The cost of trusting the general

By Imran Khan

GENERAL Musharraf’s defence for hanging on to power is based on his assertion that he alone knows what is best for Pakistan, so he alone will decide when the time is right for him to relinquish power. And the time to do so will be when he has tailored our democracy to suit our society. He gives no timeframe for this tailoring but insists that the people of Pakistan should trust him and believe in his sincerity and selflessness.

The vast majority of Pakistanis trusted him on October 1999. But does his record so far justify the trust he expects from the nation?

First, take the economy. The $10 billion foreign exchange reserves and the reduction in the fiscal deficit are indeed commendable, even if September 11 had a lot to do with it. However, it should be borne in mind that the success in reducing this fiscal deficit has been attained at a huge cost to the common man. Since 1999 a further 10 million people have fallen below the poverty line.

The cost of utilities (electricity, gas, diesel) has risen so sharply in the last three years that corruption has become essential for survival, especially in the salaried class. This has caused further deterioration in the quality of governance, which is the single most important factor impacting on investment. The ranks of the unemployed are growing ominously because, despite macroeconomic stability, there is only a minuscule rise in investment.

Strong institutions too lead to good governance and investment. Indeed, the main difference between the First and the Third Worlds is the lack of an institutional structure in the latter and a strong one in the former. This was one area where those of us who supported General Musharraf expected him to revolutionize Pakistan. He had absolute power and unlike a civilian head of government, was not under any political compulsion to take on the vested interests that hold our country hostage.

It was because of absolute power that the colonial rule built excellent institutions. The British left us a highly efficient civil service and judiciary. A colonial Hong Kong, with its superior system of governance, attracted more investment than most of the ex-colonial countries under their own civilian leaders or dictators.

Unfortunately for us, rather than reforming and strengthening the institutions that had been crippled by both our civilian and military rulers of the past, General Musharraf’s government began to systematically destroy them further. The first casualty was the judiciary, the bedrock of good governance which ensures contract enforcement and gives the business the confidence to invest. Those judges known for being incompetent and crooked were allowed to take oath under the Provisional Constitution Order. The logic behind this immoral act was to ensure a total subservience of the judiciary to the executive.

Our establishment has always operated on the premise that crooks are the most pliable. Sure enough, the judges obliged General Musharraf with wide-ranging powers. Later the judiciary’s image was further furnished when the pliant judges were unconstitutionally awarded a three years extension in service for their services.

After accumulating so much power, rather than cleaning our political stables of the mafias that have held our democratic system hostage, General Musharraf, instead, inducted them into his King’s party. Then followed the most shameless pre-poll rigging in this country’s history. The intelligence agencies and the National Accountability Bureau combined to coerce and cajole ‘electables’ into the King’s party.

The local government system set up in the districts to devolve power to the grassroots level was brazenly used in the elections to support the King’s party candidates, along, of course, with the entire state apparatus. The Q-league that does not feature as a political entity possessing little or no vote bank swept Punjab, thanks to the manipulations by the state machinery.

After the elections, when the Pushtun vote for the MMA upset the intelligence agencies’ calculations, Musharraf supporters, already feeling betrayed, saw another shameless display of rigging, this time post-poll. An assortment of crooks were given some of the most lucrative posts in the government. Again the formula of inducting these dubious characters was that the thicker the file of the loot and plunder the more pliable the crooks would be in selling their souls to the establishment.

By the time the charade was over and the Jamali government was formed, all institutions lay in tatters. The first casualty was our entire legal system. Today neither does our judiciary have any credibility, nor does NAB. The saddest aspect of this is that accountability has ceased to be an issue and its direct beneficiaries are those mega crooks who have plundered our country and impoverished it.

The second casualty is our democracy. Starting with our Election Commission which stands discredited, leaving no doubt in anyone’s mind about its total subservience to the establishment’s desires. Then we have a ruling party that is rightly perceived as a puppet of the establishment. The PM is supposed to carry the responsibility of running the government while effective power lies with General Musharraf. Such a system has never worked anywhere and it is only a matter of time before it self-destructs.

