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Conflict of Interest Coalition Statement of concern on lack of clarity on role of industry 

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French text

The Statement of Concern below was developed by the Conflicts of Interest Coalition (COIC) and was submitted to the President of the UN General Assembly in September 2011.  It has now been endorsed by 161 national, regional and global networks and organisations working in different fields of public health, including medicine, nutrition, cancer, diabetes, heart, liver and lung disease, mental health, infant feeding, food safety and development.   

The principles and recommendations of this Statement can be applied to all areas of public health policy setting, but in particular to work on NCDs. 

The statement  focuses on the lack of clarity regarding the role of the private sector in public policy-making and calls for the development of a Code of Conduct and Ethical Framework to help protect the integrity of  the UN's  public policy decision-making, to ensure it is transparent and to identify, safeguard against and manage potential conflicts of interest.

The Statement calls for:

a clear distinction to be made between business-interest not-for-profit organisations (BINGOs) and public interest non-governmental organisations (PINGOs) 

a clear  differentiation between policy and norms and standards development  and appropriate involvement in implementation. 

Since the major causes of preventable death are driven by diseases related to tobacco, poor diet, physical inactivity and alcohol drinking, the endorsers of the Statement are concerned about the overuse of the term  ‘partnerships’  - without any clarification of what this term means.  We remain concerned that  public-private partnerships in these areas can counteract efforts to protect and improve public health.

The Conflict of Interest Coalition is calling on WHO to develop  guidance for Member States to identify conflicts and eliminate those that are not permissible. We ask that WHO perform thorough risk/benefit analyses on partnerships and provide surveillance on those considered acceptable. 

Transparency, although an essential requirement and first step, is not a sufficient safeguard in and of itself against negative impacts of conflicts of interest.

Alcohol and NCDs - a need for response - 30 Mar 2012.pdf

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Please send an email to: prundall@babymilkaction.org if your organisation would like to join the 161 global, regional and national endorsers

For the attention of 

His Excellency Dr. Joseph Deiss, President of the UN General Assembly, 

Ambassador Sylvie Lucas, Permanent Representative of Luxembourg,

Ambassador Raymond Wolfe, Permanent Representative of Jamaica

Our organisations strongly support the objective of raising the profile of NCDs globally. This statement concerns the lack of clarity regarding the role of the private sector at the upcoming Civil Society Interactive Hearing in New York and UN High Level Meeting (UN HLM) in September.

We call on the UN to:

1. Recognise and distinguish between industry including business-interest not-for-profit organisations (BINGOs) and public interest non-governmental organisations (PINGOs) that are both currently under the ‘Civil Society’ umbrella without distinction.

2. Develop a ‘code of conduct’ that sets out a clear framework for interacting the private sector and managing conflicts of interest, and which differentiates between policy development and appropriate involvement in implementation.

3. Address and acknowledge these concerns ahead of the UN High Level Summit in September.

Since the major causes of preventable death are driven by diseases related to tobacco, diet, physical inactivity and alcohol drinking, we are concerned that many of the proposals to address NCDs call for ‘partnerships’ in these areas with no clarification of what this actually means.  

Public-private partnerships in these areas can counteract efforts to regulate harmful marketing practices.

It is essential that a strong and clear policy on conflicts of interest is established by the international community to provide Member States with guidance to identify conflicts, eliminate those that are not permissible and manage those considered, based on thorough risk/benefit analysis, acceptable. Transparency, although an essential requirement and first step, is not a sufficient safeguard in and of itself against negative impacts of conflicts of interest.

We propose that the following framework be used as a basis for a ‘code of conduct’ for industry:

The policy development stage should be free from industry involvement to ensure a “health in all policies” approach, which is not compromised by the obvious conflicts of interests associated with the food alcohol,  beverage and other industries, who are primarily answerable to shareholders. 

The food and beverage industry should, of course, be kept informed about policy development, through stakeholder briefings for example, but should not be in an influencing position when it comes to setting policy and strategies for addressing public health issues, such as NCD prevention and control.

While it is important for the food and beverage industries to be in dialogue during the policy development process, this should be as a means of informing the process relating to practical issues rather than as members of the policy development team.

Industries are both part of the NCD problem and the solution. It is vital therefore to engage them in the most appropriate way when implementing policy and not when developing policy, to ensure that public health policy is protected from commercial interests.

Without this approach, WHO’s principles of democratic policy-making for health, its constitutional mandate of the attainment of the highest possible level of health for all, and its independence, integrity and effectiveness will be undermined. ¹ Without such a policy, conflicts of interest can become institutionalised as the norm, impacting on the authority of governments. Industries with a strong interest in the outcome will increasingly assume greater roles in policy and decision shaping. This can fundamentally compromise and distort international and national public health priorities and policies. 

