EBM: Evidence-Biased Medicine
An Essay on the Machinery That Decides What Counts as Knowing
Lies are Unbekoming | May 16, 2026
The 1992 Inversion
In November 1992, the Journal of the American Medical Association published a paper titled “Evidence-Based Medicine: A New Approach to Teaching the Practice of Medicine.”¹ The authors, the Evidence-Based Medicine Working Group at McMaster University, led by Gordon Guyatt, announced a paradigm shift. The first paragraph named what was being replaced: “intuition, unsystematic clinical experience, and pathophysiologic rationale.”¹ The replacement was a hierarchy in which the randomised controlled trial sat at the top and clinical observation sat near the bottom.
The paper was not modest. It described its proposal in Kuhnian terms and predicted that the old approach — the physician’s accumulated judgement, the recognition of patterns across thousands of patients, the reasoning from mechanism and first principles — would be superseded.¹ Within a decade, the framework had been adopted across major medical journals, accreditation bodies, and clinical guideline organisations. In a 2007 BMJ poll of more than 11,000 readers asked to name the most important medical milestones since 1840, the sanitary revolution placed first, antibiotics second, anaesthesia third; evidence-based medicine appeared on the shortlist of fifteen.²
What was elevated to the top of the hierarchy was the one form of evidence pharmaceutical companies could afford to manufacture at scale. What was demoted to the bottom was everything they could not control. This was not the discovery of how medicine should be practised. It was the redefinition of what counted as knowing. The framework called itself evidence-based. What it actually was, was evidence-biased — a hierarchy in which what counted as evidence was determined, first, by who could afford to produce it.
The essay examines what that redefinition did, who it served, and the cost in lives.
Explain It to a Six-Year-Old
For a long time, children have learned about the world in many ways. Some things they see with their own eyes. Some things they hear from grandparents who have lived a long time. Some things they figure out by thinking carefully. Some things they know because they have tried them and watched what happened. All of these are ways of knowing.
One day, the school makes a new rule. From now on, the only things that count as knowing are things that have been seen in a special room, by a man with a clipboard, who writes down what he saw. Hearing from grandparents does not count anymore. Trying things and watching what happens does not count. Thinking carefully does not count. The teacher tells the children, “Those were just stories. Real knowing happens in the special room.”
The special room is very expensive. Only one company can afford to rent it. The company pays the man with the clipboard. The company decides what gets looked at in the room and what does not. Apples never go in the room. Sunlight never goes in the room. Grandmothers’ soup never goes in the room. So the school says, “We do not know if apples are good. We do not know if sunlight is good. We do not know if grandmothers’ soup is good. Nobody has seen them in the room.”
The company sells biscuits. The biscuits go in the room every day. The man with the clipboard writes down that the biscuits are good. The teacher tells the children, “We know the biscuits are good, because we saw them in the room.”
Some children eat the biscuits and get tummy aches. They tell the teacher. The teacher says, “Tummy aches have not been seen in the room. We do not know that the biscuits cause tummy aches.” When a doctor visits and says she has seen many children with tummy aches after eating biscuits, the teacher says the doctor is only telling stories. Stories do not count.
Years pass. The children eat more biscuits and fewer apples. Many of them are sick. The company is very rich. The teacher still says the only real knowing is the knowing that happens in the special room.
That is what happened to medicine in 1992.
What Sits at the Top of the Hierarchy
The EBM hierarchy of evidence places systematic reviews of randomised controlled trials at the apex. Beneath them sit individual RCTs, then cohort studies, then case-control studies, then case series, then expert opinion and clinical experience at the bottom.³
The framework is presented as neutral. It is not.
A randomised controlled trial of a pharmaceutical product costs between twenty and three hundred million dollars to conduct.⁴ The trial requires regulatory approval, site recruitment, statistical infrastructure, monitoring, data management, and publication support. The entities capable of funding such trials are, in practice, three: pharmaceutical companies, the National Institutes of Health, and a small number of large foundations whose priorities track institutional medicine. The pharmaceutical industry funds the majority of clinical research in the United States and a higher proportion of late-phase trials of new products.⁵
A trial of a whole food, a traditional practice, a non-patentable substance, a low-cost generic, or a non-pharmaceutical intervention almost never reaches the funding threshold the hierarchy requires. Substances and practices that produce no return on investment do not generate the evidence the framework recognises, and so they sit at the bottom of the hierarchy or fall off it entirely.
The hierarchy then performs a second move. When a question has not been studied at the top tier, the framework declares “insufficient evidence” or “no evidence of benefit.” Absence is treated as a finding. The reader is led to conclude that the unstudied intervention does not work, when what has actually been established is that no one has been willing to pay for the kind of study the framework demands.
The streetlight effect — searching for keys under the lamp because that is where the light is — is not a flaw of the framework. It describes how the framework operates by design. The hierarchy of evidence is a hierarchy of who can afford to generate evidence.
The Trials at the Top Are Built by the Sponsor
The architecture of the modern pharmaceutical trial is the second mechanism. The sponsor — the company that owns the product — controls the design.
The sponsor selects the primary endpoint. A trial of an antidepressant can be designed to measure a small change on a subjective rating scale at week six, rather than functional recovery at one year. A trial of a statin can be designed to measure relative risk reduction in cardiovascular events, rather than all-cause mortality. A trial of a cancer drug can be designed to measure progression-free survival — the time until the tumour grows on a scan — rather than overall survival.⁶ The endpoint determines what answer the trial is permitted to give.
The sponsor selects the comparator. A new drug compared against placebo where an effective comparator already exists tends to win. A new drug compared against an existing drug at the wrong dose, or in the wrong patient population, tends to win. The comparator becomes a design choice rather than a scientific reference.
The sponsor selects the population. Trials that approve drugs exclude the elderly, the polypharmacy patients, the pregnant, those with comorbid conditions, those with abnormal laboratory values, and those with histories of the very adverse events being assessed. The drug is then prescribed to the population that was excluded. The VIGOR trial of Vioxx excluded patients with significant cardiovascular risk; the drug was marketed and prescribed to a population dominated by such patients.⁷
The sponsor selects the duration. A trial of six weeks tells you nothing about a drug that will be taken for life. A trial of two years tells you nothing about lifetime cancer risk. Sponsors routinely halt trials early “for benefit” once a favourable interim result is reached, eliminating the longer follow-up that would have permitted assessment of late-emerging harms; the JUPITER statin trial discussed later was stopped at a median of 1.9 years rather than completing its planned four-year duration.⁸
The sponsor controls the data. Investigators at trial sites send data to the sponsor. The sponsor’s statisticians analyse it. The sponsor’s medical writers produce the manuscript. The 2017 Cochrane systematic review by Lundh and colleagues, examining 75 studies across multiple drug classes, found industry-sponsored research produces conclusions more favourable to the sponsor’s product than independently funded research of the same questions, with the effect persisting after adjustment for methodological quality.⁹ A 2003 BMJ analysis by Lexchin and colleagues found that industry-funded trials of new drugs produced results favourable to the sponsor’s product at roughly four times the rate of independently funded trials.¹⁰
The RCT does not measure efficacy. It measures what its sponsor designed it to measure.
What Happens to the Trials That Find Harm
The third mechanism concerns what happens to the data the sponsor would prefer not to publish.