The establishment with its well-planned propaganda of discrediting politicians (and implicitly our democracy) is preparing for the time when this system collapses and it can then lay the blame at the doorstep of the politicians. Only this time the public is fully aware that this democratic facade is entirely the establishment’s creation so that it can control all the levers of power in the country.

The sad thing is that the local government system (originally a good idea) has been badly damaged. Rather than using it to devolve power to the grassroots, it is being used to subvert democracy. The centre is using it in the NWFP to undermine an elected provincial government, while in Punjab and Sindh to eliminate any opposition to the King’s party. The puppet government suits the establishment because it makes General Musharraf look indispensable — but at a great cost to the country. How can any investment come into a country where there is so much political uncertainty and unpredictability? Can any economy take off in such an environment? But the supreme irony is that by bringing in such a weak, disjointed and important government, the establishment has resurrected the two ex-premiers, which it had tried so hard to eliminate from the political scene.

The army was the one institution that had functioned professionally. Today it too is threatened. By inducting so many officers into civilian life, firstly the professionalism of the institution is being corroded. Secondly, the public’s hostility to the army is unprecedented, especially because of the damaging label of ‘land grabbers’. At the same time, the bureaucracy is totally demoralized because of army officers occupying senior posts despite the resumption of the civilian rule. Bear in mind that the bureaucracy provides the delivery system to the common man and without its cooperation government policies cannot be implemented.

Thus, the people no longer trust Pakistan’s destiny with General Musharraf. In the name of pragmatism, the moral compass of our country has been completely shattered. The people’s destiny does not lie with one man whose overwhelming priority today is to further his rule. Instead, our destiny lies in developing strong institutions that function within their constitutional orbit and that is why the battle over the LFO issue is so critical for the country’s future. Our sovereignty has already been compromised, and history tells us that superpowers have always enjoyed dealing with kings and dictators rather than democrats.

Would a country with a democratic government and an independent and credible judiciary allow its citizens to be abducted by the FBI? Would that government have capitulated into supporting the US attack on Afghanistan on a single phone call? (given the powerful public sentiment opposing the action). Today the most important question is: can we trust unelected and increasingly vulnerable Musharraf to make agreements at Camp David — agreements that could further imperil the human rights of our citizens, our sovereignty, and, above all, our national security?

The writer is head of Tehrik-i-Insaf and an MNA.

Tale of a dangerous rat

OK, enough already with all the animal viruses. They live over there. And we live over here. And unless all cuddly creatures housing weird viruses decide to don little face masks, there’s a good reason for separation.

Everyone likes fuzzy little things. Thanks to animal cartoons and superheroes, Americans grow up anthropomorphizing, reading the most darling of preposterous thoughts into the simple instincts of ordinary animals, who can be grand companions. So it’s but one small step for mankind that live, moving critters from the wild are even more exciting than stuffed teddy bears. And in our interaction with them lies a genuine health problem, apparently growing and unmonitored.

—Los Angeles Times

Pakistanis in America

By Shahid Javed Burki

A THEME frequently explored in these columns is the benefit a country such as Pakistan could draw by using its large and young population as an economic resource. This approach runs counter to customary thinking on development. Conventional thinking treats rapid population growth as a burden. As the number of people living within the boundaries of a country continues to increase, the state must provision for their education and health and the economy must find jobs for those who will inevitably enter the workforce. It is a race few economies win.

Those who have studied the impact of population growth on increase in income per head of the population have reached the conclusion that high rates of fertility makes it difficult for poor countries to escape poverty.

While there is a great deal of substance in this argument, we have also to look at the situation where population increase has already taken place. In 1947, at the time of the country’s birth, Pakistan had a population of only 32 million; today, 56 years later, the number of people living in the country has increased to 144 million, an addition of 112 million. In spite of that, income per head of the population has increased at the average rate of three per cent a year during this period. In today’s dollars, income per head of the population has grown from about $95 to close to $480.

