In view of September's summit on non-communicable diseases where world leaders will meet at the United Nations in New York, the BMJ raises serious concerns regarding the "powerful sway" of the tobacco, alcohol, food and drug industries as international governments prepare to agree global targets to cut avoidable deaths from chronic diseases.
The summit will be focused on four conditions, namely heart disease, cancer, diabetes, and respiratory diseases; which jointly account for over half of all deaths in low and middle income countries, yet receive less than 3% of global health aid. All four conditions share common risk factors that are preventable, i.e. tobacco use, unhealthy diet, lack of physical activity and alcohol abuse.
High hopes are anticipated for marking a turning point in fighting these diseases, however, BMJ investigations editor Deborah Cohen asks in a special report published today, whether commercial interests could undermine any commitments made at this crucial summit.
Cohen writes, that although the evidential need to reduce exposure to the risk factors is clear for many, negotiations appear to be stalling.
Various member states have received heavily annotated draft documents for many months, with the latest version, dated 5 August, being kept secret, however, BMJ has managed to see a copy in which each change is marked with the names of the countries, flagging up where the fracture lines are.
According to an NCD Alliance meeting this month "member states are deeply divided on key issues." They say a major concern are the "actions of the US, Canada and the European Union to block proposals for the inclusion of an overarching goal: to cut preventable deaths from non-communicable diseases by 25% by 2025."
The concern that industry interests could undermine action to prevent and treat NCDs has been raised by many organizations, which are also concerned that industry interests may undermine action to prevent and treat NCDs. A major point of disagreement is the call for "partnerships" in current draft documents. Believing this to be a wrong strategy, some argue that it requires legislation to hold industry accountable, rather than just a "voluntary" code that is unlikely to have the power to do so.
Indeed, draft documents reveal that effective, evidence-based measures on alcohol (controlling price, availability and marketing) are being deleted and industry favored measures (partnership working, community actions and health promotion) being substituted. Commitments to tackle tobacco are also being watered down with Japan, the EU, US and Canada resisting all language on taxation.
WHO Director General, Dr Margaret Chan, warned that many threats to health are driven by commercial interests from powerful corporations.
According to Bill Jeffery from the International Association of Consumer Food Organizations, "the UN and WHO need to put up firewalls between their policy-making processes and the alcohol and food companies "whose products stoke chronic diseases" and the drug and medical technology companies "whose fortunes rise with every diagnosed case."
In support of this view, David Stuckler and his colleagues argued in an accompanying comment "much of the NCD agenda is being written by powerful vested interests." They call attention to the fact that representatives of the U.S. and Europe with key Western allies blocked consensus on NCD action after lobbying from the alcohol, food, tobacco and pharmaceutical industries at a preparatory meeting in New York and ask, "Should industries that profit on disease-causing products be viewed as trusted partners and have a seat at the table during public health negotiations?"
They conclude saying that the UN high level summit on NCDs
"is a battleground, pitting public interests against powerful private ones. Whether the meeting encourages the emergence of a global social movement for change will shape the future of our health for years to come."
Written by Petra Rattue