrichemical

So synthetic fertilizers are the same
technology, Haber -Bosch, that made the

explosives.

Pesticides are all derivatives.

of the early chemicals that killed
people in concentration camps, like

or the poison gas that killed people in
the war. So fertilizer and pesticides

are both war chemicals.

And when they're brought into
agriculture, they are not just

diversity of this planet, but they're
destroying food and contaminating

it right from the source.

And that's why we have just so much
cancer.

I mean, cases in California have been
fought on glyphosate as a carcinogen.

people have won those cases.

And the third is that the industries
that are

pushing the poisons in food are also the
big pharma. They're the same entity,

you know, buyer.

is a pharmaceutical industry, but it has
also bought Monsanto and is also the

pusher of chemicals that are causing the
disease.

And so they have created a perpetual
motion machine of super profits.

You spread illness, you spread sickness,
and then you have all the patented

drugs for expensive cures.

And that's why to go to the roots of
what a healthy food system is, is not

a health imperative, it's an ecological
imperative in our times.

I mean, the key thing as well at the
root of all this problem, chronic

epidemic obesity, is the flawed
hypothesis that lowering cholesterol

diet or drugs would curb heart disease.

Demonization of saturated fatty foods
has led to this explosion of ultra

-processed, cheap, low -fat
carbohydrate, refined carbohydrate

and sugar -enriched foods, as well as...

millions, millions of people taking
statin drugs that are not going to give

any benefit. And they don't even know
it. That's the worst part.

And you put that all together, that in
itself can explain what is a root cause

behind the chronic disease pandemic.

Flawed science, exploited by powerful
industries, big food, the big pharma.

The bad actors who have driven

the food system to a system that's
causing sickness and ecological

begins with the players in Hitler's
Germany.

At that point, it was the German cartel
called IG Farben, who

were tried in Nuremberg for crimes
against humanity.

But they had American partners.

So IG Farben had a partnership with
Standard Oil, and the company was called

Standard Oil IG Farben.

But Bayer, And Monsanto in that time had
a partnership, and they were called

MoBay. And they're back again as one.

Bayer has bought Monsanto.

So this small group of companies,
largely German and American, which

created the chemicals during Hitler's
time, are the ones still creating the

chemicals that go into industrial
farming.

But then... They've taken control of the
seed. 60 % of the commercial seed

distribution is now in their hands, the
hands of 45 companies.

And they also are the pharmaceutical
industry. One arm sells poison, the

arm sells cancer drugs.

And then you have the trading system.

Till the 70s, the trading system was
really localized.

Everywhere there was local trade.

But the big trade had taken over the
American system, the agribusiness.

And it used to be five players.

It would be Cargill, Continental.

Cargill bought Continental then. And
then Conagra.

That's what they call the ABCD
companies.

And they basically are the ones who
don't produce anything, but they

drive the system through trade.

And the third category of these
companies is the corporations that turn

into junk, the junk food industry.

But the so -called free trade of today
is what is in the WTO agreements, World

Trade Organization agreements.

And the three new treaties in this are
the Intellectual Property Rights

Agreement,

And Monsanto claims that we wrote it. We
were the patient, the diagnostician,

and physician all in one. We defined the
problem, and for them the problem was

farmers save seeds.

And they'd offered a solution. It should
be illegal for farmers to save seeds.

And that's why I save seeds.

And then Cargill wrote the agriculture
agreement.

There's not a word about food in that
agreement.

It's about markets, subsidies, market
access.

And the third is...

what I would call the junk food treaty,
which is called the sanitary and

phytosanitary agreement, which
deregulated all the food safety laws

sovereign countries had created, like
India had created a prevention of food

adulteration. Anything that was not food
added to food was considered

adulteration. And then you've got a junk
food industry that only adds things

that are not food to food.

And that's where the metabolic disorders
are exploding, because all kinds...

of chemicals are being put into the food
that we've never tested, tried. 6 ,000

are untested chemicals, including high
fructose corn syrup.

That is absolutely messing up our
system.

So these were the three groups. But now,
of course, since 2008, all of

this is now getting owned by the big
financial giants, the Black Rocks, the

vanguards.

The state streets.

And I've written about this in my book,
Oneness Versus 1%. So I would not talk

about them as bad guys. I would talk
about them as the

imperative of greed.

To not know when enough is enough.

And to constantly appropriate the
resources of the earth and the wealth of

people.

And basically turn it into destruction.

or the planet of people and profits,
super profits for the giants.

This is an environmental insult.

This is a public health crisis.

This is because of the food.

Three months medicine.

One of the key moments that really...

made me a stronger activist in this
movement was a campaign started

by the British Medical Journal in 2012
called Too Much Medicine.

And when I read the editorial, which was
instigated by its then editor -in

-chief, Dr Fiona Godley, it was
inspirational.

Established in 1840 and previously
called the British Medical Journal, the

is one of the oldest, most highly
respected medical journals in the world.

Hello, I'm Fiona Godley. I am a former
editor, previously editor -in -chief of

the British Medical Journal.

When I became editor -in -chief of the
British Medical Journal, the BMJ had

already run a theme issue asking the
question, too much medicine, was there

much medicine? Had medicine invaded
areas like death, old age, shyness,

those sort of things, where it was
extending beyond its natural remit? And

I became editor... We decided that we
would continue that question and take

the question mark because we began to
see that it really was an issue, that

medicine was invading areas of risk,
turning risk factors into diseases, so

-diabetes, pre -hypertension, pre
-dementia, where just the very fact that

might be at risk of a disease was
suddenly making you a target for

pharmaceutical intervention.

We see examples right across healthcare
where what we're seeing is what I would

call medicalised prevention.

So taking away the treatment side of
things, we've got people being given

treatments for preventive medicine.

And whereas we could be looking at the
social determinants of health, housing,

education, clean air, clean water.

active travel, diet, we are instead
offering people medication. And this is

happening at an enormous scale, in
particular in the cardiovascular

with drugs like antihypertensives and
statins, diabetes, obesity, those sort

things. And we really are medicalising
and medicating the population on an

enormous scale, both adults and
children.

Heart disease is still the number one
killer in the Western world. It's the

number one cause of premature death in
European men.

And I wanted to understand why we had
not really managed to curb heart disease

when we were told, for example, in
medical school, that high cholesterol

most important risk factor for heart
disease and therefore the lower the

cholesterol, the better.

The Nobel Prize in Physiology or
Medicine for 1985 was awarded jointly to

Michael Brown and Joseph Goldstein.

for their discoveries concerning the
regulation of cholesterol metabolism In

1996 Brown and Goldstein proposed that
exploitation of recent breakthroughs may

well end coronary disease as a major
public health problem early in the next

century But that didn't happen

So I started to question and try to
understand what was really driving heart

disease. But in that process, I also
found a huge discrepancy in one of the

prescribed drugs for cardiologists in
the world, which are statin drugs,

cholesterol lowering drugs.

And there was a discrepancy between the
side effect profile we were told, which

is extremely rare, maybe less than 1 %
of patients getting the most common side

effect of statins, which is fatigue and
muscle pain.

