Ex-government advisers worked on drug firm's campaign to push
immunization program

http://www.thestar.com/News/article/246824
Aug 16, 2007 04:30 AM
Tanya Talaga
Health Reporter

The speed with which the HPV vaccine Gardasil got onto both the
federal and provincial political agendas was no accident.

Only eight months after Gardasil was approved for sale in Canada,
Ottawa agreed in March to fund $300 million over three years for a
human papillomavirus vaccination program. And on Aug. 2, Ontario
announced that all Grade 8 girls will have free access to Gardasil.

Merck Frosst Canada Ltd., the maker of Gardasil, hired public
relations giant Hill & Knowlton to push the immunization strategies
using some well-connected lobbyists: Ken Boessenkool, a former senior
policy adviser to Prime Minister Stephen Harper; Bob Lopinski,
formerly with Premier Dalton McGuinty's office; and Jason Grier,
former chief of staff to Health Minister George Smitherman.

According to Ontario consultant registration documents, Lopinski and
Grier's lobbying activities include: "Proposed policy decision to
support a childhood immunization program for HPV and funding related
thereto."

Combine that with a catchy TV ad campaign urging young women to "Tell
Someone," as well as backing from medical groups like the Society of
Obstetricians and Gynaecologists of Canada and a national vaccine
program was born.

The medical community has largely lauded Gardasil, a $400 three-shot
vaccine that can prevent HPV types 16 and 18, which are responsible
for 70 per cent of cervical cancer cases. Nearly 400 Canadian women
die of the disease each year.

The ads worked for Christina Leighton, 31, who had an abnormal Pap
smear last year and was later diagnosed with cervical cancer. She
didn't know HPV caused the disease until she saw the TV ads.

While Leighton is aware the vaccine is still in its early stages, she
will have her daughter, Emma, vaccinated. "It's great, knowing there
is something out there that can protect young women. I wish there had
been one for me 14 years ago."

Some critics say the vaccine's long-term effects are unknown. Also
unclear is if, or when, a future booster shot will be needed.

This is "not a public health crisis," said Abby Lippman, chair of the
Canadian Women's Health Network and an epidemiologist at McGill
University. "I want that data out there for discussion before we go
and spend money when we don't have a lot of money in the health-care
system already."

Advertising and savvy marketing shouldn't set the public health
agenda, said Lippman, who was the lead author on an online commentary
in the Canadian Medical Association Journal. "It wasn't a vaccination
program that was launched. It seems to have been a program with this
product."

The Society of Obstetricians and Gynaecologists of Canada says it is
"disappointed" with the CMAJ's publication of the commentary. "The
arguments expressed in this commentary lack grounding in scientific
evidence," a news release says, adding that "Canadian governments have
made exactly the right decision in moving quickly to provide
immunization against the (HPV) for young girls and women."

Cervical cancer is the second most common cancer in Canadian women
aged 20 to 44, the group says.

But Lippman wonders how the $300 million figure to support the HPV
program was arrived at (Ontario's portion is $117 million), and if
there was any bargaining on price.

By comparison, the chicken pox vaccine Varivax costs $75 per shot and
had Health Canada approval for six years before Ontario covered the
costs of a vaccination program.

Sheila Murphy, spokesperson for Merck, makers of both vaccines,
defended the high price of Gardasil. "Vaccines are getting more
expensive. The technology is getting more sophisticated. These are
huge, extensive, clinical studies."

British Columbia health economist Hans Krueger did some number
crunching recently for a report on the HPV vaccine for the B.C. Cancer
Agency. British Columbia has not yet adopted a provincial program. He
found it would cost the government $373.6 million over 26 years to
offset the $54 million in medical treatment costs saved from using the
vaccine.

Exactly what role the lobbyists played is equally unclear.

Duff Conacher, of Democracy Watch, an Ottawa-based citizen's group
aimed at keeping government accountable, said the quick adoption of
Gardasil onto the public health agenda is a "horrendous" example of
the power of lobbyists.

Boessenkool, who was responsible for message management for the
Conservative campaign during the 2004 federal election, became a
vice-president at Hill & Knowlton in October 2004. According to the
federal lobbyist registry, his client is Merck with an effective date
of Feb. 16, 2007. The vaccination program was announced in the March
budget. He did not return calls.

Jeff Connell, director of public affairs for the Canadian Generic
Pharmaceutical Association, doesn't oppose lobbying but says the
public should be aware of it. "If we are being advised to vaccinate
huge populations of Canadian women with the vaccine, I think it's
important Canadians know who is being paid to do the advising."

Merck's Murphy sees nothing wrong with spreading the message about an
anti-cancer vaccine.

"We are talking about a huge amount of disease that can be prevented,"
she said. "Communicating this information to people has really been a
huge challenge to us."