The relationship between voluntary organisations and pharmaceutical companies has been under the microscope lately. EMHF president Dr Ian Banks calls for an honest and open debate not hypocrisy, fear and hysteria.
Many voluntary groups (NGOs) depend to varying extents for their survival on support from the pharmaceutical industry. Recently this relationship attracted considerable attention not to mention downright condemnation claiming cynical industry manipulation for drug sales promotion.
One of the latest examples involved the initiative, Cancer United, a loose partnership of politicians, health professionals and voluntary groups, launched in Brussels 2006. Its undoubtedly laudable aim was to encourage EU member states to adopt a ‘cancer plan’ or strategy on early diagnosis, definitive treatment and effective management. At the launch a study was presented showing a fairly predictable link between the amount governments spend on cancer care and outcome. So far so good. Unfortunately one single journalist in one single newspaper in one single country (England) pointed out that both the initiative and the research required for the study was solely funded by a single pharmaceutical company. There had been no attempt to hide this relationship, indeed the eminent board members were made aware of the nature of the funding right from the onset. Key individuals, however, claimed ignorance and withdrew their support.
All this occurred soon after the Association of British Pharmaceutical Industries (ABPI) had announced detailed guidelines to be drawn up on the contractual transparency between UK voluntary groups and pharmaceutical companies financially supporting them. Both sides would in future need to publish the level of support and sign a contract defining the nature of the financial agreement as well as the percentage support it represented. This was broadly welcomed by health professionals, voluntary groups and industry representatives attending the discussion seminar.
Horror stories of all sides over-stepping the mark were inevitably recounted and much to the voluntary sector’s pleasure, the industry was criticised from the platform for ‘getting it (credibility) on the cheap’.
A number of other points were made however, which balanced the debate. The European armaments industry receives nothing but praise for its profits, the UK government routinely dishes out knighthoods to the ‘bringers of death and destruction’. Cluster bombs, whose major recipients are women and children, are apparently good business. Nobel Prize winning, life saving drugs on the other hand should be dished out for free by the pharmaceutical industry. It really does beg the question of which do governments give most priority? Similarly, subsiding the European tobacco industry accounts for € millions yet the costs of diagnosis, treatment and management for lung cancer is not deducted from the subsidy package.
Of course there are potential dangers inherent for voluntary groups with funding from any source, including government and there must be safeguards and checks to prevent abuse. But there is a danger of throwing the baby out with the bathwater. Without such funding much of the cutting edge work could not be done, not least because governments are notoriously reluctant to fund the voluntary sector unless it is politically advantageous to do so. Lessons to be learned include the need for multiple funding partners, preferably from diverse areas of industry, government or public donation. Transparency on both sides is vital not just a bolt on extra. Clear, published aims of the partnership posted on the web site or in the Annual Report along with the levels of finance are no longer ‘just a good idea’.
At the same time, voluntary organisations need to make a decision. If they are prepared to take the industry’s money they must also be prepared to acknowledge the value as well as the recognised dangers of doing so. What was painfully obvious from the Cancer United fracas was the singular lack of voluntary groups prepared to raise their heads above the parapet for fear of attracting similar criticism. Uncritical, sycophantic pandering to the industry is not an option. But then neither is accepting support with one hand while using the other to keep the mouth shut.
So where do we go from here? How and from what source should NGOs get their funding? Who determines what is acceptable funding and what is not? What criteria are to be used in such an exercise and who should select them?
The debate raises tough questions about charity governance and policy-development but we need to have this discussuion – and be seen to be having it – otherwise valuable public health initiatives could be threatened by misguided criticism.
What do you think?
