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Peter J. AdamsSchool of Population Health
FUNDING OF SOCIETY ACTIVITIES BY ORGANIZATIONS WITH COMPETING INTERESTS:
RISKS & OPTIONS
ICARA MEETING, BUDAPEST 31 AUGUST 2015
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ADDICTIVECONSUMPTIONS
CONSUMPTIONS
DANGEROUSCONSUMPTIONS
LEGALADDICTIVE
CONSUMPTIONS
movies
tobacco
pharma
fast foods
clothes
houses
alcoholcocaine
opioids
books
plasticsurgery
gambling
cannabis
accepting industry money
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ADDICTIVE CONSUMPTIONS
ARE SPECIAL
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Rational consumer?
Struggles with control
Consume more than intended
Over-consume despite knowledge
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Addiction Add-on
ProductionCosts
Normal Profit
AddictionAdd-on
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PROFIT
NOT MUCH
HEAPS
NUMBER OF CONSUMERS
LOW HIGH
ADDICTIVE
NON-ADDICTIVE
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When the money’s there….
Hard to resist Money exchange
establishes expectations & obligations
Reinforced by multiple exchanges
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Ostrich Response
“I didn’t really see that!”
“We’ve done so much work already”
“Let’s just pretend it’s not there”
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Bargaining Response
“Maybe it’s not that bad”
“Gambling has its positive sides”
“Only a small number have problems”
“Can’t spoil it for the rest of us”
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Missionary Response
“Money is sitting there”
“This funding will save lives”
“If we don’t get it, somebody else less deserving will”
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Macho Response
“Be realistic” “To get things
done you need to make some unpopular choices”
“Say no to one, then the rest will follow”
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Desire vs Values Messages
favoured my ambitions
Ethical perspective minimised
Need an outside reference point to gauge my views
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SIMPLETRANSACTIO
N
FUNCTIONS IN A WIDER
ARENA
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Three Connecting Chains
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TobaccoAlcoholGamblin
gIndustrie
s
Political Chain
Publiccommunicatio
nstrategies
Lobbying& PR
companiesProducer
& retailassociation
s
Relationship
buildingactivities
Politicians
POLICYMAKERS
Purposes:• Industry is a legitimate business• Is a key player in vitality of our economy• Build long-term relations with political
actors
LOW VIS
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British Medical Journal studies on infiltration of UK Parliament
All-party MP “Beer Group”
400 MPs from both houses of Parliament
David Cameron reversal on minimum unit pricingSource:
http://www.morningadvertiser.co.uk/General-News/Chancellor-George-Osborne-named-Beer-Drinker-of-the-Year
UK Chancellor, George Osborne awarded “Beer Drinker of the Year” (2013)
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Public Good Chain
Corporate social
responsibility
Health & communit
y programsSocial aspects
& public relations
organisations
Media coverage
Public consultatio
n
TobaccoAlcoholGamblin
gIndustrie
s
POLICYMAKERS
Purposes: • Industry is a good corporate citizen• Industry is handling the harms• Individuals, not systems are
responsible
HIGH VIS
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SAPROs“Social Aspects & Public Relations
Organisations”
DrinkWise Australia Industry funded Do something visible
about harm from alcohol
Binge drinking, public awareness, alcohol & pregnancy, drink driving, underage drinking
How to Drink Properly
Source: https://www.drinkwise.org.au/
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Knowledge Chain
Priority setting processes
Researchers & research
organizationsFunding &
commissioning processes
Communication &
dissemination
Government officials
TobaccoAlcoholGamblin
gIndustrie
s
POLICYMAKERS
Purposes: • Industry knows its own business best• Industry shapes the research agenda• Credible pro-consumption knowledge
base
MOD VIS
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Six steps along the chain:
1. The handshake2. The pilot project3. The offer4. Ongoing funding5. Group membership6. Policy
communication
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US Tobacco Researcher
Ernst Wynder (1923 – 1999)
Epidemiologist, in 1950 linked smoking to lung cancer
Research funded by Philip Morris 1961 – 1990
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US Tobacco ResearcherHandshake: 1955 Philip Morris contacted himPilot: 1961 small fund for 3 yearsOffer: 1969 $50 mill in resourcesOngoing $: 1970s regular amountsMembership: 1973 key in Philip Morris stablePolicy Communicator: 1980s spoke out about passive smoking
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Brazilian Alcohol Researcher
Arthur Guerra de Andrade
Industry funded at State University of São Paulo
Heads SAPRO “Center for Information on Health & Alcohol” (CISA)
Source: Biblioteca Virtuals
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Brazilian Alcohol Researcher
Source: Biblioteca Virtuals
Handshake: 2002 AmBev invited him into discussionsPilot: Mid 2000s form CISA & few public education projectsOffer: Accepted $ for researchOngoing $: 90% from industryMembership: Late 2000s on international boards ICAP, ICAAPolicy Communicator: Advises state & federal governments
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Harvard Gambling Research
Howard Shaffer Director, Division of
Addictions, Cambridge Health Alliance
Source: https://www.youtube.com/watch?v=KhbmdyIlI7w
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Harvard Gambling Research
Source: https://www.youtube.com/watch?v=KhbmdyIlI7w
Handshake: 1996 discussions with American Gaming AssociationPilot: Accepted $140K Offer: 2000 director of industry- funded Institute (IRPGRD)Ongoing $: By 2008 $9 millMembership: Prominent researcher internationallyPolicy Communicator: Advises US and other governments
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Politicians
Public Consultation
GovernmentOfficials
TobaccoAlcoholGamblin
gCompani
es
INDUSTRY SECTOR
GOVERNMENT
SECTOR
Public Good Chain
Knowledge Chain
Political Chain
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Ethical decision making strategy PERIL analysis
Establishing benchmarks Policy & process for managing
engagement
Accepting Industry Money is a Dangerous Consumption:
Two Interventions
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Intensity of Relationship
Continuum of Risk
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OIL
LOTTERIES
ALCOHOL
TOBACCO
ARMAMENTS
SLOTS
PORN
PHARMACEUTICALS
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Low RiskModerate Risk
High RiskExtremelyHigh Risk
Primary Concern
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Intensity Indicators
Purpose
How purposes match?
Extent
Percent of funding?
Relevant-harm
How harmful the product?
Identifiers
How visible the relationship?
Link
Directness of relationship?
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Purpose Extent Relevant-harm Identifiers Links
LOWRISK
MODRISK
HIGHRISK
EXTR. H.RISK
Group 1: A public health researcher receiving funds directly from a tobacco company in a publicly visible way.Group 2: A genetics project receiving half its income directly from a brewery
Group 3: Research equipment funded partially from donations from a pokie trust
Group 4: An addiction symposium funded by a small grant from lotteries
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Traffic Light of Risk
Class C (Monitor)Pornography, Plastic Surgery, Milk
Class C (Monitor)Pornography, Plastic Surgery, Milk
Class B (Manage)Fossil fuels, Lotteries, Fast Food
Class B (Manage)Fossil fuels, Lotteries, Fast Food
Class A (Curtail)Tobacco, Armaments, Pokies, Alcohol
Class A (Curtail)Tobacco, Armaments, Pokies, Alcohol
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Final Thoughts Learnt much from tobacco Easy to plug-in without
realizing wider consequences
Promoting open dialogue about sources is key
Need ethical benchmarks & codes of practice
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MORAL JEOPARD
YThe Risks of Accepting Money from Tobacco, Alcohol & Gambling
Industries
Cambridge University Press
Peter J. Adams
UpcomingBook