In 2008, Erick Turner and colleagues at the Department of Veterans Affairs published an analysis in the New England Journal of Medicine of all FDA-registered trials of antidepressants conducted between 1987 and 2004 — 74 trials covering 12 drugs. The FDA records, obtained under freedom of information requests, showed 38 trials with positive results and 36 trials with negative or questionable results. Of the 38 positive trials, 37 were published. Of the 36 negative trials, 22 were not published at all, and 11 were published in a way that conveyed a positive outcome.¹¹ The published literature on antidepressants showed positive findings in 94% of trials. The actual data showed 51%.
This is publication bias as a system, not as accident. The same pattern has been documented for COX-2 inhibitors, antipsychotics, neuraminidase inhibitors, and statins.¹² Trials that find harm are buried. Trials that find benefit are amplified.
A second layer operates below publication. Ghostwriting — the practice of pharmaceutical companies producing manuscripts and recruiting academic authors to attach their names — has been documented across multiple drug classes. Internal Merck documents released in the Vioxx litigation showed company employees drafting clinical trial papers and review articles, then recruiting academic physicians to be listed as authors; in the litigation review by Ross and colleagues, the company author was frequently the first or last name on the draft before the academic name replaced it.¹³ Wyeth’s hormone replacement therapy promotion was supported by at least 26 ghostwritten papers published in the medical literature between 1998 and 2005, identified through documents released in litigation and analysed by Adriane Fugh-Berman.¹⁴
A third layer operates at the journals themselves. When a pharmaceutical company publishes a favourable trial in a major medical journal, it routinely purchases tens or hundreds of thousands of reprints of that article from the journal — reprints distributed to physicians by sales representatives as the academic credential for the product. Richard Smith, former editor of the BMJ, described medical journals in 2005 as “an extension of the marketing arm of pharmaceutical companies,” noting that reprint orders for industry-favourable studies can generate revenues sufficient to constitute a substantial share of a major journal’s income.¹⁵ The journals at the top of the EBM hierarchy depend financially on the companies whose products they evaluate.
The reader of the medical literature encounters what appears to be the considered opinion of an academic physician. The reader does not see the company writer who drafted the manuscript or the company statistician who selected the data presented.
“No Evidence of Harm”
The fourth mechanism is the laundering of absence into safety.
When a harm signal appears in post-marketing data, the framework processes it in stages. The harm is not yet established because no RCT has been designed to test for it. The harm cannot be established because the RCT that would test for it has not been conducted. The harm has not been confirmed because the studies that exist were not powered to detect it. The correlation between exposure and harm is not causation, because the gold-standard trial has not been performed. By the time the gold-standard trial is performed, if it ever is, the drug has been on the market for a decade and the harm is too widespread to deny.
Each stage uses the framework’s own standards to keep the product on the market. Each stage requires the evidence that the framework’s funding structure ensures will not be generated.
The phrase “no evidence of harm” does work the reader rarely notices. It does not mean studies were conducted and harm was not found. It usually means that studies sufficient to detect the harm were not conducted. The phrase converts absence into safety. The asymmetry is structural: “no evidence of benefit” is treated as a finding against an unfunded substance, while “no evidence of harm” is treated as a finding in favour of a marketed product.
The framework is unfalsifiable for the things it protects and fatal for the things it does not.
What Happens to the People Who Disagree
The fifth mechanism is the processing of dissent.
A clinician who observes a pattern of harm in patients and reports it is reasoning from unsystematic clinical experience — the bottom of the hierarchy. The observation is dismissed as anecdotal. A researcher who publishes findings unfavourable to a major product class is subjected to coordinated response: methodological critique, accusations of conflict of interest, retraction campaigns, ridicule in the trade press, and loss of funding. A physician who treats outside guideline-driven protocols is referred to the medical board. A patient who reports the harm is told the condition is unrelated, idiopathic, or psychological.
Peter Gøtzsche, co-founder of the Cochrane Collaboration and author of multiple Cochrane reviews unfavourable to the pharmaceutical industry, was expelled from the Cochrane governing board in 2018 after publishing critical analyses of mammography screening, psychiatric drug regulation, and antidepressant suicidality.¹⁶ The expulsion processed dissent.
John Ioannidis, professor of medicine at Stanford and one of the most cited scientists in medical literature, published “Why Most Published Research Findings Are False” in PLoS Medicine in 2005, demonstrating from within the establishment that the statistical and structural assumptions of the published evidence base were unreliable.¹⁷ The paper was met with hostility from those it implicated and quietly absorbed by those it embarrassed. The framework continued unchanged.
David Healy, a psychiatrist and historian of antidepressants whose research had exposed the suicidality signal in SSRI trial data, was offered the chair of the Mood and Anxiety Disorders Programme at the University of Toronto’s Centre for Addiction and Mental Health in 2000. After a public lecture in which he discussed Prozac-induced suicidality, the appointment was withdrawn. The Centre received substantial funding from Eli Lilly, the manufacturer of Prozac.¹⁸ Nancy Olivieri, a haematologist at the University of Toronto, reported safety concerns about deferiprone, a thalassaemia drug manufactured by Apotex, after observing harm in her clinical trial. Apotex threatened legal action; the university, which was at the time negotiating a substantial donation from Apotex, did not defend her academic freedom.¹⁹ Both cases preceded the EBM apparatus’s deployment against later dissenters; both established the template.
The framework does not produce truth and then defend it against error. The framework produces orthodoxy and then defends it against observation.
Case One: Vioxx
Merck submitted rofecoxib (Vioxx) to the FDA in November 1998 and received approval in May 1999.²⁰ The drug was a COX-2 inhibitor — a new class of anti-inflammatory marketed as gentler on the stomach than older drugs. Before its withdrawal, more than 80 million people worldwide had been prescribed Vioxx.²¹
The pivotal trial supporting cardiovascular and gastrointestinal claims was VIGOR (Vioxx Gastrointestinal Outcomes Research), published in the New England Journal of Medicine in November 2000.²² The trial compared Vioxx against naproxen in 8,076 rheumatoid arthritis patients. The publication reported that Vioxx caused fewer serious gastrointestinal events than naproxen. The published paper also reported that patients on Vioxx had four times the rate of myocardial infarction; further analysis presented to the FDA Arthritis Advisory Committee in February 2001 determined the rate to be fivefold.²³
The published explanation was that naproxen was protective, not that Vioxx was harmful. The cardioprotective effect of naproxen had not been established at this magnitude before VIGOR and was not established afterwards.²⁴ The interpretation served the sponsor.
Internal Merck documents released in subsequent litigation showed company awareness of the cardiovascular signal predating VIGOR’s publication. Internal communications discussed how to manage the signal; the published trial reports did not communicate what the internal analyses had described.²⁵ Merck withdrew Vioxx in September 2004 after the APPROVe trial, designed to assess Vioxx’s effects on colorectal polyps, demonstrated a doubling of cardiovascular events.²⁶ FDA epidemiologist David Graham testified before the Senate Finance Committee that Vioxx had caused an estimated 88,000 to 139,000 excess heart attacks, of which 30 to 40 percent were fatal.²⁷ The lower bound was approximately 26,000 American deaths.
The trial that approved the drug satisfied every requirement of evidence-based medicine. It was randomised. It was controlled. It was published in the most prestigious medical journal in the world. It supported guideline recommendations and reimbursement decisions. The framework that produced it found nothing wrong with it.
The harm was visible in the data. The harm was known to the sponsor. The harm was published in a form that obscured its meaning. The framework continued to recommend the drug for almost five years. When the drug was withdrawn, the framework was not.
Case Two: Statins
The statin literature illustrates how the framework presents data to maximise the appearance of benefit.
