Clinical trial registry initiative Dual job holding by public by adn78472


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                                                          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 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:                        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:
    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)

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