Corporations, Conflicts of Interest and Protecting Public Health

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How do the business and political practices of corporations conflict with protecting public health?  In a talk last week sponsored by the Mexican civil society group El Poder del Consumidor, Corporation and Health Watch founder Nicholas Freudenberg described three types of conflicts of interest:  scientific, policy and ideological.  In each of these domains, the private—or business –interests of corporations, maximizing profits, market share and return on investment, conflict with the public interest of preventing harm and reducing health inequities.

Read the talk in English here.  A Spanish language version, Corporaciones compran partidos y miman gobiernos para exprimir a la gente, afirma catedrático, was published in the Mexican online newspaper Sinembargo and is available here.

The Disinformation Playbook

Science helps keep us safe and healthy. The public safeguards that keep our drinking water clean and our children’s toys safe rely on independent science and a transparent policymaking process. And we all rely on scientific information to make informed choices about everything from what we eat to what consumer products we buy for our families.  But the results of independent science don’t always shine a favorable light on corporate products and practices. In response, some corporations manipulate science and scientists to distort the truth about the dangers of their products, using a set of tactics made famous decades ago by the tobacco industry. In a new guide called The Disinformation Playbook, the Union of Concerned Scientists describes five of the most widely used “plays” and some of the many cases where they have been used to block regulations or minimize corporate liability, often with frightening effectiveness—and disastrous repercussions on public health and safety.

Taking the Overseas Blinders Off Corporate Governance

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In its annual Good Governance report, writes Fair Observer, the Institute of Directors  assesses the United Kingdom’s largest listed companies against indicators that include board effectiveness, audit and risk accountability, remuneration, shareholder relations and stakeholder relations. Ironically, the IoD index’s top performers often come from the alcohol and tobacco industries. This year’s report gave pride of place to the distiller Diageo and the 2016 winner was British American Tobacco (BAT). The IoD’s standards may be appropriate for how these companies behave in London. In Kinshasa, Kampala and Juba, though, the praise of BAT surely raises eyebrows. As the rest of the world has learned over the intervening months, above-board corporate behavior in the UK does not guarantee ethical conduct elsewhere. Over the summer, The Guardian revealed in a series of explosive investigative pieces that BAT (as well as other multinational tobacco firms) has been ruthless in staking out market share and seeing off health regulations in African markets. BAT and its allies have threatened governments in some eight African countries to counteract policies that have underpinned public health initiatives in Western markets.

Too Big to Feed

Mega-mergers are sparking unprecedented consolidation across food systems, and new data technologies represent a powerful new driver. For decades, firms in the agri-food sector have pursued mergers and acquisitions and other forms of consolidation as part of their growth strategies. However, the recent spate of mega-mergers takes this logic to a new scale. Since 2015, the “biggest year ever for mergers and acquisitions”, a number of high-profile deals have come onto the table in a range of agri-food sectors – often with a view to linking different nodes in the chain. These include the $130 billion merger between US agro-chemical giants,

Dow and DuPont, Bayer’s $66 billion buyout of Monsanto, ChemChina’s acquisition of Syngenta for $43 billion and its planned merger with Sinochem in 2018. These deals alone will place as much as 70% of the agrochemical industry in the hands of only three merged companies. A new report Too Big to Feed Exploring the impacts of mega-mergers, consolidation and concentration of power in the agri-food sector from the International Panel of Experts on Sustainable Food Systems analyzes this issue.

Will the mHealth Business Shrink or Exacerbate Health Inequalities?

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An article in the November American Journal of Public Health analyzes the social networks of the  major stakeholders in mobile health app development and describes their financial relationships to each other and to global corporations in technology, pharmaceuticals and entertainment, prime investors in the rapidly expanding mHealth business.  The authors conclude that public health researchers need to “extend their scrutiny and advocacy beyond the health messages contained within apps to understanding commercial influences on health and, when necessary, challenging them.”  In an accompanying editorial, CHW’s Nicholas Freudenberg notes that in their effort to maintain profitability in a crowded marketplace, corporations selling the 259,000 mHealth apps now on the U.S.  market   may make misleading claims, cover up defects or market unscrupulously, thus harming rather than helping users. Those mHealth apps that are effective and safe risk widening inequalities in health by being more accessible to the users who can afford them.

The Rise and Fall of the Opioid Industry’s Drug Czar

A  Washington Post 60 minutes investigative expose revealed that  Trump’s nominee to head the Drug Enforcement Agency, Tom  Marino, a Republican from Pennsylvania  had led a successful effort in the House of Representatives to strip the DEA of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation’s streets. The revelation forced Marino to withdraw and Trump to start again in pursuing his long-promised campaign against opioid misuse.  The story suggests two lessons. First, corporate influence in Congress is so strong that even in an opioid epidemic, the drug industry can persuade Congress to deregulate to protect its profits.  Second, the power of investigative journalism continues to be an important check on abuses of authority.   

The 100 Largest Governments and Corporations by Revenue in 2016

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In 2014, 64 of the largest economies in the world were corporations and 36 were governments.  Two years later, in 2016, 69 were corporations and 31 governments.  The source for estimated revenues for governments was The CIA World Factbook and for corporations The Global Fortune 500 List, which reported 2016 annual revenues.

Between 2014 and 2016, total revenues for the 100 largest economies fell by 9%, from $29.9 trillion to $27.2 trillion. In that same period, the ratio of government to corporate revenues of the economies on the top 100 list fell from 1.9 in 2014 to 1.7 in 2016.  In both years, governments on the list spent almost twice as much as corporations. This suggests that among the world’s largest economies, governments continue to play a crucial role in spending. What they do and don’t spend their revenues on has a crucial impact on health.

In 2016, the top 5 corporations accounted for about 16% of the revenues reported by businesses on the list.  For governments, the five largest accounted for 59% of government spending, a mark of the continuing spending power of the governments of the world’s largest economies: United States, China, Japan, Germany and France.  In 2016, the five largest governments outspent the five largest corporations by a ratio of almost six to one. Among the world’s largest economies, Big Government is still much bigger the Big Corporations.

Between 2014 and 2016, government revenues fell for a striking 26 of the 31(84%) governments that were on the list both times. For the 52 corporations on the list in both years, revenues fell for 32(62%), a lower percentage of revenue losers than among governments.  Declines in oil prices contributed to falling revenues for both countries and corporations that lost revenue between 2014 and 2016.

Annual revenues are of course only one indicator of the size of a government or corporation but it is one metric that enables comparison of the two.   Understanding the changing dynamics between governments and corporations is a critical priority for public health researchers seeking to take on the social determinants of health.

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Tracking the Effects of Corporate Practices on Health