I was seeing that much more frequently
in my own clinical experience or picking

it up with patients compared to what was
published in the medical literature.

And that's where I started my journey
into ultimately realizing that medical

knowledge has been captured by
commercial entities.

Yeah, it's nice to be in the States,
actually.

Especially Boston. It's my very first
time in Boston.

and, you know, the home of Harvard,
Massachusetts being the

origins of the Framingham Heart Study.
So for me, there's a lot of

personal interest, actually, in Boston.

And it's a beautiful city.

It's lovely to walk around.

It has a lot of character, a lot of
history.

So, yeah, really excited to be here.

Basically, you know, farm a nation.
America is farm a nation. Like, it is,

is no other country on the planet in
which there is so much influence from

biopharmaceutical industry as the United
States. And now we have some, you know,

few years of data, you know, looking at
how much, you know, money is being

spread around to physicians in order to
corrupt the system. Because you cannot

have corruption, right?

in pharmaceutical corruption without
corrupt doctors. They are implicit to

entire cycle.

So does anyone care about this?

I think you have people coming in for
the right reasons. There's easier ways

make money than four years of med
school, years of residency, years of

often after residency. There's easier
ways to make money. We're actually a

magnet in the U .S. healthcare system
for the best and brightest.

But as people get in, They have no other
path to go down.

They're saddled with hundreds of
thousands of debt.

Any doctor paying attention realizes
they're part of a system where patients

not getting better.

Very excited.

Our history goes back almost 10 years
when we both caused

controversy, writing articles in the BMJ
suggesting that statin side effects

were underplayed and the fact they were
much more common than what most people

were. or what was certainly being
acknowledged in the medical journals,

saturated fat and the overprescription
of statins. He wrote a separate analysis

piece on whether statins would benefit
people at low risk of heart disease.

But we both cited the same reference,
saying that the unacceptable side effect

figure from statins is likely to be
closer to one in five people, almost

And that caused a huge backlash,
specifically from...

scientists and non -scientists in
particular that had essentially, his

had been built on his statin research,
who thought that because of our

exaggerated claims of side effects, it
would create unnecessary fear, people

would stop taking statins and people
would die.

So this got a lot of press coverage, as
you're probably aware, October 2013.

And leading up to March 2014,

Professor Sir Rory Collins of Oxford,
considered probably the leading statin

researcher, or one of the leading statin
researchers in the world, had actually

contacted the editor of the BMJ. I was
made aware of this.

And he basically had asked for both our
articles to be retracted because our

claims on statin side effects were not
evidence -based.

And the editor of the BMJ, Fiona Godley,
had quite correctly said, well, listen,

we're very happy to publish your
critique.

Most people don't get the opportunity.
We will publish it in our journals,

publish a full critique, and then, you
know, let this debate continue.

For some reason, Professor Rory Collins
didn't want to do that.

He just kept saying retract, retract,
retract.

Statins controversy that the BMJ was
involved in really began with news that

guideline bodies were beginning to say
that more people should take statins,

that healthy people over the age of 50
with no cardiovascular risk should be

given statins to reduce their longer
-term risk.

And that led to authors looking at the
data and questioning this decision.

And we received an article from John
Abramson and colleagues reviewing what

could of the data, what was available to
them, and really coming to the

conclusion that the benefits were rather
less obvious in this group of healthy

people and that there were unexplored
adverse effects that needed to be

considered, which would rather change
the kind of benefit -risk equation.

We published this article and it was
very immediately under attack from the

trialists, the staff in trialists,
namely those based in Oxford, really

the article was wrong and should be
retracted and the BMJ should apologise.

I think what people need to understand
about John more than anything else,

than the fact that he's an excellent,
you know, he's a family physician who

been a Harvard lecturer for many years,
is that he has done more.

or been involved in more drug litigation
cases than any doctor

alive. So John's insights are unique,
more important than anybody else's, to

understand exactly how drug industry has
captured medical knowledge.

It dragged on over a few months while we
were trying to get the Oxford group

to...

write publicly about their concerns,
which they refused to do. And eventually

spilled out into the media because
Oxford Group went to the media to say

this was a terrible thing that BMJ had
done.

We also published an article by Aseem
Malhotra making a similar point. And

two articles, the Abramson and Malhotra
articles, became the subject of a review

that I launched, an independent review,
to see whether the BMJ needs to retract

these two articles.

The BMJ got under so much pressure about
these so -called errors that they

were...

almost forced to be in a position where
they sent the articles for an

independent review for whether or not
they should be retracted, because there

were calls for retracting.

And the review led by Iona Heath, who
was our former ethics committee chair,

she was involved with the BMJ to some
extent, but she has a very independent

mind. And some wonderful people on the
panel, all independent, were given all

the information publicly made available,
and they came to the view that we had

done enough.

in correcting the original article and
that we didn't need to retract the

articles.

So in effect, myself and Abramson were
on trial, and that sort of thing, if it

had gone the other way, would have been
career -destroying.

But on the contrary, we then decided to
push the message about statins and

specifically about informed consent and
their prescription even further, and we

co -authored a couple of articles
together.

There was also a request from the panel
that the data for the statins trials be

made available.

And what had begun as a too -much
-medicine story about over

healthy individuals turned into a
campaign for open data, calling on the

trialists to make their data available,
because it had been a huge surprise to

me in the process.

that these data were not available. I
think, like other people, I had assumed

that the regulators had them and that
the bodies like NICE and ICWIG in

had the data, but that's not the case.
So we began a big campaign about trying

to get access to the data.

Harlan Krumholz, for example, at Yale,
wrote a wonderful article looking at the

madness of the fact that only a few
people could look at these data. He

about the Hubble telescope and how, you
know, the idea that you'd have one

person looking at this and saying, none
of you can look, only I can look, and

I'll tell you what's there, and how
ridiculous that would be. And yet that's

way in which the whole of the medical
literature works at the moment.

And it's even more serious because the
drug companies own the data from their

clinical trials.

It's so serious, Joe.

When a drug company sponsors a clinical
trial and they do the analyses and

they... write up a manuscript and they
say what happened and they send it to a

medical journal and it gets peer
-reviewed and doctors are trained that

should read and trust peer -reviewed
articles that are well -conducted. And

that's how the system works.

The peer reviewers and the editors of
the medical journals don't get to see

data. They have to take the word of the
drug companies that they've presented

the data accurately and reasonably
completely.

And you only get to see it in
litigation, you know, five years later

it doesn't matter because everyone's
formed their opinion. That seems insane.

It's insane. And doctors don't know
this.

I mean, the whole staffing saga was very
interesting and to some extent

radicalizing. I think I don't mean to
misuse that word, but it alerted me to

this issue about over -medicalization
linked to...

lack of transparency about the data. And
that was quite a big, big shift for me

and for my colleagues on the journal.

I was called into the medical director's
office of the hospital I worked in at

the time in London.

And I went there and essentially he said
he was very angry.

He said he'd been speaking to the
general medical council about me and

whether I knew my duties as a doctor and
was essentially frothing at the mouth

saying that, you know, Do you expect our
cardiac nurses to tell our heart

patients to eat butter instead of
margarine? And I said, well, yes,

there is no clear evidence for it. And
this has been peer reviewed. And he

calmed down a little bit.