The conflict of interest concern is not limited to the direct involvement of industry. UN agencies, including the WHO, are unanimous in recognising the important contributions NGOs make in the area of public health and are aware of the growth of these organisations in their numbers and influence in health at global, regional and national levels, including in the area of NCDs. However, WHO and others have so far not made a clear distinction between BINGOs (business-interest NGOs not-for-profit organisations that are set up by, representing or closely linked to, business interests) and PINGOs - public-interest NGOs. This failure to distinguish between the two groupings exacerbates any existing lack of transparency and complicates implementation of any procedures which aim to manage the role of these actors in policy and standard-setting consultations. In the Civil Society Interactive Hearing on 16th June, there was no clear differentiation between groups within Civil Society. The voice of Civil Society ought to reflect only public health interests. 

The safeguards in Article 5.3 of the Framework Convention on Tobacco Control, the WHO International Code of Marketing of Breast-milk Substitutes, the Resolutions on Infant and Young Child Nutrition and the Global Strategy on Diet, Physical Activity and Health can be used among other helpful tools to establish measures that go beyond individual conflicts of interests, and address institutional conflicts of interest. 

In summary, we call on the UN to recognise and distinguish between BINGOs and PINGOs that are currently under the ‘Civil Society’ umbrella and to develop a ‘code of conduct’ framework for industry engagement that differentiates between policy development and  appropriate involvement in implementation that complies with existing regulations and the principles established in the Code of Conduct. We ask for the UN to consider our comments and take them into account for the UN High Level Meeting in September.

(the NGOs in red or blue  are ones that were we have inserted weblinks - eventually all will have them)