There is no doubt that Pakistan would be economically better off today had its fertility rate been somewhat lower and the size of its population somewhat smaller. But this is one of those “what if” questions that tantalize; they don’t say much about the way a difficult situation that has already developed should be handled. The problem in Pakistan is that policymakers must find ways of catering to a large and very young population that, in spite of a significant decline in the rate of fertility in recent times, continues to bring to life 3.5 million people every year.

Every year, about the same number of people join the workforce. Demographic inertia will ensure that the stream of entrants into the workforce will not decline for many years to come. It is because of this that the country’s planners must take cognizance of this phenomenon. One way of dealing with it is to turn the burden of population into an asset.

An imaginative approach would be to train and educate the young not only for providing skills the economy needs. Policymakers should also keep their attention focused on the opportunities available in the developed world as it begins to deal with a problem with no precedence in history. Most of Europe and Japan will begin to see significant declines in their populations within a decade, a decline caused not by war, disease or pestilence.

The reason for this phenomenon is something not encountered before: changes in lifestyles which lead families to have fewer children or no children at all. For these countries to grow and retain economic dynamism they must bring in young workers from abroad. They can come only from countries such as Pakistan which have surplus manpower. For other countries brain-drain can cause some damage to the domestic economies.

This is precisely what had begun to happen in recent years as a steady stream of people left their homes in the developing world in search for jobs, training and education in America and Europe. According to a report published in June 2003 by the Geneva-based International Organization for Migration, nearly three per cent of the world’s population are migrants. Over the last 35 years the number of international migrants has more than doubled to 175 million. Of these, close to 50 million have come from Asia, perhaps as many as four million from Pakistan.

That was how the situation was developing before “nine-eleven.” Since that fateful day, American attitudes in particular — but also, to some extent, thinking in European countries — have turned against international migration. Migration from the Muslim countries is looked upon with great disfavour and a strong message is being sent out that young men from that part of the world are no longer welcome. For some reason, not entirely clear, the Pakistani community in America has been a particular target of authorities’ unwelcome attention. But, fortunately, some questions have begun to be raised about how the immigrants are being treated in the United States.

On April 2, in a report issued by Glenn A. Fine, US Justice Department’s Inspector-General, it was suggested that law enforcement agencies had mistreated hundreds of immigrants detained under the Patriot Act. The act, passed soon after “nine-eleven,” gave far-reaching powers to the Justice Department, including unprecedented information-sharing between law enforcement and intelligence agencies. The failure of US authorities to learn of the September 11 plot in advance was blamed in part on real and perceived legal barriers at the time to the sharing of such information.

The Fine report is a serious indictment of the misuse by law enforcement authorities of the powers given to them by the Patriot Act. It detailed “significant problems” in the detention, on charges of immigration violations, of many of the 762 foreign nationals detained after the September 11 attacks. Of these, the second largest group was made up of Pakistanis. While none of those detainees was charged with terrorism, they spent an average of 80 days in jail before the FBI completed its investigation and many went weeks before being charged with immigration violations or seeing attorneys. About 515 of those detained were eventually deported, again most of them Pakistanis.

The cases investigated by Inspector General Fine don’t cover the entire population of detainees estimated by some to number somewhere between 4,000 and 5,000 persons, once again a large number from Pakistan. It does not address the more than 1,100 persons the Justice Department has detained in connection with the Absconder Apprehension Initiative or the 2,747 persons it put in prison when tens of thousands of young men showed up for Special Registration, another anti-terrorist initiative targeted at Muslim foreign nationals.

The Patriot Act was passed by the US Congress with legislative sunset in 2005 which means that it would lapse unless renewed. Neo-conservatives who dominate the Bush administration are not going to let that happen. The campaign to enter permanently into the statute books the act’s many draconian provisions was launched by the administration three days after the publication of the report by the Inspector General. This confirmed the growing impression of orneriness on the part of the president and his administration on a host of matters, including the issue of migration.

