The Constant Gardener (26 page)

P.s. Ghita says I'm a complete whore but she can't pronounce it properly so it comes out hoo-er, like a hoover that's lost its V. Love Tess (hooer).

Defendant innocent as charged, he told her. And I as usual can be duly ashamed of myself.

•      •      •

Mystically calmed, Justin resumed his puzzled journey.

Extract from Rob and Lesley's joint report to Superintendent Frank Gridley, Overseas Crime Division, Scotland Yard, on their third interview with Woodrow, Alexander Henry, Head of Chancery, British High Commission, Nairobi:

Subject forcefully echoes what he claims to be the opinion of Sir Bernard Pellegrin, FO Director of Affairs for Africa, that further inquiry along the lines urged by Tessa Quayle's memorandum would needlessly jeopardize HMG'S relations with the Kenyan Republic and harm U.k. trade interests … Subject refuses on security grounds to divulge the contents of the said memorandum … Subject disclaims all knowledge of an innovative drug being presently marketed by House of ThreeBees … Subject advises us that any request for a sight of Tessa Quayle's memorandum should be addressed directly to Sir Bernard, assuming that it still exists, which Subject is prepared to doubt. Subject portrays Tessa Quayle as a tiresome and hysterical woman who was mentally unstable in respect of matters related to her aid work. We interpret this as a convenient method of discounting the significance of her memorandum. A request is hereby made that a formal application be sent as soon as practical to the Foreign Office for copies of all papers submitted to Subject by the deceased Tessa Quayle.

Marginal note in red, signed by F. Gridley, Deputy Commissioner: SPOKE SIR B. PELLEGRIN. APPLICATION REFUSED ON GROUNDS OF NATIONAL SECURITY.

Extracts from learned medical journals of varying obscurity extolling, in appropriately oblique terms, the sensational benefits of the innovative drug Dypraxa, its “absence of mutagenicity” and its “long half-life in rats.”

Extract from the Haiti Journal of Health Sciences, meekly expressing reservations about Dypraxa, signed by a Pakistani doctor who has conducted clinical trials of the drug at a Haitian research hospital. The words “potential for toxicity” underlined in red by Tessa, specters of liver failure, internal bleeding, dizziness, damage to the optic nerves.

Extract from the next issue of the same rag in which a string of medical eminences with impressive professorships and initials deliver a withering counterblast, citing three hundred test cases. The same article accuses the poor Pakistani of “bias” and “irresponsibility toward his patients” and calls down curses on his head.

(handwritten note from Tessa: These unbiased opinion leaders are one and all contracted to KVH by highly paid “roving commissions” to spot promising biotech research projects worldwide.)

Extract from a book entitled Clinical Trials by Stuart Pocock, written out in Tessa's handwriting as her preferred means of committing it to memory. Some passages blazoned in red in contrast to the writer's sober style:

There is a tendency for students, and indeed many clinicians, to treat the medical literature with undue respect. Major journals such as the Lancet and the New England Journal of Medicine are presumed to present new medical facts which are not to be disputed. Such a naive faith in the “clinical gospels” is perhaps encouraged by the dogmatic style that many authors adopt, so that the uncertainties inherent in any research project often receive inadequate emphasis …

(tessa's note: Articles are constantly planted by pharmas, even in the so-called quality rags.)

As regards talks at scientific meetings and advertising by pharmaceutical companies one needs to be even more skeptical … the opportunities for bias are enormous …

(tessa's note: According to Arnold, big pharmas spend zillions buying up scientists and medics to plug their product. Birgit reports that KVH recently donated fifty million dollars to a major U.s. teaching hospital, plus salaries and expenses for three top clinicians and six research assistants. Corruption of university Common Room affiliations is even easier: professorial chairs, biotech labs, research foundations, etc. “Unbought scientific opinion is increasingly hard to find.”-Arnold.)

More from Stuart Pocock:

… there is always the risk that authors are persuaded toward a greater emphasis on positive findings than is really justified.

(tessa's note: Unlike the rest of the world's press, pharma journals don't like printing bad news.)

