Day 031 - 05 Oct 94 - Page 20
1
2 Q. But that would be because?
3 A. Because of the evidence that we have, yes.
4
5 Q. That there is -----
6 A. The sum total of the evidence.
7
8 Q. That there is a risk that ----?
9 A. Yes. A possible risk that you would do those children
10 on the high saturated fat diet serious injury in one way
11 or another.
12
13 Q. The reliability of epidemiological evidence has been
14 criticised. It has been said that it suffers from
15 deficiencies. You have argued against that in your
16 statement?
17 A. Yes.
18
19 Q. Is that something that is from personal experience?
20 A. Well, yes. I have worked with the World Health
21 Organisation on several international projects and I have
22 had first hand experience of how some of this data is
23 collected. Yes, the data has a degree of unreliability
24 about it. All data is unreliable and, to a certain
25 extent, we have to go to the extent of atomic clocks to
26 know what the real time is. It is really a question of
27 the degree of unreliability.
28
29 What I was trying to express here was that the degree of
30 reliability is certainly good enough for the purposes of
31 making judgments from the epidemiological evidence. The
32 personal experience we had in Uganda, when I was working
33 there, was very clear, not just the reliability of the
34 international evidence but the reliability of the evidence
35 within Uganda was sufficient for Burkitt to discover the
36 relationship between a virus and Burkitt's Lymphoma (which
37 carries his name) for us to identify a high presence of a
38 potential carcinogen in the diet of people in Uganda.
39
40 I think the criticism on the unreliability of evidence in
41 developing countries is somewhat over done because the
42 people who collect this kind of evidence know what is
43 happening there. In Uganda you simply do not have breast
44 cancer. It is not a story. You do not have colon
45 cancer. You have other problems. You have volvulus,
46 endomyocardial fibrosis but you do not have heart disease,
47 cardiovascular disease as we know it. I think it is
48 probably wise, when talking of cancer, to remember that we
49 are not talking about all cancers, because in Uganda we
50 have primary carcinoma of the liver. This is really quite
51 common, but we do not see primary carcinoma of the liver
52 in northern Europe.
53
54 MR. JUSTICE BELL: If you look at the first paragraph under
55 "Reliability of epidemiological evidence", can you give
56 me an example -- it is probably not much use going to
57 Uganda over cancer of the breast and colon in the light of
58 what you have just said -- of how first hand knowledge of
59 local health would flag a serious discrepancy, so I can
60 see what you mean by that?
