ABN Sydney - ACMA Investigation Report 2855

Investigation Report No. 2855

File No. ACMA2012/1066

Broadcaster Australian Broadcasting Corporation

Station ABN Sydney

Type of Service National broadcasting

Name of Program Catalyst

Date of Broadcast 17 May 2012

Relevant Code Standards 2.2, 4.1 and 4.2 of the ABC Code of Practice 2011

Date finalised 16 January 2013

Decision No breach of clause 2.2 (not present factual content in misleading way) No breach of clause 4.1 (impartiality) No breach of clause 4.2 (present a diversity of perspectives)

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 The complaint On 26 July 2012, the Australian Communications and Media Authority (the ACMA) received a complaint regarding the program, Catalyst, broadcast on 17 May 2012 by the Australian Broadcasting Corporation (the ABC). The complainant was concerned that the program ‘deceive[d] the public about vaccination and disease’, ‘was one sided and didn’t address alternative viewpoints’, and contained factual inaccuracies. The complaint has been assessed against standards 2.2 [accuracy], 4.1 [impartiality] and 4.2 [diversity of perspectives] of the ABC Code of Practice 2011 (the Code).

The program Catalyst is a program that broadcasts stories on scientific developments and discoveries. It is described on the ABC’s website as:

At Catalyst we know that science is a dynamic force for change. Each week Catalyst brings you stories from Australia and around the world. Our passion to meet scientists at the forefront of discovery is matched by our fascination with science breakthroughs however big or small. Science changes all our lives. For better or worse, we are committed to showing you what our future holds.

On 17 May 2012, the program included segments entitled: (i) ‘Danger Zones’; and (ii) ‘Kawasaki Disease’, both of which were the subject of the complaint. ‘Danger Zones’ was about vaccinations, herd immunity and ‘misinformation’ about the side effects of vaccinations, which result in areas of low levels of vaccination or so-called ‘danger zones’. The segment included interviews with: > Director, NSW North Coast Public Health; > Immunisation and Infectious Disease Expert, National Center for Immunisation Research and Surveillance; > Paediatrician, NSW North Coast; > parents whose newborn baby passed away as a result of whooping cough; and > three people on the street in Byron Bay. ‘Kawasaki Disease’ was about the heart disease, Kawasaki Disease, and how little is known about it, as well as a new theory about how the disease is spread. The segment included interviews with: > Head of Cardiology, Royal Children’s Hospital Melbourne; > Director, Kawasaki Research Centre, University of California San Diego School of Medicine; > Principal Research Fellow, Infection, Immunity and Environments, Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne; > a family who has a child with Kawasaki Disease; and > a man who suffered an aneurysm as a result of Kawasaki Disease.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 2 Transcripts of the relevant segments are at Appendix A.

Assessment This investigation is based on submissions from the complainant and the ABC and a copy of the broadcast provided to the ACMA by the ABC. General considerations to which the ACMA has regard to in assessing compliance with standards 2.2, 4.1 and 4.2 of the Code are at Appendix B.

Ordinary, reasonable viewer In assessing content against the Codes, the ACMA considers the meaning conveyed by the relevant material broadcast. This is assessed according to the understanding of an ‘ordinary, reasonable’ viewer. That is, the assessment is made against what message the ordinary, reasonable viewer would have understood was being conveyed by the material that was broadcast. Australian courts have considered an ‘ordinary, reasonable' viewer to be:

A person of fair average intelligence, who is neither perverse, nor morbid or suspicious of mind, nor avid for scandal. That person does not live in an ivory tower, but can and does read between the lines in the light of that person’s general knowledge and experience of worldly affairs1.

The ACMA considers the natural, ordinary meaning of the language, context, tenor, tone and inferences that may be drawn. Once this test has been applied to ascertain the meaning of the broadcast material, it is for the ACMA to determine whether the material has breached the Codes.

Complainant’s submission The complaints to the ABC and the ACMA are at Appendix C.

ABC’s response to the complainant The ABC’s response to the complainant is at Appendix D.

Issue 1: Impartiality and diversity of perspectives

Relevant standards 4.1 Gather and present news and information with due impartiality;

4.2 Present a diversity of perspectives so that, over time, no significant strand of thought or belief within the community is knowingly excluded or disproportionately represented.

Finding The ABC did not breach standards 4.1 or 4.2 of the Code.

1 Amalgamated Television Services Pty Limited v Marsden (1998) 43 NSWLR 158 at 164–167 (references omitted).

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 3 Reasons The Code requires that the standards are interpreted and applied in accordance with the Principles applying in each Section. Relevant Principles in relation to impartiality and diversity of perspectives include the following:

Judgements about whether impartiality was achieved in any given circumstances can vary among individuals according to their personal and subjective view of any given matter of contention. Acknowledging this fact of life does not change the ABC’s obligation to apply its impartiality standard as objectively as possible. In doing so, the ABC is guided by these hallmarks of impartiality:

 a balance that follows the weight of evidence;

 fair treatment;

 open-mindedness; and

 opportunities over time for principal relevant perspectives on matters of contention to be expressed.

The ABC aims to present, over time, content that addresses a broad range of subjects from a diversity of perspectives reflecting a diversity of experiences, presented in a diversity of ways from a diversity of sources, including content created by ABC staff, generated by audiences and commissioned or acquired from external content-makers.

