By Dr. Thomas Kerr and Dr. Evan Wood
The principal role of science in society is to advance human understanding. Unfortunately, in modern times a host of political masters have invested considerable energy and resources in an effort to cloud science. The primary goal of such efforts is to manufacture uncertainty about the world we live in.
The politicization of science is not a new problem. Junk science was used to justify and then deny the Holocaust, and with Stalin, scientists were under strict ideological control. In more recent times, science has taken a beating at the hands of various industries, special-interest groups, and politicians. Instances deserving of special mention include the tobacco industry’s efforts to misrepresent and politicize the science showing that smoking is harmful and Exxon Mobil’s donation of more than $16 million to various organizations working to refute the science specific to climate change.
The Bush administration has also been singled out for its poor treatment of science. According to a survey by the Union of Concerned Scientists, one-fifth of U.S. Food and Drug Administration scientists reported being asked, for nonscientific reasons, to exclude or alter information or conclusions in an FDA scientific document. The Union of Concerned Scientists has been so outraged by the Bush administration’s treatment of science that it dedicated a full report to the topic. According to the report, the administration has repeatedly placed unqualified individuals or individuals with conflicts of interest in official posts, censored and suppressed government reports, and misrepresented scientific knowledge in an effort to mislead the public.
Although this problem has been evident for some time and has been seen in countries throughout the world, it has been less well publicized in Canada. However, with the rise of the Stephen Harper government, Canada too has been singled out for its mistreatment of science. For example, a February editorial in the prestigious journal Nature slammed the Harper government for muzzling Environment Canada scientists and for closing the office of the national science adviser.
The scientific evaluation of Insite, Vancouver’s supervised injection site, has also been challenging for the Harper government. The Tories clearly favour a get-tough, U.S.–style, “war on drugs” approach, and in their new “anti-drug strategy” there is no room for public-health-based strategies such as supervised injection sites that fall under the rubric of “harm reduction”—despite the wealth of scientific evidence to support these interventions.
As scientists, we were contracted by Vancouver Coastal Health to conduct an arm’s-length evaluation of Insite. After three years of evaluation, we published 22 studies that described the impacts of Insite. These studies appeared in various peer-reviewed medical journals—including the New England Journal of Medicine, the Lancet, and the British Medical Journal—and showed that Insite was doing exactly what it was set up to do. This fairly small and simple public-health program was contributing to reductions in the number of people injecting in public and the number of discarded syringes on city streets. Insite was also helping to reduce HIV-risk behaviour and likely saving lives that might otherwise have been lost to fatal overdose. We also found a 30-percent increase in the use of detoxification programs among Insite users in the year after the site opened. Potential harms were ruled out as research showed that the opening of Insite did not increase crime or lead more vulnerable citizens to take up injection-drug use.
Despite this large body of scientific evidence, the Harper government remained unconvinced of the merits of Insite. Harper stated publicly that he would look to the RCMP for their evaluation of Insite, and when asked to renew the federal exemption that allows Insite to operate legally, Health Minister Tony Clement gave a brief extension and called for more research. The RCMP did end up paying SFU criminology professor Ray Corrado to conduct an external evaluation of our research. Although Corrado fully agreed with our findings, Clement was unconvinced. He gave Insite another brief extension, called for yet more research, and formed a national “expert advisory committee” to commission new research and comment on the state of the evidence pertaining to Insite.
Last week, the expert advisory committee released its report. It stated that Insite is helping to reduce public disorder, HIV-risk behaviour, and overdose risks, and is helping people get into addiction treatment. The committee also stated that Insite is not increasing crime and/or encouraging people to start injecting drugs. Sound familiar? But that is not all. The committee also added that the site appears to be cost-effective and is popular among the public, including among local police officers.
The next chapter in this story should be an interesting one. Will Harper and Clement continue their call for more research on Insite? Will they dismiss the findings of their handpicked committee and start over? Perhaps they will give up and let those crazy West Coast folks do what they want when it comes to protecting the health of Vancouver’s most marginalized citizens. Maybe they will remain tight-lipped, wait for a majority, and then try to close Insite. Whatever their next move, it will not go unnoticed, as this government may already have garnered a reputation for being the most antiscience government in Canadian history.
Dr. Thomas Kerr and Dr. Evan Wood are research scientists at the British Columbia Centre for Excellence in HIV/AIDS and assistant professors in the UBC department of medicine.