… Even if they do produce a trial report of their negative findings it is likely to be in an obscure specialist journal rather than in the major general journals … consequently this negative rebuttal of the earlier positive report could not be made available to such a wide audience.

… Many trials lack essential features of design to achieve an unbiased assessment of therapy.

(tessa's note: Are geared to prove a point, not question it, i.e., worse than useless.)

Occasionally, authors may deliberately dredge the data to prove a positive …

(tessa's note: Spin it.)

Extract from the London Sunday Times, headed “Drug Firm Put Patients at Risk in Hospital Trials.” Heavily scored and underlined by Tessa and presumably reproduced or faxed to Arnold Bluhm since it bore the superscription: Arnie, have you SEEN this?!

One of the world's largest drug companies placed hundreds of patients at risk of potentially fatal infections by failing to disclose crucial safety information to six hospitals at the start of a nationwide drug trial.

Up to 650 people underwent surgery in Britain in the experiment organized by Bayer, the German pharmaceutical giant, despite the company having conducted studies which showed its drug reacted badly with others, seriously impairing its ability to kill bacteria.

This prior research, obtained by The Sunday Times, was not revealed at the start of the study to the hospitals involved.

The trial, whose flaw has never been revealed to the patients or their families, resulted in nearly half of those operated on at one test center in Southampton developing a variety of life-threatening infections.

Bayer declined to reveal overall numbers for postoperative infections and fatalities, on the grounds that the data remained confidential.

“The study was approved by the competent regulatory authority and all local ethics committees prior to initiation,” said a spokesman.

Full-color, full-page advertisement torn from a popular African magazine, captioned: I BELIEVE IN MIRACLES! Center stage, one pretty young African mother in low white blouse and long skirt, smiling radiantly. Happy baby sits sideways across her lap, one hand to her breast. Happy brothers and sisters cluster round, handsome father towers over all. Everyone including mother is admiring conspicuously healthy child on her lap. Along the bottom of the page, the words THREEBEES BELIEVE IN MIRACLES TOO! Speech bubble issuing from pretty young mother's mouth reads: “When they told me my baby had TB, I prayed. When my GP told me about Dypraxa, I knew my prayer was heard in heaven!”

Justin returns to the police file.

Extract from officers' report on their interview with PEARSON, Ghita Janet, locally employed member of Chancery, British High Commission, Nairobi:

We interviewed Subject on three occasions of nine minutes, fifty-four minutes, and ninety minutes respectively. At Subject's request our interviews were conducted on neutral ground (the house of a friend) in discreet circumstances. Subject is aged twenty-four, of Anglo-Indian birth, ed. U.k. convent schools (Rc), adopted daughter of professional parents (lawyer and doctor), both strong Catholics. Subject is an honors graduate of Exeter University (english, American and Commonwealth Arts), of obvious intelligence and highly nervous. Our impression of her was that, in addition to being grief-stricken, she was in considerable fear. For instance, Subject made several statements which she then withdrew, e.g.: “Tessa was murdered to keep her quiet.” E.g.: “Anybody who takes on the pharmaceutical industry is liable to get her throat cut.” E.g.: “Some pharmaceutical companies are arms dealers in shining raiment.” Pressed about these statements, she refused to substantiate them and requested they be wiped from the record. She also dismissed the suggestion that BLUHM could have committed the Turkana murders. BLUHM and QUAYLE, she said, were not an “item” but they were “the two best people on earth” and those around them “just had dirty minds.”

Under further questioning, Subject first claimed to be bound by the Official Secrets Act, then by oath of secrecy to the deceased. For our third and final meeting we adopted a more hostile attitude to Subject, pointing out to her that by withholding information she could be shielding Tessa's murderers and impeding the search for BLUHM. We attach edited transcripts at Appendix A and B. Subject has read this transcript but refuses to sign it.

APPENDIX A Q. Did you at any time assist or accompany

Tessa Quayle on field expeditions? A. At weekends and in my spare time I

accompanied Arnold and Tessa on several

field trips to Kibera slum and up-country

in order to assist at field clinics and

witness the administration of medicines. This is the

particular remit of Arnold's NGO.

