Monday, December 05, 2011

CDC Partnership with Pfizer Puts Question Mark on Its Scientific Objectivity

According to a CDC Foundation press release, the CDC Foundation, the CDC, and Pfizer have formed a partnership, made possible by Pfizer funding, to conduct a study examining the economic impact of smoke-free bar and restaurant laws in nine states.

According to the press release: "As part of ongoing efforts to reduce disease and death caused by smoking and secondhand smoke exposure, the CDC Foundation and CDC have launched a new initiative to study the economic impact of smoke-free policies on restaurants and bars in nine states. ... This initiative, made possible by a partnership grant from Pfizer to the CDC Foundation, will assess the economic impact of local smoke-free laws on restaurants and bars by examining objective economic indicators." ...

"'We deeply appreciate our ongoing partnership with Pfizer to support CDC’s work to protect us all from dangerous and expensive health threats,' says Charles Stokes, president and CEO of the CDC Foundation. 'Each public-partnership forged through the CDC Foundation helps CDC put science into action to save lives. We believe this innovative partnership, which was made possible by Pfizer, could substantially improve health for many individuals and communities.'"

"'As part of Pfizer's commitment to addressing important public health needs, we are proud to partner with the CDC Foundation on this research initiative,' said Freda C. Lewis-Hall, M.D., FAPA, chief medical officer and executive vice president, Pfizer. 'Our goal is to help the CDC Foundation, working with CDC and other partners, provide state and local health groups with an independent, objective assessment of the economic impact of smoke-free policies on restaurants and bars. We hope that the results of this analysis will advance efforts to reduce secondhand smoke and the serious health risks it poses to nonsmokers.'"

The Rest of the Story

According to the CDC Foundation, it accepts partnerships only if they "present no conflict of interest for CDC or the CDC Foundation."

I do not understand how the CDC can argue that partnering with Pfizer is not a conflict of interest. If CDC conducted no work that related to the approval of disapproval of products manufactured by Pfizer, I would agree that the partnership does not represent a conflict of interest. But that is not the case. The CDC reviews and issues approval or disapproval to products manufactured by Pfizer and other pharmaceutical companies all the time.

For example, the CDC makes recommendations regarding the use of vaccines. One vaccine about which the CDC deliberated was Pfizer's Prevnar. The CDC Advisory Committee on Immunization Practices (ACIP) regularly makes recommendations regarding the use of vaccines.

Furthermore, CDC makes recommendations regarding a wide range of other drugs, related to the prevention and treatment of all sorts of infectious and chronic diseases.

Through its partnership with CDC and the CDC Foundation, Pfizer has the potential to gain an increased corporate image among CDC staff, and therefore, to influence decisions that the CDC makes about the approval or disapproval of Pfizer products. I am not arguing that the influence is a conscious one. I’m not saying that CDC will consciously say to itself: we received money from Pfizer so let’s be extra nice to them in our formulation of public recommendations. However, I do believe that the receipt of this funding from Pfizer, which the CDC Foundation praises heavily in its press release, will have the effect of improving the company’s image within the agency, and that it could potentially have a subconscious effect on the agency and therefore influence its actions. This is precisely how conflicts of interest work.

If this were an individual researcher rather than an agency, there is no question that the partnership with Pfizer and other pharmaceutical companies would represent a conflict of interest. I see no reason why it is not a conflict just because the CDC is an agency rather than an individual. The conflict of interest would be expected to work in exactly the same way.

The CDC Foundation has a large number of partnerships with Big Pharma companies, including GlaxoSmithKline, Bristol-Myers Squibb, Eli Lilly, Johnson & Johnson, Novartis, and Sanofi-Aventis. So the problem is not restricted to this one partnership with Pfizer.

The CDC Foundation also partners with the Coca-Cola Company. According to the CDC Foundation, partnerships are only accepted with "Corporations whose goals or philanthropic interests align with CDC’s work...".

In what way do Coca-Cola’s goals align with those of CDC? The CDC is in the business of trying to improve the public’s health. Coca-Cola is in the business of trying to market and sell sugar-laden soft drinks that contribute to the obesity epidemic. The CDC presumably favors school nutrition improvement. Coca-Cola has opposed virtually every piece of state legislation to improve school nutrition. The CDC presumably wants to decrease the consumption of sugar-laden soft drinks. Coca-Cola is working to sustain the sales of its sugar-laden soft drinks.

Don’t get me wrong. I’m not criticizing Coca-Cola. They are not in business to reduce obesity. They are in business to sell soft drinks and I wouldn’t argue that they should do otherwise. If anything, I commend Coca-Cola for being brilliant enough to use its money in a way that may soften the CDC’s stance on sugar-laden soft drinks.

The CDC Foundation also partners with Abbott Laboratories.

How could the CDC’s partnership with Abbott Laboratories not constitute a violation of its corporate partnership policy? Abbott Laboratories is one of the leading manufacturers of infant formula, which it is pushing to pregnant women through programs such as the giveaway of infant formula in hospitals. Presumably, the CDC has a vested interest in promoting increased breastfeeding and reduced use of infant formula. This certainly appears to represent a conflict of interest.

The CDC Foundation also partners with Georgia Pacific.

How could CDC’s partnership with Georgia Pacific not constitute a conflict of interest? Georgia Pacific is one of the nation's leading corporate polluters. In what way does that align with CDC's mission and goals?

The rest of the story is that through its corporate partnerships with companies which either produce products that are causing harm to the public or which are within the scope of CDC’s public recommendations, the CDC Foundation is creating significant conflict of interests that conflict with its stated policy of avoiding such conflicts. I believe that these partnerships taint the scientific objectivity of the agency, are inconsistent with the stated mission and policy of the CDC and CDC Foundation, and represent a disservice to the public’s interest.

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