Tag Archives: Food industry

Conflicts of Interest at the UN Noncommunicable Disease Summit? Bingo.

Just in advance of the United Nations High Level Meeting on the Prevention and Control of Non-communicable Disease, a coalition comprising more than 140 nongovernmental and public health organizations has called on the UN to restructure the way in which the food and beverage industry has been involved in the policy negotiations.   

Photo by Christian Cable / Wikimedia Commons

The Conflicts of Interest Coalition (COIC) describes itself as a group of “civil society organizations united by the common objective of safeguarding public health policy-making against commercial conflicts of interest through the development of a Code of Conduct and Ethical Framework for interactions with the private sector.” 

The COIC sent a Statement of Concern to the President of the United Nations General Assembly and the UN summit’s facilitators, decrying the lack of clarity regarding the role of the private sector in public policy-making in relation to the prevention and control of non-communicable diseases (NCDs).  

“Since the major causes of preventable death are driven by diseases related to tobacco, unhealthy diet, physical inactivity and alcohol drinking, we are concerned that many of the proposals to address NCDs call for ‘partnerships’ in these areas with no clarification of what this actually means. Public-private partnerships in these areas can counteract efforts to regulate harmful marketing practices,” the COIC wrote.

Calling industries “both part of the NCD problem and the solution,” the COIC believes industry should be involved in the implementation of policy but not its development. To that end, the group’s Statement offered two proposals:

First, a change in the nomenclature of nongovernmental organizations (NGOs) to distinguish between those that are industry-supported and those that are strictly civil society: “Business-interest-not-for profit organizations (BINGOs) and public interest nongovernmental organizations (PINGOs).

Second, a “code of conduct” that sets out a clear framework for interaction with the food and beverage industry and managing conflicts of interest, differentiating between policy development and implementation. 

“We ask for the UN to consider our comments and take them into account for the UN High Level Meeting in September,” the COIC wrote in the Statement, a version of which was published Sept. 16 online in The Lancet.  

Indeed, food industry lobbying is believed to have played a role in the removal of specific targets and indicators for reductions in salts, sugars, and saturated fats from earlier versions of the Political Declaration that will be voted on at the UN High-Level meeting, but it is probably too late to change that document since the vote is expected to take place Monday morning, according to Ann Keeling, chair of the Noncommunicable Disease Alliance (NCDA), the leading NGO that pushed for the Summit.

Ann Keeling photo courtesy of the International Diabetes Federation

However, she told me in an email, there will be time to address the conflict of interest issue in 2012, when the UN will be making decisions on both the establishment of partnerships as well as targets and indicators.

“The view of the NCDA is that the private sector, subject to ethical frameworks on conflict of interest, must be part of the solution, especially in implementation. We believe there should be a ‘triple partnership’ going forward – public/private/people with NGOs being the people and with far greater involvement from global to community level of people with NCDs.”

–Miriam E. Tucker (@MiriamETucker on Twitter)

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Filed under Cardiovascular Medicine, Endocrinology, Diabetes, and Metabolism, Epidemiology, Family Medicine, Health Policy, IMNG, Internal Medicine, Pediatrics, Primary care, Pulmonary Diseases and Sleep Medicine, Uncategorized

Is Global Health Funding Fair?

Leaders in the noncommunicable disease community often state that international donor spending on chronic conditions such as heart disease, diabetes, and cancer far underrepresents their burden in developing countries. Now, a new report from the nonprofit Center for Global Development provides stark data to back up the claim.

Photo by Lawrence OP via Flickr Creative Commons

“Where Have all the Donors Gone? Scarce Donor Funding for Non-Communicable Diseases” examines the trends in public and private donor resources from 2004 to the present. The work was supported by PepsiCo.

Contrary to widespread belief, the impact of chronic, noncommunicable diseases (NCDs) exceeds that of infectious/communicable disease in the developing world as well as the developed. In 2008, NCDs contributed 48% to morbidity and mortality in developing countries, compared with 39% from infectious diseases (with the remainder due to injury). For mortality, those proportions were 59% vs. 31%, according to World Health Organization (WHO) data quoted in the report.

At a panel event held at the CGD’s headquarters in Washington last week, report coauthor Rachel A. Nugent, Ph.D., said $503 million was spent on NCDs in 2007, accounting for less than 3% of the $22 billion in total development assistance for health. In contrast, nearly a third of the total — $6.3 billion — was devoted to HIV, tuberculosis, and malaria.

By disease burden, this works out to less than one U.S. dollar – just 78 cents – per disability-adjusted life year (DALY), compared with $23.9/DALY for the three infectious diseases. “That’s fairly staggering. … It’s a significant disparity in level of effort,” Dr. Nugent commented.

Approximately 15% of health funding in low-income countries comes from external donor sources. The WHO contributed the greatest amount in 2007, $812 million. Other top donors include the Wellcome Trust UK, the World Bank, the Bloomberg Family Foundation, and the Gates Foundation.

Funding for noncommunicable disease will be the focus of a high-level United Nations NCD Summit scheduled for September 2011. The idea is not to take away money from infectious disease, Dr. Nugent said.

Rather, “I hope that growing attention to this issue stays focused on achieving greater health for the money that’s being invested already and additional money that may eventually be invested to increase flexibility in health delivery across sectors and across health conditions, because I think that’s where we’re going to get the most bang for the buck and the best development results.”

Dr. Rachel Nugent and Dr. Derek Yach / Photo by Miriam E. Tucker

And why is PepsiCo interested in this? I asked the company’s senior vice president for global health policy Dr. Derek Yach, who also spoke at the CGD event. His reply: “We are committed to addressing major nutritional and other underlying causes of ill health and NCDs as part of a broad commitment to health and the environment. It is in our long term interests and represents a convergence between opportunities for PepsiCo to build a profitable business based on healthy products.”

-Miriam E. Tucker (@MiriamETucker on Twitter)

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Filed under Cardiovascular Medicine, Endocrinology, Diabetes, and Metabolism, Family Medicine, Health Policy, IMNG, Infectious Diseases, Internal Medicine, Oncology, Primary care, Uncategorized