Corporations, driven by profits, often overlook ethical considerations.
#Merck exemplifies this issue.
Here are three ways it’s putting profits over people right now. 🧵 1/12 
Discussion
1⃣GARDASIL is a great vaccine. So great, in fact, that a single dose offers solid protection against HPV cancers.
Yet in spite of the #WHO’s recommendation and substantial evidence for the efficacy of 1 dose, Merck promoted 2 doses at this year’s #IPVC. 2/12 
Colleague Cameron B. Haas explains: #Merck constrained its statistical models so 1 HPV dose could never outperform 2 doses.
But there’s no justification for this assumption: more jabs give more antibodies, but this doesn’t necessarily translate to better protection. 3/12
It’s worth noting #Merck manufactured insufficient quantities of overpriced HPV vaccine for years.
Folks from low-income countries have lacked access.
Cervical #cancer is preventable but not prevented — due in part to corporate-driven inequities. 4/12 https://www.cervicalcancerdeclaration.org/
2⃣MOLNUPIRAVIR (MOV). #Merck obtained emergency approval for MOV in December 2021 — just barely the first oral antiviral against COVID-19.
But MOV works by causing viral mutations, the raw material for new variants of concern. 5/12 
Weeks before the US #FDA decision on MOV, numerous scientists identified issues with Merck’s statistical analyses, the risks posed to individual patients, and the risks for viral evolution.
Sally Otto and I explained the viral evolution risk here. 6/12 https://virological.org/t/mutagenic-antivirals-the-evolutionary-risk-of-low-doses/768
Unfortunately, MOV was recommended 13-10.
Merck’s case to the FDA repeatedly confused mutation and selection, arguing that all drugs impose selection.
But the problem is mutation: MOV potentiates rare but impactful ‘black swan’ variants. 7/12 https://www.youtube.com/watch?v=fR9FNSJT64M
Concerns about MOV’s risks have sadly been validated.
For example, work by Theo Sanderson and colleagues shows elevated — but sublethal — mutations in viral genomes, consistent with MOV, in regions where it’s used. 8/12 https://www.medrxiv.org/content/10.1101/2023.01.26.23284998v2
Updates on MOV mutations continue to be provided by Ryan Hisner on Twitter.
Further, as he explains, the drug 1) doesn’t work and 2) could be harmful.
The FDA panel argued MOV should be reconsidered after other drugs became available.
That time has come. 9/12
3⃣MEDICARE. Last week, #Merck sued the US government over a new law that will allow Medicare to negotiate certain drug prices — a common practice worldwide.
Failure to negotiate is one reason a vial of insulin costs $300 in the US but $30 in Canada. 10/12 https://www.nytimes.com/2023/06/06/business/merck-medicare-drug-prices.html
One of #Merck’s reasons for suing is likely its cancer drug Keytruda, upon which it relies to maintain yearly profits of US$14.5 billion.
Among other complaints, Merck’s lawyers suggest the company’s ‘free-speech rights’ will be violated. 11/12
In summary, the for-profit health industry urgently needs reform to address
1⃣inordinate profits on good drugs developed from public research
2⃣bad drugs
3⃣price gouging
Such practices have arguably done more than any media influencer to stoke public distrust in science. 12/12
Interesting to see you doing threads here, considering we have no character limits 🤔
The problem with threads on Damus is you can’t scroll to read them. You have to tap each reply to view it.
Maybe have a thread reading client? But yeah good point …
One thing that occurs to me about the advantage of threads is that you can link to something new, with its own media preview, in each post component. Haven’t tried a long post here yet, but I assume it’s like elsewhere and limited to a single link preview or image(s)? Just a thought
Yes, that’s true.
I think nostr:npub180cvv07tjdrrgpa0j7j7tmnyl2yr6yr7l8j4s3evf6u64th6gkwsyjh6w6 also likes threads. Maybe someone thinks of some way to display things that way as an option 🤔
Threads are cool because scrolling to the next post is quicker if you’re not interested in the Nostr report again for example
someone just showed me this https://zapddit.com/feed which can present it in more threadlike form
More specifically, this thread can be accessed at
https://zapddit.com/n/note1znwwy7hyq8amp5u9dx9jp8tpz0nmcg02pkemj28kkfdhl7qvrn8qxg5sav
Thread structure is strange on here but great thread! followed
Thanks and likewise! Totally new here too, just jumped right in without learning the ‘culture’ first. Oops!
Another small request for Amethyst, nostr:npub1gcxzte5zlkncx26j68ez60fzkvtkm9e0vrwdcvsjakxf9mu9qewqlfnj5z: if an author makes subsequent notes (a thread) it would be nice if that thread is recognized. Now the rest of the thread is burries by newer replies from other people.
Not sure what the heuristic is though. Maybe first reply from the author is the next note in the thread, recursively.
While typing this, it probably warrants a thread view, which is slightly different compared to a note view in how notes are ordered.
See this note: