Investigative Roundup
ACIP Disclosures Not Released
The Department of Health and Human Services (HHS) has not released conflict of interest disclosures for the CDC's newly appointed vaccine advisers, despite earlier promises to do so. Last month, HHS Secretary Robert F. Kennedy Jr. replaced all 17 members of the Advisory Committee on Immunization Practices (ACIP) with eight new appointees. Kennedy criticized the previous committee for being too close to pharmaceutical companies, suggesting this influenced their vaccine recommendations.
However, several of the new members have been linked to conflicts of interest themselves, including paid involvement in legal actions against vaccine maker Merck. ACIP members must file OGE Form 450, disclosing financial interests and agreeing to ethics rules. An HHS spokesperson initially assured that these forms would be public before the committee began work, but no disclosures appeared before their first meeting.
When questioned recently, the spokesperson avoided directly addressing the delay, stating only that the new members completed ethics reviews and training. Dr. Kathryn Edwards, a pediatrician and Immunize.org board member, called this a "hypocrisy," noting the contradiction between HHS’s calls for transparency and the lack of disclosure.
Gaming AI in Peer Review
Some researchers have been manipulating artificial intelligence (AI) tools used in peer review by embedding hidden messages intended to influence AI-generated assessments. This technique, called prompt injection, involves inserting white text in tiny fonts that instruct AI to produce positive reviews. A Nature investigation found 18 preprints using this method, all within computer science fields.
One paper contained 186 words of hidden text urging AI to highlight the paper's strengths and minimize weaknesses. Testing showed that ChatGPT adjusted its output based on these hidden prompts, while other language models like Claude and Gemini did not. Although many publishers forbid AI use in peer review, some researchers still use language models to evaluate manuscripts.
Dr. Kirsten Bell, an expert in research ethics, noted that if peer review functioned properly, such manipulations would have no effect on outcomes.
Rise of a Healthcare Oligarch
Ralph de la Torre, MD, cofounder and former CEO of Steward Health Care, exemplifies how private equity-backed leadership can profit from a health system while weakening it. In 2010, when the Caritas Christi hospital network in Massachusetts faced financial troubles, de la Torre brought in Cerberus Capital, a private equity firm, to acquire the system. The sale, which converted the nonprofit into a for-profit entity, was approved by then-Massachusetts attorney general Martha Coakley shortly after a $5,000 donation from de la Torre to her campaign.
Under Cerberus and de la Torre, Steward Health Care sold assets to affiliated real estate trusts and imposed rent payments on properties it had owned. Cerberus expanded Steward by acquiring more hospitals, making it the largest for-profit hospital system in the U.S. before selling it in 2020. During this period, Cerberus extracted $800 million, while Steward’s leadership paid themselves $111 million in dividends.
Before this private equity takeover, the hospitals were financially stable. The aggressive financial maneuvers left the system burdened with debt and ultimately bankrupt. When questioned by reporters, de la Torre evaded inquiries and remains in contempt of Congress for ignoring a subpoena.
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