Attorney-General John D. Ashcroft appeared before the US Congress on June 5 not only to defend his department’s performance under the act but to request the legislators to strengthen many of its provisions. He called many provisions of the Patriot Act “weaknesses which terrorists could exploit.” He asked for adjustments that will make it “crystal clear that those who train for and fight with a designated terrorist organization” can be charged under the statute that prohibits providing “material support for terrorism.”

Will the Bush administration’s latest initiative to target immigrants for special and unwarranted treatment as part of its anti-terrorism campaign succeed? Since foreigners, including legal immigrants, don’t vote, they have little influence over politics and the political process. The voting population is proving hard to mobilize on this issue, traumatized as it has been by “nine-eleven” and the continuing war against terrorism. Nonetheless, some voices against the administration’s current approach towards immigrants have begun to be heard.

Recently the American Civil Liberties Union (ACLU) ran full-page advertisements in major newspapers soliciting support against the continuation of the Patriot Act of 2001, certainly not its further strengthening as proposed by Attorney-General John Ashcroft. A number of liberal newspapers ran prominently placed stories on how various immigrant communities have suffered in the post-”nine-eleven” period. Some of these stories focused on the Pakistanis living in New York where a community, called little Pakistan, has been decimated.

Will the liberal community’s campaign have an effect? The legal logic behind the Patriot Act has some unpleasant precedents. In October 2001, a few weeks after 9/11, Attorney-General Ashcroft announced that just as former attorney-general Robert F. Kennedy would arrest a mobster for spitting on the sidewalk, so Ashcroft would use all available laws, especially immigration law, to lock up suspected terrorists and thereby prevent terrorist attacks.

This approach, in legal parlance, is described as preventive law enforcement — action by the state to prevent future crimes. One of the earlier attempts to apply this approach was in 1919 when the United States was rocked by a series of terrorist bombings. Mail bombs were found addressed to 18 prominent people, including Supreme Court Justice Oliver Homes, Attorney-General A. Mitchell Palmer, two US Senators and business leaders John D. Rockefeller and J.P. Morgan.

“Then, as now, the government went into preventive mode and exploited immigration law to sweep broadly and blindly,” writes David Cote, a professor at Georgetown University’s Law Centre and author of the forthcoming book, “Alien Enemies, Double Standards and Constitutional Freedoms in the War on Terrorism.” Like those detailed after “nine-eleven,” the “Palmer raids,” named after the attorney-general at that time, led to the detention of immigrants who were “interrogated incommunicado, denied release on bond and refused access to lawyers. Hundreds were deported. No bombers were found. And like Ashcroft’s sweep, the Palmer raids targeted the most vulnerable — foreign nationals.”

If this campaign against aliens continues and if the Pakistanis — both those who are already in the country and those who wish to come to the country in search for jobs and education — continue to be subjected to discriminatory treatment, there will be grievous damage done to the country’s economy. President Bush and his associates maintain that they are very pleased — in fact, very grateful — that General Pervez Musharraf has provided so much support to the latter’s war against terrorism. The cost of this war for Pakistan will increase enormously if America’s door is shut — or even if it is partially closed — to new migration from the country. The day this article appears, General Musharraf will be in Camp David discussing Pakistan’s relations with his host’s country. Migration from Pakistan and the treatment of Pakistanis living in the United States should be high on the list of topics for discussion with the American president.

“For demographic, economic and social reasons you can’t stop migration,” wrote Brunson McKinley, director-general of the International Migration Organization, in the report cited above. “Policy choices made now will serve to determine whether migration is managed to maximize its benefits or will remain a source of concern and potentially of tension between states,” he continued. This observation is particularly true for Pakistan and its continuously evolving relations with the United States.