On the back of that, one of the senior
cardiologists in the hospital

essentially, I wouldn't say threatened,
but he said to me

that if I continue to talk about
anything negative about statin drugs in

media, that this would affect my job.

And I wasn't going to stop talking about
the fact that I felt there was a lack

of transparency in their prescription.

And not long after that, I got a letter
basically saying that my one -year

contract in the hospital had been cut
short to six months.

I effectively lost my job.

We continued to call for the data on
statins to be made available, not to us

a journal, but to researchers who would
be able to scrutinize it.

And we did have promises from the
trialists that those data would be made

available, in particular the data on
adverse effects.

And to this day, that has not happened.

It has been estimated that the
cholesterol treatment trialist

taken $700 million in funding from
statin manufacturers since 1994.

The raw data from their trials has never
been released.

The statin saga is still continuing. By
the end of 2019, myself, a number of

eminent doctors, including medical
journal editors, other cardiologists,

actually co -authored a letter to the
then chair of the Science and Technology

Committee, Norman Lamb, calling for
independent release of the raw data on

statins so we have a better
understanding.

of the true rate of side effects from
these very widely prescribed drugs.

This made headlines in the iNewspaper.

It sort of comes to the case that I was
involved in, where the male on Sunday

attacked myself and Asim and Zoe Harkam
by basically saying, because we were

critical of the cholesterol hypothesis
and we said things about statins that

were not as effective as generally
accepted or claimed.

The articles were written basically
saying that we were statin deniers.

Comments such as there is a special
place in hell for these people.

We were accused of being propagandists.
We were accused of doing everything we

did because we wanted to make money from
doing so, which is a bit of a joke on

the basis that it's the other side who
make the billions and we make nothing at

all. Essentially, you are going to be
obliterated if you take on this

And they tried to obliterate us. So we
sued them for libel.

And the judges basically said that they,
on Sunday, had committed libel and

had attacked us and defamation and blah,
blah, blah. The trial is not

necessarily, the whole thing is not
necessarily finished, but it probably

we felt we needed to fight back, in part
to clear our names and in part also

because it's very important that we can
kill people. You can't just...

attack and crucify people who are
critical because sometimes they're going

gather the energy to get back at you. In
this case, we did. Hurrah!

Hello!

Finally!

How are you?

Really good. Good to see you.

Thank you.

Ten years.

And we've never met.

Wow. John Abramson. I'm a medical
doctor. I also have a master's in

degree.

I completed a family medicine residency
and after that completed a fellowship, a

Robert Wood Johnson fellowship, in which
I studied epidemiology, research,

design, and statistics, but decided
rather than going into an academic

I'd rather go out and take care of
people and function in the more pastoral

of a family doc in a community.

So I did that and became chair of family
medicine at Leahy Clinic and began

teaching Harvard medical students in my
office and had a lovely practice and

thought I would spend my entire career
there.

And I started to notice that the
journals were becoming increasingly

by the commercial sources, the drug
companies.

Medical journals are businesses and they
have to make money.

medical journals, editors and publishers
work very hard to minimize the

conflicts of interest that arise because
of their business model.

But a number of the ways in which
medical journals make money really do

conflicts. And those include the use of
drug advertising.

A lot of journals are reliant on that.

The receipt of sponsorship for
educational congresses or conferences or

programs. And then reprint revenue.

And it's that third one which I think
creates the most immediate and difficult

to manage conflict of interest because
medical journals will publish usually a

pharmaceutical trial.

and then will be paid quite large sums
for providing the pharmaceutical company

with reprints of that article.

And it's very hard for an editor to
remove that conflict when they're making

editorial decision.

They know they might get a million
dollars, for example, for publishing the

trial, and I don't really see how you
can manage that as a conflict of

The vastly profitable commercial model
underpinning the modern medical

publishing industry was established by
the controversial British business

Robert Maxwell.

Maxwell recognised and exploited the
appeal of scientific notoriety amongst

researchers and scientists to win their
approval for hundreds of new journal

titles and their participation as unpaid
peer reviewers.

With research content willingly provided
by drug companies, the Maxwell model

married a free -of -charge content and
peer -review process with a lucrative

subscription model to generate unheard
-of profit margins for a publishing

business. Maxwell sold his empire for
more than half a billion dollars in

but his fingerprints remain on one of
the world's most profitable publishing

opportunities.

What changed my career was an article
that was published in the New England

Journal that claimed that Vioxx was a
safer anti -inflammatory drug than over

-the -counter drugs because it caused
fewer GI complications.

And the article showed that there were
fewer GI complications.

The article failed to report overall
serious adverse events.

At the time we were dealing with this
drug called Vioxx, which was a drug that

was a pain medication put out by Merck.
Huge scan all the time.

They had cut their clinical trials
short.

We found out later it was causing
cardiovascular issues.

And this was prior to my coming on to
the Senate Finance Committee.

But when we found out all the problems
with Vioxx, the staff started asking,

like, well, how did this drug ever get
on the market, right?

How did the FDA ever approve this? So,
you know, you start going back and

looking backwards into, like, what had
happened. What they found was the panel,

the FDA panel that approved Merck's
Vioxx was just filled with physicians

who had ties to the pharmaceutical
industry. They're like, well, this is

interesting. You know, so like what's
going on?

Vioxx was not only no safer than over
-the -counter anti -inflammatory drugs,

but it was far more dangerous. It was so
much more dangerous that one out of 40

people who took Vioxx instead of an over
-the -counter drug had a serious

adverse event, like serious enough to go
to the hospital.

And the article failed to report the
overall frequency of serious

complications, meaning cardiovascular
deaths, strokes, and heart attacks.

But in fact, the FDA data, the FDA
reports showed clearly that the data

Merck had submitted to the FDA showed
that there was more than a doubling of

risk of serious cardiovascular events
and that the risk of serious adverse

events rather than being lower with
Vioxx was higher. And then finally that

Vioxx was no more effective as a pain
reliever than the over -the -counter

drugs. So this was a drug that was a
clear and present danger to people. The

drug industry have a legal
responsibility to produce profit for

shareholders.

They do not have a legal requirement to
give you the best treatment, although

most people would expect or hope that to
be the case.

But the real scandals are these.

Regulators fail to prevent misconduct by
industry.

And doctors, academic institutions, and
medical journals that have a

responsibility to patients and
scientific integrity collude with

financial gain.

Vioxx was the most heavily advertised
drug at the time.

and the FDA knew that the New England
Journal of Medicine article was wrong.

FDA didn't correct the article, and the
New England Journal didn't correct its

original 2000 article until 2005, which
was many months after the drug had been

pulled from the market. What most
doctors and patients don't even know is

the medical regulators themselves take
substantial amounts of money.

from the drug industry for example the
medical regulator in the UK the MHRA

takes 86 % of its funding from pharma
the FDA in the United States gets 65 %

its funding from pharma this in my view
is an absolute scandal

those bodies are there to protect
doctors

and patients from the excesses and
manipulations of the drug industry whose

primary motive is profit, not to give
you the best treatment.

