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Ask mothers why babies are constantly picking things up from the floor or ground and putting them in their mouths, and chances are they’ll say that it’s instinctive — that that’s how babies explore the world. But why the mouth, when sight, hearing, touch and even scent are far better at identifying things? Accumulating evidence strongly suggests that eating dirt is good for you. In studies of what is called the hygiene hypothesis, researchers are concluding that organisms like the millions of bacteria, viruses and especially worms that enter the body along with “dirt” spur the development of a healthy immune system. Several continuing studies suggest that worms may help to redirect an immune system that has gone awry and resulted in autoimmune disorders, allergies and asthma. These studies, along with epidemiological observations, seem to explain why immune system disorders like multiple sclerosis, Type 1 diabetes, inflammatory bowel disease, asthma and allergies have risen significantly in the United States and other developed countries. “What a child is doing when he puts things in his mouth is allowing his immune response to explore his environment,” Mary Ruebush, a microbiology and immunology instructor, wrote in her new book, Why Dirt Is Good. “Not only does this allow for ‘practice’ of immune responses, which will be necessary for protection, but it also plays a critical role in teaching the immature immune response what is best ignored.”

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Virtually all the dominant strain of flu in the United States this season is resistant to the leading antiviral drug Tamiflu, and scientists and health officials are trying to figure out why. The problem is not yet a public health crisis because this has been a below-average flu season so far, and because the Tamiflu-resistant strain, one of three circulating, is still susceptible to other drugs. But infectious disease specialists are worried nonetheless. Last winter, about 11 percent of the throat swabs from patients with the most common type of flu that were sent to the Centers for Disease Control and Prevention for genetic typing showed a Tamiflu-resistant strain. This season, 99 percent do. “It’s quite shocking,” said Dr. Kent A. Sepkowitz, director of infection control at Memorial Sloan-Kettering Cancer Center in New York. “We’ve never lost an antimicrobial this fast. It blew me away.” The single mutation that creates Tamiflu resistance appears to be spontaneous, and not a reaction to overuse of the drug. Complicating the problem, antiviral drugs work only if taken within the first 48 hours of infection.

Note: Isn't Tamiflu the same drug that was, according the the U.K.'s respected Independent, "bought in massive amounts by Governments to treat a possible human pandemic of the disease [avian flu]," and from which Donald Rumsfeld "made more than $5m in capital gains from selling shares"? What ever happened to all the panic about the avian flu? Could it be that it was only fear mongering? For reliable information on this key topic, click here.

What are the pills in your medicine cabinet, and how do you know they're best for you? When drug companies seek approval to market new medicines, they must show the U.S. Food and Drug Administration the results of all the tests they've run on volunteer patients - at first on only a few, then on dozens, and finally on hundreds or sometimes thousands. After winning approval, the companies typically sponsor reports of those tests in medical journal publications, which many doctors often rely on to determine whether to prescribe new drugs for their patients. Now a skeptical team of medical investigators at UCSF has accused the major drug companies of bias by distorting the results of their trials in those publications, making it hard for doctors to judge for themselves the pros and cons of prescribing the new drugs. As a result, the researchers say, patients may sometimes be taking medicines they don't need - or with unwanted side effects - that their doctors have prescribed on the basis of inadequate information. The UCSF team, led by Lisa A. Bero of the medical center's Institute for Health Policy Studies, probed the details of 164 drug trials involving as many as 1,500 patients over a two-year period and then examined reports on those trials that were published in medical journals, as well as those that remained unpublished. "We found really important information from the official trial reports that were either not published at all or that stressed mostly the positive results of trials in the published versions," said Kristin Rising, a physician at the institute who did the major investigation.

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Children and teenagers are five times more likely to get brain cancer if they use mobile phones, startling new research indicates. The study, experts say, raises fears that today's young people may suffer an "epidemic" of the disease in later life. At least nine out of 10 British 16-year-olds have their own handset, as do more than 40 per cent of primary schoolchildren. Yet investigating dangers to the young has been omitted from a massive Ł3.1m British investigation of the risks of cancer from using mobile phones, launched this year, even though the official Mobile Telecommunications and Health Research (MTHR) Programme – which is conducting it – admits that the issue is of the "highest priority". Despite recommendations of an official report that the use of mobiles by children should be "minimised", the Government has done almost nothing to discourage it. Last week the European Parliament voted by 522 to 16 to urge ministers across Europe to bring in stricter limits for exposure to radiation from mobile and cordless phones, Wi-fi and other devices, partly because children are especially vulnerable to them. They are more at risk because their brains and nervous systems are still developing and because – since their heads are smaller and their skulls are thinner – the radiation penetrates deeper into their brains. David Carpenter, dean of the School of Public Health at the State University of New York said: "Children are spending significant time on mobile phones. We may be facing a public health crisis in an epidemic of brain cancers as a result of mobile phone use."

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It seemed an ideal marriage, a scientific partnership that would attack mental illness from all sides. Psychiatrists would bring ... their expertise and clinical experience, drug makers would provide their products and the money to run rigorous studies, and patients would get better medications, faster. But now the profession itself is under attack in Congress, accused of allowing this relationship to become too cozy. After a series of stinging investigations of individual doctors’ arrangements with drug makers, Senator Charles E. Grassley, Republican of Iowa, is demanding that the American Psychiatric Association, the field’s premier professional organization, give an accounting of its financing. "I have come to understand that money from the pharmaceutical industry can shape the practices of nonprofit organizations that purport to be independent in their viewpoints and actions," Mr. Grassley said. In 2006 ... the drug industry accounted for about 30 percent of the association’s $62.5 million in financing. One of the doctors named by Mr. Grassley is the association’s president-elect, Dr. Alan F. Schatzberg of Stanford, whose $4.8 million stock holdings in a drug development company raised the senator’s concern. Commercial arrangements are rampant throughout medicine. In the past two decades, drug and device makers have paid tens of thousands of doctors and researchers of all specialties. Worried that this money could taint doctors’ research plans or clinical judgment, government agencies, medical journals and universities have been forced to look more closely at deal details.

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Europe this month rolled out new restrictions on makers of chemicals linked to cancer and other health problems, changes that are forcing U.S. industries to find new ways to produce a wide range of everyday products. The new laws in the European Union require companies to demonstrate that a chemical is safe before it enters commerce -- the opposite of policies in the United States, where regulators must prove that a chemical is harmful before it can be restricted or removed from the market. The changes come at a time when consumers are increasingly worried about the long-term consequences of chemical exposure and are agitating for more aggressive regulation. The European Union's tough stance on chemical regulation is the latest area in which the Europeans are reshaping business practices with demands that American companies either comply or lose access to a market of 27 countries and nearly 500 million people. From its crackdown on antitrust practices in the computer industry to its rigorous protection of consumer privacy, the European Union has adopted a regulatory philosophy that emphasizes the consumer. "There's a strong sense in Europe and the world at large that America is letting the market have a free ride," said Sheila Jasanoff, professor of science and technology studies at Harvard University's John F. Kennedy School of Government. "The Europeans believe . . . that being a good global citizen in an era of sustainability means you don't just charge ahead and destroy the planet without concern for what you're doing."

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Race and place of residence can have a staggering impact on the course and quality of the medical treatment a patient receives, according to new research showing that blacks with diabetes or vascular disease are nearly five times more likely than whites to have a leg amputated and that women in Mississippi are far less likely to have mammograms than those in Maine. The study, by researchers at Dartmouth, examined Medicare claims for evidence of racial and geographic disparities and found that on a variety of quality indices, blacks typically were less likely to receive recommended care than whites within a given region. But the most striking disparities were found from place to place. For instance, the widest racial gaps in mammogram rates within a state were in California and Illinois, with a difference of 12 percentage points between the white rate and the black rate. But the country’s lowest rate for blacks — 48 percent in California — was 24 percentage points below the highest rate — 72 percent in Massachusetts. The statistics were for women ages 65 to 69 who received screening in 2004 or 2005. In all but two states, black diabetics were less likely than whites to receive annual hemoglobin testing. But blacks in Colorado (66 percent) were far less likely to be screened than those in Massachusetts (88 percent). The study was commissioned by the nation’s largest health-related philanthropy, the Robert Wood Johnson Foundation, which on Thursday planned to announce a three-year, $300 million initiative intended to narrow health care disparities across lines of race and geography.

