Dr. Derek Yach at the launch of the Foundation for a Tobacco Free World credit
Last September, Phillip Morris International , which calls itself the “world’s most successful cigarette company”, announced that beginning in 2018, it would contribute about US$80 million annually over the next 12 years to create the Foundation for a Smoke-Free World with the goal of accelerating “progress in reducing harm and deaths from smoking worldwide.” Derek Yach, whose credits include serving as a key architect of the WHO’s Framework Convention on Tobacco Control and a stint as Senior Vice President for Global Health and Agriculture Policy at PepsiCo, was hired to serve as President of the new foundation.
Within the public health and tobacco control community reaction to the new foundation has been divided—mostly negative.
Writing in The Wire, an independent news platform based in India, Anoo Bhuyan summarized some of the reactions:
Philip Morris International is attempting to distribute nearly $1 billion for research on reducing smoking. But the grant is being called a “billion dollar bribe” of “blood money,” a “wolf in sheep’s clothing,” a “smokescreen,” a “public relations stunt” and the “height of hypocrisy.” The American Cancer Society has even called it a “new twist out of the tobacco industry’s deadly playbook”, while the World Heart Federation says it is a “vehicle for the tobacco industry.” One anti-smoking group said “the tobacco epidemic will never be ended by its perpetrators.” Another found it so unbelievable they said it “truly sounds like fake news.”
A number of top universities in the US and UK have said they will not be accepting this research funding as it clashes with their ethics policies. Columbia University remained non-committal on the issue. However, one scholar at Harvard’s prestigious T.H. Chan School of Public Health told The Wire that they are “discussing” if it violates their 15-year-old policy of rejecting funding from the tobacco industry. He added, however, that the university’s ban on tobacco industry funds remained firmly in place.
In a blog for the British Medical Journal, Richard Smith, who served as editor of that journal until 2004, offered a different opinion:
There is a logic to Yach’s move. It will probably never be possible to achieve a nicotine-free world, not least because people with severe mental health problems find benefit from nicotine…. But with the arrival of e-cigarettes it may be possible to achieve a tobacco-free world. E-cigarettes might be harmful, but even the most ardent anti-tobacco campaigner would agree that it’s the smoke not the nicotine that kills. The appearance of e-cigarettes is changing the world of tobacco as railways changed canals and digital images changed film. How should tobacco companies react? …Philip Morris International seems to have bet that e-cigarettes will be the future, and so there is business logic to funding a Foundation for a Smoke-Free world. Unfortunately, there is also a business logic to continuing to block attempts to reduce cigarette consumption in markets where e-cigarettes have yet to make inroads.
This two-faced attitude will seem unacceptable to many, but if the foundation can achieve real independence from the company then much can be achieved with $1 billion. Many foundations have little or no independence from their companies, but I believe that it is possible to achieve true independence with the right governance—at least if the money is committed for 12 years.
The debate about BMI’s billion dollar investment mirrors a larger dispute about e-cigarettes and the future of the tobacco/nicotine industry and of tobacco/nicotine control. A few recent reports illustrate the scope of the conflict.
In a special report on Philip Morris research on e-cigarettes, Reuters questioned the quality of the research PMI has sponsored to justify its new smoking devices to the US Food and Drug Administration and other regulatory agencies.
Tamara Koval, who worked at the company from 2012 to 2014 and helped coordinate clinical trials for the device, questioned the quality of some of the researchers and sites contracted to carry out those experiments. Koval was a co-author of the company’s protocol used to run the studies globally. When she highlighted an irregularity in one of the studies, Koval said, Philip Morris excluded her from meetings.
Reuters also found irregularities during interviews with some of the principal investigators contracted to conduct the trials for the company. One principal investigator said he knew nothing about tobacco. Philip Morris had to jettison the experiment that investigator performed after it emerged he hadn’t followed a basic procedure for obtaining informed consent from participants during clinical trials.
The allegations raise questions as to whether despite its new foundation, PMI is following its old strategy of distorting science to achieve its business goals. David Kessler, a former FDA commissioner told Reuters, “taken as a whole, it’s clear they do not have the sophistication to carry out adequate and well-controlled clinical trials.”
The conflicts about PMI and e-cigarettes also raise larger questions for the public health community:
- What might be the consequences of creating corporate sponsored research foundations at the same time as the federal government is cutting public health regulations and the agencies that support them?
- How will private corporate-sponsored philanthropy influence government decisions about public research funding?
- What effect will corporate -sponsored research foundations—however rigorous and independent their research—have on public trust of science and scientists?
As tobacco control activists debate the specific questions of how to respond to PMI’s new Foundation for a Smoke-Free World, it is important to also pay attention to the longer-term consequences of corporate funding for public health research.
Corporations and Health Watch