There's no way they're able to do that
if they continue to take money from

industries. They don't want to bite the
hand that feeds them. In the meantime,

the New England Journal had sold $927
,000 worth of

reprints back to Merck.

So they published this article.

that minimized the danger of Vioxx,
maximized the purported benefits,

which weren't overall benefits.

And why might they have done that? They
were making a fortune on selling

reprints back to Merck so Merck's drug
reps could hand them out to doctors to

convince doctors that, according to the
article in the New England Journal, they

should be prescribing Vioxx for their
patients.

Doctors do tend to trust the medical
literature. I think we've been

to have the evidence base, but they may
have slightly misplaced trust in the

overall system.

And the biases and the distortions that
come about because of the way

in which medical literature is created,
I think often that won't be apparent to

most doctors.

We need to apply quite a big dose of
skepticism to the medical literature.

Yeah. If we think about the awareness of
doctors of research misconduct, it

rather depends which doctors you're
talking about.

If you're talking about, say, GPs or
clinicians who don't actually do any

research, many of them will not be aware
of the extent of the problem. And, of

course, many junior doctors or most
junior doctors will not be aware of the

problem.

speak to senior academics, of course,
all of them know there are major

And in many cases, many of them are
involved in the cover -up of the

These are not average doctors.

These are the most top -level, most, you
know, prestigious,

influential physicians, like, in
American medicine, right? That's who

are. You know, one of the leading
physicians in the United States...

guy named Ralph Schneiderman, ran Duke
Medical School, which is the number

research medical school in the United
States.

What was Ralph Schneiderman doing,
right?

Ralph, we know now from court documents,
he was directly advising the Sacklers

on ways to increase opioid use in
America and drive the opioid epidemic.

There is absolute proof that Merck knew
about the cardiovascular risk.

not just when the article was published,
but they knew about the cardiovascular

risk the day that the data from the
Vigor trial were unblinded.

Their chief scientist is quoted in the
Wall Street Journal in an email that he

wrote to his colleagues saying, I'm
paraphrasing now, saying, it's a shame

cardiovascular risks are there, meaning
he knew that there was an increased risk

of serious cardiovascular complications.

It's a shame the cardiovascular risks
are there, but the drug will do well and

we will do well.

We will do well, meaning the executives
with their stock options will benefit

from the sale of Vioxx, which on the
first day of unblinding, they

understood.

doubled the risk of serious
cardiovascular complications.

How do you explain this kind of
behavior?

Isn't it unethical? Isn't it evil? What
would you say this kind of behavior?

How can a scientist act in such a way?

It's mind -boggling. I was on the front
lines of family practice. We work hard.

We read our journals. We try to practice
evidence -based medicine.

And it turned out that...

One of the chief executives at Merck,
the head of research at Merck, actually

knew about this danger and yet was
having the drug reps come in and tell us

prescribe Vioxx, ostensibly because it
was safer when it was more dangerous.

And I think that these executives are
embedded in a culture that

accepts the goal of maximizing sales of
drugs, and yet it's also a culture.

that's quite confident that people won't
be held personally responsible.

So the head of Merck Research, who knew
about the cardiovascular events, not

only was he not held responsible for his
participation, his...

facilitating the harm of so many
Americans.

But he ended up fine, and he went on and
was promoted to a prestigious position

in another organization when he left
Merck. There was no penalty.

You buy stock in a pharma company,
right, and they have a fiduciary

responsibility to their investors to
make money, no matter how they do it.

That's their job. Like, it's implicit
within a corporation that you're going

invest in me, and I'm going to make
money for you.

Their job is not to behave ethically.

Their job is to make profit, right?

I don't want to throw the baby out of
the bathwater here.

Modern medicine has a very important
role to play in

improving people's health, curing
diseases, treating people acutely and

lives.

But what has happened is they are now
out of control as an entity that is

there to make money.

And we are now, in my view, doing more
harm than good.

Well, we don't know exactly how many
people are killed by research fraud in

medicine. But we do know that there's an
estimate that the frauds in six papers

by Don Polderman's may have resulted in
as many as 800 ,000

patient deaths, excess patient deaths.

So if one research fraudster can cause
that many.

excess patient deaths and we think about
all the very many research fraudsters

with a significant proportion of
research being fraudulent 30

percent of gynecological randomized
trials containing false data we're

talking about many millions of people
killed by research fraud in medical

science

Between 40 ,000 and 60 ,000 Americans
died. So this is approximately equal to

the number of Americans who died in the
Vietnam War, died from taking Vioxx.

And most of those people died after the
New England Journal was aware and the

FDA was aware that the drug caused
significantly more serious problems than

prevented.

It is possible for regulators who decide
whether a drug should be made available

to use in a certain country to be really
much more muscular about how they go

about this. And a really good example is
Equig, which is the German regulator.

And they were deciding about whether to
make Roboxetine, which is a drug used in

mental health issues.

available more widely.

And Pfizer was the drug company
involved.

And they said, we need all the data. And
Pfizer said, we've given you all the

data. And then they said, no, you
haven't. And eventually they said, we're

going to make your drug available. Give
us the data.

fessed up with all this data.

75 % of it had never been published.

And when they reviewed the published
versus the unpublished data and put them

all together, a drug that had been
considered effective and safe was found

ineffective and harmful.

So it's a really good case of a
regulator doing what it should do. It

of effort, a lot of backlash from
industry, but we get a result that

really matters to the public.

and regulators around the world need to
do this work. That's their job.

Ultimately, Merck was found guilty in
two different arenas.

In one arena, the federal government
sued them, and Merck had to pay almost a

billion dollars in fines for under
-reporting the cardiovascular risk of

Vioxx, of which they were fully aware.

And they were also found guilty in civil
litigation where there were 27 ,000

plaintiffs. And that case was settled
for approximately $4 .8 billion.

The CEO of Merck went on to teach at
Harvard Business School as if he hadn't

just overseen.

one of the most profitable drugs in
history at that time that killed 50 ,000

Americans and that it was known that it
was going to be, that there were going

to be serious cardiovascular
consequences.

He didn't go to jail. He went to Harvard
Business School.

Pfizer lied.

Then Woody died.

I'm Professor J .S. Bamra.

I'm a consultant psychiatrist, senior
NHS consultant psychiatrist.

I'm the past chair of the British
Association of Physicians of Indian

and I've had various other senior roles
in the NHS, such as medical director of

a mental health trust and various other
positions, board positions.

My name is Kim Witzak, and my background
is I'm a drug safety advocate. I also

like to call myself having a portfolio
career because I do a lot of different

things. My profession is I'm in
advertising and marketing.

And I also sit on the FDA's
Psychopharmacologic Drugs Advisory

consumer representative.

But most importantly, I like to call
myself the accidental advocate because I

drug safety work. I never set out to do
this work, but I'm extremely passionate,

and I've been now doing it for 20 years.

My life looked very different than it
does today.

I was happily married to my husband of
almost 10 years, traveling the world

our professions. We both had successful
careers.

