This study by Adam Bertscher, posted on Open UCT explores the complex policy formulation process in South Africa, using the draft Control of Marketing of Alcoholic Beverages Bill as a tracer case and focused on the alcohol industry, as a central actor, to understand how it – together with other actors – may influence this process. The study concludes that networks of actors with financial interest use diverse strategies to influence policy formulation processes to contest proposed regulation. The implications are that measures to insulate policy development are needed to prevent industry influence potentially undermining public health goals, such as: government to moderate certain consultations with industry; industry to declare conflict of interest; guidelines for bureaucrats and policymakers to advise on whose evidence to consider; and guidelines for bureaucrats and policymakers to assess quality of evidence.
A report released by the minority members of the US. Senate Homeland Security and Governmental Affairs Committee provides new information regarding the significant efforts the pharmaceutical company Insys has undertaken to reduce barriers to the prescription of Subsys, its powerful fentanyl product. These efforts include actions to mislead pharmacy benefit managers (PBMs) about the role of Insys in the prior authorization process and the presence of breakthrough cancer pain in potential Subsys patients. An internal Insys document suggests Insys apparently lacked even basic measures to prevent its employees from manipulating the prior authorization process and received clear notice of these deficiencies.
In May, Maryland became the first state to take action against the alarming trend of price gouging of off-patent brand-name and generic drugs, writes Jeremy Greene in an op-ed in The Washington Post. The state’s concise new law, which permits the attorney general to argue in front of a court when the price of an older essential medication increases so precipitously as to “shock the conscience,” passed with overwhelming bipartisan votes and broad popular support. The generic pharmaceutical industry would prefer to see it overturned. While the problem of pharmaceutical pricing is felt most keenly in newer specialty drugs that can cost more than $30,000 a year, interpretations of federal patent law limit the ability of states to protect residents from price increases in these newer drugs whose monopolies are protected by patents.
Novo Nordisk (Denmark) has agreed to pay $58.65 million to end a federal investigation by the US Department of Justice (DoJ) related to the company’s diabetes medication marketing practices, reports Bloomberg News. The investigation was launched in February 2011 into sales and marketing activities concerning Novo Nordisk’s leading type 2 diabetes drug Victoza. The financial terms of the agreement mean that Novo Nordisk will pay about $46.5 million as settlement to the federal government and to US states responsible for reimbursing Victoza under the Medicaid program. Furthermore, Novo Nordisk has agreed to pay $12.15 million to resolve complaints lodged by the US administration on behalf of the FDA. The alleged off-label marketing unnecessarily increased the costs for government healthcare programs while allegedly endangering patients, according to the whistleblower complaints and the government.
With a new semester getting underway, students and faculty in public health and related fields are looking for additional ways to gain the skills and competencies they need to become effective public health professionals. One promising approach may be to bring corporations more squarely into the public health classroom. No, we’re not talking about giving away McDonald’s branded backpacks to our students, as some schools in Detroit are doing. Nor are we suggesting inviting Fortune 500 CEOs to teach public health classes on corporate social responsibility or market solutions to global health problems.
Today corporations play a decisive role in shaping patterns of health and diseases, public health policy and what the public knows about lifestyles and health. Yet few schools of public health teach systematically about the health impact of corporations or prepare their students to analyze the role of corporations in health and social policy.
In this post, I suggest a few resources for public health faculty and students who want to bring a deeper understanding of corporations into the public health curriculum. These sources can help public health faculty to add assignments and readings about the role of corporations to required and elective public health courses in policy, health education, epidemiology, public health history and environmental and occupational health. They can also help students to write papers, find field work opportunities and pursue careers that help to define appropriate roles for public and private sectors and to prevent or reduce corporate practices that harm health.
Five Useful Websites on Corporations and Health
Corporate Accountability International. One of the oldest and largest global corporate accountability groups with documents covering its campaigns against infant formula, tobacco, fast food, water, nuclear weapons and other industries. Organizes and supports global campaigns to end abusive corporate practices.
