Thursday, June 11, 2015

CDC Lying About Financial Conflicts of Interest and Failing to Disclose Big Pharma Funding When It Releases Statements About E-Cigarettes

The Centers for Disease Control and Prevention (CDC) makes a multitude of recommendations regarding the prevention and treatment of a variety of diseases and adverse health conditions. Many of these recommendations involve the promotion of specific pharmaceutical products, such as antibiotics, vaccines, or smoking cessation drugs.

For this reason, it would seem important that the CDC remain independent of any corporate influence and that the agency not accept funding from corporations, especially from Big Pharma.

In fact, the CDC claims to have no financial interests or other relationships with any manufacturers of commercial products that are involved in its recommendations. The CDC claims that it does not accept any commercial support.

For example, on the web page for a smoking cessation tutorial funded by CDC, the following disclaimer is provided:

"CDC, our planners, and our content experts wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters with the exception of: Dr. Neal Benowitz. He wishes to disclose that he was a member of the Pfizer Inc. advisory board and a paid consultant for GlaxoSmithKline. Dr. Nancy Rigotti. She wishes to disclose that she was a member of the Pfizer Inc. scientific advisory board, receives royalties for chapter on smoking cessation from UpToDate, Inc., and a research grant was awarded to Massachusetts General Hospital (not to Dr. Rigotti) from Nabi Biopharmaceuticals."

Thus, CDC is claiming that the agency receives no funding from any companies.

This disclaimer appears widely in virtually all of the course content provided by the agency.

For example, in its course on the tetanus/diphtheria/pertussis vaccine, the CDC states:

"CDC, our planners, and our content experts wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. ... CDC does not accept commercial support."

As I have revealed on this blog, the CDC has made numerous (false) public statements about electronic cigarettes, including the claim that they are a gateway to youth smoking and a source of lifetime addiction for kids who experiment with them. In none of these statements has the CDC disclosed any financial conflicts of interest. This would certainly lead the public to believe that CDC has no financial relationship with Big Pharma, as this would represent a conflict of interest. The pharmaceutical companies' profits are seriously threatened by electronic cigarettes, as these products represent an alternative to smoking cessation drugs, including the nicotine patch, nicotine gum, nicotine inhaler, Chantix, Zyban, and others.

The Rest of the Story

The rest of the story, quite simply and sadly, is that the CDC is lying. Not only about electronic cigarettes being a gateway to smoking and a source of lifetime addiction for kids, but also about its having no financial interests or other relationships with the manufacturers of commercial products.

The truth is that CDC has multiple partnerships with corporations and that it receives a great deal of funding from multiple companies. And these companies include Big Pharma.

According to its fiscal year 2014 report, the CDC Foundation, which provides financial support for CDC programs, received funding from multiple pharmaceutical companies, including:
  • Bristol-Myers Squibb;
  • Jansenn Therapeutics;
  • Johnson & Johnson;
  • Kadman Pharmaceuticals;
  • Lupin Pharmaceuticals;
  • Merck;
  • Novo Nordisk;
  • Onyx Pharmaceuticals;
  • Pfizer;
  • Sanofi-Aventis; and
  • Vertex Pharmaceuticals.
The CDC Foundation readily admits that its purpose is to forge relationships between CDC and private companies and to raise money to support CDC's work. The CDC partners with at least one funding partner (i.e., company) to implement public health programs. In the CDC Foundation's own words:

"Established by Congress as an independent, nonprofit organization, the CDC Foundation connects the Centers for Disease Control and Prevention (CDC) with private-sector organizations and individuals to build public health programs that make our world healthier and safer. Since 1995, the CDC Foundation has provided $450 million to support CDC's work, launched more than 750 programs around the world and built a network of individuals and organizations committed to supporting CDC and public health. Each CDC Foundation program involves a talented team of experts at CDC and at least one outside funding partner. Sometimes, a program begins with a CDC scientist who has a great idea and wants to collaborate with an outside partner to make it happen. At other times, organizations in the private sector recognize that they can better accomplish their own public health goals by working with CDC through the CDC Foundation."

According to an article in The BMJ, the CDC Foundation received $12 million from corporations in 2014 and the CDC itself received $16 million from sources including individuals, philanthropic organizations, and corporations. Moreover, the CDC receives some funding directly from the CDC Foundation.

According to the article:

"Despite the agency’s disclaimer, the CDC does receive millions of dollars in industry gifts and funding, both directly and indirectly, and several recent CDC actions and recommendations have raised questions about the science it cites, the clinical guidelines it promotes, and the money it is taking. Marcia Angell, former editor in chief of the New England Journal of Medicine, told The BMJ, “The CDC has enormous credibility among physicians, in no small part because the agency is generally thought to be free of industry bias. Financial dealings with biopharmaceutical companies threaten that reputation.”"

According to the article, CDC director Dr. Thomas Frieden "did not respond to a question about the disclaimer." However, he apparently did acknowledge that the agency's funding from corporations does present conflicts of interest, stating: "When possible conflicts of interest arise, we take a hard, close look to ensure that proper policies and guideline are followed before accepting outside donations."

In other words, Dr. Frieden has essentially admitted that the CDC is lying in its disclaimer.

If the CDC is lying so readily about its funding from and partnerships with private corporations then perhaps it is not surprising that the CDC is also lying about electronic cigarettes being a gateway to smoking and condemning millions of kids to a lifetime of addiction. The agency's funding from pharmaceutical companies that stand to lose severely if electronic cigarettes are promoted creates a clear conflict of interest that CDC has failed to disclose.

This story is particularly troubling because CDC is the nation's leading public health agency and the public relies on its credibility to make decisions and formulate policies that literally affect life and death. That the CDC's recommendations may be tainted by corporate conflicts of interest is inexcusable. That the CDC is hiding these conflicts is reprehensible. And that the CDC is lying about having these financial relationships in the first place is a tragedy because it threatens the basic credibility of the agency, which in turn, threatens the agency's ability to protect and promote the public's health.

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