Assessing the impartiality due in given circumstances requires consideration in context of all relevant factors including:

 the type, subject and nature of the content;

 the circumstances in which the content is made and presented;

 the likely audience expectations of the content;

 the degree to which the matter to which the content relates is contentious;

 the range of principal relevant perspectives on the matter of contention; and

 the timeframe within which it would be appropriate for the ABC to provide opportunities for the principal relevant perspectives to be expressed, having regard to the public importance of the matter of contention and the extent to which it is the subject of current debate.

In this case, the ACMA notes that the program is a program about scientific developments and discoveries and that the audience expectation would be that it would refer to peer reviewed science on these issues. The ABC’s Principles provide that, among other things, in applying the ABC’s impartiality and diversity of perspective standards as objectively as possible, the ABC must create a balance that follows the weight of evidence. The Principles further provide that not every facet of every argument is required to be presented.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 4 Danger Zones In relation to the segment, ‘Danger Zones’, the segment clearly identified the fact that some people and organisations disagree over various aspects of vaccination and the contentious nature of the subject matter. This was evident from comments broadcast during the segment such as:

> vaccination still ignites fierce opposition;

> the greatest lie ever told is that vaccinations are safe and effective;

> vaccines have been plagued by reports of nasty side effects;

> we’ve had forty-four children present with febrile convulsions;

> do people now fear a vaccine’s side effects more than they fear the disease itself?; and

> sometimes with [an alternative lifestyle] goes a distrust of western medicine, and so people believe that public health and pharmaceutical companies, doctors and other immunisation providers are collaborating in some conspiracy.

The three women who were interviewed in Bryon Bay expressed views against vaccination.

A substantial proportion of the information presented in the segment suggested that the side effects of vaccines are often minor and that vaccines can effectively prevent certain diseases. The relevant information was presented by experts equipped with the scientific information and medical knowledge to present such evidence. In this regard the ACMA notes the following statements by the following experts:

> Director, NSW North Coast Public Health:

We’ve seen twice the level of disease in Byron Bay [with low vaccination rates] as we’ve seen right next door in Ballina [with high vaccination rates].

> Immunisation and Infectious Diseases Expert, National Centre for Immunisation, Research and Surveillance:

But [the side effects] are minor and they go away quickly. Rare side effects are something in the order of one hundreds of thousands. An allergic reaction for example.

Herd immunity is the means by which those who are vulnerable but not able to be vaccinated can still be protected, because so many people around them are vaccinated, and are immune. And so whenever a germ comes into a community, it keeps coming up against full stops, against barriers, and it can’t get to that one or two vulnerable children. For herd immunity to work, in terms of quite a few diseases, we need ninety-five per cent immunity, so it’s really quite high.

If we don’t keep immunisation high, epidemics can come back.

> Paediatrician, NSW North Coast:

I’ve [...] treated a lot of children with vaccine-preventable disease.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 5 The messages are all wrong, they have no truth in them, yet they are plausible. And people who aren’t sure, could say, ‘Well, on balance, I’m not going to vaccinate’. And that’s happening a lot.

The complainant submitted that statements made comparing the disease infection rate of Byron Bay with Ballina was ‘pointless’ and made for the purpose of ‘deceiv[ing] the public about vaccinations and disease’. The ACMA notes that the Director of NSW North Coast Public Health compared disease infection rates of Byron Bay and Ballina. It was clear from the Director’s statement, ‘We've seen twice the level of disease in, in Byron Bay as we've seen right next door in Ballina’, that the comparison was made for the purpose of illustrating how two towns in close proximity with differing levels of vaccinations can have significantly different infection rates. The purpose was not to discuss the infection rate of Byron Bay in relation to the national average infection rate but to compare two towns that share many similar characteristics other than vaccination rates. In this regard, the ACMA considers that comparing the infection rates of Byron Bay and Ballina, and not the national average, was relevant for the intended purpose. As outlined at Appendix B, presenters can and do play a key role in setting the tone of a program through their style and choice of language. The manner in which a presenter presents a report can influence the conclusions that an ordinary, reasonable viewer draws from a broadcast. While the presenter outlined her position in relation to vaccines in statements such as, ‘Now I'm not here to mince words. Vaccines work’, her position was reasonably supported by the information presented during the segment and reiterated by medical and scientific experts interviewed during the segment. The ACMA does not consider that the presenter conveyed a prejudgement, or gave effect to any affections or enmities in respect of the content of the program. The ACMA notes that views from organisations identifying as natural therapy organisations were not presented during the segments. However, the ACMA accepts that, in the context of a program dealing with scientific facts about vaccination and herd immunity, it was not necessary to present alternative views sourced from outside the medical and scientific community. The ACMA is of the view that it was appropriate to constrain the perspectives presented in the segment to public health professionals, medical doctors and researchers, and individuals who had contracted vaccine preventable diseases and their families. Notwithstanding that, the ACMA considers that the inclusion of statements in the program expressing views against vaccination adequately conveyed to the audience that the subject is contentious. Having regard to the weight of evidence presented in the segment and the body of scientific evidence regarding the low risk of side effects from vaccines,2 the ACMA is satisfied that the broadcaster presented information with due impartiality and, in the context of a science program, appropriately presented a diversity of perspectives in the segment.

