In this month’s installation of Heliograph: The Investigative Journalism Playbook, reporters Rosa Furneaux and Laura Margottini at the Bureau of Investigative Journalism take us behind the scenes into their award-winning investigation that revealed the global spread of poor-quality childhood cancer medicines.
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The Tip
At the end of an interview about COVID-19 with cancer specialist Tim Eden in 2020, U.K.-based reporter Rosa Furneaux of the Bureau of Investigative Journalism (BIJ) asked a routine question: “Is there anything else you’d like to tell me?”
Eden changed the subject and told Furneaux about a particular brand of a drug called asparaginase which treats acute lymphoblastic leukemia, a common childhood cancer. He said doctors in Brazil were concerned that the brand may be substandard.
That means they could simply be ineffective in fighting the cancer they were designed to target. In other cases, the drugs were allegedly contaminated with by-products including harmful bacteria that could make patients more sick.
“I thought, okay, this could be a story for us – a brand of bad medicine being given to really sick kids in maybe two, three, possibly four countries,” Furneaux recalls.
But that was only the beginning.
The Process
With further digging, the reporters learned that Brazilian doctors weren’t the only ones raising red flags. Asparaginase with the same substandard profile was showing up in Haiti as well. Then Furneaux dug up a letter written on the other side of the world, where a professor in Saudi Arabia urged hospitals to stop using a brand of asparaginase after it made children ill, some of whom ultimately died.
“At that point, I thought… what more could be out there?” says Furneaux.
She cross-referenced the names of substandard brands produced in India with an international shipping database called Panijva. The database – which tracks commodities and their movement around the world – detailed the spread of the substandard drug across the globe.
“My jaw just hit the floor because name after name after name came up,” said Furneaux. “Suddenly we weren’t just talking about a handful of countries. We were talking about nearly a hundred.”
PANJIVA – Follow the link below:
Credit – Panjiva.com
Meanwhile, Laura Margottini was looking into substandard asparaginase brands in Italy. A professor told her about a shortage of asparaginase brands that match the gold standard. As a result, Italian hospitals had to import other substandard brands of the drug – but were supposed to return to the gold standard brand whenever it became available again.
Magottini filed freedom of information requests to Italian hospitals and the responses left her astonished. She found hospitals were continuing to purchase cheaper substandard brands even when the gold standard was available.
“I realized that they were buying this drug for like €20 per vial against €2,500 per vial of the golden drugs,” Margottini said.
Challenges
As the reporters followed the trail of the substandard cancer drugs, they struggled to get their editors fully on board. But Furneaux and Margottini believed they were onto something groundbreaking.
“We had to fight a lot (for this story),” Margottini said. “We needed to convince our editors in order to convince our readers. This can be frustrating but it gives you the fuel you need to break this wall that is preventing you from (following) your gut senses.
Beyond the Story
Since the stories were published, a major medical journal wrote an editorial calling for better standards. In Italy, the senate launched an inquiry about how the brands were getting into the country. Questions were raised at the European Commission, where Laura was invited to speak. Doctors from around the world reacted to the news, stopping their patients from receiving the substandard brands.
Now, researchers are developing a test for doctors to tell if their asparaginase is safe.
“If I was going to give advice coming out of this story, it would be to trust yourself,” said Furneaux. “If you have doubts, it’s good. You should doubt what you’re finding out. You should question everything. You should always wonder whether you’re getting it right all the way up until that final moment when it’s been through the fact check and the lawyers…
“But at the heart of it, if there’s a story that won’t let you go, that’s the story you need to be doing.”
Margottini advises reporters to take nothing for granted, especially initial hypotheses.
“We started with the hypothesis that these drugs were being imported into Europe because of the shortages of the golden standard,” Margottini said. “We ended up uncovering that hospitals were importing them even when the golden standard was available. It was a big shift for us in understanding.”
Heliograph is a monthly podcast from the Investigative Journalism Bureau examining powerful investigative work by reporters from across the globe.
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