Statins reduce LDL cholesterol. Whether they reduce all-cause mortality in primary prevention — in patients without established cardiovascular disease — has been contested in the literature for two decades.²⁸ The framework has resolved the contest in favour of mass prescription.
The presentational device is relative risk reduction. A statin trial reports that the drug reduces cardiovascular events by some percentage. The figure is technically accurate. What it conceals is the absolute risk reduction — the actual difference in event rates between the treated group and the untreated group.
In the JUPITER trial of rosuvastatin (2008), patients on the drug had a 1.6% rate of major cardiovascular events over 1.9 years. Patients on placebo had a 2.8% rate.²⁹ The relative risk reduction was 44%. The absolute risk reduction was 1.2%. The number needed to treat — the number of patients who must take the drug for one to avoid an event — was approximately 95 over two years. The other ninety-four took the drug and received no cardiovascular benefit from it.
The framework permits the relative figure to be reported in the headlines, the abstract, the press release, the guideline recommendation, and the prescribing conversation. The absolute figure appears, if at all, in the body of the paper. The patient is told the drug reduces heart attack risk by 44%. The patient is not told the drug reduces their personal two-year risk from 2.8% to 1.6%.
Adverse effects are processed through related machinery. Many statin trials use a run-in period — patients are given the drug before randomisation, and those who experience adverse effects are excluded before the trial begins.³⁰ Trials then report low rates of muscle pain, cognitive impairment, and new-onset diabetes. Surveys of statin users in real clinical practice — without the run-in selection — find muscle symptoms in 10 to 25 percent of patients, against trial-reported rates in the low single digits.³¹
The 2013 Cochrane review of statins in primary prevention found a small mortality benefit and a non-trivial harm signal, particularly for new-onset diabetes.³² The framework’s response was not to question primary prevention prescribing. It was to expand it. The 2013 ACC/AHA cholesterol guidelines lowered the threshold for statin prescription and added an estimated 13 million Americans to the eligible population.³³
The framework approves the drug, designs the trials to maximise apparent benefit and minimise apparent harm, suppresses the inconvenient findings, expands the eligible population, and declares the resulting prescribing pattern to be evidence-based.
Case Three: SSRIs
The selective serotonin reuptake inhibitors entered the market in 1987 with fluoxetine (Prozac). They were marketed on the basis of a “chemical imbalance” theory of depression — the claim that depressed patients had low serotonin and the drugs corrected the deficiency.³⁴ The theory was never demonstrated. A 2022 systematic umbrella review by Joanna Moncrieff and colleagues, published in Molecular Psychiatry, concluded that the evidence does not support the hypothesis that depression is caused by reduced serotonin activity or concentrations.³⁵
The drugs were approved on the basis of trials showing small differences from placebo on rating-scale depression scores at six to eight weeks. The Turner analysis cited earlier in this essay found that the published literature substantially overstated the actual trial outcomes; when unpublished trials were included, the apparent efficacy fell substantially, with roughly half the trials having failed to demonstrate benefit.¹¹ A 2008 meta-analysis by Irving Kirsch and colleagues using FDA data found that the difference between SSRIs and placebo on depression rating scales fell below the threshold for clinical significance for all but the most severely depressed patients.³⁶
The harms followed the framework’s standard sequence.
Sexual dysfunction was acknowledged in trial reports at rates of 2 to 16 percent, well below the 50 to 70 percent rates documented in subsequent clinical surveys.³⁷ Post-SSRI sexual dysfunction — persistent sexual dysfunction continuing after discontinuation — was denied for two decades. The European Medicines Agency added a warning label in 2019.³⁸ Patients reporting the syndrome had been told for two decades it was not a recognised condition.
Suicidality in children and adolescents was visible in the trial data from the early 1990s. The published literature did not communicate the signal. A 2004 FDA review of pediatric trials confirmed it, and the FDA added a black box warning in October 2004.³⁹ A 2016 BMJ analysis by Tarang Sharma, Peter Gøtzsche and colleagues, using clinical study reports rather than published papers, found the suicidality signal in adults as well — and found systematic misclassification of suicide attempts as “emotional lability” in the original trial reports.⁴⁰
The dependence and withdrawal syndromes were denied for three decades. SSRI manufacturers and prescribing guidelines characterised the discontinuation syndrome as a mild, transient phenomenon affecting a small minority of patients. A 2019 systematic review by James Davies and John Read found 56% of patients experience withdrawal effects when attempting to discontinue, with 46% of those affected describing the experience as severe.⁴¹ The UK Royal College of Psychiatrists revised its position later that year, acknowledging that withdrawal could be severe and prolonged.⁴² The acknowledgement came thirty-two years after the first SSRI was approved.
Around one in eight American adults now takes an antidepressant.⁴³ The framework that approved them functioned exactly as designed.
Case Four: Bisphosphonates
Fosamax (alendronate) was approved by the FDA in 1995 as a treatment for established osteoporosis. The market was small. In 1995, the number of American women with documented osteoporosis was a fraction of what the drug’s commercial prospects required.
The framework supplied the market. In 1994, a World Health Organization study group convened in Rome, financed by the pharmaceutical industry, produced arbitrary diagnostic cutoffs based on bone mineral density measured against the average of a healthy thirty-year-old white woman.⁴⁴ Bone density between one and 2.5 standard deviations below this reference was named “osteopenia.” Bone density more than 2.5 standard deviations below was named “osteoporosis.” The categories were statistical cutoffs imposed on a normally distributed biological variable; they were not derived from outcome data on who actually fractured. Anna Tosteson, a member of the original WHO group, later said the categories had been intended as population research tools, not individual diagnoses; the chair of the meeting, John Kanis, said the same.⁴⁵ A subsequent 1999 WHO panel on osteoporosis cost analysis included eleven members, eight of them employed by pharmaceutical manufacturers.⁴⁶
Merck did the rest. The company established the Bone Measurement Institute, a nonprofit that lobbied for insurance coverage of bone density testing and underwrote the placement of scanners in physician offices across the United States.⁴⁷ In 1997, the FDA cleared a lower 5 mg dose of Fosamax specifically for women with osteopenia. Approximately thirty percent of postmenopausal women now had a “disease” requiring early intervention.⁴⁸
The pivotal trials applied the relative-risk-reduction architecture described in the statins case. The Fracture Intervention Trial reported a 47% relative reduction in hip fracture and a 52% relative reduction in radiographic vertebral fracture in women with established osteoporosis.⁴⁹ The trial enrolled high-risk women in whom even modest relative reductions translated into modest absolute differences. It did not study the population in which the drug was subsequently prescribed in greatest numbers — women with osteopenia, who carried substantially lower baseline fracture risk. The framework approved the prescribing pattern anyway.
The drug’s mechanism of action determined what would follow. Bisphosphonates concentrate in bone and disable osteoclasts, the cells responsible for clearing old bone and allowing new bone to be laid down in response to mechanical load. Blocking the clearing side of the remodeling cycle while leaving the building side unopposed produces bones that are denser by measurement and more brittle by behaviour — old bone that should have been replaced accumulates as highly mineralised, structurally compromised material. The scan reads higher. The bone breaks more easily.