And on August 6, 2003, I got a phone
call that changed my trajectory of my

forever. My dad called to tell me when I
was out of town on business that my

husband, Woody, of almost 10 years, was
found hanging from the rafters of our

garage, dead at age 37.

So antidepressants have a valid usage
for depressions. What we do know

also is that antidepressants are greatly
over -prescribed, particularly in

primary care.

They have been used, sometimes very
wrongly and often very wrongly, for

problems, for eating disorders.

for anxiety, for pain, and of course,
you know, there is the risk in the

stages of antidepressant prescribing
that patients might have increased risk

suicide.

Woody wasn't depressed. He had no
history of depression or any other

illness.

He had just started his dream job with a
startup company and was having trouble

sleeping, which is not uncommon for
entrepreneurs.

And I think it's very important that we
address those causes or the triggers by

non -pharmacological means before we
decide that antidepressants are

And so he went to his doctor and after a
short visit was given Zoloft, which is

an antidepressant for insomnia, and five
weeks later took his own life.

Lifestyle changes should be our first
port of call, both for our physical as

well as our mental health, and we don't
often do that. We also know that...

Other interventions, you know, such as
Pilates, yoga, you know, meditation, all

these are very important in terms of
combating stress and depression.

But we don't do that enough in the NHS.

We need to know all information.

We need to know the good, the bad, the
ugly.

Also, like, what would happen if we did
nothing?

Right? So I don't think Woody should
have ever been given an antidepressant

insomnia. For Woody, some of the other
things that could have been, we could

have looked at, what are you doing,
like, for exercise? What are you doing

meditation? What are you doing?

Obviously, it was anxiousness around a
new job.

What are we doing? What does your food
look like? What's your health like?

There's a lot of other things we should
have started with.

And, again, I go back to an
antidepressant, and it was used off

insomnia, and that should never have
been first -line treatment.

But we didn't know. There was no
conversation.

missing key information.

And I remember, you know, at these FDA
advisory panel committee meetings where

we got to, as a member of the public, I
got to go and get my three minutes and

tell Woody's story, but also what I
wanted the FDA to know and the advisors.

And I remember saying, don't you decide
what information we need and don't need.

We're not, like, we are not afraid of
information.

But what we're afraid of is when we
don't have the information and then we

out after the fact that you knew
something.

A lot of the research is done in
research studies, which, as you can

many of these are fueled by
pharmaceutical companies.

So it's very hard to actually come to
good facts in terms of life -limiting

effects. But we see that in clinical
life. You know, I can't tell you how

might suffer these, but a significant
proportion of the patients will have

significant problems with
antidepressants. There were no warnings

drugs. We didn't even get a warning.

And I don't even know that he knew.

to ask that it was an antidepressant
because, you know, even that in itself,

might have said, why am I getting an
antidepressant? I'm not, you know, I'm

depressed. You know, there are
significant areas of concern about

usage in various age groups. For
instance, in children, and now we see

antidepressants are prescribed in
children.

There have been cases, particularly, you
know, the case of paroxetine, which is

quite famous now.

where they conceal data of patients
experiencing suicidal thoughts within

of starting paroxetine. And other SSRIs,
by the way, are implicated in this, not

being aware of that, and actually those
patients then going out to recurrently

harm themselves and sometimes sadly die
by suicide.

And in the elderly, we know that
antidepressants are a significant cause

risks, and risk, as you know, then
increase the...

morbidity and mortality for that
particular patient.

Any fall, the risks of fall is
significant. And a lot of older patients

informed about this, you know, that
there is a risk of this. And many of

remember, live on their own.

So risk of fall leads to them, I've seen
patients who have a fall, gone into

hospital, had a hip operation, can't go
back home again.

So one of the things that we did when we
got all these documents released is we

marched them out to anybody and
everybody in D .C. from the members of

We hand -delivered them to the FDA
officials that were actually in some of

documents, as well as the media, and
really to help. Because when you

see in black and white what the
companies and the FDA knew,

Didn't tell the doctors, and my
husband's dead, and countless others,

kids, are dead. You have to do
something. We are considered acceptable

collateral damage.

Patient began to verbalize feelings of
killing other people, and then himself.

To me, this is fraud, because they know.

that they owe a duty.

They're committing a tort. They're
committing an injury because they are

presenting themselves to medical
professionals as an arbiter of truth and

as a neutral referee and a reliable
referee of the truth.

And they know that those medical
professionals are relying on journal

to treat patients.

that if they tell a lie, if they're
committing fraud, that they can injure

kill people.

They know that. And so we have all the
ingredients. They have a duty.

They knowingly violate that duty of
care.

And so I believe they can be prosecuted,
and not only can they be prosecuted for

those injuries, but they can be
prosecuted on the racketeering statutes

promoting fraud.

So I'm going to do that as soon as I get
in there, and I'm going to bring them

all in.

And I'm going to say, you have to come
up with a plan to show us to bring the

editors and the owners in. You know, a
lot of them are owned by giant companies

like Elsevier.

There's thousands of them.

To bring them in and say, you know,
we're going to prosecute you under

racketeering statutes, criminal
statutes, and civil statutes.

unless you come up with a plan to show
us how you're going to start

publishing real science again rather
than bought and paid for science, phony

science.

Most recently, there has been a lot of
hype around Alzheimer's drug licanumab,

which John Abramson has studied in great
detail.

And what's become quite clear is that
the efficacy is extremely poor. The side

effects are... quite significant and
potentially serious.

The cost is through the roof.

And this has not had any good deal of
scrutiny at all from the mainstream

I think this is giving people false
hope. And really, it's just another

of the fact that, I'll just say as it
is, I think it reflects again very

that the business model of Big Pharma is
one of fraud.

deliberate deception in order to make
money.

You know, one of the really interesting
things about how pharmaceutical

companies have operated the last few
decades is that rather than focusing on

development of drugs that treat a
disease in particular,

What they'll do is they'll find an
animal model or some kind of sort of

model that identifies a biomarker that
correlates with the disease.

A good example of this is Alzheimer's
disease.

In Alzheimer's disease, there was a long
sort of line of research saying

that people with Alzheimer's disease
have a certain protein in the brain

amyloid protein.

that produces plaques in the brain.

It took a long time, but eventually
people figured out how to measure the

amyloid or a correlate of the amyloid.
Now, amyloid is very far removed

from the thing you care about. The thing
you care about is I don't want to lose

my memory. I want to be able to do the
things I normally do in life. That's

Alzheimer's robs you of.

But it's much easier to develop a drug
that treats amyloid.

rather than treating the thing you care
about, which is losing my memory, losing

my ability to function.

There's a new drug that was approved in
June of 2023 by the FDA that supposedly

decreases the rate at which people with
mild Alzheimer's disease progress

towards dementia, a drug called Lekembe.

The drug company did a study where they
gave Lekembe to some people, half the

people. And they gave a placebo to half
of the people.

And they measured what's called a
clinical dementia rating scale.

And they found a statistically
significant lower decline in

mental status in the people who were
treated with Lekembe. The company that

manufactures Lekembe has brilliantly
designed this study.

To have a statistically significant
difference, 0 .45 is statistically

significant, but not have a clinically
meaningful significance.

