The hijacking of science and truth by political conflict
Luis L C Correia and colleagues 1Correia LCL Sette C Santos M Magliano CAS Toscas FS Brazil's COVID-19 guidelines: political hijack of public health.Lancet. 2022; 3991223Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar filled their Correspondence with malicious and false information. Although they claimed to have no competing interests, at least two of them were directly involved in the approval of the recommendations proposed in the Brazilian guideline for COVID-19 outpatient treatment (which would only become guidelines if approved by the Brazilian National Secretary of Science, Technology, Innovation, and Strategic Products in Healthcare). These recommendations were disapproved because of too many inconsistencies, including meta-analyses with low statistical power. Correia and colleagues make three false accusations. First, they falsely accuse the Secretary of Science of having suggested that “statistical significance should not be a necessary condition for establishing drug efficacy”.1Correia LCL Sette C Santos M Magliano CAS Toscas FS Brazil's COVID-19 guidelines: political hijack of public health.Lancet. 2022; 3991223Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar What has been said is that one should not conclude that a drug is ineffective in the face of data with low statistical power and without considering other elements. Second, they accuse the Secretary of Science of having “proposed Bradford Hill criteria as a means to claim drug efficacy in the absence of controlled empirical observations, such as large and low risk of bias clinical trials”.1Correia LCL Sette C Santos M Magliano CAS Toscas FS Brazil's COVID-19 guidelines: political hijack of public health.Lancet. 2022; 3991223Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar However, there was no claim to the efficacy of any technology. Such was not the object of the remarks or the conclusions in the Technical Note2Ministério da SaúdeSecretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. NOTA TÉCNICA No. 3—SCTIE/MS. Fundamentação e decisão acerca das diretrizes terapêuticas para o tratamento farmacológico da COVID-19 (hospitalar e ambulatorial).http://conitec.gov.br/images/Audiencias_Publicas/Nota_tecnica_n3_2022_SCTIE-MS.pdfDate: 2022Date accessed: May 20, 2022Google Scholar of the final decision concerning the guidelines. Third, they report that the Secretary of Science “concluded in favour of the effectiveness of hydroxychloroquine, while claiming that vaccination has no demonstrated effectiveness”,1Correia LCL Sette C Santos M Magliano CAS Toscas FS Brazil's COVID-19 guidelines: political hijack of public health.Lancet. 2022; 3991223Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar which is also untrue. However, the Technical Note itself informs that vaccines were incorporated in Brazil's public health care system because of reported beneficial effects in published work. There was also no conclusion in favour of any technology. The conclusions of the Technical Note are clearly displayed at the end of the document, in section 8, plainly disproving Correia and colleagues’ narrative. Correia and colleagues end their Correspondence by creating precisely the polarised scenario that it criticises so much. They place themselves on the side of science, democracy, and freedom of expression, while ignoring the technical and administrative arguments available in the Technical Note they attack, and they take an aggressive stance against the Brazilian Government and those who disagree with them. Their Correspondence is a perfect example of how science and truth were hijacked by political conflicts. I declare no financial competing interests. I was the former National Secretary of Science, Technology, Innovation, and Strategic Products in Healthcare at the Ministry of Health of Brazil and currently work for the Brazilian Government as National Secretary for Healthcare Human Resources and Education Management at the Ministry of Health of Brazil. Brazil's COVID-19 guidelines: political hijack of public healthOn Jan 20, 2022, in an unprecedented move, the Brazilian Secretary for Science, Technology, and Innovation overrode the Brazilian guideline for COVID-19 outpatient treatment. The guideline was originally demanded by the Ministry of Health, developed by a team of academics, specialists, and health technology analysts, according to GRADE-ADOLOPMENT methodology.1 The guideline, which recommended against the use of drugs without scientific proof of efficacy, such as hydroxychloroquine and ivermectin,2 was finally approved by the National Committee for Health Technology Incorporation (CONITEC) in December, 2021. Full-Text PDF