holders to promote transparency and Dual job holding can also increase
Clinical trial registry initiative allow patients and their healthicare health professionals’ status, as patients
Editor – The news item in the January i
providers access to clinical trial infori can witness that those working in state
2006 issue of the Bulletin announcing mation, while preserving protection of facilities are equally competent to work
a new WHO clinical trial initiative,1 intellectual property. O in private facilities, whose infrastruci i
inappropriately and inaccurately refers ture may support firstiworld medicine.
to Merck, a company that has always Competing interests: none declared. Dual job holding also increases
been committed to the highest stani i the productivity of health professionals
dards of scientific integrity and patient Laurence J Hirsch a as they can be employed after “normal
safety. Merck promptly and approi i working hours”. Such health professionals
priately disclosed the results of Vioxx 1. WHO clinical trials initiative to protect the may be able to inject new ideas from the
public. Bull World Health Organ 2006;84:10-1. private into the public sector, where in
clinical trials — positive and negative 2. Clinical trial registration: a statement from the
— including VIGOR and APPROVe. some cases the quality of care may be beti i
International Committee of Medical Journal
Merck’s behaviour over Vioxx is not that Editors. N Engl J Med 2004;352:1250-1. ter than that in the public health system.
of a company “withholding negative Clearly, it would be unethical for health
research findings,” as your article inaci i professionals to treat private patients
curately suggests. during the time they are employed by
We also wish to clarify the timing Dual job holding by public- the public sector and to use its resources
of certain events. The editorial by the sector health professionals for individual income generation. But if
International Committee of Medical may be beneficial to patients health professionals bear this in mind,
Journal Editors (ICMJE) calling for regi i and refrain from abusing public resources,
istration of clinical trials as a condition Editor – The paper recently pubi i there should be no problem.
of publication, which you cite in your lished in the Bulletin by Jan et al. on The migration of health profesi i
news item, appeared online at www. dual job holding (in the public and sionals from Africa to developed couni i
nejm.org on 8 September 2004, and on private sectors) by health professioni i tries is bad enough2 and all attempts
16 September 2004 in the print version als in developing countries makes an to retain them in developing countries
of the New England Journal of Medic c important contribution to the debate should be investigated. But doing it in
cine, as well as in other ICMJE journals. on human resources for health.1 Dual an ethical way that does not jeopardize
This was several weeks prior to Merck’s job holding can provide continuity of i
patients’ wellbeing is a difficult chali
voluntary withdrawal of Vioxx on 30 care to those patients who can move lenge. Finally, although the phenomenon
September 2004,2 i.e. not in response to between the two sectors. For example, of public health sector professionals who
the withdrawal as the Bulletin news item patients attending a private facility also hold jobs in the private sector has
implies. Additional information can be would have the opportunity of obtaini i been described,3 there is a need to study
found on our Vioxx information page ing services they cannot afford to pay their privateisector counterparts who also
at: http://www.merck.com/newsroom/ for but which might be available in the work in the public sector. O
vioxx_withdrawal/. public sector.
Merck has been an active particii i Jan et al. appear to be suggesting Competing interests: none declared
pant in the WHO International Clinical that the flow of patients from the public
Trials Registry Platform, taking part in to the private sector is a bad thing per Adamson S Muula b
meetings when invited, and commenti i se. In the case of Malawi, however, the
ing on proposals. Merck’s commitment flow of patients from the predominantly 1. Jan S, Bian Y, Jumpa M, Meng Q, Nyazema N,
to registering all Phase II, Phase III, free public health sector to the private Prakongsai P, et al. Dual job holding by public
and postimarketing controlled clinical sector may even be desirable as it reduces sector health professionals in highly resource-
pressures on the public sector. Also, pai i constrained settings: problem or solution? Bull
trials that we conduct anywhere in the World Health Organ 2005;83:7716.
world goes well beyond both the curi i tients who demand services that are not
2. Muula AS. Is there a solution to the “brain
rent US law that mandates registration available within the public sector, but drain” of health professionals and knowledge
of clinical trials designed to test the which are available in the private sector, from Africa? Croat Med J 2005;46:219.
efficacy of products for lifeithreatening can be offered them against payment 3. Ferrinho P, Van Lerbeghe W, Fronteira I, Hipolito F,
or otherwise serious illnesses and the by dually employed physicians. Biscaia A. Hum Resour Health 2004;2:14.
industry commitment to register all
“confirmatory” trials. Our policy on the
registration and publication of clinical
trials is posted at: http://www.merck. Corrigendum
com/mrl/swf/Merck_Position_on_ In Vol. 84, issue number 3, 2006, page 181, the correct affiliations for the sixth author of this
Clinical_Trials_Registries.swf. paper, Yohannes Kinfu, should be “Australian National University, Canberra, Australia, and ACDIS,
Africa Centre, University of KwaZulu-Natal, Durban, South Africa”. The name of the eleventh
We look forward to continued
author was incorrectly spelled; it should read “Kubaje Adazu”.
dialogue with WHO and other stakei i
Executive Director, Medical Communications, Merck Research Laboratories, 126 E. Lincoln Ave., Rahway, NJ 07065, USA (email: email@example.com).
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill. 529 Hillsborough St, H 7, Chapel Hill, NC 27514-3114, USA.
336 Bulletin of the World Health Organization | April 2006, 84 (4)