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Hundreds of Environmental Protection Agency scientists complain they have been victims of political interference and pressure from superiors to skew their findings. The Union of Concerned Scientists said that more than half of the nearly 1,600 EPA staff scientists who responded online to a detailed questionnaire reported they had experienced incidents of political interference in their work. Francesca Grifo, director of the Union of Concerned Scientists' Scientific Integrity Program, said the survey results revealed "an agency in crisis" with low morale, especially among scientists involved in risk assessment and crafting regulations. "The investigation shows researchers are generally continuing to do their work, but their scientific findings are tossed aside when it comes time to write regulations," said Grifo. The group sent an online questionnaire to 5,500 EPA scientists and received 1,586 responses, a majority of them senior scientists who have worked for the agency for 10 years or more. The survey included chemists, toxicologists, engineers, geologists and experts in the life and environmental sciences. The report said that 60 percent of those responding, or 889 scientists, reported personally experiencing what they viewed as political interference in their work over the last five years. Senior managers and the White House Office of Management and Budget frequently second-guess scientific findings and change work conducted by EPA's scientists, the report said. Nearly 400 scientists said they had witnessed EPA officials misrepresenting scientific findings, 284 said they had [witnessed] the "selective or incomplete use of data to justify a specific regulatory outcome" and 224 scientists said they had been directed to "inappropriately exclude or alter technical information" in an EPA document.

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More than 120 veterans of the wars in Afghanistan and Iraq commit suicide every week while the government stalls in granting returning troops the mental health treatment and benefits to which they are entitled, veterans advocates told a federal judge. The rights of hundreds of thousands of veterans are being violated by the Department of Veterans Affairs, "an agency that is in denial," and by a government health care system and appeals process for patients that is "broken down," Gordon Erspamer, lawyer for two advocacy groups, said in an opening statement at the trial of a nationwide lawsuit. He said veterans are committing suicide at the rate of 18 a day - a number acknowledged by a VA official in a Dec. 15 e-mail - and the agency's backlog of disability claims now exceeds 650,000, an increase of 200,000 since the Iraq war started in 2003. U.S. District Judge Samuel Conti ... ruled in January that the case could go to trial. In doing so, he rejected the government's argument that civil courts have no authority over the VA's medical decisions or how it handles grievances. If the advocates can prove their claims, Conti said in his ruling, they would show that "thousands of veterans, if not more, are suffering grievous injuries as the result of their inability to procure desperately needed and obviously deserved health care." He also ruled that veterans are legally entitled to five years of government-provided health care after leaving the service, despite federal officials' argument that they are required to provide only as much care as the VA's budget allows in a given year. The trial follows publication of a Rand study last week that estimated 300,000 U.S. troops returning from Afghanistan and Iraq, or 18.5 percent of the total, suffer from major depression or post-traumatic stress.

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Britain's first human-animal hybrid embryos have been created, forming a crucial first step, scientists believe, towards a supply of stem cells that could be used to investigate debilitating and so far untreatable conditions such as Alzheimer's disease, Parkinson's and motor neurone disease. Lyle Armstrong, who led the work, gained permission in January from the Human Fertilisation and Embryology Authority (HFEA) to create the embryos, known as "cytoplasmic hybrids". His team at Newcastle University produced the embryos by inserting human DNA from a skin cell into a hollowed-out cow egg. An electric shock then induced the hybrid embryo to grow. The embryo, 99.9% human and 0.1% other animal, grew for three days, until it had 32 cells. Eventually, scientists hope to grow such embryos for six days, and then extract stem cells from them. The researchers insisted the embryos would never be implanted into a woman and that the only reason they used cow eggs was due to the scarcity of human eggs. Cardinal Keith O'Brien used his Easter sermon to denounce what he called experiments of "Frankenstein proportion" and called the bill a "monstrous attack on human rights, human dignity and human life". Catholics object to the idea of putting human and animal DNA in the same entity and to the notion of creating what they regard as a life for the purposes of research, a life that will then be destroyed.

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What happened to little, red-haired Hannah Poling is hardly unique in the world of autism. She had an uneventful birth. And then, right after receiving a bunch of vaccines, she fell ill. Hannah, now 9, recovered from her acute illness but she lost her words, her eye contact and, in a matter of months, began exhibiting the repetitive behaviors and social withdrawal that typify autism. Parents of kids like Hannah have been fingering vaccines - and, in particular, the mercury-based vaccine preservative thimerosal - as a cause of autism for over a decade, but researchers have repeatedly failed to find a link. What's unique about Hannah's case is that for the first time federal authorities have conceded a connection between her autistic symptoms and the vaccines she received, though the connection is by no means simple. A panel of medical evaluators at the Department of Health and Human Services concluded that Hannah had been injured by vaccines - and recommended that her family be compensated for the injuries. The panel said that Hannah had an underlying cellular disorder that was aggravated by the vaccines, causing brain damage with features of autism spectrum disorder (ASD).

