The commercial campus (continued) BY MICHAEL LUKAS

NOWHERE IS THE influence of corporate-sponsored funding more evident than in the relationship between academia and the pharmaceutical industry. Well known for courting doctors with free lunch lectures and medical school textbooks, pharmaceutical companies typically exert influence in the academy by sponsoring research, a quite successful tactic. In a 1996 study published in the Annals of Internal Medicine, Mildred Cho, a bioethicist at Stanford University, found that 98 percent of papers based on corporate-sponsored research reflected well on the drug in question. Pharmaceutical companies also retain a number of prominent doctors and scientists as paid consultants. In a 1998 study of Massachusetts journals, published in Psychotherapy and Psychosomatics, Krimsky found that "one in three lead authors had a financial interest in the outcome of the article."

For a more concrete example, one need not look farther than professor Martin Keller, chairman of Brown’s department of psychiatry and human behavior. In 1998, the Boston Globe reported that Keller "was paid more than $500,000 in consulting fees . . . most of it from pharmaceutical companies whose drugs he touted in medical journals and conferences." Keller did not reply to requests for an interview, but the publicity doesn’t seem to have fazed him. A recent study by Keller found that the antidepressant Paxil may be successful in treating major depression in adolescents. According to the George Street Journal, the study — one of two required by the Food and Drug Administration to approve the use of the drug in teens — was funded by GlaxoSmithKline, the makers of Paxil.

"It’s all about the money," fumes Dr. David Egilman, a clinical associate professor at Brown Medical School. "That’s what funds the medical school." Although the medical school’s Web site says the federal government is "the largest source" of the $52 million in sponsored funding it received in 2001 — roughly half its budget — it doesn’t specify the amount from other sources. "It’s not transparent," says Egilman, an outspoken critic of corporate misconduct. "They don’t publish it on the Brown Web site. Why shouldn’t they, if they have nothing to hide?" For his part, Egilman also cites the tremendous influence of pharmaceutical companies in explaining why, he says, "The entire curriculum of the medical school is based on drug treatment of disease, not preventing disease or public health." Richard Besdine, dean of the medical school, did not respond to requests for an interview.

For the last 10 years, Brown’s Division of Biology and Medicine has also run what is essentially a professional development program for employees of Pfizer, one of the world’s largest drug companies. According to Elizabeth Power, a spokeswoman at Pfizer’s Groton Laboratory, Brown professors began teaching the specially designed courses to Pfizer employees in 1991 and started awarding master’s degrees in fall 1994. So far, 51 Pfizer employees have graduated from the program, which is taught at Pfizer’s Groton Laboratory and paid for by the Pfizer Educational Assistance Plan.

Pharmaceutical influence also extends to a number of scientific journals. "If you look at the editorial boards of the journals, they’re made up of individuals who do a lot of drug company studies," said Brown psychiatry professor Mark Zimmerman. "How difficult is it to reject studies when you’re part of the industry? Even if they have significant methodological problems?"

Zimmerman says a good deal of pharmaceutical-sponsored research does have significant methodological problems. In a recent study, he applied industry-standard inclusion methodology (which determines whether or not subjects can be included in a study) to patients in his own clinical practice. "We found that somewhere on the order of 80 percent of our patients would never make it into a [pharmaceutical company sponsored] study," because they didn’t exhibit enough symptoms, "and therefore suggested that for the majority of individuals treated in routine clinical practice, we really don’t know if the medication works."

Confidentiality and right-of-review clauses can also assure favorable outcomes when it comes to corporate-sponsored research. Universities might talk a good game about academic freedom, but they sometimes fold when faced with legal action, leaving professors to fend for themselves. According to Egilman, one of the most cited instances of this occurred at Brown. In 1996, David Kern, then an associate professor of medicine, and director of occupational health at Memorial Hospital (one of Brown’s affiliate hospitals), discovered a dangerous new lung disease among employees at Microfibres, a Pawtucket textile company, for whom he was consulting. When Kern informed Microfibres that he planned to present his findings about the new disease — which the Centers for Disease Control recognized as flock workers’ lung in 1997 — to a meeting of the American Thoracic Society, the company threatened to sue, citing a confidentiality agreement.