Paki is a racist slur

THE High Court in England has ruled that the word ‘Paki’ was a slang expression which is racially offensive and for good measure added that it was odd and a shame “but the unpleasant context in which it is so often used has left it with a derogatory or racist connotation.”

Every national or religious or ethnic community has found itself the butt of abuse and ridicule. It is a kind of defensive mechanism applied when the majority sees itself threatened by the presence of strange-looking faces speaking in a language that sounds like gibberish. It has been the fate of all those who have migrated to foreign shores including those who were abducted and brought in fetters, like the Africans who were sold as slaves, at auctions.

The Pakistani immigrants do not come in that category. They went to Britain voluntarily and cannot rightly complain if they are made to feel unwelcome. But what is perplexing is that of all the immigrant communities in Britain, it is the Pakistanis who seem to attract antagonism and in many instances, downright hostility. This despite the fact that they are the most law-abiding and the least menacing as a group, unlike the West Indians, for example.

Is it their religion? After 9/11, one could say that their religion may have been a factor but Paki-bashing started long before that and it is something I have failed to understand. Racial bigotry in any case is irrational and feeds on imagined fears but why are Pakistanis singled out? In their own country, as against their Empire, the British were not racists and on the whole have shown a great tolerance. They may not take to their bosom people with dark skins but I would suggest that these people with dark skins fare far better than do the Afro-Americans in the United States.

The Afro-Americans make up 12 per cent of the general population but there is a disproportionately high representation of Afro-Americans who make up the prison population and those who are on death-row, awaiting their meeting with their Maker. No such statistical nightmare exists for the coloured immigrants in Britain though, increasingly, the police is getting more high-handed and more muscular in dealing with them.

The Pakistani immigrants began to arrive in Britain in the early 1960s and by the law of duplication, one will get you two, the trickle became a flood. I worked with the PIA in those days and even though these immigrants were the primary source of revenue, and therefore, deserved our gratitude, we called these immigrants “bakra traffic.” Seeing them not as passengers but as volume business. If we had been inventive enough, we ourselves would have called them Pakis.

In 1962, one of the immigrant passengers was discovered to have smallpox after he had reached his destination and someone pressed the panic-button and the media went to town. Overnight, it seemed, that the Pakistani immigrant posed a dire health threat and Enoch Powell had already made his anti-immigration speech in which he had warned of “rivers of blood” and the National Front, Britain’s equivalent of White Supremacists, had started to get active, enrolling ‘skinhead’ thugs as the vanguard of its street-power with their own version of ethnic cleansing.

Of all the immigrant communities, they found the Pakistanis to be the meekest. A serious race riot had erupted and I happened to be in London and I wrote an article for Combat, a weekly that Yunus Said brought out from Karachi. I had termed these ‘skinheads’ as pathological louts who like all bullies were cowards. A ‘skinhead’ had been asked why they didn’t pick on West Indians and the answer was revealing: “Because they hit back.” It was about this time that the word ‘Paki-bashing’ appeared. Paki-bashing was of the same genre as “getting a nigger” a kind of sport, like fox-hunting where the Pakistani was the fox and the ‘skinhead’ the hounds.

The Pakistan Embassy in London kept its eyes shut tightly and all but gave the impression that their lives would be made happier if the Pakistani immigrants were to disappear. I do not recall any strong protest being lodged. They took the fixed bureaucratic position that it was not a government to government affair. This attitude may well provide the answer why Pakistanis were being singled out. Or, part of the answer.

And it may explain too why the Indian immigrants were not being targeted, though for all appearance, they looked like Pakistanis and the ‘skinheads’ did not have the intelligence to know the difference. It may be too sweeping but the perception is that the Pakistani is fair game because he gets no official support.

But a new generation of Pakistanis have grown up and they know their rights. I remember once going to a Pakistani restaurant in London at about its closing time. I was told that I was too late and when I argued the toss in a light-hearted manner, I was told somewhat sharply that this was London and to make the point even more forcefully that “this is not Pakistan.”