Note: CBS reported that the Poling family eventually received $1.5 million in compensation for the autism caused by vaccines. For more along these lines, see concise summaries of deeply revealing vaccine controversy from reliable major media sources.

Lawmakers and watchdog groups had harsh words Monday for the U.S. Department of Agriculture after the agency ordered a recall of 143 million pounds of beef from a Southern California slaughterhouse. Beef products dating to Feb. 1, 2006, that came from Westland/Hallmark Meat Co. of Chino (San Bernardino County) are subject to the recall, which is the largest such action in U.S. history. The notice came after the Humane Society of the United States shot undercover video showing crippled and sick animals being shoved with forklifts - treatment that has also triggered an animal-abuse investigation. A congresswoman who chairs a House subcommittee that determines funding levels for the USDA sent a letter ... to the agency's undersecretary for food safety demanding an explanation of the Westland case before a March 5 budgetary review hearing. Rep. Rosa DeLauro, D-Conn., chairwoman of the House Agriculture, Food and Drug Administration Appropriations Subcommittee, called the scenes in the video inhumane and said the video "demonstrates just how far our food safety system has collapsed." DeLauro has called for an investigation into the government's ability to secure the safety of meat in the nation's schools. Westland was a major supplier of beef for the National School Lunch Program. She also asked how the agency is addressing staff shortages among slaughterhouse inspectors - an issue also raised by several food safety experts and watchdog groups. According to Felicia Nestor, a senior policy analyst with Food and Water Watch, a consumer advocacy group based in Washington, anywhere from 7 to 21 percent of slaughterhouse inspector positions have been left vacant by the USDA, depending on the district. "They just don't fill vacancies," Nestor said.

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The U.S. Department of Agriculture yesterday asked U.S. farmers to keep their cloned animals off the market indefinitely even as Food and Drug Administration officials announced that food from cloned livestock is safe to eat. Bruce I. Knight, the USDA's undersecretary for marketing and regulatory programs, requested an ongoing "voluntary moratorium" to buy time for "an acceptance process" that Knight said consumers in the United States and abroad will need, "given the emotional nature of this issue." Yet even as the two agencies sought a unified message -- that food from clones is safe for people but perhaps dangerous to U.S. markets and trade relations -- evidence surfaced suggesting that Americans and others are probably already eating meat from the offspring of clones. Executives from the nation's major cattle cloning companies conceded yesterday that they have not been able to keep track of how many offspring of clones have entered the food supply, despite a years-old request by the FDA to keep them off the market pending completion of the agency's safety report. At least one Kansas cattle producer also disclosed yesterday that he has openly sold semen from prize-winning clones to many U.S. meat producers in the past few years, and that he is certain he is not alone. "This is a fairy tale that this technology is not being used and is not already in the food chain," said Donald Coover, a Galesburg cattleman and veterinarian who has a specialty cattle semen business. "Anyone who tells you otherwise either doesn't know what they're talking about, or they're not being honest." Last year, [only] 22 percent of Americans who responded to a major survey said they had a favorable impression of food from clones.

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Things did not exactly go as planned when Ricki Lake and Abby Epstein conceived the idea of working together on an expose of America's delivery rooms. Called "The Business of Being Born," the documentary examines the politics, economics and history of how and where most Americans take their first breaths. This includes the births of Epstein's and Lake's own babies - Lake delivered at home aided by a midwife. Although they were longtime friends, Epstein had written off Lake's interest in home birth and midwifery as a "reckless" crusade that she admits she "totally didn't get." That all changed in 2004 when Lake showed Epstein a home video of [Lake] giving birth to her second son in a bathtub in 2001. "Ricki's video was so inspiring. I didn't know you could have a baby like that - with no blood, in her own home," Epstein says. "It was clean. It was beautiful. She looked so powerful and so in control." While "The Business of Being Born" clearly takes a stance in defending the craft of midwifery, Epstein and Lake insist that their mission is more about empowering women with knowledge and reminding them that they may have more choices than they realize. "The film is not advocating anything but choice. I'm not at all telling people to have a home birth like me," says Lake, who after reading a book called Spiritual Midwifery decided she wanted to give birth to her second child at home. Citing statistics that show home-birthing rates declining from 95 percent in 1900 to less than 1 percent by 1955, the film questions whether American women today have been convinced that they are not responsible for the births of their children or simply don't know how to give birth on their own.