Although the medical school stated in a May 1997 press release that it "support[s] Dr. Kern in his right to conduct research and in his academic freedom to publish results," Peter Shank, then the dean of the medical school, advised Kern not to present his findings, according to a March 2000 article in the Atlantic Monthly. Kern ignored the advice and ended up paying with his job. A week after he presented his findings to the thoracic society, Kern received letters from then-Brown president Vartan Gregorian and Memorial Hospital President Frank Dietz, notifying him that his contract would not be renewed. Outraged, Kern resigned before his contract expired, writing in a letter to the faculty, "All academics at Brown are subject to punishment if their publications offend powerful outside interests."

Kern who is currently practicing internal medicine on the coast of Maine, says he tries to "limit his interactions with those who wish to write about these past events." But making a less-than-subtle point, Kern cited an article written by Donald Marsh, a former dean of the Brown Medical School, "in which he ties the future health of Rhode Island’s economy to the health of Brown University’s relationship with the biotechnology industry."

UNIVERSITIES don’t just defend these "powerful outside interests"; Many have begun to work with them, entering into corporate partnerships that often put profits in competition with academic values. Kmart recently endowed a chair in the management school at Western Virginia University. And in 1997, Stanford University teamed up with Yamaha to create a brand-name sound-synthesizer called the Sondius-XG.

"A lot of universities are using this model as a way to draw in more income," says Krimsky, the author and Tufts professor. "It comes at a cost, but many don’t realize what that cost is." The GM-Brown Materials Science Lab, funded in 2001 with a three-year $3 million grant from General Motors, provides a good example of some of the costs that can come with corporate/academic cooperation.

From his office on the seventh floor of the Barus and Holley building, a boxy cement structure on Hope Street, engineering professor Bill Curtin has directed the GM lab since its inception two years ago. Curtin sees the lab as a symbiotic relationship, a convergence of Brown and GM’s interests. "One of the main things GM wanted was a collaborative research lab," he explains. "Which meant that faculty here would collaborate with scientists and engineers at General Motors on projects, and from that General Motors would learn things that we do. . . . They have their own technological goals, [which is] why they want these things, and what kind of problems they need to be applied to. They have their overall picture of things that they’re interested in. However, among those were exactly the kinds of thing that motivate faculty."

GM, though, is motivated more by profit than science. "We feel this arrangement had great potential to give GM a competitive advantage," remarks Alan Taub, executive director of science at GM’s Research and Development Center, in a GM press release. To this end, GM has funded similar labs in universities in disparate points, including the University of Michigan, Stanford University, and Jiaotong University in China.

In addition to working with, and learning from, Brown professors, GM also has a significant interest in developing inventions made at the lab. Curtin says he’s unsure about the specifics of Brown’s contract with GM. "The work that is done jointly is, I believe, owned by both GM and Brown University," he says. "GM may be able to license that technology. They may be able to get an exclusive license and that is, in a sense, the recognition that it was their support of the work that led to this."

Curtin says the contract with GM contains provisions that can limit what can be published, and when, by the professors who work in the lab. "There are some things they wish to protect," he says. "GM has to be able to look at and review joint publications." Curtin says the contract doesn’t violate Brown’s patent and invention policy, which states that the university "intends to foster the sharing of the fruits of discovery to support and encourage other discoveries." But when I asked to review the contract, he refused. In Universities In the Marketplace, Derek Bok writes that such agreements, "Inhibit scientific progress, at least to some extent, by limiting the flow of information and ideas that investigators need in order to advance their work."