I do not approve of the invasion of the cricket pitch by buoyant supporters. In fact, I consider the behaviour boorish and which only brings a bad name to Pakistan. But in a convoluted way, it is a sign that the Pakistanis are no longer afraid and it was good to see so many of them with national flags and some of them dressed outlandishly and some had war-paint on their faces. It was a kind of a statement.

One of the best ways of handling racial discrimination is to laugh at racist jokes and my favourite is about the Pakistani immigrant who went to a travel agent to buy an air ticket. He was short by 25 pence. He thought he would scrounge for it and he turned to a customer in the travel agent’s office, a crusty Englishman. “Please Sir, can I have 25p?” he asked him. “Why?” growled the Englishman. The Pakistani said: “I want to go home.” The Englishman handed him a pound. “Here,” he said, “and take three of your mates with you.” I told this joke to an Englishman who had the decency to feel embarrassed.

Crucial talks at Camp David

By Farhatullah Babar

THE two points on which General Musharraf would seek to convince President Bush during their June 24 meeting at Camp David would be: that the general is the legitimate leader of his country and, secondly, that he is the man of peace seriously striving for peace in the region and fighting terrorism.

As the countdown for the visit started the general began searching for straws of legitimacy beginning with his own power base in the army. Several weeks before the visit a lead story in an English daily said that the corps commanders had voiced support for the general to also continue as president while still holding the office of army chief.

No source for this expression of support was quoted in the report, which was attributed to ‘people who are in the know of things’. The ISPR press release of the commanders’ meeting however did not say any such thing; it merely said that the commanders discussed the security situation. The lack of credibility of the commanders’ reported support was obvious.

Then legitimacy was elusively sought from the lawyers’ community. The lawyers have been in the forefront of the fight against constitutional superimposition. They have refused to recognize General Musharraf as a constitutional and legitimate head of state. In an unprecedented move, the Supreme Court Bar Association declared that it would not take any constitutional matter to the judiciary because the courts’ independence had been severely undermined by the military government.

They cited instances such as the removal of half of Supreme Court judges, the taking of oath from judges of loyalty to General Musharraf rather than allegiance to the Constitution and giving the judges a three-year extension in tenure in an attempt to buy their loyalty, in support of their contention. The lawyers’ community has banned the general’s entry into the country’s bars.

So when a group of lawyers recently invited General Musharraf to their meeting in Lahore purportedly held under the auspices of the Lahore Bar Association, many saw it as a bid to create some facade of legitimacy accorded by the legal community. But no one was deceived. The representative status of the lawyers inviting the general was obvious from the fact that the meeting could not be held in the district bar office but was held in a hotel. There were reports of security personnel wearing lawyers black gowns attending the meeting. The President of the Lahore Bar Association, who had invited General Musharraf, was promptly stripped of his membership of the High Court Bar Association.

Then came the Lahore High Court’s verdict in a constitutional petition filed before it sometime back not by any political party or a member of the lawyers community but by a private individual. The court said that it found nothing in the Constitution from which it could be inferred that donning the army chief uniform by the president violated any provision of the Constitution.

The political parties deplored the verdict, pointing out that Article 43(1) of the Constitution clearly stated that the president “shall not hold any office of profit in the service of Pakistan or occupy any other position carrying the right to remuneration for the rendering of services”. The general was not bothered if in his search for legitimacy the judiciary was diminished.

The parliamentary party of the ruling coalition in Punjab was made to pass a resolution saying that it was imperative that the country had a president in uniform. It is hard to say whether the Punjab legislators will ever be proud of this historic resolution.

Then came the ruling by the speaker of the National Assembly, that the controversial Legal Framework Order was already part of the Constitution. The opposition had agreed to accept the speaker as the head of the government-opposition committee on the dialogue on the LFO. The speaker was thus morally bound to remain neutral. But when he gave the ruling and that too without the knowledge of the opposition, he compromised his moral authority as the custodian of the whole House. The speaker of the national Assembly was thus diminished only to lend some facade of legitimacy sought by General Musharraf.