Now, there's another point that's really
essential.

The New England Journal published this
study.

They didn't include a breakdown in terms
of the response by sex.

Turns out that two -thirds of the people
who have Alzheimer's disease in the

United States are women.

And it turns out that study that was
buried in supplemental data in the New

England Journal article that is not
talked about, I've never heard it talked

about in the media, women had
significantly less positive effect than

And the effect on women wasn't 0 .45
points, it was 0 .2 points, which didn't

even reach statistical significance.

The FDA did not make...

the drug manufacturer put the lack of
efficacy of this drug for women in the

label.

So that two -thirds of the people who
are going to be taking Lekembe happen to

be female, and the best and only study
that we have shows that it's not going

be effective. Not clinically effective,
but not even statistically effective.

This is very common with drug companies.
So companies will develop...

that treat the biomarker that supposedly
correlates with a clinical outcome

people care about, but they won't
necessarily measure the effect on the

that people actually care about. And so
they can get regulators to approve the

drug because it definitely reduces this
correlate, but who cares about the

correlate? What we really care about is
the outcome.

My conclusion is that the rules of this
game haven't changed, but the ante has

gone up enormously.

So that now we're playing these games
not for $2 ,000 a year drugs, but for

drugs that are going to cost the system
$100 ,000 a year, and yet the game is

the same. You can manipulate how many
people are in your study and what

dementia rating scale you're going to
use, and you can get a...

statistically significant difference,
but not a clinically meaningful

difference. And the FDA is not going to
protect doctors and the public and the

insurers and Medicare from this
deception about the clinical value of

In July 2024, Dr. John Abramson
contacted the UK regulator, the MHRA,

to voice his concerns regarding the
Canemab.

It was too late.

The MHRA had already fast -tracked the
drug for approval into the U .K. market.

So when I came on the Hill in 2007, we
had been dealing with, on the Senate

Finance Committee, the Senate Finance
Committee oversees Medicare and

and these are the two big health care
programs for the United States federal

government.

23 % of federal spending.

So, you know, it's a big chunk. It's
right up there with defense, right?

are the two big programs for American
spending.

And we were dealing with constant,
constant, constant drug scandals. You

we had Vioxx was one that, you know, was
a big one.

The thing I think is funny about drug
scandals is I think people forget.

Which drug schedule is which? Like, you
mix them up in your head because there's

so many of them. There's, like, another
one coming, right? I mean, the latest

one now is Ozempic, you know, which is
this weight loss drug.

And, you know, when it was just being
all over the media and people were

Ozempic, I was just like, I know.

I know this story. Like, we're going to
find out there's huge side effects. And

sure enough, you know, they've come out
now in the last month, you know, but,

like, hey, they had a good run of, like,
three months with all these constant

positive stories in the media, people
tweeting crazy about Ozempic, and I've

lost so much weight over Zempic, and
then all the side effects start coming

right?

This new set of drugs, Ozempic and
Wagobe, which, by the way, are the same

It's semaglutide in two different doses.

Not two different drugs. There's a third
drug called Monjaro, which is about to

come out, made by a different company,
and it's a slightly different mechanism

of action.

Bottom line, they work.

They do.

16 % weight loss, median.

Yeah, that's good.

And as an endocrinologist, I've known
about this for a long time.

I'm also glad they're here because they
can help patients with diabetes. They

can help patients with obesity.

However, we have to then take that 16 %
weight loss and balance it against

the problems.

And there are several.

There's the physiologic problem.

There's the side effects problem.

And there's the economic problem.

Physiologic problem.

Yes. there is a 16 % weight loss. What
is that weight?

Turns out it's equal amounts of fat and
muscle.

Now, if you're trying to lose weight,
you want to lose fat. You don't want to

lose muscle.

Ask any little old lady who breaks her
hip whether or not she's happy that she

has a little extra muscle or not.

Sarcopenia is one of the things that
causes early demise.

So losing as much muscle as fat, is not
a good thing.

Now, side effect profile.

These two drugs, hemagglutide and also
the third one, terzepatide, lead to

nausea, vomiting, pancreatitis, and

now there's a warning label on Ozempic
for gastroparesis.

which means stomach not moving, stomach
paralyzed.

Stomach turns to stone.

And guess what? It lasts way beyond the
discontinuation of the drug.

Now, do you think that that's a good
idea? In fact, that's why the drugs

is because you can't eat.

Because it delays gastric emptying. It
delays your stomach from being able

Move the food along.

You think that's a great way to lose
weight? In fact, if you can't eat,

starvation. Well, the fat in the muscle
shows that's how it works.

Is that a good idea? Are you going to
starve to death?

That's not such a good idea. And not
only that, but

the company...

is now touting it as a treatment for
certain types of addiction because you

get people off alcohol, you can get
people off opioids with Ozempic. Yes,

can. The reason is because it's
suppressing the reward pathway in the

Well, when you suppress the reward
pathway in the brain, you get major

depressive disorder and suicide.

And we learned this the hard way back in
2006 with a previous obesity drug

called Romanobant.

which never made it to the American
market because of the suicides.

So reward is what gets you up in the
morning. And if you basically

paralyze reward, you're not doing
anybody any favors.

And then finally, the economic problem.

If everyone in America who qualified for
Ozempic got it, That

would be $2 .1 trillion added on to the
health care system, which is currently

at $4 .1 trillion. So this would be a
greater than 50 % increase in health

dollars. And Medicare is going broke by
the year 2026.

Now, do you really think our health care
system is going to be able to survive

that?

Conversely, a 16 % weight loss for $2 .1
trillion cost.

If we just took the sugar out of the
food and brought

sugar consumption down to USDA
guidelines of 12 teaspoons per day

we would lose 29 % body weight and we
would save $3 .0

trillion.

So, better weight loss, $5 .1 trillion
difference.

Which do you think is better?

Yeah, so no one knows is very
interesting because they're very

based and really had control from a
nonprofit board for their history.

And there's actually been a war.

Among the governance structure of Novo
Nordics where they feel like growing and

making as much money as possible, even
going against the principles that they

held where obesity is a much more
complicated issue than an injection,

been overtaken by just the desire to
make as much money as possible where

feel like that's in the best interest of
the nonprofit.

The righteousness they feel about.

being such a prominent nonprofit, has
led them to be one of the top 10

spenders and advertisers in the United
States of America, literally paying

Harvard doctors to say obesity is a
genetic condition not tied to lifestyle,

literally buying off medical journals,
being one of the top donators to U .S.

members of Congress, saying that it's
racist and classist to not government

subsidize obesity shots.

We're actually really coming after
anyone who suggests that obesity and the

cause of it is tied to food, not a lack
of ozempic. It's against the principles

that they would have wanted. For most of
their history, they really wanted to do

the right thing and help people. They
wouldn't overcharge for their insulin,

they fought to make things affordable.

But I really think that many people at
Novo Nordisk feel that they've lost

way.

Denmark, where the company is based.

Where are we off to?

We're off to Constitution Hill to meet
my friend, Jay Naidoo,

freedom fighter, the man who...

instigated the release of Nelson Mandela
from prison by organizing a strike of a

million people as a trade union leader.