2 World Health Organisation, Global Vaccine Safety Initiative, www.who.int/vaccine_safety/en/; Centers for Disease Control and Prevention, Vaccines and Immunisations, www.cdc.gov/vaccines/vac- gen/6mishome.htm; National Institutes of Health, Immunisations – general overview, www.nlm.nih.gov/medlineplus/ency/article/002024.htm accessed on 28 November 2012.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 6 Kawasaki Disease In relation to the segment, ‘Kawasaki Disease’, the ACMA notes that the purpose of the segment was to provide an insight into the disease and report on a new theory about how the disease is carried. In doing so, the segment included interviews with: > Head of Cardiology, Royal Children’s Hospital Melbourne; > Principal Research Fellow, Infection, Immunity and Environments, Murdoch Children’s Research Institute, Royal Children’s Hospital Melbourne; and > Director, Kawasaki Research Center, University of California San Diego School of Medicine. The segment also included interviews with individuals who had contracted Kawasaki Disease and their families. For the same reasons as those outlined above, the ACMA is satisfied that the broadcaster presented information with due impartiality and that, in the context of a scientific segment about Kawasaki Disease, it was appropriate to constrain the perspectives presented in the segment to medical doctors, medical researchers, and individuals who had contracted Kawasaki Disease and their families. The ACMA does not consider that perspectives from natural therapy organisations were required to be presented during a program concerned with scientific facts and developments in scientific research.

Issue 2: Factual accuracy

Relevant Code Standard 2.2 Do not present factual content in a way that will materially mislead the audience. In some cases, this may require appropriate labels or other explanatory information.

Finding The ABC did not breach standard 2.2 of the Code.

Reasons The complainant’s concern relates to statements made about Kawasaki Disease being ‘carried on the wind from Japan to America’. He also complains that the role of diet and food colouring was not referred to as a cause of the disease. The ACMA has identified the following program material (transcribed below) as of relevance in this context:

Presenter: Now there's a surprising twist in this story. New research has found not the cause of Kawasaki disease, but perhaps what it's carried by - the wind.

Director

Kawasaki Research Centre: There are no examples that I know of in human medicine where there has been trans-oceanic transport of a human pathogen carried by dust particles on the wind.

Presenter: The [Director, Kawasaki Research Center] is speaking at the international conference on Kawasaki disease. What she

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 7 has to say in a lecture called 'Blowing in the Wind' stuns the medical community.

Director

Kawasaki Research Centre: This will be a revolutionary new concept in transmission of human disease.

Presenter: Over the last forty years, when north-westerly winds blow over Japan, there are spikes in Kawasaki cases. That's remarkable in itself, but when the winds from Asia connect with winds crossing the North Pacific, there are epidemics on both sides of the ocean at the same time.

Director

Kawasaki Research Centre: If it's something that lofts up into these wind currents over the plains of Central Asia, and then can drop out of the sky on children in Japan, but then can also follow these wind portals across the Pacific Ocean, and then rain down on children here in the United States, and particularly here in Southern California, then it must have some kind of particle mass.

Presenter: Atmospheric scientists are flying high-tech sampling instruments above Japan in the hope of isolating what those particles might be.

Director

Kawasaki Research Centre: If it's in fact true that infectious agents can move around the planet on dust particles, that would also open up the possibility that anthrax or influenza or other infectious agents might also move around the planet that way too.

Presenter: This is a detective story with plenty of suspects.

The first issue to consider is whether the statements made regarding Kawasaki Disease being ‘carried on the wind’ amount to factual content or expressions of opinion or viewpoint. Opinion and viewpoint are not subject to the requirements in standard 2.2 of the Code. The ACMA considers that the ordinary, reasonable viewer would have understood the above material to convey the Director of the Kawasaki Research Centre’s hypothesis about how Kawasaki Disease may be carried across countries and continents. Phrases used by the Director such as ‘new research’, ‘new concept’, ‘sampling instruments’, ‘hope’, ‘if it’s in fact true’, and ‘plenty of suspects’ would suggest to the ordinary, reasonable viewer that the Director’s hypothesis is contestable, not yet proven and, at this point in time, is her opinion. It is also noted that the presenter, in the introduction, stated that ‘perhaps’ Kawasaki disease is carried by the wind, and that the scientists are using instruments ‘in the hope of’ isolating what the particles might be. As the ACMA considers that the material was clearly an expression of scientific opinion it is not subject to the accuracy provisions of the Code. In any event, the ACMA considers that the

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 8 statements and commentary in the segment accurately presented the views of the Director of the Kawasaki Research Centre and would not have materially misled the audience. In relation to the complainant’s concern that the role of diet and food colouring was not referred to as a cause of the disease, the ACMA notes that no conclusion as to the cause of Kawasaki Disease was drawn in the program. Rather, both the Head of Cardiology at the Royal Children’s Hospital Melbourne and the Director of the Kawasaki Research Centre stated that is unclear was causes the disease. The ACMA is of the view that, in the context of a program reporting on a particular scientific hypothesis, factual content about Kawasaki Disease was presented in a way that did not materially misled viewers. Accordingly, the ABC did not breach standard 2.2 of the Code.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 9 Appendix A Transcript: ‘Danger Zones’, Catalyst

Presenter: Watch as this baby gasps for air. One in 200 newborns with whooping cough will die.