1. Access to Essential Medicines Campaign - Médecins Sans Frontières (Global)
2. ACTIS Norwegian Policy Network on Alcohol and Drugs  (Norway)
3. Active – sobriety, friendship and peace (Europe)
4. Affaires Européennes et Internationales (France)
5. Aktionsgruppe Babyhahrung (Germany)
6. Alcohol Action Ireland  (Ireland) 
7. Alcohol Focus Scotland (Scotland)
8. Alcohol Health Alliance (UK)
9. Alcohol Policy Youth Network (Europe)
10. All India Drug Action Network (India)
11. Alliance Against Conflict of Interest (AACI) (India)
12. Alliance for the Control of Tobacco Use (ACT) Brazil
13. Arugaan(Philippines)
14. Association for Accountancy and Business Affairs (UK)
15. Association for Consumer's Action on Safety and Health (India)
16. Association Nationale de Prévention en Alcoologie et Addictologie (ANPAA) (France)
17. Australian Breastfeeding Association (Australia)
18. Baby Feeding Law Group (UK)
19. Baby Milk Action (UK)
20. Balance North East Alcohol Office (UK)
21. Bangladesh Breastfeeding Foundation (Bangladesh)
22. Biomedical Research Centre for Maternal and Child Healthcare  (Italy)
23. Birth Light (UK) 
24. Blue Cross Norway (Norway)
25. Borstvoeding vzw (Belgium) 
26. Brazilian Institute for Consumers Defense (IDEC) (Brazil)
27. Brazilian Front for the Regulation of Food Advertising (Brazil)
28. Breastfeeding Friends (United Arab Emirates)
29. Breastfeeding Network (UK)
30. Breastfeeding Promotion Network of India (India) 
31. British Liver Trust (UK)
32. British Society for the Study of Liver Disease (UK) 
33. Calgary Breastfeeding Matters Group Foundation (Canada)
34. Campaign for Development and Solidarity (FORUT) (Norway)
35. Cancer Research UK (UK)
36. Canterbury Breastfeeding Advocacy Services (New Zealand) 
37. Caroline Walker Trust (UK)
38. Centre for Counselling Nutrition and Health Care (Tanzania)
39. Centre for Science in the Public Interest (Canada)
40. Consensus Action on Salt and Health (UK)
41. Consumers Korea (Korea)
42. Consumer Organization of South Sulawesi (Indonesia)
43. Consumers International (Global)
44. Corporate Accountability International (USA)
45. Corporate Europe Observatory (Europe)
46. Declaration de Berne (Switzerland)
47. Diabetes Association Norway (Norway)
48. Earth Dharma Farm (USA)
49. Ecowaste Management Coalition (Philippines)
50. El Poder del Consumidor (Mexico)
51. Estonian Temperance Union
52. Ethics and Health Foundation (UK) 
53. European Alcohol Policy Alliance – Eurocare (Europe)
54. European Heart Network (Europe)
55. European Childhood Obesity Group (ECOG)
56. European Mutal Help Network for Alcohol Related Problems (EMNA) (Europe)
57. Europe Third World Centre (CETIM) (Europe)
58. Food Ethics Council (UK)
59. Geneva Infant Feeding Association (Switzerland)
60. Global Action Against Poverty (GAAP) (Global)
61. Global Alcohol Policy Alliance (GAPA)
62. Handicap International Federation (Switzerland)
63. Health Action Information Network (Global)
64. Health Action International Africa
65. Health Action International Asia Pacific
66. Health Action International Global
67. Health Action International Europe
68. Health Action International Latin America
69. Health Care Without Harm (Global)
70. Health Consumer Protection (Thailand)
71. Health Equity Initiatives (Malaysia).
72. Health Innovation in Practice (Switzerland)
73. Health Poverty Action (UK)
74. Heart of Mersey (UK)
75. Hypertension Prevention and Control CIHR HSFC (Canada)
76. INFACT Canada (Canada)
77. Indian Alcohol Policy Alliance (India)
78. Indian Medico-legal & Ethics Association (IMLEA) (India)
79. Initiativ Liewensufank (Luxembourg)
80. Initiative for Health & Equality in Society (India)
81. International Association for the Study of Obesity (Global)
82. International Association of Consumer Food Organisations (IACFO) (Global)
83. International Baby Food Action Network (Global)
84. International Baby Food Action Network Europe
85. International Baby Food Action Network Latin America