And he has some, I think, interesting
insights and wisdom to share with us on

this battle and this journey to take on
and expose big pharma

corporate tyranny.

Any parallels?

I think there are lots of parallels.

Hey,

so what you saw in the development of
modern medicine was a capture in

the first instance of the training
facilities

medicine and so once you control the
container that produces the

people that are implementing a medical
system then you're in control of the

system and as we've seen the evolution
of the system it may have started with

good intentions but what modern Western
medicine has done and it has a right to

exist and it has useful value in what it
delivers to us as citizens of the world

but it's gone to a point of view where
it believes that it is the only way we

can heal ourselves it's the only way in
which we can deliver a modern medical

system and so gradually they've they've
conditioned us away from the traditional

way in which we healed ourselves if you
take countries like india and and china

where oh africa as a whole they were at
powerful systems of healing

and delivering human well -being, of
being able to treat

many of the challenges we face at the
level of medicine and health.

But it's done from a perspective of
human well -being that is part of an

environmental well -being. The only
large body of evidence on reversal of

disease has come from India from
cardiologist Satish Gupta's work I had

and see it to believe it myself and
looking at the angiograms of patients

had gone through his lifestyle program
and to see actual reversal of those

blockages in the arteries and even some
arteries which were completely blocked

and then opened up was extraordinary for
me extraordinary to see that

the medical model

is in part perpetuated by suppression of
some of this ancient

wisdom as well, you know, and also the
issue, again, around, you know, what

actually is behind your health, what
really determines your health.

Okay.

I want to tell you about two types of
stress.

We know that chronic stress, that means
that we're dealing with some ongoing

situation every day.

we don't get a break. We don't get time
to restore and recover.

That's the type of stress that wears our
biology out and promotes accelerated

levels of cardiovascular disease as well
as really risks for any type of chronic

disease.

Basically, the diagnosis was that I had
a heart sickness, which I've never heard

of. My body rejects my stunts, and my
heartbeat rises to 240.

My lifestyle was irregular.

I was a drinker. So that was a problem
with me.

So we're here in the Indian state of

Rajasthan on route to Mount Abu to meet
cardiologist Satish Gupta.

He's done some fascinating work.

He published research in 2011 in the
Indian Heart Journal, in which

he attempted, through healthy lifestyle
changes,

to reverse heart disease.

And he actually managed to do that.

So I'm fascinated and excited to find
out what was the secret

behind that heart disease reversal.

I'll start with one minute of
meditation.

So that everything goes with vibrations,
not without vibrations.

I am Dr. Satish Kumar Gupta.

I am the director of Department of
Cardiology and Medicine at RMM Global

Hospital Trauma Center, Shantivan, Abu
Road.

See, Mount Abu Open Heart Trial was
started in February 1998.

And it was a non -randomized pilot
study, open heart trial, in which we

patients who all of them were caught.

had angiogram done, and many of these
patients had already intervention

done, or they had diffuse disease, not
operable, or borderline disease.

Or they had chronic, all of them had
chronic stable angina, and who were not

willing to undergo bypass surgery.

It was a seven -day in -house program in
which patients were coming with the

spouse. If the wife was suffering, the
husband has to come.

As an attendant, and if the husband is
suffering, then wife has to come with

During this seven -day house program,
patients were trained.

It was a program from morning till
evening.

It was a whole -day program, and on the
day one, patients were given

psychological analysis. As they entered
the campus after some time, first thing

they were given was psychological
analysis, in which they had type A

anxiety content, anger content,
depression.

score and the overall lifestyle, healthy
lifestyle or unhealthy lifestyle or

overall feeling well -being, like that.
Those different six, seven parameters

were taken on the day one.

And then along with that, on the second
day morning, we did their EEGs.

EEG was done, heart rate variability was
done, and the hormones, the happy

hormones and the stress hormones.

We did their epinephrine levels, the
norepinephrine levels, dopamine levels,

cortisol, ATM and 4PM samples. We did in
the blood as well as we did 24 -hour

urine samples that were collected.

We did the melatonin levels in the
saliva overnight. We took those and we

did the lipoprotein levels.

And along with that, we also did the...

The endorphin levels and serotonin
levels were done.

And all the patients had their lipid
profile, hemoglobin, blood sugar,

post -prandial levels. All these
patients had come with their angiograms.

In his particular healthy living
program, which really focuses on quite

Hindus, it was a high -fiber vegetarian
diet. It was two 30 -minute brisk walks

a day.

And then it was 40 minutes of...

something called Raj Yoga Meditation,
which involves breathing techniques, but

also it's a spiritual transformation.

And that spiritual transformation really
just changes the focus of the way

people go about their lives and trying
to help them think in a way which is

going to have the least negative impact
on their mental well -being as well as

their physical well -being. And that, I
think, is a huge component.

not just for potentially reversing heart
disease, but actually for managing and

preventing many chronic diseases.

You know, all those factors, lack of
sleep, smoking, alcohol, all the

addictions, you know. So they were told
in detail about that, you know. And

along that, they were taught about mind.
What is the mind?

Mind -body connection.

We call it mind has got four aspects,
thoughts, emotions, attitudes, and

memories. That is called a team, right?

So how this negative team or positive
team, from where it comes up, right?

with this, they were taught about Raja
Yoga meditation.

What is the basic concept of Raja Yoga
meditation?

And how to use Raja Yoga meditation to
modify their personality, their

psychological behavior.

And also because it has been seen that
the people have got, you know, their

habits of smoking and...

taking junk food you know and they get
used to that they go to bed late and get

up late right so those how to modify
those things you know with that rush

king and according to this tradition the
king of the body is the mind so for

russia yoga we do need to understand our
mind we need to understand our thinking

models and our cognitive process in
order for us to attain awareness or or

confidence so The real type of
meditation that looks for the self is

Now, when we talk about reversing heart
disease related to meditation,

especially rush yoga, I'd like to be
very clear that there are certain

that happens when we meditate.

So there are also changing in habits.
We're much more aware of what we eat.

We're much more aware on how we breathe.

And the interoceptibility on our body
increases.

Therefore, we are much more in tune with
what we do.

As I said earlier, what we eat, what are
our habits, what is our stress levels,

right? So by practicing rush yoga, we
increase our neuroplasticity, therefore

having immense effect on our stress and
our anxiety.

As we know, when we reduce our stress
and anxiety, we also reduce our

inflammation in the body. Therefore,
here you have the full circle completed

around how meditation can benefit the
heart.

And what we think now is stress.

is that people tend to keep their stress
response on as a default.

And we need to consciously bring into
our life

safe environments and safety signals and
telling ourselves that we're safe to

turn off the stress response.

The good news is that everything that
stress does to ourselves is reversible.

So we know that mind -body practices.

lifestyle behaviors, meditation
retreats, these reverse the very

that stress accelerates. These can
reduce levels of inflammation.

Lots of studies show that meditation can
reduce gene expression of

pro -inflammatory cytokines.

There's no pill that can reduce pro
-inflammatory cytokines without bad side

effects. So just actually letting go.

relaxing, training ourselves to be
present is the best medicine.