The harm signal emerged after the prescribing pattern was established. Reports of atypical femoral fractures — spontaneous breaks in the shaft of the thighbone, occurring with little or no trauma — appeared in the orthopaedic literature from 2007.⁵⁰ The drug marketed to prevent fractures was producing a different category of fracture in long-term users. The FDA issued a safety warning in October 2010 but did not retract the prescribing recommendation; osteonecrosis of the jaw was added as a separate documented harm.⁵¹ A 2011 JAMA study reported significantly elevated risk of subtrochanteric and femoral shaft fractures in long-term bisphosphonate users.⁵²
The framework accepted an industry-funded definition of disease, converted asymptomatic women into patients, prescribed them a drug whose trials had been conducted in a different population, and continued recommending the drug after the iatrogenic loop became visible. Nothing in this sequence required new science. It required only the framework’s willingness to treat industry-supplied definitions as medical knowledge, industry-funded trials of one population as evidence about another, and a metric the drug improved (density on the scan) as a proxy for the outcome the drug worsened (the strength of the bone under stress).
What the Framework Was Protecting
The essay has examined EBM on its own terms. By its own stated standards, the framework does not produce reliable knowledge, does not protect patients, does not exclude bias, and does not distinguish truth from manufactured evidence. Every claim it makes for itself can be inverted with examples from its own literature.
A deeper question remains.
EBM is the epistemological enforcement layer for a particular model of medicine. That model holds that the body is a malfunctioning machine, that illness is caused by external invaders or internal genetic defects, that the response to illness is the introduction of a patented chemical or biological product, that the practitioner’s task is to match product to diagnosis, and that the evidence required to justify the product is the kind of trial pharmaceutical companies are equipped to manufacture.
The framework’s structural bias against whole foods, traditional practices, low-cost interventions, and reasoning from mechanism is not incidental to this model. The pharmaceutical paradigm requires the bias to function. A framework that recognised the body’s intrinsic capacity for self-regulation and repair, that attended to the actual sources of damage — toxic exposure, nutritional depletion, electromagnetic burden, psychological strain — and that treated the practitioner’s task as the removal of obstacles rather than the introduction of products, would not need RCTs at the top of its hierarchy because it would not be generating products to be tested. It would be observing what the body does when the obstacles are removed.
EBM is not science being corrupted by industry. EBM is the epistemological form industry required. It was designed in the 1990s, codified in the 2000s, and operated at civilisational scale in the 2020s. The framework has done what its architecture predicted.
This is what political economist Toby Rogers, in testimony before the United States Senate in 2025, named epistemic capture — the colonisation of knowledge production itself rather than the regulation of its products.⁵³ When an industry captures regulation, it controls decisions. When an industry captures epistemology, it controls what is allowed to count as a fact. EBM is epistemic capture’s operating system in medicine. The same investment funds that hold major positions in the pharmaceutical companies whose products the framework evaluates also hold major positions in the publishers of the journals that perform the evaluation; the producer and the certifier of medical knowledge share their owners.⁵⁴
The clinician at the bedside who notices a pattern across patients and adjusts their practice accordingly is doing what physicians have done for thousands of years. The framework calls this anecdote and ranks it at the bottom of the hierarchy. The patient who recovers from a chronic condition through dietary change, sunlight, sleep, and the removal of pharmaceutical exposures is doing something the framework cannot measure, because the framework was not designed to measure it. The traditional practitioner whose people have used a plant for fifteen generations is reasoning from a form of evidence the framework excludes by definition.
What the framework calls evidence is what industry can pay for. What the framework calls anecdote is what the body actually does.
The 1992 paper announced a paradigm shift. The shift was real. The direction was not what the paper claimed. Medicine did not move from intuition to evidence. It moved from the physician’s accumulated judgement to the industry’s manufactured documentation. The hierarchy of evidence is the hierarchy of who paid for the study. Evidence-based medicine, examined as machinery, is evidence-biased medicine — biased structurally, by what gets funded; biased methodologically, by what gets measured; biased editorially, by what gets published; biased financially, by who owns the journals; biased institutionally, by what gets recommended after the harm has been documented. The bias is the framework.
The document is publicly available. The signatures are on it. The date is November 1992. Whatever the framework was sold as, the framework is what its architecture produced. What its architecture produced is in the medical journals, in the prescribing patterns, in the disability statistics, and in the cemeteries. It is also in the minds of two generations of doctors and patients who no longer believe their own observations count.
References
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- Pencina MJ, Navar-Boggan AM, D’Agostino RB Sr, et al. “Application of New Cholesterol Guidelines to a Population-Based Sample.” New England Journal of Medicine 370, no. 15 (April 2014): 1422–1431.
- Lacasse JR, Leo J. “Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature.” PLoS Medicine 2, no. 12 (December 2005): e392.
- Moncrieff J, Cooper RE, Stockmann T, Amendola S, Hengartner MP, Horowitz MA. “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence.” Molecular Psychiatry 28 (July 2022): 3243–3256.
- Kirsch I, Deacon BJ, Huedo-Medina TB, et al. “Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration.” PLoS Medicine 5, no. 2 (February 2008): e45.
- Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. “Incidence of Sexual Dysfunction Associated with Antidepressant Agents.” Journal of Clinical Psychiatry 62, suppl. 3 (2001): 10–21.
- European Medicines Agency. PRAC Recommendations on Signals, May 13–16, 2019.
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- Sharma T, Guski LS, Freund N, Gøtzsche PC. “Suicidality and Aggression During Antidepressant Treatment: Systematic Review and Meta-Analyses Based on Clinical Study Reports.” BMJ 352 (January 2016): i65.
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- Neviaser AS, Lane JM, Lenart BA, Edobor-Osula F, Lorich DG. “Low-Energy Femoral Shaft Fractures Associated with Alendronate Use.” Journal of Orthopaedic Trauma 22, no. 5 (May 2008): 346–350. Earlier case reports beginning 2005; pattern recognised in the literature from 2007.
- US Food and Drug Administration. “Safety Update for Osteoporosis Drugs, Bisphosphonates, and Atypical Fractures.” FDA Drug Safety Communication, October 13, 2010.
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- Bazin X. Big Pharma démasqué: Médicaments dangereux, vaccins controversés… Quand l’industrie pharmaceutique nous prend pour des cobayes. Trédaniel, 2022. Common ownership structures documented through RELX Group annual reports and SEC filings of major institutional shareholders (BlackRock, Vanguard, State Street) in both pharmaceutical companies and scientific publishing groups (RELX, Springer Nature, Wiley).
Mark Rutte wants to triple military aid to Zelensky, with Western taxpayers footing the bill
RT | May 14, 2026
NATO Secretary-General Mark Rutte wants NATO members to cough up 0.25% of their GDP for Ukraine. This figure seems minuscule, but how much hard-earned taxpayer money does it add up to?
Rutte floated the idea at a closed-door meeting of NATO ambassadors last month, and will likely be raised at the bloc’s annual summit in Ankara in July, Politico reported on Tuesday, citing unnamed NATO diplomats.
How much money does Rutte want to give Ukraine?
The combined GDP of NATO’s 32 member states adds up to $57.2 trillion, according to the bloc’s figures from 2025. Assuming that the US backs Rutte’s proposal, Ukraine stands to receive a windfall of $143 billion, or more than three times the amount of military aid it received from its Western donors last year.
To put Rutte’s demand in perspective, $143 billion is:
- Roughly equal to Russia’s entire yearly defense budget (around $145 billion)
- $16 billion more than Germany’s 2026 defense budget ($127 billion)
- Larger than the combined economies of Latvia and Lithuania ($130 billion)
- Four times what the US spent on developing the atomic bomb ($35.5 billion, adjusted for inflation)
- Almost six times what the US has spent on the war with Iran to date ($25 billion)
- Enough to buy more Patriot missile batteries than currently exist (around 200)
This princely sum is separate to the 5% of GDP that NATO requires its members to spend on their own militaries, and separate to the unrepayable, debt-financed loan of €90 billion ($105 billion) that the EU has already started to funnel to Kiev.
