A recent book by Gerald Otero, The Neoliberal Diet: Unhealthy Profits, Unhealthy People, analyzes how global diets have changed in recent decades, what caused these changes, and who loses and gains by the transformation. In the book, Otero describes how the global diet that emerged at the turn of the 21st century has contributed to world-wide increases in overweight and obesity and how neoliberalism, the variant of capitalism that evolved in this period, promotes obesogenic diets.
In September, 2017, notes a new letter in Lancet, Philip Morris International, one of the world’s largest tobacco companies, set up the Foundation for a Smoke-Free World, with almost US $1 billion of funding over 12 years. The Foundation claims to be an independent scientific body aiming to “accelerate an end to smoking”. Yet controversy has surrounded the Foundation since its inception; its claims of legitimacy and independence have been strongly disputed and WHO and hundreds of public health organizations globally have taken a strong stance in rejecting collaboration with the Foundation.
A smoggy Los Angeles street in 1960. Credit
As President Trump, the auto industry and the state of California battle over air pollution standards, a new article in Public Health Reports analyzes the early years of 20th-century air pollution control in Los Angeles. In both scholarship and public memory, mid-century efforts at the regional level were overshadowed by major federal developments, namely the Clean Air Act and creation of the US Environmental Protection Agency in 1970.
An institute whose experts have occupied key positions on European Union and United Nations regulatory panels is, in fact, reports The Guardian, an industry lobby group that masquerades as a scientific health charity. The revelations, based on a review of more than 17,000 documents released under U.S. freedom of information laws, appear in a new article in Globalization and Health. Sarah Steele, the lead author and a researcher at Cambridge University said: “Our findings add to the evidence that this nonprofit organization has been used by its corporate backers for years to counter public health policies. ILSI should be regarded as an industry group—a private body and regulated as such, not as a body acting for the greater good.” Among the companies that support ILSI are Coca Cola and Monsanto.
Overt the last several years, the pharmaceutical industry has been accused of inappropriately and misleadingly advertising prescription drugs to consumers, charging exorbitant prices, paying competitors not to release less expensive generic drugs, and negotiating trade agreements that benefit the industry at the expense of the public. As public concern about these practices grows and as the 2020 election gets closer, Big Pharma is getting closer scrutiny.
A few recent actions illustrate this new climate. Earlier this month, reports The New York Times, the Trump administration announced that for the first time will, it will require pharmaceutical companies to include the price of prescription drugs in television advertisements if the cost exceeds $35 per month. The move is the most visible action the administration has taken so far to address the rising cost of prescription drugs. It has been a key issue for American voters and one that both Republicans and Democrats have vowed to address.
In Congress, Reps. Judy Chu (CA-27) and Devin Nunes (CA-22) last month introduced the Sunshine for Samples Act of 2019. This bill would amend the Sunshine Act, which requires pharma companies to report payments to doctors, to require companies that manufacture drugs, devices, biologics, or medical supplies to publicly make available the number and value of free drug samples given to health care providers and charities each year. The bill closes a loophole in the Sunshine Act and does not prevent drug and device manufacturers from continuing to provide free samples, nor does it add any new burdens to providers under the Open Payment Programs.
Both the Federal Trade Commission and Congress have also acted to oppose “pay for delay” a costly legal tactic that more and more branded drug manufacturers have been using to stifle competition from lower-cost generic medicines. These drug makers have been able to sidestep competition by offering patent settlements that pay generic companies not to bring lower-cost alternatives to market. Last month , Congressman Jerrold Nadler introduced H. R. 2375 , the Preserve Access to Affordable Generics and Biosimilars Act. The bill proposes to prohibit prescription drug companies from compensating other prescription drug companies to delay the entry of a generic drug, biosimilar biological product, or interchangeable biological product into the market.
These recent actions suggest that the 2020 election will provide public health professionals and advocates with opportunities to educate the American people and elected officials about the practices of the pharmaceutical industry and to counteract pharma’s extensive spending to influence Congress.
The 2010 World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol recommends countries adopt evidence-based interventions. A recent review in PLOS One updated, summarized, and appraised the methodological rigor of systematic reviews of selected alcohol control interventions in the Strategy. The authors identified 42 systematic reviews. Most reviews identified only observational studies with no studies from low or lower-middle income (LMIC) countries. Ten reviews were rated as low risk of bias. Methodological deficiencies included publication and language limits, no duplicate assessment, no assessment of study quality, and no integration of quality into result interpretation. We evaluated the following control measures as possibly beneficial: 1) community mobilization; 2) multi-component interventions in the drinking environment; 3) restricting alcohol advertising; 4) restricting on- and off-premise outlet density; 5) police patrols and ignition locks to reduce drink driving; and 6) increased price and taxation including minimum unit pricing. The authors concluded that robust and well-reported research synthesis is deficient in the alcohol control field despite the availability of clear methodological guidance. The lack of primary and synthesis research arising from LMIC should be prioritized globally.
Citation: Siegfried N, Parry C. Do alcohol control policies work? An umbrella review and quality assessment of systematic reviews of alcohol control interventions (2006–2017). PLoS One. 2019 Apr 10;14(4):e0214865.
Alcohol use is a leading risk factor for global disease burden, and data on alcohol exposure are crucial to evaluate progress in achieving global non-communicable disease goals. A new report in Lancet presents estimates on the main indicators of alcohol exposure for 189 countries from 1990–2017, with forecasts up to 2030.