Paediatrician: They can't breathe in, they just continue to cough and cough. And um, will turn blue.

Presenter: We can protect ourselves from these diseases. But vaccination still ignites fierce opposition.

TV commercial: The greatest lie ever told is that vaccines are safe and effective.

Presenter: But vaccines have been plagued by reports of nasty side effects.

Spokesman: We've had forty-four children present with febrile convulsions.

Presenter: So do people now fear a vaccine's side-effects more than they fear the disease itself?

I've come to the beautiful coastal town of Byron Bay. This is where you come to embrace your inner hippie, and see what alternative living is all about. But does this laid-back lifestyle come at a cost?

Director, NSW North Coast Public Health:

This part of New South Wales is known as an alternate lifestyle area. Sometimes with that goes a distrust of western medicine, and so people believe that public health and pharmaceutical companies, doctors and other immunisation providers are collaborating in some conspiracy.

Presenter: If people in the community don't get vaccinated, it can lead to disease outbreaks. This creates danger zones in areas with low levels of vaccination.

Director, NSW Public Health:

Some periods they can drop down to fifty per cent.

Presenter: Wow.

Or very close to fifty per cent.

Presenter: So does that translate into an increase in disease rates?

We've seen twice the level of disease in, in Byron Bay as we've seen right next door in Ballina.

Presenter: I was baffled by the extraordinarily low vaccination rates. So I decided to hit the streets of Byron to find out why.

Woman 1: And I really think that the vaccinations actually don't help with letting the body naturally build its own immune system.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 10 Woman 2: I just feel that I don't really want to put anything unnatural in him, because I just don't feel it's natural, yeah.

Woman 3: No, I haven't been vaccinated.

Presenter: What's the reason for that?

Woman 3: Um, well my parents did not believe in it, and like I know someone who has been vaccinated and got Down's Syndrome from it.

Presenter: It surprised me how much misinformation there is out there about vaccination. No vaccine comes without risks. But the majority of side effects are minor.

Paediatrician: Okay, Mum's going to hold you really tight. Give mum a cuddle.

Immunisation & Infectious Diseases Expert: It's common to get a bit of redness or swelling at the injection site. Bit of pain that lasts a couple of days, a fever, maybe for a day.

Paediatrician: Okay, all good.

Mother: Good girl.

Immunisation & Infectious Diseases Expert: But they're minor and they go away quickly. Rare side effects are something in the order of one hundreds of thousands. An allergic reaction, for example.

Paediatrician: Good girl.

Immunisation & Infectious Diseases Expert: It's really important for people to be able to weigh up this risk - when I get on a plane, will my chances of surviving and landing be okay? When I have my child vaccinated or myself vaccinated, what are the likelihood of a serious side effect? We all go on planes, and we should all be vaccinated.

Presenter: Now I'm not here to mince words. Vaccines work. They protect us from diseases like smallpox and polio. These are diseases which maim, paralyse, even kill their victims. But to sustain this protection, we must achieve what we call 'herd immunity'.

Immunisation & Infectious Diseases Expert: Herd immunity is the means by which those who are vulnerable but not able to be vaccinated can still be protected, because so many people around them are vaccinated, and are immune. And so whenever a germ comes into a community, it keeps coming up against full stops, against barriers, and it can't get to that one or two vulnerable children. For herd immunity to work, in terms of quite a few diseases, we need ninety-five per cent immunity, so it's really quite high.

Presenter: Vaccines not only protect you, they protect your community. And that's why immunisation can be called altruistic. It's not good enough to say that you've been vaccinated as a baby. Older children and adults need boosters. This has been a timely reminder that I'm due for mine. Remarkably, only twelve per cent of adult Australians have had a whooping cough booster. [Presenter gets vaccinated] I'm done.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 11 The problem is that most people are too young to remember the devastation caused by epidemics in the early 1900s.

Immunisation & Infectious Diseases Expert: There were children dying left, right and centre from diphtheria in the forties, paralysed by polio in the 1950s, and since then there's been many children who have still died from whooping cough, for example. If you don't see it, out of sight, out of mind. How do they weigh up what they see in front of them - a serious side effect, which occurs rarely - against an infectious disease they've hardly even heard of?

Mother of deceased baby: [Baby’s first name].

Father of deceased baby: [Baby’s first name] who?

Mother of deceased baby: [Baby’s full name].

Presenter: [Baby’s name] was born perfectly healthy in 2009.

Mother of deceased baby: We'd made the decision to have a third child, we'd just moved to a new area, so for us it was, you know, another step in a new life.

Presenter: But [mother’s name] and [father’s name] had no idea that moving to Lennox Head in northern New South Wales was a potential danger zone.

Mother of deceased baby: I had never been warned about whooping cough. But at the time [baby’s name] was born, the rates of notification were seven times what they were the previous year. There was one day that I dropped James to school, I had to take my newborn baby [baby’s name] with me. And walked into a school, and just completely unaware.

Presenter: It's still not known how, but [baby’s name] came in contact with someone carrying pertussis - the bug which causes whooping cough.

