03 Apr Health professional associations and industry funding
In October 2016, the Council of the UK Royal College of Paediatrics and Child Health (RCPCH) announced its decision to continue accepting funding from baby food companies to support their activities. This is despite a successful motion adopted at RCPCH’s 2016 AGM for the practice to cease. The decision by the Council of RCPCH, its formal decision making body, is a disappointment to many who look to the UK institution for leadership in matters affecting child health. It sets a bad example for other national health professional associations.
In February 2016, a group of experts from the WHO questioned RCPCH’s integrity and impartiality, warning that the decision to continue accepting funding from industry contravenes the aim of the International Code of Marketing of Breast Milk Substitutes.
Writing in The Lancet ( http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30277-5/fulltext?elsca1=etoc), Dr Anthony Costello, Director of the Department of Maternal, New-born, Child and Adolescent Health at the World Health Organization and his colleagues warned that a decision to receive funding from baby food companies “creates clear competing interests”. They said the WHO Guidance on Ending Inappropriate Promotion of Foods for Infants and Young Children also prohibits this type of funding.
In defence of the decision of its Council, RCPCH said it has necessary safe guards in place and will conduct an internal due diligence process regarding potential donors, something WHO experts believe health professional associations are not in a position to do. According to the WHO experts,
“Acceptance of funding or other incentives, however conditional, creates a sense of obligation and loyalty to the company in question. This is exactly what health professional associations, including the RCPCH, should avoid. They have a moral obligation to protect themselves and their members from inappropriate promotion of BMS in all forms, however indirect, and from resulting competing interests in healthcare settings. Furthermore, health professional associations have a moral obligation to respect and protect women’s and children’s rights to be free from all forms of inappropriate marketing practices”
WHO experts went on to say that the RCPCH has forfeited an opportunity to be a standard bearer and champion for children and young people globally and to exemplify implementation of the International Code and Guidance. Instead, they lamented that RCPCH is sending a strong message to its members and others worldwide that benefitting from funding from baby food companies is acceptable, a position that should be reversed.
The Lancet letter received support from organisations that advocate for the elimination of sponsorship from industry. In our comment to the Lancet, IBFAN-ICDC recounted our experience in dealing with health professional associations that accept industry funding. In meetings to discuss infant and young child feeding policies, it is often health professional associations that are most vocal in defending industry positions. Their ardent support of industry lends support to our belief that the culture of dependence brought forth by sponsorship has compromised the integrity of health professionals.
IBFAN-ICDC hopes that the letter from WHO experts to the Lancet will lead to renewed discussions in RCPCH and eventually to a change in policy. The letter should hopefully contribute to much needed reflections and actions to safeguard public decision making spaces from conflicts of interest and undue influence of powerful companies.
Editorial note: The International Code (article 7.3) and associated resolutions ( WHA 49.15 and WHA 58.32) prohibit the acceptance by health workers of financial or material inducements (including contributions to fellowships and research grants for health workers, as well as contributions towards their participation in study tours or attendance at professional conferences) and call for avoidance of conflicts of interests. The WHO Guidance on Ending Inappropriate Promotion of Foods for Infants and Young Children states that “health professional associations should not…accept equipment or services from companies that market food for infants and young children, accept gifts or incentives from such companies” or “allow such companies to sponsor meetings of health professionals and scientific meetings”.