"Some recent studies suggest that over-consumption of fluoride can raise the risks of disorders affecting teeth, bones, the brain and the thyroid gland," reports Scientific American [magazine]. "Scientific attitudes toward fluoridation may be starting to shift," writes author Dan Fagin. "Fluoride, the most consumed drug in the USA, is deliberately added to [two-thirds] of public water supplies theoretically to reduce tooth decay, but with no scientifically-valid evidence proving safety or effectiveness," says lawyer Paul Beeber [of the] New York State Coalition Opposed to Fluoridation. Fagin, Director of New York University's Science, Health and Environmental Reporting Program, writes, "There is no universally accepted optimal level for daily intake of fluoride." After [three] years of scrutinizing hundreds of studies, a National Research Council committee "concluded that fluoride can subtly alter endocrine function, especially in the thyroid -- the gland that produces hormones regulating growth and metabolism," reports Fagin. Fluoride in foods, beverages, medicines and dental products can result in fluoride over-consumption, visible in young children as dental fluorosis -- white spotted, yellow, brown and/or pitted teeth. Reports Fagin, "a series of epidemiological studies in China have associated high fluoride exposures with lower IQ. Epidemiological studies and tests on lab animals suggest that high fluoride exposure increases the risk of bone fracture, especially in vulnerable populations such as the elderly and diabetics."

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"What if I told you," Joel Weinstock said, "there were countries where the doctors had never seen hay fever?" It is another piece of evidence, another "aha" moment in the global medical mystery that Weinstock - the chief of gastroenterology and hepatology at Tufts-New England Medical Center - has narrowed down to one chief suspect: the worms. Weinstock, 59, specializes in studying why immunological diseases ... are on the rise in developed countries but remain relatively uncommon in undeveloped countries. He believes these diseases, many of which were almost unheard of 100 years ago, are because of changes in our environment, a lack of exposure to something. And he thinks that something may be the worms. "We realized that one thing people always had was intestinal worms," he said. The parasites that we have been told to avoid - such as hookworm and pinworm - may be the good guys, while excessive hygiene may be the bad guy. "I get about 5,000 e-mails a year from patients all over the world asking what to do," he said. "People know that something isn't right. They keep their kids in the cleanest environments and they get asthma. We get all of these things that were rare becoming common. And a lot of it comes down to hygiene. Excessive hygiene can potentially lead to disease." The "hygiene hypothesis," which was first proposed nearly two decades ago, argues that aspects of cleanliness prevent the immune system from programming itself to fight off disease. "The big question is what are those aspects? We don't want to go back to the standards of the 1800s," Weinstock said. "Public hygiene and cleanliness are very good for us, but removing ourselves entirely from our natural environment is bad for us. We need to figure out the aspects of dirt and exposure that are good for us and hopefully we can find a balance."

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Pharmaceutical ingredients exported from China are often made by chemical companies that are neither certified nor inspected by Chinese drug regulators, The New York Times has found. Because the chemical companies are not required to meet even minimal drug-manufacturing standards, there is little to stop them from exporting unapproved, adulterated or counterfeit ingredients. The substandard formulations made from those ingredients often end up in pharmacies in developing countries and for sale on the Internet, where more Americans are turning for cheap medicine. [At a pharmaceutical trade show in Milan], the Times identified at least 82 Chinese chemical companies that said they made and exported pharmaceutical ingredients — yet not one was certified by the State Food and Drug Administration in China, records show. Nonetheless, the companies were negotiating deals at the pharmaceutical show, where suppliers wooed customers with live music, wine and vibrating chairs. In China, chemical manufacturers that sell drug ingredients fall into a regulatory hole. Pharmaceutical companies are regulated by the food and drug agency. Chemical companies that make products as varied as fertilizer and industrial solvents are overseen by other agencies. The problem arises when chemical companies cross over into drug ingredients. “We have never investigated a chemical company,” said Ms. Yan [Jiangying], deputy director of policy and regulation at the State Food and Drug Administration. “We don’t have jurisdiction.” China has an estimated 80,000 chemical companies, and the United States Food and Drug Administration does not know how many sell ingredients used in drugs consumed by Americans. The Times examined thousands of companies selling products on major business-to-business Internet trading sites and found more than 1,300 [Chinese] chemical companies offering pharmaceutical ingredients.