Mother of deceased baby: She was about eleven days old, and started to get a blocked nose. And I took her to the doctor and that's what they thought it was, just a cold.

Presenter: But things turned bad quite suddenly. [Baby’s name] was airlifted to Brisbane hospital in a critical condition.

Mother of deceased baby: I heard [baby’s name] scream and I ran up. And we just stood there, alarms going off, everybody on deck, pumping your child. And as they count down, every minute, and they get to a minute, and they're yelling at you, going, 'Right, now she has permanent brain damage, now she has this, now she has that.' And you know it was just, it was horrific.

Father of deceased baby: It was horrific, it was horrific. It was your worst nightmare.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 12 Mother of deceased baby: All from something that was described to me as 'just a cold'. And five days later my baby's dead. It was … it just … It was a complete shock, yeah.

Father of deceased baby: It was that quick.

Presenter: At eleven days old, [baby’s name] was too young to be vaccinated. She had to rely on herd immunity for protection. But tragically, it failed her.

Mother of deceased baby: It's horrible to think … I killed my child by taking her into that school. It took me months, if not years to be able to walk through the school gates again without that voice in my head.

Presenter: That feeling of regret.

Mother of deceased baby: It's just that feeling of, if I had simply stayed home that day, she might be alive.

Paediatrician: I've been here for twenty-five years now, treated a lot of children with vaccine- preventable disease. There's a certain anti-authority, anti-mainstream view - the idea, in their heads, that vaccination is not a good thing. It is something which stems from their alternative lifestyle, and then it affects everyone around them.

Presenter: The anti-vaccination sentiment has been spurred on by bad publicity around vaccine side-effects.

A report in 1998 by British doctor [AW] linked the MMR, or Measles Mumps Rubella vaccine with autism.

Immunisation & Infectious Diseases Expert: I was living and working in the UK in the late nineties when the autism theory came along. It was really rubbish science, but it caught people's imagination, and particularly the anti-vaccination group swung in behind Dr [AW] and said, 'Oh, this must be true.'

Presenter: It took many years to prove his research was bogus. But the damage was already done.

Immunisation & Infectious Diseases Expert: It made people think that vaccines were unsafe, that their child could be dreadfully damaged. And so for a time, immunisation uptake in the UK of the MMR vaccine went down to about sixty per cent.

Presenter: This hasn't stopped the anti-vaccination lobby from drowning out the science.

Paediatrician: The messages are wrong, they have no truth in them, yet they're plausible. And people who aren't sure, could say, 'Well, on balance, I'm not going to vaccinate.' And that's been happening a lot.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 13 Immunisation & Infectious Diseases Expert: It's only around the corner, if we don't keep immunisation rates high, that epidemics can come back.

Presenter: The [mother and father of deceased baby] have since had another baby named [baby’s name]. [Mother’s name] tells me she's worked hard to ensure every new parent receives a warning about whooping cough.

Mother of deceased baby: That sticker now is going on every baby's health record book - saying, 'Watch out, whooping cough is about. Parents and Grandparents get a booster now.' Just those words may have changed my life.

Presenter: So even if this saves one life, it's been worth it.

Mother of deceased baby: Oh yeah. The reality is, these diseases kill, and that when they turn deadly, medicine can't stop them. There is no cure.

Presenter: Immunisation is one of the best defences we have against deadly epidemics. The fear now is that the tide of people reluctant to get vaccinated may see the re-emergence of diseases we once thought had been eradicated. Let's hope not.

Transcript: ‘Kawasaki Disease’, Catalyst

Presenter: It's an infectious disease that literally breaks the hearts of thousands of children worldwide, but we know surprisingly little about it, not even its cause.

Head of Cardiology, Royal Children’s Hospital Melbourne:

What the infection is? Don't know. Why some people are more prone to it? Don't know. And why people react to it and have a lot of damage to the coronary arteries, we don't really know.

Director, Kawasaki Research Centre: Kawasaki disease is a mystery that has grabbed the imagination of paediatricians all over the world.

Presenter: Medical research races to keep up as it spreads to every continent, and in many countries, it's on the rise.

Principal Research Fellow, Murdoch Children’s Research Institute: And fascinatingly it is increasing with rapid industrialisation. So as countries move from a rural to an industrial economy, there seems to be an explosion, if you like, of Kawasaki disease.

Presenter: It was first diagnosed in Japan by Dr Tomisaku Kawasaki in 1967. Now 88, Dr Kawasaki still hopes to reveal the secrets of the disease that bears his name.

After more than forty years of research, Kawasaki disease remains a mystery. We just don't know if it's a virus, or bacteria, or something else. But we do know it crosses oceans to be the most common cause of childhood heart

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 14 disease in the developed world, including Australia.

It's hard to believe that a few months ago, five-year-old [child’s name] was gripped by pain and fever. After a week of getting worse, his mum rushed him to hospital.

Child’s mother: By then I had to carry him, because he couldn't walk, and his eyes were bloodshot, and he still had a temperature of, it was now thirty-nine point something. They admitted him straight away.

Presenter: [Child’s name] is one of two hundred cases of Kawasaki disease recorded in Australia each year - mostly children less than five years old. If undetected in childhood, Kawasaki can lead to heart disease later in life.

