Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
A victory for public health and stuff that matters
A victory for public health and stuff that matters

Editor Barbara Fountain can’t help feeling pleased by some landmark news this month
Public health advocates should feel safe to speak out without fear of public vilification.
In these days of bloggers, social media, citizen journalists and fake news, it can be hard to spot a bona fide journalist. Let me give you a tip. Lean in close, watch the eyebrows and speak the words “defamation”.
It might be subtle in the veteran reporter, but it will still be there – the twitch that belies the fear of a mistake made, against the odds, that is going to cost time, money, energy and, worst of all, reputation.
I say against the odds because your regular journalist, in the traditional mould, goes to some lengths to ensure what they write is fair, reasonable and true. Not that that will always save us: some people are not keen on truth and the resulting legal threats sap time, energy and resource. But dealing with these is part of the territory.
Such is not the case for public health academics. Which is why I was thrilled the five-year defamation case taken by Boyd Swinburn, Doug Sellman and Shane Bradbrook came to an end in the High Court at Auckland early this month with a win for the trio.
They had taken a case against PR man Carrick Graham, his PR company, blogger Cameron Slater, and the New Zealand Food & Grocery Council and its chief executive Katherine Rich for repeated defamations that suggested unethical behaviour by the three in their research and use of funding.
These defamations were published on Mr Cameron’s now-defunct Whale Oil blog, which was subsequently hacked, the details of the dodgy dealings being exposed in Dirty Politics by Nicky Hager in 2014.
The lawyer for the academics surprised those present in court with the announcement a settlement had been reached.
Mr Graham’s lawyer then read an apology from his client in which Mr Graham agreed to make a payment to the three, and apologised “sincerely and unreservedly” for the hurt and harm caused by “untrue, unfair, offensive, insulting and defamatory” claims about them.
This was a comprehensive admission. Three days later, the judge also ruled that Mr Slater had defamed the three.
In his effusive apology, Mr Graham admitted he had encouraged, inspired and contributed to the blog posts, and said he had done so “as part of his business and in order to advance the interests of industry”.
Which brings us to the fourth and fifth defendants in the case – the New Zealand Food & Grocery Council and Ms Rich, who had allegedly paid for Mr Graham’s services but reached a settlement with Professors Sellman and Swinburn in October last year.
Ms Rich’s involvement was particularly galling in public health circles. At the time Dirty Politics was published, she was a member of the board of the Health Promotion Agency.
In October 2014, then health minister Jonathan Coleman was challenged in the House on potential conflicts arising from Ms Rich’s industry role and possible involvement in blog attacks on the researchers. Dr Coleman said he had seen no credible evidence to back up those allegations, and he was satisfied with assurances from then agency chair Lee Mathias. Ms Rich stood down after her third term in 2015.
This settlement is a big deal for public health in New Zealand. Dr Swinburn hopes it will be a wake-up call.
By uncovering the connections between big money, underhand PR and defamatory blogs, and with light being shone on unethical industry practices, he hopes the path will be laid for better public health policies from government. It also means public health advocates should feel safe to speak out without fear of public vilification.
The action taken by this academic trio, at great personal cost, has the potential to have a more far-reaching impact than their individual research efforts.
In August last year, two of our now-celebrity epidemiologists – Michael Baker and Nick Wilson – suggested we should not wait until we can regard COVID-19 as conquered, but should start reviewing the pandemic response. I agreed with them – it’s never too soon to learn from your mistakes.
Chris Hipkins, health minister at the time, said nah, now is not the time for reflective thinking, it wouldn’t be “sensible”.
Now, it seems, the time has come and last week, as COVID-19 response minister, Mr Hipkins announced an independent review of the COVID response is being formed, to be chaired by Sir Brian Roche.
Sir Brian will be remembered as a member of the Health and Disability System Review Panel chaired by health economist Heather Simpson, after which the twosome went on to sort out problems with border breaches. Ms Simpson was also appointed to a review this month – of Pharmac. I wonder if it was a case of paper, scissors, rock.