Corporations and Health Watch Monitors the impact of corporate business and political practices of food and beverage, firearms, automobile, pharmaceutical, alcohol and tobacco industries. Contains repository of media articles and scientific publications on these topics.
Corporate Watch Provides information on the social and environmental impacts of corporations and capitalism. Since 1996 its research, journalism, analysis and training have supported people affected by corporations and those taking action for radical social change.
The Poison Papers Documents the Hidden History of Chemical and Pesticide Hazards in the United States. The “Poison Papers” represent a trove of rediscovered chemical industry and regulatory agency documents and correspondence stretching back to the 1920s. The papers show that both industry and regulators understood the extraordinary toxicity of many chemical products and worked together to conceal this information from the public and the press. These papers will transform our understanding of the hazards posed by certain chemicals on the market and the fraudulence of some of the regulatory processes relied upon to protect human health and the environment.
Toxic Docs Contains millions of pages of previously secret documents about toxic substances. They include secret internal memoranda, emails, slides, board minutes, unpublished scientific studies, and expert witness reports — among other kinds of documents — that emerged in recent toxic tort litigation. Based at Columbia University and the City University of New York.
Know of other non-profit websites or organizations useful in learning more corporations and health? Send us link and description and we will update resources.
Five Useful Recent Books
These books published in the last year or two introduce recent scholarship on corporations and health. They provide faculty and students with an overview of the topic and can be used in teaching about the health impact of corporations.
Freudenberg N. Lethal But Legal: Corporations, Consumption, and Protecting Public Health. Paperback Edition With new Afterword. Oxford University Press, 2016.
Kenworthy N, MacKenzie R. Lee K, eds. Case Studies on Corporations and Global Health Governance: Impacts, Influence and Accountability 1st Edition Rowman & Littlefield International; 1 edition (July 18, 2016)
Lee K, Hawkins B. Researching Corporations and Global Health Governance An Interdisciplinary Guide. Rowman and Littlefield, 2016.
Quelch JA, ed. Consumers, Corporations, and Public Health: A Case-Based Approach to Sustainable Business . Oxford University Press, 2016.
Walker MJ. (Editor)Corporate Ties That Bind: An Examination of Corporate Manipulation and Vested Interest in Public Health, 2017.
Know of other recent books that might help public health professionals learn more about corporations and health? Send us link and description and we will update resources.
15 Recent Useful Articles
This selection of articles from the last two years shows some of the questions public health researchers are asking about corporations and should provoke discussion in a variety of public health classes. They might also serve as starting points for semester projects or research papers for public health students.
Ajunwa I, Crawford K, Ford JS. Health and Big Data: An Ethical Framework for Health Information Collection by Corporate Wellness Programs. J Law Med Ethics. 2016 Sep;44(3):474-80.
Anaf J, Baum FE, Fisher M, Harris E, Friel S. Assessing the health impact of transnational corporations: a case study on McDonald’s Australia. Global Health. 2017 Feb 6;13(1):7.
Baker P, Friel S. Food systems transformations, ultra-processed food markets and the nutrition transition in Asia. Global Health. 2016 Dec 3;12(1):80
Banerjee D. Markets and Molecules: A Pharmaceutical Primer from the South. Med Anthropol. 2017 May-Jun;36(4):363-380.
Baum FE, Sanders DM, Fisher M, Ana J, Freudenberg N, Friel S, Lamont R, London L, Monteiro C, Scott-Samuel A, Sen A. Assessing the health impact of transnational corporations: its importance and a framework. Global Health. 2016 Jun 15;12(1):27.
Brisbois BW, Cole DC, Davison CM, Di Ruggiero E, Hanson L, Janes CR, Larson CP, Nixon S, London K, Stim B. Corporate sponsorship of global health research: Questions to promote critical thinking about potential funding relationships. Can J Public Health. 2016 Dec 27;107(4-5): e390-e392.
Casswell S, Callinan S, Chaiyasong S, Cuong PV, Kazantseva E, Bender T, Chuckle T, Parker K, Rialtos R, Wall M. How the alcohol industry relies on harmful use of alcohol and works to protect its profits. Drug Alcohol Rev. 2016 Nov;35(6):661-664.
