With increasing scrutiny over the dire health consequences of sugar-sweetened beverages, soda manufacturers have turned to obscuring the science, confusing the consumer, and sponsoring medical organizations whose recommendations influence both providers and patients. Unfortunately these corporate partnerships are conflicts of interest that undermine the credibility of the organizations and stymie reform.
Patient information website FamilyDoctor.org has information about diabetes and recommendations for a healthy diet nestled neatly next to an advertisement for Coca-Cola.
Most notably, the American Academy of Family Physicians (AAFP) has had acorporate partnership with The Coca-Cola Company (TCCC) since 2009, which has resulted in educational materials and underwriting of their patient information website FamilyDoctor.org. A striking example of how the partnership undermines the family physician’s credibility occurs on the page for “Diabetes,” which recommends a healthy diet, while nestled neatly next to an advertisement for Coca-Cola (see screen capture on the left) and a footnote acknowledging TCCC as “partial underwriter” for the page.
In a 2010 Annals of Family Medicine article, family medicine physician and medical ethicist Howard Brody clearly outlines the danger that conflicts of interest present to professional medical organizations. The problem goes beyond what happens “when one enters into arrangements that reasonably tempt one to put aside one’s primary obligations in favor of secondary interests, such as financial self-interest,” with a deeper concern for the “development of a corporate culture within a medical professional society,” that can lose focus on “its duty to the public health and public trust.” As the partnership grows, there will be a point where the AAFP cannot afford to end the partnership. The AMA learned a difficult and costly lesson when they signed a contract with Sunbeam back in 1998.
Unfortunately, this trend is becoming more and more common among medical organizations, as documented by the Center for Science in the Public Interest’s 2013 report Selfish Giving, which lists over ten medical organizations with soda industry sponsorship. The American Academy of Pediatrics (AAP) is on the list—an accolade that irked New York pediatrician Arnold Matlin MD so much that he crafted and got a resolution passed through the New York chapter this year calling for an end to corporate sponsorships of this kind. Dr Matlin laments that his organization takes money from the very company that profits from, “products that we know are bad for the health of children.” His resolution will be debated among the AAP membership next March at their headquarters in Illinois.
Another example of industry influence occurs at the Academy of Nutrition and Dietetics (AND) conferences, with sessions regularly sponsored by TCCC and McDonald’s. A group of outraged members of the AND call themselves Dietitians for Professional Integrity, and have organized resistance to sponsorship by companies who promote unhealthy products.
Gifts create bias
What studies have shown about taking money and gifts from pharmaceutical companies is that, however small, they influence us. For a medical organization, the consequences are even more important, as industry funding compromises the organization’s goals and messaging.
Whereas tobacco industry funding of medical organizations was once commonplace (as were medical institution investments in tobacco companies), soda companies have forged and maintained partnerships by seeding doubt in the public’s mind about the health consequences from over-consumption. The Union of Concerned Scientists’ Center for Science and Democracy’s publication “Sugar-Coating Science” details these deceptive practices and recommends combating industry claims with rigorous data and regulations.
Rejecting unhealthy corporate influence
We as family physicians have been combating these conflicts of interest for years. We are currently building a consortium of data and advocacy groups to speak out. Under the name Physicians Against Unhealthy Corporate Influence (PAUCI), we are encouraging physicians and other healthcare providers to distance themselves from industry influence, so a “new social norm may emerge that promotes patient care and scientific integrity.” Our group aims to be a hub for scientific and medical professionals to advance the work of reducing corporate conflicts of interest.
We call on the scientists and experts in the field to help contribute to advancing this goal. Please consider signing our petition to the AAFP Board of Directors, liking ourFacebook page, joining our LinkedIn group, helping fund our exhibit booth at the AAFP Scientific Assembly, and passing this article on to those who may be willing to speak up in their medical organizations to end these types of corporate partnerships. We have made significant headway with resolutions passed through the AAFP student and resident congress of delegates, as well as the Maryland Academy of Family Physicians, calling for the end of the AAFP-Coca Cola alliance. If you will be attending the upcoming AAFP Scientific Assembly in Washington, DC, October 23-25, please visit the PAUCI booth #1863 in the exhibit hall.
We believe that the integrity of these organizations can be regained through rejection of current conflicts of interest so that members and the public can have confidence in the vision and mission to promote the health of the public. As anti-lead activist and geophysicist Dr. Claire Patterson once warned, “It is not just a mistake for public health agencies to cooperate and collaborate with industries in investigating and deciding whether public health is endangered—it is a direct abrogation and violation of the duties and responsibilities of those public health organizations.”
We never want money and power to have a louder voice than science, and we reject sponsorship from corporations who profit from making our patients sick.