86. International Baby Food Action Network Asia
87. International Baby Food Action Network Arab World
88. International Baby Food Action Network Africa
89. International Baby Food Action Network Oceania
90. International Baby Food Action North America
91. International Code Documentation Centre (Malaysia)
92. International Federation of Blue Cross (Global)
93. International Institute for Legislative Affairs (Kenya)
94. International Insulin Foundation (UK) 
95. International Society for Behavioural Nutrition & Physical Activity (Global)
96. International Union Against Tuberculosis & Lung Disease (Global)
97. Institute of Alcohol Studies (UK)
98. Institute of Nutrition of the Rio de Janeiro State University (Brazil)
99. Institute for Development and Community Health – LIGHT  (Vietnam)
100. Instituto Alana - Projeto Criança e Consumo from Instituto (Brazil) 
101. IOGT International (Global)
102. IOGT-NTO (Sweden)
103. Malaysian Breastfeeding Association (Malaysia)
104. Medicus Mundi International Network (Switzerland)
105. Medsin UK (UK)
106. Midwives Information and Resource (UK) 
107. Mozambique Ministry of  Health
108. Kazan Federal University, Department of Basic and Clinical Pharmacology, Russian Federation
109. Kikandwa Rural Communities Development Organization KIRUCODO (Uganda) 
110. Lactation Consultants of Great Britain (UK)
111. Nada India Foundation (India) 
112. National Childbirth Trust (UK) 
113. National Heart Forum (UK)
114. National Institute of Alcohol and Drug Policies (Brazil)
115. Navdanya Research Foundation for Science Technology & Ecology (India)
116. Nepal Breastfeeding Promotion Forum (Nepal)
117. Network for Accountability of Tobacco Transnationals (Global)
118. No Excuse Slovenia (Slovenia)
119. No grazie, pago io (Italy)
120. Nordic Work Group for International Breastfeeding Issues (NAFIA)
121. Norwegian Cancer Society (Norway)
122. Norwegian Health Association (Nasjonalforeningen for folkehelsen) (Norway)
123. Norwegian Heart and Lung Patient Organisation (Norway)
124. Oakland Institute (CA, USA)
125. Osservatorio Italiano Sulla Salute Globale (Italy)
126. Oxfam International (Global)
127. People’s Health Movement (Global)
128. Prevention Institute (USA) 
129. Research and Advocacy for Health, Education , Environment (Pakistan)
130. Royal College of General Practitioners (UK)
131. Royal College of Midwives (UK) 
132. Royal College of Paediatrics and Child Health (UK)
133. Royal College of Physicians (UK)
134. Save Babies Coalition (Philippines)
135. Scottish Health Action on Alcohol Problems (Scotland)
136. Sining Yapak (SIYAP), Philippines
137. StopDrink Network (Thailand)
138. Sustain Children’s Food Campaign (UK)
139. Sweet Enough Network (Thailand)
140. Swaziland Infant Nutrition Action Network (Swaziland)
141. Sumy Youth Regional NGO, Gender Agency on Consultation and Information (Ukraine)
142. Thai Breastfeeding Centre (Thailand)
143. The Corner House (UK)
144. The Informative Breastfeeding Service (TIBS) Trinidad and Tobago 
145. Trade Union of Nutritionists of the State of Sao Paulo (Brazil)
146.  Universities Allied for Essential Medicine (Global)
147. UK Faculty of Public Health (UK)
148. Vereniging voor Begeleiding en Bevordering van Borstvoeding  VBBB (Belgium)
149. War on Want (UK)
150. WEMOS (The Netherlands)
151. Western Cape Dept. of Health and the School of Public Health, University of Cape Town (South Africa)
152. Women Concern Forum of South Sulawesi (Indonesia)
153. Women’s Environmental Network (UK)
154. World Action on Salt and Health (WASH) (Global)
155. World Alliance for Breastfeeding Action (Global)
156. World Cancer Research Fund International (Global)
157. World Association of Clubs of Alcoholics in Treatment (WACAT) (Italy/Global)
158. World Lung Foundation (Global)
159. World Organisation of Family Doctors (WONCA) (Global)
160. World Public Health Nutrition Association (Global)
161. Young Professionals Chronic Disease Network (Global)

