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Plot Against WHO Director; Doctors as Political Targets; Erased From GLP-1 History?

— This past week in healthcare investigations

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INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Plot Against WHO Director

Documents reviewed by reveal a coordinated attempt by the Ethiopian government and 2019 Nobel Peace Prize winner Abiy Ahmed, PhD, its prime minister, to discredit World Health Organization director Tedros Ghebreyesus, PhD, MSc.

Before Ghebreyesus' reappointment in 2022, the administration pushed allegations of sexual misconduct and embezzlement against the leader, detaining his family members in Ethiopia and subjecting them to harassment, despite a lack of evidence supporting the claims, the article stated.

The conflict stems from Ghebreyesus' affiliation with an opposing political party, the Tigray People's Liberation Front, that previously governed the country, Bloomberg reported. In 2020, the Tigray war broke out, killing hundreds of thousands just as the WHO's role grew more important than ever given the global pandemic.

No charges have been filed so far, but documents include bank statements, handwritten witness accounts, and emails among investigators, witnesses, and banks, and were sent to judicial officials and federal police. The allegations, which Ghebreyesus vehemently denies, include alleged illegal procurement of HIV test kits and epidemic drugs; enriching himself through contracts given out by the health ministry and the Pharmaceutical Supply Agency, including accepting a bribe; and harassing and assaulting women.

Bloomberg reported that so far, there is no evidence to back up these claims, and that the government's intelligence unit requested financial details and bank statements related to Ghebreyesus, his family, and Tigrayan officials.

"When government officials subvert the fight against corruption and financial crime to settle political scores, it undermines the rule of law and is a setback to authentic good governance efforts," Gabriel Bourdon-Fattal, director of programs at the French whistleblower organization that originally received the documents, said in a statement. According to Bloomberg, Ghebreyesus remains fearful of returning home because of arrests and actions against his family, though the investigation is no longer active.

Doctors Navigate Political Landmines

In recent years, physicians have inadvertently entered a political minefield, reported. As distrust of science and medicine grows and conservative policy on abortion and gender-affirming care grow ever more restrictive, some healthcare professionals and organizations are being pushed to their limit.

Kevin Wang, MD, of Swedish Family Medicine in Seattle, found himself at the center of this polarizing environment after a clip of him speaking about gender-affirming care went viral. It attracted first vitriol from right-wing media outlets, then harassment that led to his employer removing his employee page off their website for security reasons.

Julie Burkhart, who runs the only full-service abortion clinic in Wyoming, considered herself lucky when her workplace was fire-bombed -- responders were able to put the fire out quickly because a neighbor called 911.

Meanwhile, healthcare as a profession is shifting, STAT reported. As an older generation retires, healthcare professions face high turnover and shortages in the wake of the COVID-19 pandemic, and burnout grows. As Republican policy priorities increasingly turn toward social conservatism and a crackdown on abortion and gender-affirming care, medical students may be shaping their choices of specialty and residency location accordingly, which may only widen healthcare disparities between rural and urban, and red and blue states.

Medical organizations like the AMA are wading into political disputes, according to STAT, only this time, "It's more that this string of battles has not revolved around who should pay for health care, but whether people should be allowed it all."

Researcher's Early GLP-1 Work Obscured

The work of Svetlana Mojsov, PhD, was critical in early research that led to the discovery of GLP-1, but her contributions -- including first authorship on the earliest papers that showed the structure and function of the hormone -- have been cut out of the story of this drug class, .

Though she spoke to Massachusetts General Hospital's intellectual property office a number of times about a patent for GLP-1 around the time of her research, it was eventually granted in 1992 with Joel Habener, MD, an endocrinologist she had collaborated with, listed as the sole inventor.

Habener, his postdoc Daniel Drucker, MD, and Jens Holst, MD, DMSc, a Danish researcher who came into the picture later, have been widely credited as the founders of GLP-1, and won prestigious awards related to the discovery of the hormone. The conflict, STAT reported, "places her in a long history of medicine sidelining female researchers" and "exposes a disciplinary bias against chemists and in favor of physicians and biologists."

Mojsov has been represented as a post-doctoral researcher working in Habener's lab in the 1980s, when this work was done, although she held an independent position with her own NIH funding, STAT reported. In 1983, Mojsov theorized that a shorter version of a hormone similar to glucagon, known as "incretin," would stimulate insulin, rather than a longer version that had shown only weak effects in animal models. She made synthetic GLP-1 peptides, and showed that natural versions existed in the guts of rats, leading to the first study reporting this shorter GLP-1 in natural gut tissue. Later, in 1987, she showed that the hormone triggered insulin secretion as the missing "incretin."

Around the same time Habener asked his postdoc, Drucker, to work on the same problem. The resulting paper was published slightly earlier, though using cell lines from pituitary and pancreatic cells, not the gut as Mojsov had. They also published a paper slightly after Mojsov's that showed the shorter version stimulated insulin.

She argued her papers were more consequential, and entered into a protracted legal battle after learning about the patent being granted to Habener. She ultimately won, Mojsov told STAT, but Mass General only agreed to give her half as much of the royalties as Habener. "All I want is not to be erased from history," Mojsov told STAT.

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    Sophie Putka is an enterprise and investigative writer for 51˶. Her work has appeared in the Wall Street Journal, Discover, Business Insider, Inverse, Cannabis Wire, and more. She joined 51˶ in August of 2021.