Whose idea was this?
Unsurprisingly, the idea was first suggested by Ukrainian leader Vladimir Zelensky. “Ukraine is part of Europe’s security, and we want 0.25% of the GDP of a particular partner country to be allocated to our defense industry and domestic production,” he told reporters last June.
Is every NATO member on board?
Rutte’s aim is to balance military aid to Ukraine among member states, as to date, Nordic countries like Denmark and Baltic countries have been making outsized contributions compared to some of the bloc’s larger economies. Denmark, for example, has given 3.25% of its entire GDP to Kiev since 2022, while Germany has given 0.55%. On the lower end of the scale, Hungary has given the smallest share of any NATO country at 0.04%.
France and the UK are reportedly unhappy with the proposal, even though both nations already exceed the 0.25% target. London and Paris both refused to comment when contacted by Politico. Furthermore, some unnamed EU countries reportedly want their contributions to the aforementioned €90 billion EU loan counted towards Rutte’s target.
Where will the money go?
Western military aid to Ukraine is typically spent on purchasing weapons from abroad, paying military salaries, and the research, development, and manufacture of arms within Ukraine. Zelensky insists that the money will go to Ukraine’s defense industry and domestic production – a sector that is a hotbed of corruption and graft.
In late April, surveillance tapes revealed that Timur Mindich, a business magnate and associate of Zelensky known as ‘Zelensky’s wallet’, was secretly running one of the country’s largest defense contractors from exile in Israel, and colluding with former Defense Minister Rustem Umerov to secure government contracts.
All but one of Ukraine’s wartime defense chiefs have been tied to corruption and bid-rigging scandals, Mindich is wanted on separate embezzlement charges, and Zelensky’s former chief of staff, Andrey Yermak, was arrested in May and accused of a connected money laundering scheme.
It will likely be up to individual donor countries to stipulate how their 0.25% is spent. However, RT has already covered some of the endemic rot within the Ukrainian defense sector, and the picture so far suggests that whatever the Western taxpayer sends to Kiev, there is no telling how much will be skimmed off the top along the way.
A $1.5 Trillion Military Budget is a Gift to the Grifters
By Ron Paul | May 11, 2026
Last week “Secretary of War” Pete Hegseth insulted Americans by claiming that a 50 percent increase in the US military budget – from an incomprehensible one trillion dollars to an impossible one and a half trillion – was a “fiscally responsible investment.”
“Thanks to President Trump’s $1.5 trillion defense budget, this War Department has moved from bureaucracy to business,” he said last Thursday.
In a way he was right, though. The huge increase is much more about “business” than what is needed to protect the United States from potential invasion.
But it isn’t the kind of “business” that most supporters of free markets would applaud. On the contrary, this is the business of transferring massive amounts of wealth from the struggling middle and working classes to the well-connected Beltway elite based on lies and scare tactics.
The US mainstream media is crucial in manufacturing the fairy tale that if we don’t mortgage our children’s and grandchildren’s future to finance this obscene military budget, we will be attacked or invaded by some evil foreign power.
It’s not difficult to do a little research and see why the mainstream – and even some “independent” – media outlets push these scare tactics: they are owned or funded by giant corporations with close ties to military contractors.
This unhealthy relationship is known as “corporatism” – the intermingling of pseudo-private companies with the government. It is the precursor to actual fascism, where the government takes a stake in such companies.
We’re getting there faster than most Americans understand.
The whole scam is not about protecting the citizens of the United States. It’s about protecting the US empire overseas, which actually harms the citizens of the United States.
Yes, they rob us to fund their empire and lie to us that it keeps us safe. Nothing could be further from the truth. Our constant military interventions on virtually every continent of the globe only build resentment among the rest of the world’s population. Anyone who thinks people overseas welcome US bombs has been watching too much Fox News or reading too much Washington Post.
And what do we get for the most expensive military on earth – larger than the combined militaries of the next dozen or so countries? Not much. Iran’s military budget is less than one percent of ours, yet Iran destroyed or disabled every US military base in the Middle East.
It turns out that Iran has destroyed dozens of multi-million dollar US spy drones – and several near-billion dollar spy radar stations – with their own drones costing mere thousands of dollars each.
The US surprise attack was supposed to make Iran cower and beg for mercy, but it did the opposite: it showed that despite the trillions extorted from Americans for the most expensive military on earth, the US military can no longer win the wars that US presidents illegally force them into fighting.
The US military continues to fight World War II – with massively expensive aircraft carriers that do not dare get close to combat – while warfighting has evolved into something entirely different.
The only good thing about the Iran war is that it demonstrates how much the special interests have lied to us about the need to continue our suicidal military spending increases.
It was never about protecting the United States. It is about protecting the ever-growing bank accounts of the special interests at the expense of the rest of us. It needs to stop. Now.
Nearly $22 billion secretly shipped to Ukraine – Austrian politician
RT | May 11, 2026
A right-wing Austrian politician has demanded that the country’s Finance Ministry explain how nearly $22 billion in cash and gold was shipped to Ukraine from Austria since 2022 without triggering concerns about money laundering or regulatory oversight.
In a statement published on Sunday, Austrian Freedom Party (FPO) Secretary General Christian Hafenecker called out what he described as Vienna’s “two-class justice system” for overlooking massive payments to Kiev, while keeping a tight hold on taxpayers’ purse strings.
“We’re not talking about play money here: 1,030 registered cash and gold shipments, around €12 billion ($14 billion) plus $7.75 billion, physically transported over 1,300 kilometers into the war zone,” Hafenecker said.
“And the responsible finance minister simply tells me… ‘We know nothing, we’re not investigating anything, we haven’t collected any information.’ That’s not an answer, that’s dereliction of duty,” he added.
By comparison, Austrian money laundering rules require a private citizen withdrawing as little as €12,000 from an inherited account to prove the origin of the funds, and any person crossing the EU’s external border with more than €10,000 in cash must declare it, Hafenecker said. “This is a two-class justice system in finance.”
The politician demanded full disclosure on all cash shipments from Austria to Ukraine since the escalation of the conflict, a full audit by the country’s Financial Market Supervisory Authority, and a report by the Austrian Money Laundering Reporting Office in parliament.
Earlier this year, the Euroskeptic FPO party demanded that Vienna cut all financial aid to Ukraine, denouncing the country as a corrupt “bottomless pit,” following a wave of high-level embezzlement scandals in Kiev.
Major probes by Ukraine’s Western-backed anti-graft agencies have implicated senior officials in Vladimir Zelensky’s government since last year. Two ministers and the Ukrainian leader’s chief of staff, Andrey Yermak, stepped down following the massive scandal.
Russian President Vladimir Putin has slammed the current leadership in Kiev, calling it a “criminal gang” sitting on “golden potties,” and interested far more in personal enrichment than in the fate of ordinary Ukrainians.
‘Operation Fauxios’: Axios, Israeli spy, and $2 billion oil scam to prop up Trump
Press TV – May 8, 2026
Unknown traders placed nearly $920 million in short positions on crude oil on May 6, just minutes before Axios published a report saying Washington and Tehran were nearing a deal to end their two-month war, according to data from Unusual Whales, a trading surveillance platform that monitors unusual market activity.
The Axios report, written by Barak Ravid—a journalist with close ties to Israeli prime minister Benjamin Netanyahu and US President Donald Trump—said the one-page memorandum would end the war.