1. Access to Essential Medicines Campaign - Médecins Sans Frontières  (Global)
2. Active – sobriety, friendship and peace (Europe)
3. Affaires Européennes et Internationales  (France)
4. Aktionsgruppe Babyhahrung (Germany)
5. Alcohol Action Ireland 
6. Alcohol Focus Scotland 
7. Alcohol Health Alliance (UK)
8. Alcohol Policy Youth Network (Europe)
9. All India Drug Action Network (India)
10. Alliance Against Conflict of Interest (AACI) (India)
11. Alliance for the Control of Tobacco Use (ACT) Brazil
12. Arugaan (Philippines)
13. Association for Accountancy and Business Affairs (UK)
14. Association for Consumer's Action on Safety and Health (India)
15. Association Nationale de Prévention en Alcoologie et Addictologie (ANPAA) France
16. Australian Breastfeeding Association  (Australia)
17. Baby Feeding Law Group (UK)
18. Baby Milk Action (UK)
19. Balance (North East Alcohol Office) (UK)
20. Bangladesh Breastfeeding Foundation (Bangladesh)
21. Berne Declaration (Switzerland)
22. Biomedical Research Centre for Maternal and Child Healthcare (IRCCS) (Italy)
23. Birthlight (UK)
24. Blue Cross Norway
25. Borstvoeding vzw (Belgium)
26. Brazilian Institute for Consumers Defense (IDEC)  (Brazil)
27. Brazilian Front for the Regulation of Food Advertising (Brazil)
28. Breastfeeding Friends (Sharjah, United Arab Emirates)
29. Breastfeeding Network (UK)
30. Breastfeeding Promotion Network of India (India)
31. British Liver Trust  (UK)
32. British Society for the Study of Liver Disease (UK)
33. Calgary Breastfeeding Matters Group Foundation (Canada)
34. Campaign for Development and Solidarity  (FORUT) Norway
35. Cancer Research UK   
36. Canterbury Breastfeeding Advocacy Services (New Zealand)
37. Caroline Walker Trust (UK) 
38. Centre for Counselling Nutrition and Health Care (Tanzania)
39. Centre for Science in the Public Interest (Canada) 
40. Consensus Action on Salt and Health (CASH)
41. Consumers Korea (Korea)
42. Consumer Organization of South Sulawesi (Indonesia)
43. Consumers International (Global)
44. Corporate Accountability International  (USA)
45. Corporate Europe Observatory (Europe)
46. Diabetes Association Norway 
47. Earth Dharma Farm  (USA)
48. El Poder del Consumidor (Mexico) 
49. Ecowaste Management Coalition (Philippines)
50. Ethics and Health Foundation (UK)
51. European Alcohol Policy Alliance – Eurocare (Europe)
52. European Heart Network (Europe)
53. Europe Third World Centre (CETIM)  (Europe)
54. Food Ethics Council (UK)
55. Geneva Infant Feeding Association  (Switzerland)
56. Global Action Against Poverty (GAAP) (Global)
57. Global Alcohol Policy Alliance (GAPA)
58. Handicap International Federation (Switzerland)
59. Health Action Information Network  (Global)
60. Health Action International  Africa
61. Health Action International Asia Pacific
62. Health Action International Global
63. Health Action International Europe
64. Health Action International  Latin America
65. Health Care Without Harm (Global)
66. Health Consumer Protection (Thailand)
67. Health Innovation in Practice (Switzerland) 
68. Health Poverty Action (UK)
69. Heart of Mersey (UK)
70. INFACT Canada 
71. Indian Alcohol Policy Alliance
72. Indian Medico-legal & Ethics Association (IMLEA) 
73. Initiativ Liewensufank (Luxembourg)
74. Initiative for Health & Equality in Society (India)
75. International Association for the Study of Obesity 
76. International Association of Consumer Food Organisations
77. International Baby Food Action Network  (Global)
78. International Baby Food Action  Network Europe
79. International Baby Food Action Network Latin America
80. International Baby Food Action Network Asia
81. International Baby Food Action Network Arab World
82. International Baby Food Action  Network Africa
83. International Baby Food Action Network Oceania
84. International Baby Food Action North America 
85. International Code Documentation Centre (Malaysia)
86. International Federation of Blue Cross
87. International Institute of Legislative Affairs (Kenya)
88. International Insulin Foundation (UK)
89. International Society for Behavioral Nutrition & Physical Activity
90. International Union Against Tuberculosis and Lung Disease
91. Institute of Alcohol Studies (UK)
92. Institute of Nutrition of the Rio de Janeiro State University (Brazil)
93. Institute for Development and Community Health – LIGHT (Vietnam)
94. IOGT International 
95. IOGT-NTO (Sweden)
96. Kikandwa Rural Communities Development Organization - KIRUCODO (Uganda)
97. Lactation Consultants of Great Britain 
98. Malaysian Breastfeeding Association
99. Medicus Mundi International Network (Switzerland)
100. Medsin-UK 
101. Midwives Information and Resource Service  (MIDIRS) (UK)
102. Nada India Foundation
103. National Childbirth Trust (UK)
104. National Heart Forum (UK)
105. National Institute of Alcohol and Drug Policies (Brazil)
106. Navdanya Research Foundation for Science Technology & Ecology (India)
107. Nepal Breastfeeding Promotion Forum
108. Network for Accountability of Tobacco Transnationals
109. No Excuse Slovenia 
110. No grazie, pago io  (Italy)
111. Nordic Work Group for International Breastfeeding Issues  (NAFIA) 
112. Norwegian Cancer Society
113. Norwegian Health Association (Nasjonalforeningen for folkehelsen)
114. Norwegian Heart and Lung Patient Organisation
115. Norwegian Policy Network on Alcohol and Drugs (ACTIS)
116. Oakland Institute (CA, USA) 
117. Osservatorio Italiano Sulla Salute Globale (Italy)
118. Oxfam International (Global)
119. People's Health Movement (Global)
120. Prevention Institute (USA)
121. Research and Advocacy for Health, Education , Environment (Pakistan)
122. Royal College of General Practitioners (UK)
123. Royal College of Midwives (UK)
124. Royal College of Paediatrics and Child Health (UK)
125. Royal College of Physicians (UK)
126. Save babies Coalition (Philippines)
127. Scottish Health Action on Alcohol Problems (Scotland)
128. Sining Yapak (SIYAP) (Philippines)
129. StopDrink Network (Thailand)
130. Sustain Children’s Food Campaign (UK)
131. Sweet Enough Network (Thailand) 
132. Swaziland Infant Nutrition Action Network (SINAN)
133. Sumy Youth Regional NGO, Gender Agency on Consultation and Information (Ukraine).
134. The Breastfeeding Centre (Thailand)
135. The Corner House (UK)
136. The Informative Breastfeeding Service (TIBS) Trinidad and Tobago
137. Trade Union of Nutritionists of the State of Sao Paulo (Brazil)
138. Universities Allied for Essential Medicine 
139. UK Faculty of Public Health (UK)
140. Vereniging voor Begeleiding en Bevordering van Borstvoeding  VBBB (Belgium)
141. War on Want (UK)
142. WEMOS (The Netherlands) 
143. Western Cape Dept. of Health and the School of Public Health, University of Cape Town
144. Women Concern Forum of South Sulawesi (Indonesia) 
145. Women’s Environmental Network (UK)
146. World Alliance for Breastfeeding Action  (Global)
147. World Cancer Research Fund International (Global) 
148. World Action on Salt and Health (Global)
149. World Association of Clubs of Alcoholics in Treatment (Italy)
150. World Lung Foundation
151. World Public Health Nutrition Association (Global)
152. Young Professionals Chronic Disease Network (Global)

www.unjiu.org/data/reports/2010/JIU.REP.2010.9_For%20Printing_17%20January%202011.pdf

Beyond Pragmatism: Appraising UN-Business Partnerships:  http://www.unrisd.org/80256B3C005BE6B5/(search)/DFE614E0A0ACA2BCC12573070033BB77?Opendocument&highlight=2,beyond,pragmatism&fromsearch=yes&query=beyond+pragmatism