Decoding disclosure: Comparing conflict of interest policy among the United States,France, and Australia

“Sunshine” policy, aimed at making financial ties between health professionals and industry publicly transparent, has recently gone global. Given that transparency is not the sole means of managing conflict of interest, and is unlikely to be effective on its own, it is important to understand why disclosure has emerged as a predominant public policy solution, and what the effects of this focus on transparency might be. We used Carol Bacchi’s problem-questioning approach to policy analysis to compare the Sunshine policies in three different jurisdictions, the United States, France and Australia. We found that transparency had emerged as a solution to several different problems including misuse of tax dollars, patient safety and public trust. Despite these differences in the origins of disclosure policies, all were underpinned by the questionable assumption that informed consumers could address conflicts of interest. We conclude that, while transparency reports have provided an unprecedented opportunity to understand the reach of industry within healthcare, policymakers should build upon these insights and begin to develop policy solutions that address systemic commercial influence.     

The tobacco industry’s challenges to standardised packaging: A comparative analysis of issue framing in public relations campaigns in four countries

Tobacco industry public relations campaigns have played a key role in challenges to standardised cigarette packaging. This paper presents a comparative analysis of industry campaigns in Australia and the United Kingdom, which have implemented standardised packaging legislation; Canada, where policy has been adopted but not yet implemented; and the Netherlands, which has considered, but not enacted regulation. Campaigns were identified via Google searches, tobacco industry websites, media coverage, government submissions and previous research; analysis focused on issue framing and supporting evidence. Public relations campaigns in all case study countries drew on similar frames - the illicit trade in tobacco products, the encroaching ‘nanny state’, lack of evidence for the effectiveness of standardised packaging, a slippery slope of regulation, and inherent threats to intellectual property rights. These claims were supported by industry research, front groups and commissioned reports by accountancy firms, but were not with verifiable research. Independent evidence that contradicted industry positions was overlooked. Similarities in structure and content of public relations campaigns in countries that have enacted or considered regulation points to a strategic co-ordinated approach by cigarette manufacturers. Countries considering standardised packaging policy can expect powerful opposition from the tobacco industry. Tobacco control communities and policy makers can learn from previous experience, and share best practise in countering industry arguments.     

Evaluating the transparency of pharmaceutical company disclosure of payments to patient organisations in the UK

Patient organisations contribute to many areas of pharmaceutical policy. In developing their organisational capacity, many turn to financial support from pharmaceutical companies, which may create conflicts of interests. However, the transparency of the industry’s self-regulatory approach to the disclosure of payments to patient organisations has evaded scrutiny. Using company reports disclosing payments to UK patient organisations in 2012–2016, we evaluate the transparency of reporting using indicators derived from industry’s European patient organisation Code. We found a large proportion of companies did not have any disclosure reports available despite many having made payments, confirmed by comparing with annual financial accounts of patient organisations registered as charities. Where disclosure reports were available, many payments were not adequately described, resulting in large portions of money being disclosed without clarity as to the payment type and purpose. We found companies were clearer regarding whether payments were financial or benefits-in-kind, but transparency was particularly inadequate as to whether it could be determined if payments were indirect or direct and restricted or unrestricted, and almost no companies mentioned the VAT status of payments. Our findings suggest that the industry’s self-regulatory approach to transparency has not been working efficiently. We suggest ways for standardising and increasing the precision of information by pharmaceutical companies and advocate for the introduction of a centralised, and easily accessible national-level payment database.     

An Environmental Scan of the National and Provincial Diagnostic Reference Levels in Canada for Common Adult Computed Tomography Scans

Several regulatory bodies have agreed that low-dose radiation used in medical imaging is a weak carcinogen that follows a linear, non-threshold model of cancer risk. While avoiding radiation is the best course of action to mitigate risk, computed tomography (CT) scans are often critical for diagnosis. In addition to the as low as reasonably achievable principle, a more concrete method of dose reduction for common CT imaging exams is the use of a diagnostic reference level (DRL). This paper examines Canada's national DRL values from the recent CT survey and compares it to published provincial DRLs as well as the DRLs in the United Kingdom and the United States of America for the 3 most common CT exams: head, chest, and abdomen/pelvis. Canada compares well on the international scale, but it should consider using more electronic dose monitoring solutions to create a culture of dose optimization.     

Heightened hypocrisy: a critical analysis of how the alcohol industry-sponsored ‘‘Nigerian Beer Symposium’’ jeopardises public health

This paper analyses how an alcohol industry-sponsored ‘Nigerian Beer Symposium’ (NBS) could endanger public health. The NBS, an annual one-day symposium, sponsored by Heineken-Nigerian Breweries, was recently introduced to create awareness of the ‘health and nutritional benefits of beer consumption’. Amongst other resource persons, Heineken-Nigerian Breweries contracts professors, medical doctors, nutritionists, advertisers, and celebrities from Africa and Europe to discuss the health and nutritional benefits of beer consumption. While all of the speakers strategically focused on the health and nutritional benefits of beer consumption, a few, in passing, mentioned drinking in moderation. In particular, male speakers focused on how beer prevents cancer, reduces the incidence of kidney stones, enhances vitality and cardiovascular health, and facilitates longevity and cognition among the aged. The female speakers encouraged women to consume beer because it enhances vitality and improves skin/physical beauty. Overall, none of the speakers specifically mentioned the consequences of alcohol (mis)use. This paper argues that the NBS is strategically organised to encourage beer initiation and/or high consumption, which will increase the sponsor’s profit. By providing biased information about the purported health and nutritional benefits of beer, the NBS will mislead the public, leading to more alcohol-related problems in Nigeria. Therefore, NBS should be regulated by implementing WHO-recommended alcohol policies in Nigeria.     

Impact of environmental biofilms: Industrial components and its remediation

The growth of technology and requirements globally for various commodities has brought about new challenges. Biofilms are aggregations of microbial cells, which contaminate and spoil industrial components and environments. These microbial cells with extracellular polymeric substances colonize living and nonliving surfaces and pose a serious problem for all industries, affecting their processes, leading to a reduction of product quality and economic loss. Industries, such as medical, food, water, dairy, wine, marine, power plants are exposed to biofilm formation. Pipe blockages, waterlogging and reduction of the heat-transfer efficiency, hamper the operating system of plants. Many industries do not set up remedial measures to control biofilm formation as they are not aware of this threat. Various conventional methods to control these biofilms are adopted by industries in their regular workflow, but these are temporary solutions. This calls for further research into remediation of the biofilm and its control for industrial components. This review article addresses the problems of biofilms and proposes solutions for various industrial components. Nanotechnology promises several options, and bring about a new aspect into the industrial economy, by solving the problems of environmental biofilms.     

2016—2020年我国中药资源学学科建设及科学研究进展与展望

中药资源学学科建设主要包涵中药资源学相关专业建设、教材体系建设、人才团队建设,以及中药资源学理论与方法技术创新、成果转化及服务社会等方面。中药资源领域的科学研究主要涉及中药资源调查研究、中药材规范化生产、中药资源有效利用、中药资源保护、中药资源产业发展等方面。在以往连续报道的基础上,对2016―2020年我国中药资源学学科建设及科学研究进展等进行归纳整理,基本反映了本领域的发展概况和广大科技工作者、企业家及管理者的代表性贡献,以期为中药与天然药物资源领域的学科建设、人才培养、科学研究、社会服务及中药产业发展起到相互借鉴的作用,共同致力于我国中医药事业和中药资源产业的高质量发展。