Principal Research Fellow, Murdoch Children’s Research Institute: It's more common than meningococcal disease, and children with Kawasaki disease have very high fevers, up to forty degrees, and the fevers go on for days. So you need to have a fever for four or five days before you can actually make the diagnosis. They often have a bright red rash, red lips, red eyes - bloodshot eyes, swollen and painful hands and feet. And the older children will have a swollen gland in the neck, often.

Presenter: When the visible symptoms have faded away, the real worry is left hidden here, around the heart. Ironically it's the body's own defence system that does the damage. The disease attacks the coronary arteries that supply blood to the heart muscle by triggering an overreaction of the immune system. Cells of the immune system invade and inflame the artery walls. How to stop the damage? Dampen down the immune response, as quickly as possible.

Principal Research Fellow, Murdoch Children’s Research Institute: The only proven treatment for Kawasaki disease at the moment is immunoglobulin, which is an antibody taken from blood donors, so it's the sort of clear part of the blood, not the red part of the blood.

Presenter: Used within ten days of the infection, the immunoglobulin dramatically reduces the risk of heart damage and makes the fever disappear.

Child’s mother: And that's exactly what happened, they treated him and within twenty-four hours he was a different child. His bloodshot eyes had almost gone and his temperature had come right down to normal

Presenter: But that's not the end of hospitals for kids sick with Kawasaki disease. The next visit is an echocardiogram, an ultrasound to check for swollen arteries called aneurysms.

Head of Cardiology, Royal Children’s Hospital Melbourne:

The goal of the treatment is to protect the heart. We don't want the coronary arteries damaged, we want the heart muscle to be working as well as possible for a long life.

Presenter: In five per cent of cases, the treatment fails. This is an x-ray image of an aneurysm in a child, the potentially fatal impact of Kawasaki disease.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 15 Head of Cardiology, Royal Children’s Hospital Melbourne:

Yeah, unfortunately this one was probably the worst one that we've seen here for many years. And what you can see here is a very enlarged coronary artery through that section over a long distance. It's a bit like a river, if you've got a river bend, and a bit of a, a bank there, then the water swirls around it. Little clots may form there, and if those little clots then go out into the periphery and into these smaller blood vessels, it may cause temporary blockage of the blood supply, and cause the heart muscle to suffer because of that.

Presenter: And that can require surgery, something that [man’s name] and his mother know all too well.

Presenter: Here you are with heart man.

Mother: Hearty Heart, they call him.

Presenter: Back in 1994, [man’s name] caught Kawasaki disease and spent his seventh birthday in hospital.

Mother: Out of that he had this massive aneurysm in his heart, which … At that point I'd never really heard much … you don't sort of associate heart disease with children, really.

Presenter: What's that big black ball there?

Man: That's the aneurysm that you can see, and a typical coronary artery is three to four millimetres, and mine is eighteen millimetres.

Presenter: So it's really swollen up?

Man: Yes, it is. And eight millimetres is what they consider as a giant one.

Presenter: What do they call yours?

Man: A humongous one.

Presenter: By the time he was fourteen, young [man’s name] needed an adult-sized coronary bypass operation to save his life.

Principal Research Fellow, Murdoch Children’s Research Institute: I'm particularly interested in why some kids get sick and others don't, when really kids are exposed to the same bugs and triggers all the time.

Mother: I think there's a lot more out there, probably years and years ago there was a lot more that's just never been diagnosed.

Presenter: It looks like whatever causes Kawasaki disease is spread throughout the population. So the question is this - why do so few people catch it, when so many are exposed?

Principal Research Fellow, Murdoch Children’s Research Institute: There's good evidence that genetics plays a major role in deciding or determining who gets Kawasaki disease. For example, we know that Kawasaki disease is twenty times commoner in the Japanese than it is in Caucasians in Europe and in Australia. But when Japanese families move to

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 16 the US, which is a low-incidence country, their children have an incidence that is as high as it is in Japan, in fact it's slightly higher.

Presenter: Now there's a surprising twist in this story. New research has found not the cause of Kawasaki disease, but perhaps what it's carried by - the wind.

Director, Kawasaki Research Centre: There are no examples that I know of in human medicine where there has been trans-oceanic transport of a human pathogen carried by dust particles on the wind.

Presenter: [Director, Kawasaki Research Center] is speaking at the international conference on Kawasaki disease. What she has to say in a lecture called 'Blowing in the Wind' stuns the medical community.

Director, Kawasaki Research Centre: This will be a revolutionary new concept in transmission of human disease.

Presenter: Over the last forty years, when north-westerly winds blow over Japan, there are spikes in Kawasaki cases. That's remarkable in itself, but when the winds from Asia connect with winds crossing the North Pacific, there are epidemics on both sides of the ocean at the same time.

Director, Kawasaki Research Centre: If it's something that lofts up into these wind currents over the plains of Central Asia, and then can drop out of the sky on children in Japan, but then can also follow these wind portals across the Pacific Ocean, and then rain down on children here in the United States, and particularly here in Southern California, then it must have some kind of particle mass.

Presenter: Atmospheric scientists are flying high-tech sampling instruments above Japan in the hope of isolating what those particles might be.