Curtin nonetheless views the GM-Brown lab in a positive light. "It provides us with a source of more focused problems, as well as some outlet for applications of the work," he says. The partnership, he notes, is also beneficial to students: "One can see the immediate motivations for why they need to understand something about aluminum, what problems they encounter about rough gear surfaces . . . and for student education, that’s extremely valuable."

The only drawback Curtin sees in the arrangement is the management of the research. "GM has a structure for how they manage projects," he notes, "so their desires for management control are higher than what a typical government contract would require."

AS AN ALTERNATIVE to these often constrictive corporate partnerships, many professors and administrators prefer to license patents and inventions after the (usually federally funded) research has been completed — a practice called technology transfer. According to the Association of University Technology Managers, technology transfer generated more than $40 billion in 1999. Because of Dole/Bayh, the 1980 law, Brown owns the patent to anything developed at the university. But it gives professors between 20 percent and 50 percent of a patent’s revenue as an incentive.

Provost Robert Zimmer, who is responsible for Brown’s academic and budgetary functions, says, "For certain types of research, the maximal impact of this research is only achieved through commercialization. This is typically the case when there is very significant investment needed to further develop the work into a product that can be used for the public good."

Yet although it involves less direct corporate influence than other types of collaboration, technology transfer is not without its potential problems. It often involves using federal money for personal or institutional gain; it discourages professors from investigating unprofitable research; and can easily lead to conflicts of interest. As Brown’s new conflict of interest policy — approved by the University’s Advisory and Executive Committee in April 2002 — warns, "With proactive technology transfer comes increasingly close relationships between industry and university, which provide benefits but also increase the risks of academic research being compromised through either or both individual or institutional conflict of interest."

Few professors at Brown are more forward about technology transfer than Clyde Briant, director of the Materials Research Science and Engineering Center (MRSEC), an interdisciplinary research group funded by the National Science Foundation (NSF). "The Brown MRSEC is eager to work with companies and establish new relationships with our colleagues in industry," he wrote in the spring 2002 MRSEC newsletter. "We are very flexible and would like to hear from you if you feel your company can benefit from the MRSEC." Briant is effusive about the benefits of technology transfer, writing, "Industrial collaborations always turn out to be mutually beneficial to both the university and the company." Asked for details of the MRSEC’s collaborations with industry, however, he declined comment.

Although funded by the NSF, Brown’s MRSEC has particularly close ties with industry. Four of its six external advisory committee members are from HKS (a Providence-based engineering-software company), Caterpillar, IBM’s T.J. Watson Research Center, and General Motors. The GM representative, Alan Taub, was also instrumental in establishing the GM lab at Brown and worked with Briant years ago at General Electric. Such relationships do not necessarily imply a conflict, but they might run the risk — as Brown’s conflict of interest policy states — of being "perceived as compromising important academic values, research integrity or the university mission." According to Krimsky, such perceptions "destroy the trust of the general public. They begin to lose the sense that the university is a place where you can get disinterested knowledge." This is especially true when, as is the case with the Materials Research Science and Engineering Center, taxpayers fund the research.

The larger question is whether Brown, which does not publicly disclose conflicts of interest, can be trusted to manage them appropriately.

As academia increasingly marches to the rhythm of the free market, Brown needs administrators who will support transparency and inspire public trust. If, however, as a source in the Office of Vice President of Research puts it, "conflicts may have been disclosed, but not well managed [in the past]," it offers little assurance that such concerns are now being better addressed. And considering the growing financial benefit offered by corporate- and government-sponsored research, the willingness of universities like Brown to hold themselves accountable seems open to question.

At stake is the core mission of academia. As Krimsky puts it, "As universities begin to see their goal as to partner with industry, they are closing out the idea of public interest work at universities. There is going to be less and less interest in hiring people who criticize, and the general public will loose out by not having this reservoir of public interest scientists."

Michael Lukas, a May 2003 graduate of Brown, can be reached at mdlukas@yahoo.com