Finally, just on the eve of his departure for his four-country visit, a resolution was presented in the Senate expressing support for General Musharraf in violation of all rules. The resolution had not even been placed on the ‘order of the day’ agenda. No application for suspension of rules was moved for presenting the resolution which requires a seven-day notice before it can be tabled. Yet it was passed in the absence of the opposition when the house was about to be prorogued.

At Camp David General Musharraf will make a mention of the enormous difficulties he has been facing in pursuing peace and stability in the region and in fighting terrorism. The religious parties controlling two provinces of the NWFP and Balochistan are pushing their fundamentalist agenda, he might argue. They are seeking to reincarnate the Taliban in their areas of influence. The fugitive Benazir Bhutto and Nawaz Sharif who have no following have joined hands with the fundamentalists only to destabilize his government, he might well be telling the American President.

Armed with such dubious forms of legitimacy and crying wolf over a supposed fundamentalist backlash with the support of what he believes to be political rejects, the general would hope to convince President Bush of his credentials to speak on behalf of the Pakistani people. But if such arguments have not convinced the Commonwealth and the European Union, the US president is also unlikely to be impressed.

General Musharraf would also like to convince his host that he has embarked on a sincere process of dialogue with India for restoration of peace in the region. The appointments of high commissioners, mutual visits by parliamentarians, release of prisoners by both sides and restoration of communication links will no doubt be cited as major steps forward in this regard.

But these measures, howsoever important in the contest of the normalization process, cannot hide the real agenda, which is often exposed unintentionally in unguarded moments. Only the other day the architect of the Kargil episode, in a TV interview, promised another Kargil if need be. “Before Kargil, Kashmir was a dead issue”, he told a private TV channel, adding “to avoid Kargil, we need to resolve disputes”.

A man who still cannot see the military disaster and diplomatic humiliation which Kargil had brought and sees it as necessary for resolving disputes has a lot to explain before he can be trusted.

The writer is a PPP Senator.

Deadly devices

ALL remedies to treat serious diseases are subject to some degree of failure. But the conduct of medical device maker Guidant Corp., as revealed in its guilty plea to 10 federal felonies last week, was despicable.

The company, through its subsidiary EndoVascular Technologies, failed to report serious complications, up to and including deaths, following the use of one of its devices. The fines imposed thus far are insufficient to punish this reckless behaviour or, more important, to deter future misconduct in the medical world.

The Ancure Endograft System was designed to treat abdominal aortic aneurysms, the weakening in the wall of a major blood vessel, without major surgery. Guidant put Ancure on the market knowing doctors had concerns about the delivery of the device into the body, according to the plea agreement.

After the device was approved by the Food and Drug Administration, doctors frequently found that the system to insert it, through a small incision, became lodged in a patient, sometimes requiring abdominal surgery — the drastic measure the product was supposed to prevent.

In response, Guidant sales representatives attending surgeries suggested breaking off the handle of the delivery device and extracting it in pieces. At least one patient died after this procedure, which had not been taught to doctors or tested on patients.

Altogether more than a third of patients receiving the device suffered problems — including serious injury, device malfunction and death — that by law should have been disclosed to the FDA. Between Sept. 30, 1999, and March 23, 2001, the company disclosed 172 such incidents to the FDA.

But another 2,628 incidents were not disclosed, though the information was tabulated and distributed to company officials at EndoVascular Technologies, according to the plea agreement. The company failed to report 12 of 28 deaths that followed insertion of the device.

The company has now agreed to pay more than $92 million in criminal and civil penalties and to implement a batch of “corporate integrity agreements.” On Monday Guidant announced that it was discontinuing its Ancure device. The company assured investors and analysts that its financial position remains strong. The company had more than $3 billion in sales and a net income last year of $612 million. Although more than a dozen lawsuits relating to the device are on the horizon, Guidant expects insurance to cover much of its liability.

— The Washington Post



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