Director, Kawasaki Research Centre: If it's in fact true that infectious agents can move around the planet on dust particles, that would also open up the possibility that anthrax or influenza or other infectious agents might also move around the planet that way too.

Presenter: This is a detective story with plenty of suspects. [Principal Research Fellow, Murdoch Children’s Research Institute] has a hunch of his own.

Principal Research Fellow, Murdoch Children’s Research Institute: I think it's more than one bug can act as the same trigger, and actually I suspect there might be two bugs acting at once.

Presenter: Research continues, but the answer to this mystery is elusive. Whatever the cause, getting the correct diagnosis as quickly as possible is crucial.

Principal Research Fellow, Murdoch Children’s Research Institute: And if you get fobbed off by your doctor or your emergency department and they haven't thought about it, as the fever gets beyond four or five days, just get them to consider Kawasaki disease.

Presenter: In the shifting winds of a changing world, a child's heart could depend on it.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 17 Appendix B

Considerations which the ACMA has regard to in assessing compliance with standard 2.2 of the Code

The following principles are applied by the ACMA in assessing content against the obligation in standard 2.2 of the Code: > The ACMA must assess whether the relevant statement would have been understood by the ordinary, reasonable viewer as a statement of fact or an expression of opinion. > The primary consideration would be whether, according to the natural and ordinary meaning of the language used and the substantive nature of the message conveyed, the relevant material presents as a statement of fact or an expression of opinion. > In that regard, the relevant statement must be evaluated in its context, i.e. contextual indications from the rest of the broadcast (including tenor and tone) are relevant in assessing the meaning conveyed to the ordinary reasonable viewer. > The use of language such as ‘it seems to me’, ‘we consider/think/believe’ tends to indicate that a statement is presented as an opinion. However, a common sense judgment is required as to how the substantive nature of the statement would be understood by the ordinary reasonable viewer, and the form of words introducing the relevant statement is not conclusive. > Inferences of a factual nature made from observed facts would usually still be characterised as factual material (subject to context); to qualify as an opinion/viewpoint, an inference reasoned from observed facts would usually have to be an inference of a judgmental or contestable kind. > While broadcasters are not required to present all factual material available to them, if the omission of some factual material means that the factual material presented is not presented accurately, that might amount to a breach of the clause. > The identity of the person making the statement would not in and of itself determine whether the statement is factual material or opinion, i.e. it is not possible to conclude that because a statement was made by an interviewee, it was necessarily a statement of opinion rather than factual material.

Considerations which the ACMA has regard to in assessing compliance with standards 4.1 and 4.2 of the Code

The following principles are applied by the ACMA in assessing content against the obligation in standards 4.1 and 4.2 of the Code: > Achieving impartiality requires a broadcaster to present content in a way which avoids conveying a prejudgement, or giving effect to the affections or enmities of the presenter or reporter in respect of what is broadcast. In this regard: > The ACMA applies the ordinary English meaning of the word ‘impartial’ in interpreting the Code. The Macquarie Dictionary (online Edition) defines ‘impartial’ as: ‘not partial; unbiased; just’. It defines ‘partial’ to include: ‘biased or prejudiced in favour of a person,

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 18 group, side, etc., as in a controversy’. ‘Bias’ is defined as: ‘a particular tendency or inclination, especially one which prevents unprejudiced consideration of a question’. > The ACMA considers that a helpful explanation of the ordinary English usage of the term ‘bias’ is set out by Hayne J in Minister for Immigration and Multicultural Affairs v Jia Legeng3 as follows:

‘Bias’ is used to indicate some preponderating disposition or tendency, a ‘propensity; predisposition towards; predilection; prejudice’.4 It may be occasioned by interest in the outcome, by affection or enmity, or, as was said to be the case here, by prejudgement. Whatever its cause, the result that is asserted or feared is a deviation from the true course of decision-making, for bias is ‘anything which turns a man to a particular course, or gives the direction to his measures’. > The relevant provision requires the ABC to ‘gather and present news and information with due impartiality’. Inclusion of the word ‘due’ indicates an element of flexibility depending on the particular context: for example, the gathering and presentation of factual information for a news bulletin may be materially different from an interview of a political figure, where challenging questions are ordinarily appropriate. > A perspective may be quite reasonably favoured if all the evidence supports it; it is only where the favouring is undue in some way that the Code is breached. > A program that presents a perspective that is opposed by a particular person or group is not inherently partial. Whether a breach of the Code has occurred will depend on the themes of the program, any editorial comment, the overall presentation of the story and the circumstances in which the program was prepared and broadcast. > Presenters and reporters can play a key role in setting the tone of a program through their style and choice of language. The manner in which a report is presented or reported can influence the conclusions that an ordinary reasonable listener would draw from a broadcast. > The nature of current affairs reporting requires reporters and presenters to be questioning, and at times sceptical, in their analysis of important issues. However, while probing and challenging questions may be used to explore an issue, programs must demonstrate a willingness to include alternative perspectives without prejudgement.

3 (2001) 205 CLR 507 at 563 [183] Gleeson CJ and Gummow J at 538 [100] agreeing. 4 Oxford English Dictionary (Second Edition), meaning 3(a).