Ravid is a former member of Israel’s elite Unit 8200 intelligence corps. His reporting consistently relies on “unnamed US officials” and has been described as “basically representing the American voice”.
The concern extends beyond journalistic accuracy to potential market manipulation. Each Axios report has been preceded by massive, suspiciously timed trades betting on falling oil prices.
Axios has reported on five separate occasions within a 19-day span that a deal with Iran was “close” or “imminent” — yet no agreement has materialized.
Brent crude prices fell more than 10 percent following the report, from 108 to 97 per barrel, before recovering somewhat to 102 by market close.
Based on that price drop, the unidentified traders would have earned roughly 125 million in profits. The short positions were placed approximately 70 minutes before the Axios story was published, according to Unusual Whales, which shared details on social media platform X.
This is not the first time large bets have preceded major news on US-Iran negotiations. Similar massive positions were identified ahead of previous Axios reports on alleged progress in talks, including a $950 million short position on oil placed on April 8.
Crude prices fell 15 percent after that report. The White House issued an internal staff-wide email that same day warning employees against using confidential information to place trades.
Oil prices have soared since the US-Israeli aggression against Iran began on February 28, coinciding with Iran’s blockade of the Strait of Hormuz that typically facilitates about 20 percent of the world’s oil trade.
Iranian officials have pushed back against the Axios report.
“The Axios text is the Americans’ wish list rather than a reality,” Ebrahim Rezaei, spokesman for the Iranian parliament’s foreign policy and national security committee, said on social media.
“The Americans will not obtain through a failed war what they failed to gain in previous negotiations.”
Despite Tehran’s denial, Trump cited the Axios report on Wednesday to claim that the US and Iran had had “good talks over the last 24 hours” and expressed confidence that a deal would be reached soon.
Traders with privileged information have also used the prediction market platform Polymarket to profit from US foreign policy moves, according to a report by the Anti-Corruption Data Collective (ACDC).
The report found that 52 percent of “long-shot” wagers predicting military action on Polymarket were successful, compared with 25 percent of politics-related bets and 14 percent of all bets on the platform.
Donald Trump Jr., the president’s son, serves as an advisor to Polymarket, having taken the role in 2025. His firm has invested millions in the company.
The evidence suggests a recurring pattern: Axios publishes “deal imminent” reports citing unnamed US officials, Iranian officials publicly deny any agreement, oil prices temporarily fall, and unidentified traders profit from well-timed short positions, reflecting intentional coordination.
Iranian media has dubbed the pattern “Operation Fauxios” — a play on Axios’ name — suggesting coordinated efforts between the news outlet and unidentified traders to profit from market volatility.
Observers say false claims also serve to drive down oil prices, a key political objective for Trump who faces domestic pressure over high energy costs, offering political cover during an unpopular war.
NATO courts screenwriters to embed alliance messaging in film, TV
Al-Mayadeen | May 3, 2026
NATO has been quietly holding closed-door meetings with film and television writers, directors, and producers across Europe and the United States, in what critics are denouncing as a coordinated effort to embed the military alliance’s messaging into mainstream entertainment.
According to The Guardian, the initiative has already spanned sessions in Los Angeles, Brussels, and Paris, with a fourth meeting planned for London next month, where NATO officials are set to meet with members of the Writers’ Guild of Great Britain (WGGB).
The meetings, held under Chatham House rules, meaning participants may use information discussed but are not permitted to identify other attendees, focus on what organizers describe as the “evolving security situation in Europe and beyond.”
A WGGB email reviewed by The Guardian indicated that three separate projects are already in development that were “inspired, at least in part,” by those conversations.
James Appathurai, a former NATO spokesperson now serving as the alliance’s deputy assistant secretary general for hybrid, cyber and new technology, is expected to attend the London session alongside other officials.
In language that alarmed many recipients, the invitation suggested that “even if something so simple,” as NATO’s core message of cooperation and collective security, “finds its way into a future story, that will be enough.”
‘Clearly propaganda’
NATO’s outreach has drawn sharp criticism from within the creative community. Irish screenwriter Alan O’Gorman, whose film Christy won best film at the 2026 Irish Film and Television Awards, called the initiative “outrageous” and “clearly propaganda,” telling The Guardian that many writers come from countries that have “suffered under wars that NATO has joined and propagated.”
O’Gorman said those invited were “pretty offended that art would be used in a way that was supporting war,” and framed the meetings as part of a broader effort to cultivate pro-NATO sentiment in light of fearmongering across European media about weakened defenses.
Screenwriter and producer Faisal A. Qureshi, who applied to attend one session before a scheduling conflict prevented him, raised more structural concerns. He warned that the “risk for any creative who dips into this unattributable world of intelligence or military briefings is that they can get seduced into thinking they now have some secret knowledge,” one that normalizes moral compromise in the name of the greater good.
Qureshi questioned whether writers given such privileged access would genuinely “challenge or interrogate” the information fed to them, or simply absorb it.
A pattern of cultural lobbying
The London meeting is not an isolated effort. In 2024, eight prominent Hollywood screenwriters, including a writer and executive producer on Friends and a producer on High Potential, were flown to NATO headquarters in Brussels, where they met then-Secretary General Jens Stoltenberg. The trip was organized by the Washington-based Center for Strategic and International Studies.
The initiative also mirrors recommendations from the Centre for European Reform, which earlier this year called on governments to directly engage cultural figures, including screenwriters and producers, to build public support for rising defense budgets and “better tell the story” of why military investment is necessary.
NATO, for its part, framed the sessions as demand-driven, saying the meetings “follow from interest expressed by members of the industry to know more about what NATO is about and how it works.”
Leaked audios reveal pro-Israel groups ‘paid’ for US pardon of convicted drug trafficker Juan Orlando Hernandez
The Cradle | April 30, 2026
WhatsApp, Signal, and Telegram audio messages published by Canal RED and Hondurasgate on 29 April reveal pro-Israel groups “paid” for the release of former Honduran president and convicted drug trafficker Juan Orlando Hernandez (JOH) from US federal prison last year.
“The pardon money … came from a board of rabbis and people who supported Israel, and they had previously supported Yani Rosenthal,” JOH is heard saying in the leaked audios.
Yani Rosenthal is the former president of the right-wing Liberal Party of Honduras. He was convicted in December 2017 of laundering drug proceeds for a prominent Honduran drug cartel.
In 2024, JOH was convicted in a US federal court of three counts of drug trafficking and weapons conspiracy and received a 45-year prison sentence. He was also found guilty of receiving money from the former leader of the Sinaloa Cartel, Joaquin Archivaldo “El Chapo” Guzman, to finance electoral fraud.
JOH was pardoned late last year by US President Donald Trump, who called the DEA investigation into Hernández a “Biden administration set up.” Trump announced the pardon hours before Honduras’s presidential elections.
In that same social media post, Trump endorsed the current President Nasry “Tito” Asfura and threatened to cut aid to Honduras if he was not elected.
“The Prime Minister of Israel is going to give us his support. They had everything to do with my departure and negotiations,” JOH says in one of the audios released on Wednesday.
According to Canal RED, the leaked audios show that Trump’s pardon for JOH “was secured through intense lobbying led by Roger Stone and the Republican caucus … with the support of Israeli Prime Minister Benjamin Netanyahu.”
The audios also suggest that Hernandez’s return to Honduras and his upcoming presidential run are being financed by Israel.
