DRUGS, HEALTH AND COMMON SENSE

THE WORKINGS OF DRUGSRe effective prescribing: what factors promote or impede it? Significance of individual –v- collective drug response? Relevance, quality and impact of drug regulation?

THE QUALITY OF HEALTHHealth for All, or only some - the role of drugs in securing it?Drugs for health - and the balance of benefits and harms?Importance of new drugs for personal and public health?

DRUG WISDOM AND UNDERSTANDINGValue and limits of science and scientific integrity?Information hygiene and effectiveness in communication?Role of patients and consumers in using drugs for health?

Written contributions

14 diverse and challenging essays

9 wonderful tributes

See www.haiweb.org

Tribute by Graham Dukes: 1973

… on an Autumn day in 1973, I betook myself in search of good advice to Kings College on the Strand in London, where Andrew had his office. Never, to my recollection, have I beheld so small a room with so vast an accumulation of palpable wisdom. Andrew, who clearly had it all in his head and therefore appeared to have no very great need of paper, was nevertheless dwarfed by vast heaps of documents groping for the ceiling, disconcertingly unstable in the draught which swept in when anyone opened the door … “

This is me in my office …

Tribute by Hirokuni Beppu

Not only his appearance but also his wit and humor, and the warm personality which captures everyone’s heart, all remain unchanged. Like Yoda in “Star Wars”, he never gets old and brings many people up as the Jedi Knights to fight the evil power of Pharma-Empire.”

Tribute by Charles Medawar

Andrew Herxheimer provides a model of what ‘thought leadership’ should be. He personifies intellectual hygiene, with a deep commitment to straightforward communication with professionals and lay people alike. His hallmarks are solid evidence and good reason; breadth of vision, open mindedness; a keen ‘health focus’ and lack of conflicts of interest. His gentle temperament and great sense of humour add to his impact as a fine teacher, an indefatigable net-worker and a brilliant catalyst. Andrew’s modus operandi exemplifies perhaps the main ground rule of influence (Zealley CB, personal communication, 2004): ‘You can have no end of influence, provided you don’t want to take the credit’.

Tribute by Charles Medawar: AH-79 evidence to the House of Commons

Select Committee enquiry into, “The Influence of the Pharmaceutical Industry”

The point at issue: was it sensible and realistic to enquire into the impact of the whole ‘industry’ – when there might be significant differences in the conduct of different companies? What differences between companies exist, or are they as one?

Q 155 – Witness responds

Professor Herxheimer: I have had interactions with many

pharmaceutical companies … and I cannot recall one that I would wish to praise.

 Q156 Mr Amess: Right. Well, that is that!

Four presentations

• “First principles – Second Draft, by Charles Medawar

• Dipex and AH, by Ann McPherson

• Law and Ethics of the Pharmaceutical Industry, by Graham Dukes

• What can Aristotle teach us about adverse reactions to treatment, by Trish Greenhalgh

Five star participants

• Jeff Aronson (A paradigm for maintaining the product licences of beneficial drugs in the face of serious adverse effects)

• Sam Shuster (Tailor-Made Dreams or Off-The-Peg Realities?)

• Rosalind Grant (What Is Effective Prescribing?) • Arthur Teuscher (Dissimilarity of natural and

recombinant ‘human’ insulin)• Dinesh Mehta and Anne Prasad (The Evolution of the

British National Formulary as a Tool for Effective Prescribing)

Why we all wanted to come

• To thank Andrew, for all kinds of reasons • To congratulate and celebrate with him• To bear witness to his accomplishments• To mingle with his best mates• To focus on issues that most matter to him• To light candles, as well as blowing some out