This can reduce those feisty chronic
levels of inflammation.

What could be better news?

And it's pleasant, but we just don't
allow ourselves to slow down. We don't

allow ourselves the time to take mind
-body practices seriously.

But our body takes them very seriously.
It doesn't matter what you practice. It

could be tai chi, yoga, meditation.

Some hobby yoga nidra is magical when
you're lying down and you're literally

allowing yourself to be guided and let
go of stress, tension, control.

These are the practices that our bodies
respond to so beautifully.

So we just need to realize that these
ancient practices have

been developed over thousands of years
because they work.

I'm going to show you some angiograms
pre and post of the Mount Abu Open Heart

Trial, right?

And in which, you know, we have done the
angiograms after two years of the

study. And the first angiogram shows
about 80 % block in the RCA, right,

coronary artery, right? This is here
near the crux.

And the repeat angiogram in the same
view, in the same view, you can see

significant regression, right?

Significant regression is observed in
the same artery, right?

Similarly, this is 80 % block here. Can
you see this?

80 % block here, about 78 % block as per
the electronic digitometer.

And this is opened up, right? And
similarly, ejection fraction here, 20%.

the repeat angiogram after one year, it
becomes 50%. This again shows that how

the agiogram meditative lifestyle, this
three -dimensional healthcare lifestyle

for healthy heart, happy mind, healthy
body works.

And see this, another 100 % calcified
block has opened up. See this?

flow is so nice.

So, the people who had less than 50 %
adherence to the program, actually the

blocks had increased.

See this?

This is the baseline and this is the
blocks that are increasing.

This is a pre -angiogram in which it is
the RCA, cryo -corneal artery,

mid. This is 100 % calcified block. This
is total cut -off cryo -corneal artery

here. You can appreciate this here,
right?

Total cut -off.

Here it is seen.

Okay, let's cut off.

And this is a repeat angiogram where it
is seen that the whole artery territory

has come up beautifully.

Okay, so I've had a look at the
angiogram findings from Mount Abu and

surprise me at all.

I'm a professional speaker. I go around
the world talking about all aspects of

health and stress management.

And one of the big comments I make is
that so many people are climbing the

ladder to success.

on the wrong wall.

And I really think we've got to get on
the right wall and spend more time with

our patients discussing the vital
importance of lifestyle.

Lifestyle is king, but unfortunately,
most of our colleagues would just prefer

to write a quick script, tell people to
go on to the generic statin, ACE

inhibitor, aspirin, beta blocker, and
then say, oh, by the way, lose a bit of

weight and do some exercise.

And that's the extent of the lifestyle
discussion they have. I have a...

husband and wife sitting in front of me
and say, look, the most important thing

I can see for your health is that you
two have a good relationship.

Much more important than whether we're
reducing your cholesterol to targeted

levels.

These statin trials are designed by the
companies. So they pick a population

they're going to study that will...

from their point of view, optimize the
benefits of the drugs. And they do their

study. They give the statins to half
people and placebo to half people, and

try to create an outcome measure that
will be statistically significant so

they can then get FDA approval and sell
their drugs.

What these studies don't include is a
lifestyle arm. It would be very simple

not very expensive to have three arms,
to have a placebo group, a statin group,

And a lifestyle group.

And you could even have a fourth group,
which is a statin group and a lifestyle

group. And then you'd find out how best
to prevent heart disease, not how best

to sell statins. So the purpose of the
way all of the statin studies have been

done so far is to sell statins, not to
prevent heart disease.

Lifestyle modification, diet, exercise,
medication, and meditation.

This helped me reverse my heart disease.
And my heartbeat has become normal.

Irregular beads which are 44 ,000 in a
day.

They are only 2 ,000 and then 1 ,000.

Right now I am very okay.

See, when I came down here, I used to
walk hardly you can say 500

meters. That was the maximum.

Even less than that.

So after that course here, Dr. Shatish
Mukta said you have to dance.

And I danced for 45 minutes in my life.

That changed.

And now I am regular in the morning. I
go for a walk around 2 to 3 kilometers.

In the evening also I go for a walk. And
daily going for the meditation in our

center at Jaipur.

Mount Abu has since completed a
randomized controlled trial which

their findings. The data from this trial
was shared with the US Cardiology

Association, but the study has not yet
been published.

I think what's quite clear is you can't
solve socially driven disease, which is

predominantly what drives disease in
populations, by just giving someone a

The pharmaceutical industry want you to
believe that their pills are very

effective and they come with minimum
side effects.

But as we know, nothing can be further
from the truth.

In his London cardiology clinic, Dr.
Asim Mulhatra continues to advocate a

lifestyle medicine approach to manage,
avoid or even reverse heart disease.

Keep walking.

So you all, it's a beautiful day to save
lives.

to capture hearts and minds.

There was a shared decision -making
process when I was talking to a theme,

is very important for a patient.

Do doctors read research papers? No,
they don't. Do they understand

analysis? No, they don't.

Are they being given the information in
a way that helps them to prescribe? No,

they are not.

Is the entire medical research framework
just about completely, utterly useless?

Yes, it is.

So there's no way around it unless you
have really stiff things.

And once you get a few people in jail, I
think things will change.

If you knew, why didn't you do anything?

Why did you wait for me to do it?

The key thing is the regulator creating
a system where the pharmaceutical

companies want to do the right thing.

In general, medicine is best for sick
people.

I

think

we

have to keep pushing on these issues and
we have to really try to...

ensure that accountability is received
and the public interests are best

We have seen an over -medicalisation and
over -prescription of antidepressant

drugs.

I didn't mention pets at all. I didn't
mention pets, though.

It's a remarkable situation.

I love it.

But you know, in the same breath, it's
an opportunity.

Because never before has so much been
revealed. And what is revealed must be

then known.

I'm happy I told my story.

It's just crazy.

The one key to health and happiness is
to have someone else in your life who

loves and cares for you, who you love
and care for.

I was training to be an arrhythmia
specialist nurse and I was doing a

in cardiology and it became my passion.

for my whole life.

And what I can say here explicitly, that
these organizations have been captured.

One of the things that I remember
telling my law firm is, it is not about

it's about uncovering documents, because
that is the benefit of having a

lawsuit, is discovery.

See, basically, yoga means connection.

Yoga means connection, right?

Connection with what? Connection with
the truth.

There are so many strategies to help us
manage daily stress, and none of them

are pills.

Our minds are unable to relate to the
richness of this

planet. with the capacity of living
systems to grow, to heal and repair,

and to regenerate.

With a stroke of a pen, a president can
root out corruption in scientific

guidelines.

Don't you want a safe environment for
your children?

All you want to know is that the food
that you're feeding them is not filled

with chemicals that are going to give
them cancer and chronic disease.

Make America healthy again.

Hi Dr. Malhotra. I am doing great thanks
to your advice at your clinic five

years ago.

I followed your recommendations
regarding diet and exercise.

My carotid artery block was 65 -70 %
post -operation.

After roughly a year following your
advice, my block was down to 50 % and

years later it was down to 20 -30%. I am
forever grateful to you.

for my good health today.