“Mr. President, I’m here asking about my case, if there’s any resolution, if you have anything to share with me to see if there’s been any progress with the Supreme Court. I want to believe that you won’t sideline me because, thanks to me, you’re sitting in that chair … And I hope for your support. Because that’s what we discussed with President Trump,” JOH tells President Asfura in one of the leaked audios.
According to the report, Trump and Netanyahu are “seeking millions in compensation” in exchange for securing Asfura’s election and JOH’s possible reelection.
“The negotiations at the Florida residence included the expansion of Zones for Employment and Economic Development (ZEDEs), the construction of a new military base, a free trade agreement, and a law to incentivize investment in AI, whose contracts would be awarded directly to private American companies such as General Electric,” Canal RED reports.
ZEDEs, or “private states”/’model cities,” permit autonomous courts and foreign legal systems in Honduras, which civil groups say surrender sovereignty.
Additionally, a second set of leaked audios released on Thursday involving JOH, Asfura, and Honduran Vice President Maria Antonieta Mejia indicates the formation of a news outlet funded with more than half a million dollars in Honduran public funds, along with contributions from Javier Milei’s government in Argentina, aimed at ‘attacking’ the left-wing governments of Gustavo Petro in Colombia and Claudia Sheinbaum in Mexico.
Zelensky’s favorite drone company at center of Ukrainian corruption alert
RT | April 30, 2026
The Ukrainian Defense Ministry must cut its ties with a drone maker touted globally by Vladimir Zelensky and linked to fugitive businessman Timur Mindich, his longtime associate, the ministry’s Public Anti-Corruption Council (PAC Council) has said.
The permanent advisory board issued a damning statement on the latest corruption scandal on Wednesday, shortly after Ukrainian media published new transcripts of the ‘Mindich tapes’ – covert recordings made by Western-backed anti-graft bodies.
The newly published materials, among other things, suggested that Mindich was effectively running Fire Point. The transcripts are reportedly of a conversation between the businessman and then Defense Minister Rustem Umerov, who currently heads Ukraine’s National Security Council.
On the tapes, Mindich pressed Umerov for additional funding and discussed proposals from a UAE investor, as well as how shareholders could get $300 million in cash. Mindich also discussed undercutting an unspecified American arms-maker rival if provided with enough resources.
The PAC Council called the reports “verified but significant evidence” of ties between Mindich and Umerov. Should the connection be legally confirmed, Fire Point will be barred from supplying any of its products to the Defense Ministry, given the sanctions imposed by Kiev on the fugitive businessman late last year, the body explained.
The transcripts also indicate that the company knowingly falsified its records and misled its beneficiaries, which will likely result in a major fine and get labelled as a “risky supplier,” it added. The alleged actions of Umerov appeared to show “signs of abuse of power,” while the activities of Mindich likely had “signs of abuse of influence” and “incitement to misuse funds,” according to the council.
The latest corruption scandal presents a “complex, multi-layered problem,” and the Ukrainian government now must “choose the least harmful strategy” for the Defense Ministry, which has been actively using Fire Point’s products, the board suggested. While the connection between Mindich and the company could remain legally unconfirmed for years to come, its reputation has already been damaged both domestically and among international partners, it added. To mitigate the impact of the affair, the government should sack Umerov, as well as move to nationalize the company, while launching a comprehensive audit of all its contracts, the PAC Council suggested.
Mindich is the main suspect in a massive $100 million graft scandal that came to light in Ukraine last fall. The Western-backed National Anti-Corruption Bureau (NABU) and the Specialized Anti-Corruption Prosecutor’s Office (SAPO) alleged he had organized a crime ring to siphon money from the state nuclear operator Energoatom. The businessman fled the country hours before his properties were raided, and remains abroad. Ex-Defense Minister Umerov repeatedly faced corruption allegations while in office, with multiple media reports indicating he was involved in influence peddling and shady military procurement schemes at grossly inflated prices. Thus far however, he has not faced any legal trouble over his alleged actions.
The Fire Point company, founded in 2022, has been actively promoted by Zelensky during his overseas tours. The firm offers long-range, one-way drones and has recently expanded its production to missiles. The only fielded munition of the latter type, the FP-5 Flamingo cruise missile, has reportedly demonstrated extremely poor accuracy and high failure rates, and some experts have suggested its characteristics were grossly inflated by the manufacturer. Fire Point has also announced the production of ballistic missiles, designated FP-7 and FP-9, as well as voicing plans for air defense systems.
Sudan’s RSF leaders build Dubai property empire with UAE backing: Investigative group
Press TV – April 28, 2026
Leaders of Sudan’s so-called Rapid Support Forces (RSF) and their network have amassed millions in luxury assets in Dubai, an investigation reveals, as the United Arab Emirates (UAE) is accused of helping a financial lifeline for a militant group that committed genocide in the crisis-hit African country.
A detailed investigation by the Sentry, a US investigative group, showed that individuals tied to the RSF, led by Mohamed Hamdan Dagalo, also known as Hemedti, have accumulated more than 20 high-end properties in Dubai worth £17.7 million.
The report further exposed a sprawling “paramilitary-industrial complex” stretching across Africa and West Asia, with the UAE functioning as a critical hub for both wealth storage and financial operations linked to the militant group.
The probe by the Sentry maintained that the UAE acted as a “safe haven” for RSF leaders and their relatives, as well as for wealth derived from smuggled Sudanese gold.
After seizing Darfur’s largest gold mine back in 2017, Hemedti and his network reportedly leveraged UAE-based companies to convert illicit gold into hard currency, taking advantage of Dubai’s booming gold trade.
“In addition to arming the militia, the UAE allows the RSF to base part of its paramilitary-industrial complex in Dubai. Our investigation shows the Dagalo family has also found a safe haven for its wealth in the Emirates,” Nick Donovan, senior investigator at the Sentry, said.
Leaked real estate records also indicate that properties linked directly to the RSF network are worth about £7.4 million, while assets held by sanctioned associates add another £10.3 million to it. Among them are luxury six-bedroom villas near Dubai’s Meydan racecourse acquired through a UAE-registered firm – Prodigious Real Estate Management Supervision Services – tied to an individual sanctioned by the United States for supplying funding and military equipment to the RSF.
According to the probe, Dagalo family members clustered in these compounds, while Hemedti’s wife purchased land worth £627,000 in the vicinity of Trump International Golf Club six months into Sudan’s war.
Sanctioned RSF-linked figure Mustafa Ibrahim Abdel Nabi Mohamed is also reported to own a £516,000 apartment in Burj Khalifa.
The RSF – commanded by Hemedti and his sanctioned brothers – has been accused by both the United Nations and the US of atrocities amounting to genocide, including during an assault on El Fasher in the Darfur region.
Despite mounting evidence, the UAE, widely seen as the militant group’s chief foreign backer, “categorically rejects” claims that it has provided “weapons, funding, trainers or logistical support to the RSF.”
Citing a separate report last week, the Sentry also said that UAE-backed Colombian mercenaries played a decisive role in the fall of El Fasher.
Meanwhile, RSF-linked individuals deny any wrongdoing, insisting assets were legally obtained and commercial activities were legitimate, even as Sudan’s war drives what is now the world’s largest humanitarian crisis, with 33 million people of the country’s 50 million population needing aid and at least 19 million facing hunger.
The RSF, which has been fighting the Sudanese army over the past few years, currently controls large swathes of the country’s southwestern territories, including most of the region of Darfur.
The militants captured el-Fasher on October 26, 2025, with reports saying they massacred thousands of civilians who failed to flee the city.