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 19 Appendix C

Complainant’s submission In a letter of complaint to the ACMA dated 26 July 2012 the complainant submitted:

I am writing about the ABC’s response to my complaint to them in regards to the content of the Catalyst program called ‘Danger Zones’ and ‘Kawasaki Disease’. Their response was inadequate and didn’t address the details of my complaint. Their defence on this matter is that the ‘weight of evidence’ is on their side which allows them to be biased on this subject. They didn’t address the fact that they had compared Byron Bay with Ballina as their example of disease rates. Why didn’t they compare Byron Bay with the national average? They spent most of their reply discussing ‘Herd Immunity’ of which I didn’t address in my letter to them. They didn’t address the fact that no representative from the natural health industry was consulted during the program. Also, the ABC is not an independent organisation as they claim and they are heavily biased in favour of the AMA medical system. Not to mention, their strong left-wing favouritism on political issues.

In a letter of complaint to the ABC dated 2 July 2012 the complainant submitted:

The program targeted the Byron Bay area which was said to have a higher incidence of disease than that of Ballina. This is a pointless statement, because comparing one town with another town is cherry picking and too myopic to be of any consequence. Why didn’t they compare Byron Bay with the state average for example?

The answer to this question is that they are out to deceive the public about vaccinations and disease. Knowing how corrupt the medical system is, I wouldn’t be surprised if the doctors in Byron Bay have been told to report every small case of infection so as to increase the disease reporting rate for the area for the specific purpose of giving it a bad name and other propaganda purposes.

Note – the main cause of the vast majority of respiratory problems is consumption of dairy and sugar products. They used to call it Consumption (TB) in the old days but the medical authorities changed the name so that there would be a disconnect between cause and effect. They also did this with sugar diabetes, changing the name to diabetes so people wouldn’t know what the main cause was.

Note – diseases are generally diagnosed through ‘symptoms’. The so called ‘viruses’ are generally never seen. This allows medical authorities to makeup and allocate disease names at their pleasure.

The next story was called ‘Kawasaki Disease’. This disease was said to be a virus which infects young children. They highlighted the case by using a disease sufferer [child’s name] as their main story line. It should be noted that [child’s name] was sucking on a red ice block during the filming. I believe it is of no mere coincidence that one of the symptoms of this disease is red blotches which appear all over the body. It should be noted that red food colouring can have the same immune reactions as that of Kawasaki Disease. In fact, a bad diet in general would cause similar symptoms as shown on this documentary.

It should be noted that medical authorities never blame food preservative chemicals for any medical conditions or diseases.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 20 They also said the disease was carried on the wind from Japan to America. This must be a truly amazing disease to do this. I wonder why the disease waited to travel to America to only just recently? Is it because the disease didn’t have a passport yet? Why didn’t the disease travel to America last century? All these unanswered questions and so many serious scientists are working on these problems at our great expense. The program was one sided and didn’t address alternative view points from any natural therapy organisations.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 21 Appendix D

ABC’s submission In its response to the complainant dated 23 July 2012, the ABC’s submitted:

In light of your concerns, we have reviewed the reports against the ABC’s standards for impartiality [...].

On review of the report on vaccination, we note that its focus could reasonably be said to be the notion of herd immunity, explained by [Principal Research Fellow, Murdoch Children’s Research Institute] during the program as:

“... the means by which those who are vulnerable but not able to be vaccinated can still be protected, because so many people around them are vaccinated, and are immune. And so whenever a germ comes into a community, it keeps coming up against full stops, against barriers, and it can’t get to that one or two vulnerable children. For herd immunity to work, in terms of quite a few diseases, we need ninety-five percent immunity, so it’s really quite high.”

In considering whether impartiality has been achieved, the ABC is guided by a balance that follows the weight of evidence. Audience & Consumer Affairs consider that in this case, the presentation of the benefits of vaccination for herd immunity, along with its risks, was consistent with the weight of scientific evidence. While the program acknowledged that there are risks associated with vaccination (which is why it is still voluntary), we note that there is scientific and medical evidence in support of vaccination and its overall public health benefit.

This was borne out of the perspectives included in the report, which included a range of professionals operating in the areas of public health, academia and medical practice. We believe that Director of NSW North Coast Public Health [...], [Principal Research Fellow, Murdoch Children’s Research Institute] and [a Paediatrician] on the NSW North Coast, were suitably qualified to discuss the topic of vaccination and more specifically the concept of herd immunity, and that a range of perspectives was presented in keeping with the requirement of standard 4.2. Director of NSW North Coast Public Health [...] referred to vaccination rates in the North Coast areas of Ballina and Byron Bay, and this was a valid example to support his view about herd immunity. We note that the report did make clear that some people disagree with, and distrust, vaccinations. In addition, the ABC will continue to broadcast a range of perspectives on vaccinations over time and across ABC platforms and networks.

Your view on the cause of Kawasaki disease has been noted. Although you have raised concerns “they also said the disease was carried on the wind from Japan to America”, we note that this is not the case. The report included comment from [Director of Kawasaki Research Center] at the University of California, San Diego, who put forward the theory that Kawasaki disease might be carried by dust particles on the wind. It was made clear during the story that this was [her] theory, and we note that [she] is an eminent researcher in the field, who is well-placed to discuss the matter at hand.

ACMA Investigation Report – Catalyst broadcast by ABN on 17 May 2012 22