Several of the medicines that Arnold examined

turned out to be long past their expiry date and

had destabilized, though they might work to a

certain level. Others were inappropriate to the

condition they were supposed to treat. We were also

able to confirm a common phenomenon experienced in

other parts of Africa, namely that the indications

and contra-indications on some packets had been

rewritten for the Third World market in order

to broaden the use of the medicine far beyond its

licensed application in developed countries,

e.g., a painkiller used in Europe or

U.s. for the relief of extreme cancer

cases was being offered as a cure for period pain

and minor joint aches. Contra-indications were not

given. We also established that even when the

African doctors diagnosed correctly,

they routinely prescribed the wrong treatment

due to lack of adequate

instructions. Q. Was ThreeBees one of the distributors

affected? A. Everyone knows that Africa is the

pharmaceutical dustbin of the world and

ThreeBees is one of the main distributors of

pharmaceutical products in Africa. Q. So was ThreeBees affected in this instance? A. In certain instances ThreeBees was the

distributor. Q. The guilty distributor? A. All right. Q. In how many instances? What proportion? A. (after much prevarication) All. Q. Repeat, please. Are you saying that in every

case where you found fault with a product,

ThreeBees was the distributor of that

product? A. I don't think we should be talking like this

while Arnold may be alive.

APPENDIX B Q. Was there one particular product that Arnold

and Tessa felt particularly strongly about, do

you remember? A. This just can't be right. It can't be. Q. Ghita. We're trying to understand why Tessa

was killed and why you think that by discussing these things

we put Arnold in greater danger than he's

already in. A. It was everywhere. Q. What was? Why are you crying? Ghita. A. It was killing people. In the villages. In the

slums. Arnold was sure of it. It was a good

drug, he said. With five more years'

development they'd probably get there. You

couldn't quarrel with the idea of the drug. It was

short-course, cheap and patient-friendly. But

they'd been too quick. The tests had been

selectively designed. They hadn't covered

all the side-effects. They had tested on

pregnant rats and monkeys and rabbits and

dogs, and had no problems. When they got

to humans—all right, there were problems, but there

always are. That's the gray area the drug

companies exploit. It's at the mercy of

statistics and statistics prove anything you

want them to prove. In Arnold's opinion

they had been too intent on getting the

product onto the market ahead of a

competitor. There are so many rules and

regulations that you'd think that wasn't possible,

but Arnold said it happened all the time. Things

look one way when you're sitting in a plush

U.n. office in Geneva. Quite another when

you're on the ground. Q. Who was the manufacturer? A. I really don't want to go on with this. Q. What was the drug called? A. Why didn't they test it more? It's not the

Kenyans' fault. You can't ask, if you're

a Third World country. You have to take what

you're given. Q. Was it Dypraxa? A. (unintelligible) Q. Ghita, calm down please and just tell us.

What's the drug called, what's it for and who

makes it? A. Africa's got eighty-five percent of the

world's AIDS cases, did you know that? How

many of those have access to medication? One percent!

It's not a human problem anymore! It's

an economic one! The men can't work. The

women can't work! It's a heterosexual

disease, which is why there are so many orphans!

They can't feed their families! Nothing gets

done! They just die! Q. So is this an AIDS drug we're talking

about? A. Not while Arnold is alive! … It's

associated. Where there's tuberculosis, you

suspect AIDS … Not always but usually

… That's what Arnold said. Q. Was Wanza suffering from this drug? A. (unintelligible) Q. Did Wanza die of this drug? A. Not while Arnold is alive! Yes.

Dypraxa. Now get out. Q. Why were they heading for Leakey's place? A. I don't know! Get out! Q. What was behind their trip to Lokichoggio?

Apart from women's awareness groups? A. Nothing! Stop it! Q. Who's Lorbeer? A. (unintelligible)

RECOMMENDATION

That a formal request is made of the High Commission that the witness be offered protection in exchange for a full statement. She should be given assurances that any information she provides regarding the activities of Bluhm and the deceased will not be used in a way that might place Bluhm in jeopardy, assuming he is alive.