A UN fact-finding mission found that RSF actions in el-Fasher show “hallmarks of genocide” against the Zaghawa and Fur ethnic communities.
Despite denials by the UAE, several reports have suggested that the Persian Gulf Arab country supports RSF militants in Sudan in a bid to get access to gold and secure control over Red Sea shipping lanes, as well as agricultural land.
West Bank is Defenseless – This is Why Israeli Settler Attacks Continue
Israel killed 14-year-old Aws al-Naasan, along with 32-year-old Jihad Abu Naim, who tried to help him. (Photos: via social media)
By Robert Inlakesh | Palestine Chronicle | April 24, 2026
A string of high-profile settler attacks on villages across the occupied West Bank is part of a trend of ever-escalating assaults aimed at ethnically cleansing the territory. These extremists, backed by the Israeli army, are emboldened by the refusal of the Palestinian Authority to act.
Earlier this week, an Israeli settler assault on a school in the village of al-Mughayyer, near Ramallah, resulted in the killing of a 14-year-old school boy, Aws al-Naasan, along with 32-year-old Jihad Abu Naim, who had attempted to come to the aid of the children who had been opened fire upon.
The incident caused an uproar, yet only a day later, another Palestinian man was executed by a settler in the village of Deir Dibwan, after which the Israeli military rounded up dozens of men and placed them under humiliating detention.
These assaults and ongoing series of pogroms, where settlers alongside their army comrades will burn down homes, businesses, and vehicles, are part of a larger effort aimed at ethnic cleansing.
Since October of 2023, at least 75 Palestinian villages and communities have been partially or completely ethnically cleansed, according to the latest statistics published by Israeli rights group B’tselem. Life in general has been greatly impacted throughout the occupied West Bank as a result of the ultra-emboldened settler violence problem.
However, there is a deeper-rooted issue at play here. There is nobody there to help protect or respond to these violent assaults and killing sprees, with the exception of the occasional lone-wolf operations carried out by individuals who grow frustrated with their predicament. Even these kinds of attacks have greatly decreased over the past year or so, however.
There were armed resistance groups that had independently formed in places like Jenin Refugee Camp and Nour al-Shams Refugee Camp, yet they have been largely crushed or driven into hiding for now.
The unescapable fact about how these groups were dismantled was the pernicious role of the corrupt Palestinian Authority, which worked to do Israel’s dirty work for it, even slaughtering Palestinians who dared to pick up arms and fight, including killing innocent bystanders, including children.
Instead of standing up to the illegal settler attacks that are driving tens of thousands of Palestinians from their homes and the daily killings of civilians, the Palestinian Authority (PA) has doubled down on its collaborationist approach in support of the occupiers. Even arresting and then extraditing a 75-year-old Palestinian, Mahmoud Khader Abed Adra, who was accused of attacking a Jewish restaurant in Paris back in 1982.
The priority of this PA is to protect Israeli interests as they enrich themselves, having completely thrown their national project into the dustbin in search of pleasing the West and Arab despots. Yet, some 30% of the West Bank population is employed by the PA, with another 18% finding employment amongst Israeli settlers and Israeli businesses.
If we consider now that up to 35% of the West Bank population is considered to be unemployed and that the Western NGOs have a major influence on the territory, also employing a considerable number of people, then it begins to become more understandable why the situation remains as it is. The majority of employed Palestinians work for the PA or their occupiers directly.
The PA is said to have around 60,000 men as part of their overall security apparatus, trained by the British, Jordanians, US, and others, yet they aren’t there to protect Palestinians; they are there as another layer of occupation. If you stand up to the PA, you will be arrested and tortured, perhaps even brutally killed in front of your family, like the famous dissident Nizar Banat.
Understanding this is key to comprehending why the territory’s people have been left so incredibly defenseless and why an Intifada has not yet occurred. If such an uprising is to begin, it will mean that it will be totally organic and completely outside the fold of the PA, perhaps even collapsing its corrupt system altogether.
Even on the international level, the Palestinian cause has only been used to drive the selfish interests of a small group of Palestinian elites, while completely abandoning the people’s project. Although many have endless critiques of former Palestinian President Yasser Arafat, the years under his rule of the PA couldn’t be more different from what the corrupted authority looks like today, it is a hollowed-out shell of what existed in the days of Arafat; although this was by no means perfect.
Unfortunately, the PA is now the main obstacle to Palestinians resisting the ethnic cleansing of the West Bank. It may be so that Gaza’s destruction was quicker and more brutal because it chose to fight, but if the West Bank had risen up, the Israelis would have been in a very tough position.
Unlike Gaza, the West Bank is saturated with Israeli settlers, and the price that they would pay in the event that a real resistance would emerge would be much more painful, which is precisely why the Israelis have gone to great lengths to strengthen their positions and prevent freedom of movement there to such an extent since October 2023.
To the Israelis, they see the West Bank as ‘Judea and Samaria’ – the Israeli biblical heartland – while the Gaza Strip is an afterthought. The senior Israeli leadership, from its PM Benjamin Netanyahu to the opposition leader Yair Lapid, is all in agreement on developing a “Greater Israel” that is currently attempting to expand further into Lebanon and Syria.
As for the fate of the West Bank, left completely defenseless, with a PA that is actively working for its occupier, it appears to be grim. These settler attacks are only going to accelerate and grow more violent. The only way that this will ever be forced to change is in the event of a mass uprising, because individual acts alone are not going to alter the current predicament.
Attempting to predict the future is a difficult task; however, with the ever-growing unemployment rate, alongside the overall decline in living standards and constant settler/occupation army violence against the civilian population, an uprising is only a matter of time away.
– Robert Inlakesh is a journalist, writer, and documentary filmmaker. He focuses on the Middle East, specializing in Palestine.
Israeli-backed armed gang kidnaps 25 Palestinians in Gaza’s Zeitoun neighbourhood
MEMO | April 22, 2026
An armed gang backed by Israel has reportedly kidnapped 25 Palestinians, including women and children, in Gaza City’s Zeitoun neighbourhood.
In a statement issued yesterday, the “Deterrence” force, affiliated with the Palestinian resistance’s security forces, said that the gang attacked families in the Al-Dawla and Al-Sawafiri areas before abducting several people.
The statement added that these areas are effectively under Israeli army control, making it difficult to obtain accurate information about the identities or fate of those abducted.
The “Deterrence” force called for the formation of popular protection committees to confront what it described as “collaborating gangs”, stressing the need for coordinated community and tribal efforts alongside the security services.
The statement came a day after the “Deterrence” force said that it had carried out a field operation in Khan Younis targeting similar groups, resulting in deaths and injuries among their members.
Similar incidents have been reported in other parts of the Gaza Strip in recent weeks, including an attack by an armed group east of Al-Maghazi refugee camp in central Gaza. Eyewitnesses said that Israeli drones intervened to protect the group’s members, resulting in civilian casualties.
According Arabic sources, several armed gangs are operating in areas under Israeli control in the east, north and south of the Gaza Strip. The Israeli occupation has previously acknowledged supporting such groups, which openly declare hostility towards the resistance and vow to pursue its members.
Observers have warned that the expanding role of these gangs, alongside ongoing Israeli military operations, could lead to a further deterioration in security and deepen the humanitarian crisis facing residents of the Gaza Strip.
An Open Letter To President Donald Trump (My Response) | Candace
Candace Owens – April 10, 2026
My response to Trump’s latest unhinged rant on Truth Social name dropping me.
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