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BMJ raises concern over the "powerful sway" of industry ahead of UN health summit
(Feature: Will industry influence derail UN summit?)
http://www.bmj.com/cgi/doi/10.1136/bmj.d5328
(Commentary: UN high level meeting on non-communicable diseases: an opportunity for whom?)
http://www.bmj.com/cgi/doi/10.1136/bmj.d5336
Today the BMJ raises serious concerns about the "powerful sway" of tobacco, alcohol, food and drug industries as international governments prepare to agree global targets to cut avoidable deaths from chronic diseases.
In September, world leaders will meet at the United Nations in New York for a high level summit on non-communicable diseases (NCDs).
The meeting will focus on four conditions - heart disease, cancer, diabetes, and respiratory diseases - that together cause more than half of all deaths in low and middle income countries, yet account for less than 3% of global health aid.
They also share common risk factors - tobacco use, unhealthy diet, lack of physical activity and abuse of alcohol - making them largely preventable.
Hopes are high that the meeting will mark a turning point in tackling these diseases, but in a special report published today, BMJ investigations editor, Deborah Cohen asks: could commercial interests undermine any commitments made at this crucial meeting?
For many, the evidence is clear - there needs to be a reduction in exposure to the risk factors - but negotiations appear to be stalling, writes Cohen.
Heavily annotated draft documents have been circulating among the various member states for many months. Each change is marked with the names of the countries, flagging up where the fracture lines are. The latest version - dated 5 August - is being kept under wraps. The BMJ has, however, seen a copy.
An NCD Alliance meeting this month suggested that "member states are deeply divided on key issues." Of particular concern, they say, are the "actions of the US, Canada and the European Union to block proposals for the inclusion of an overarching goal: to cut preventable deaths from non-communicable diseases by 25% by 2025."
Many organisations are also worried that industry interests might be undermining action to prevent and treat NCDs.
A key sticking point is the call for "partnerships" in current draft documents. Some believe this is the wrong strategy and argue that legislation is needed, rather than simply a "voluntary" code that is unlikely to hold industry to account.
Indeed, draft documents show that effective, evidence-based measures on alcohol (controlling price, availability and marketing) are being deleted, and industry favoured measures (partnership working, community actions and health promotion) being substituted. Even commitments to tackling tobacco are being watered down, with Japan, the EU, US and Canada resisting all language on taxation.
WHO Director General, Dr Margaret Chan, has warned that many threats to health come from powerful corporations, driven by commercial interests.
Bill Jeffery from International Association of Consumer Food Organisations, says that the UN and WHO need to put up firewalls between their policy-making processes and the alcohol and food companies "whose products stoke chronic diseases" and the drug and medical technology companies "whose fortunes rise with every diagnosed case."
This view is supported in an accompanying commentary by David Stuckler and colleagues, who argue that "much of the NCD agenda is being written by powerful vested interests."
They point out that, at a preparatory meeting in New York, representatives of the United States and Europe - with key Western allies - blocked consensus on NCD action after lobbying from the alcohol, food, tobacco and pharmaceutical industries.
Should the industries that profit on disease-causing products be viewed as trusted partners and have a seat at the table during public health negotiations, they ask?
The UN high level meeting on NCDs "is a battleground, pitting public interests against powerful private ones," they conclude. "Whether the meeting encourages the emergence of a global social movement for change will shape the future of our health for years to come."
Contact:
David Stuckler, University Lecturer in Sociology, Department of Sociology, University of Cambridge, UK
Email: ds450@cam.ac.uk