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Every year, malnutrition kills five million children -- that's one child every six seconds. But now, the Nobel Prize-winning relief group "Doctors Without Borders" says it finally has something that can save millions of these children. It's cheap, easy to make and even easier to use. What is this miraculous cure? It's a ready-to-eat, vitamin-enriched concoction called "Plumpynut," an unusual name for a food that may just be the most important advance ever to cure and prevent malnutrition. "It's a revolution in nutritional affairs," says Dr. Milton Tectonidis, the chief nutritionist for Doctors Without Borders. "Now we have something. It is like an essential medicine. In three weeks, we can cure a kid that ... looked like they're half dead. It’s just, boom! It's a spectacular response," Dr. Tectonidis says. No kids need it more than ... in Niger, a desperately poor country in West Africa, where child malnutrition is so widespread that most mothers have watched at least one of their children die. Why are so many kids dying? Because they can't get the milk, vitamins and minerals their young bodies need. Mothers in these villages can't produce enough milk themselves and can't afford to buy it. Even if they could, they can't store it -- there’s no electricity, so no refrigeration. Powdered milk is useless because most villagers don't have clean water. Plumpynut was designed to overcome all these obstacles. Plumpynut is a remarkably simple concoction: it is basically made of peanut butter, powdered milk, powdered sugar, and enriched with vitamins and minerals. It tastes like a peanut butter paste. It is very sweet, and because of that kids cannot get enough of it. The formula was developed by a nutritionist. It doesn't need refrigeration, water, or cooking; mothers simply squeeze out the paste. Many children can even feed themselves. Each serving is the equivalent of a glass of milk and a multivitamin.

Bristol-Myers Squibb Co. and a former subsidiary have agreed to pay more than $515 million to settle federal and state investigations into their drug marketing and pricing practices. The civil settlement ... resolves a broad array of allegations against Bristol-Myers Squibb, dating from 1994 through 2005. Among them was a charge that the ... company illegally promoted the sale of Abilify, an anti-psychotic drug, for pediatric use and to treat dementia-related psychoses. Neither use is approved by the U.S. [FDA]. Although physicians are permitted to prescribe drugs for off-label uses, drug companies are prohibited from marketing them for uses that have not been approved by the FDA. U.S. Attorney Michael Sullivan said when pharmaceutical companies market drugs for unapproved uses, there is a potential risk that patients could be harmed, because the drugs have not been tested as rigorously as they are during the FDA approval process. The government also alleged the company paid illegal inducements in the form of consulting fees and trips to luxury resorts to influence doctors and other health care providers to buy and prescribe the company's drugs. The company's former generic drug subsidiary, Apothecon Inc., also was accused of giving illegal enticements to induce retail pharmacy and wholesale customers to buy its products. Bristol-Myers Squibb misreported its best price for the anti-depression drug Serzone, violating a law that requires drug companies to report their lowest price to Medicaid, prosecutors said. The company was selling Serzone to a larger commercial purchaser at a lower price, prosecutors said. Bristol-Myers Squibb and Apothecon also inflated prices for an assortment of oncology and generic drugs knowing that federal health care programs established reimbursement rates based on those prices, Sullivan said.

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The revelation that the diabetes drug Avandia can potentially cause heart disease is the latest in a string of pharmaceutical disappointments. Vioxx was pulled from the market in 2004 because it doubled the risks for heart attacks and strokes. Eli Lilly recently paid $750 million to settle lawsuits alleging that Zyprexa causes diabetes. Many have criticized the Food and Drug Administration as being too lax about monitoring drug safety. While those criticisms have merit, there is another culprit: the transformation of continuing medical education into an enterprise for drug marketing. The chore of teaching doctors how to practice medicine has been handed to the pharmaceutical industry. As a result, dangerous side effects are rarely on the curriculum. Most states require that doctors obtain a minimum number of credit hours of continuing medical education each year to maintain their medical licenses. Not so long ago, most of these courses were produced and paid for by universities and medical associations. But this has changed drastically over the past decade. Drug-industry financing of continuing medical education has nearly quadrupled since 1998, from $302 million to $1.12 billion. Half of all continuing medical education courses in the United States are now paid for by drug companies, up from a third a decade ago. Because pharmaceutical companies now set much of the agenda for what doctors learn about drugs, crucial information about potential drug dangers is played down, to the detriment of patient care. For example, GlaxoSmithKline footed the bill for dozens of educational courses intended to emphasize the benefits of Avandia over other drugs.

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