Delobelle P, Sanders D, Puoane T, Freudenberg N. Reducing the Role of the Food, Tobacco, and Alcohol Industries in Noncommunicable Disease Risk in South Africa. Health Educ Behav. 2016 Apr;43(1 Suppl):70S-81S.
Hawkins B, Holden C, Eckhardt J, Lee K. Reassessing policy paradigms: A comparison of the global tobacco and alcohol industries. Glob Public Health. 2016 Mar 21:1-19.
Hawkins B, Holden C. a Corporate Veto on Health Policy? Global Constitutionalism and Investor-State Dispute Settlement. J Health Polit Policy Law. 2016 Oct;41(5):969-95.
Hernandez-Aguayo I, Zaragoza GA. Support of public-private partnerships in health promotion and conflicts of interest. BMJ Open. 2016 Apr 18;6(4): e009342.
Robaina K, Babor TF. Alcohol industry marketing strategies in Latin America and the Caribbean: the way forward for policy research. Addiction. 2017 Jan;112Suppl 1:122-124.
Scrinis G, Monteiro CA. Ultra-processed foods and the limits of product reformulation. Public Health Nutrition 2017;(in press) 1–6.
Weishaar H, Dorfman L, Freudenberg N, Hawkins B, Smith K, Razum O, Hilton S. Why media representations of corporations matter for public health policy: a scoping review. BMC Public Health. 2016 Aug 30; 16:899.
Zoller HM. Health Activism Targeting Corporations: A Critical Health Communication Perspective. Health Commun. 2017 Feb;32(2):219-229.
Know of other recent books that might help public health professionals learn more about corporations and health? Send us citation and link and we will update this list.
Some Corporate Related Competencies for Public Health Students
As the Council on Education for Public Health and other professional bodies are requiring schools of public health to revise and update their competencies and learning objectives, schools have an opportunity to introduce new expectations for their students –and faculty. The competencies listed below can be used in several ways. Core public health courses can include sessions on these topics as they relate to, for example, epidemiology, health policy, environmental health, or health education. Some public health programs have developed specialized courses on the topic, allowing students to pursue this interest. Or a student-faculty interest group can bring together those who want to pursue research, advocacy or practice on the corporate impact on public health
1. Identify corporate business and political practices that affect health.
2. Elucidate the pathways by which they shape patterns of health and disease.
3. Develop public health strategies to encourage health-promoting corporate practices and discourage or end health-damaging ones.
4. Analyze the public health advantages and disadvantages of various government/market relationships
5. Create alliances with consumer, environmental, labor and health organizations and movements that seek to change harmful corporate practices and policies
6. Describe the roles of public health professionals and researchers in modifying harmful corporate practices or policies.
Do you have a syllabus to share or suggested additional competencies? Send them (or a link) to us for posting.
Reuters reports that the European Commission has started an in-depth investigation of Bayer’s planned $66 billion takeover of U.S. seeds group Monsanto, saying it was worried about competition in various pesticide and seeds markets. The deal would create the world’s largest integrated pesticides and seeds company, the Commission said, adding this limited the number of competitors selling herbicides and seeds in Europe. If the deal goes through, the newly merged company will be one of the largest agrochemical firms in the world and could put 90 percent of the world’s food supply in the hands of only four multinational corporations.
Based on a review of documents detailing what Exon Mobil knew about the company’s role in climate change, Geoffrey Supran and Naomi Oreskes, writing in The New York Times, conclude that “Exxon Mobil misled the public about the state of climate science and its implications. Available documents show a systematic, quantifiable discrepancy between what Exxon Mobil’s scientists and executives discussed about climate change in private and in academic circles, and what it presented to the general public.” Their analysis is published in Environmental Research Letters. A coalition of state attorneys general and the Securities and Exchange Commission are investigating whether the company lied to the public and investors about what it knew about the dangers of climate change. Making corporations liable for misleading investors about scientific evidence may be a valuable strategy for public health advocates seeking to reduce harmful corporate practices.