The authors found that between 1990 and 2017, global adult per-capita consumption increased from 5·9 L to 6·5 L, and is forecasted to reach 7·6 L by 2030. The report forecasts that abstinence will decrease to 40% by 2030 and the proportion of current drinkers will increase to 50% by 2030. In 2017, 20% of adults were heavy episodic drinkers (compared with 1990 when it was estimated at 18·5%, and this prevalence is expected to increase to 23% in 2030.
Based on these data, global goals for reducing the harmful use of alcohol are unlikely to be achieved, and known effective and cost-effective policy measures should be implemented to reduce alcohol exposure.
Citation: Manthey J, Shield K, Rylett M, Hasan OS, Probst C. JR Alcohol exposure between 1990 and 2017 and forecasts until 2030: a global modelling study. Lancet.2019https://doi.org/10.1016/S0140-6736(18)32744-2
Excess consumption of added sugars, especially from sugary drinks, contributes to the high prevalence of childhood and adolescent obesity, especially among children and adolescents who are socioeconomically vulnerable. It also increases the risk for dental decay, cardiovascular disease, hypertension, dyslipidemia, insulin resistance, type 2 diabetes mellitus, fatty liver disease, and all-cause mortality. The 2015–2020 Dietary Guidelines for Americans recommend that added sugars contribute less than 10% of total calories consumed, yet US children and adolescents report consuming 17% of their calories from added sugars, nearly half of which are from sugary drinks. A new reportfrom the American Academy of Pediatrics and the American Heart Association finds that decreasing sugary drink consumption is of particular importance because sugary drinks are the leading source of added sugars in the US diet, provide little to no nutritional value, are high in energy density, and do little to increase feelings of satiety. To protect child and adolescent health, the report recommends, broad implementation of policy strategies to reduce sugary drink consumption in children and adolescents is urgently needed.
Agricultural Application Trends of Glyphosate in the United States According to U.S. Geological Survey (USGS) Data Credit from new ATSDR Report on Glyphosate
A French court has ruled that Monsanto was liable for the sickness of a farmer who inhaled one of its weed killers, in another legal setback for the Bayer-owned business over health claims, reports Reuters.
In the latest stage of a decade-long legal tussle, the appeals court in Lyon on Thursday found in favor of farmer Paul Francois’ claim that Monsanto’s Lasso weed killer had made him sick and that the product’s labeling had been inadequate. Francois, 55, says he suffered neurological problems, including memory loss, fainting and headaches, after accidentally inhaling Lasso in 2004 while working on his farm.
“Mr. Francois justifiably concludes that the product, due to its inadequate labeling that did not respect applicable regulations, did not offer the level of safety he could legitimately expect,” the court said in its ruling.
Another Reuters story reported that Bayer said it would comply with a U.S. federal judge’s order to enter mediation with a plaintiff who claims the company failed to warn against an alleged cancer risk from its Roundup weed killer. Bayer has seen $34 billion wiped off its market value since August, when a first U.S. jury found Bayer liable because Monsanto, the Creve Coeur-based company acquired by Bayer for $63 billion last year, had not warned of the alleged risk from Roundup, which is based on active ingredient glyphosate. It suffered a similar courtroom defeat last month and more than 10,000 cases are pending.
U.S. District Judge Vince Chhabria, who presided over the first two cases in federal court, said in a filing dated Thursday that Bayer and another plaintiff, Elaine Stevick, were ordered to start confidential mediation.
A third Reuters post reported that one of Bayer’s largest shareholders tore into the company’s management on Wednesday for underestimating the legal risks of its takeover of Monsanto, setting the stage for a fiery annual general meeting after a 30 percent plunge in the shares. “It’s quite drastic when a takeover triggers such value destruction and reputational damage so quickly. There can be no talk of a successful takeover anymore,” Ingo Speich, the head of sustainability and corporate governance at Deka Investment, told Reuters.
“What’s startling is that things have effectively moved beyond management’s control because we’re now at a point where the decisions over future development are made in court rooms,” he said, adding Bayer had clearly underestimated the risks.
Finally, a public health agency of the U.S. Department of Health and Human Services (DHHS), the Agency for Toxic Substances and Disease Registry (ATSDR), released the long-awaited Draft Toxicological Profile for Glyphosate. The report supports and strengthens the 2015 cancer assessment of another health agency, the International Agency for Research on Cancer (IARC).
As the environmental group NRD Cnotes, a pattern is emerging: non-industry experts (Zhang et al 2019) and health agencies IARC and ATSDR are finding a link with glyphosate and cancer; whereas, regulatory agencies are lining up with Monsanto and Bayer that it does not cause cancer, even when reviewing the same scientific evidence.
Lobbying expenses U.S. Beer, Wine and Liquor Industry. Source: Open Secrets
Development and implementation of evidence-based policies is needed in order to ameliorate the rising toll of non-communicable diseases (NCDs). Alcohol is a key cause of the mortality burden and alcohol policies are under-developed. This is due in part to the global influence of the alcohol industry. The authors propose that a better understanding of the methods and the effectiveness of alcohol industry influence on public health policies will support efforts to combat such influence, and advance global health. Many of the issues on the alcohol research agenda will inform, and be informed by, research into the political influence of other commercial actors.
Citation: McCambridge J, Kypri K, Sheldon TA, Madden M, Babor TF. Advancing public health policy making through research on the political strategies of alcohol industry actors. Journal of Public Health. 2019; doi.org/10.1093/pubmed/fdz031.