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可口可乐公司主导中国肥胖政策威胁科学诚信

(2019-01-11 13:47:58) 下一个

Susan Greenhal描述了可口可乐公司如何在中国主导肥胖政策: 对科学诚信的威胁, conflict of interest

改变对话: 20世纪70年代后期,可口可乐利用中国社会对国际社会的开放,利用当时极为有限的机会让中国研究人员获得资金进行研究或与西方同行建立联系。 然而,可口可乐并没有向中国研究人员提供这些方法。 相反,它是一个名为国际生命科学研究所的组织 - 这个名称结合了健康,学术和国际联系的思想,同时也形成了一个令人难忘的首字母缩略词ILSI。 然而,ILSI由可口可乐公司高管建立,并由该公司提供大量资金。
我们现在知道,公司广泛利用ILSI等第三方来创建一个主导性叙述,其中描述了如何看待问题,并设定了响应被视为“合理”的界限,同时排除了最有效的措施 - 尤其是那些有害的措施公司的利益 - 来自议程。有些人有特定的目标,例如室内空气研究中心,该中心试图破坏关于二手烟危害的证据.6其他人使用广泛的方法,包括促进个人选择而非集体行动,支持往往无效的教育活动与解决其产品的价格,可用性和营销的法律或监管措施相比.7使用“保姆国家”一词来攻击许多最有效的公共卫生措施.8他们的方法也强调了“ “公共卫生问题的复杂性,暗示无法解决这些问题,将相同的语言应用于垃圾食品,赌博和石棉等各种问题。”
这种方法也淡化了潜在的利益冲突。 行业资助的报告认为,每个人在某种程度上都存在冲突 - 例如,在持有某些政治观点 - 并且只要资金被宣布,任何冲突都很容易管理。 如果每个人都有冲突,就没有理由担心.10然而,大量证据表明,行业资助的研究倾向于得出有利于其赞助者的结论11,而且资金的披露本身就不充分,因为研究人员可能会夸大他们的研究结果并且评论者会对 偏见的可能性
ILSI在中国的活动与其他地方的活动类似,长期以来一直引起关注。 2001年,世界卫生组织的一份报告谴责其与烟草业的联系.13 2002年的一篇论文将ILSI参与研究伙伴关系描述为“对科学诚信的威胁”.14然而,尽管这些信息可以免费获得,但ILSI的18个组成机构继续 在世界各地都有影响力。
改变态度
然而,有迹象表明态度正在发生变化。最近,食品公司Mars退出了ILSI,并指出其对“倡导主导研究”的关注“主要是出于正当理由而受到批评。”15菲利普莫里斯新资助的无烟世界基金会引起了很多不利评论16,许多大学和公共卫生协会表示他们不会接受来自它的资助。美国国立卫生研究院已退出酒精行业资助的中度饮酒项目,并为此类合作伙伴关系发布了新指南.17英国慈善委员会正在质疑一些最积极支持叙述的智库的地位。公司18但拒绝公布其资助者的详细信息.19然而,最近英国公共卫生部与酒精行业资助慈善机构Drinkaware合作的严厉批评决定显示,这条消息并未传达给大家.20

Banning commercial-funded research gives benefits that far outweigh any minor side effects of no-commercially-funded research ever seen? any big data?
禁止商业资助的研究带来的好处远远超过有史以来没有商业资助的研究的任何轻微副作用? 任何大数据?


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Features

Mao Zedong famously said that “political power grows out of the barrel of a gun.”1 As he was someone who looked to the Russian Revolution for inspiration while engaged in a war to liberate his country from Japanese occupation, his view was understandable. Yet power can be exerted in different ways and can be most effective when it is hidden, with decisions made behind closed doors, or even invisible, so that the decisions one person makes are influenced by another without them realising it.2

The growing literature on what are termed “the commercial determinants of health” pays particular attention to the hidden and invisible forms of power, whereby large corporations use various methods to shape thinking about what are appropriate responses to the health consequences of their products.3 In the accompanying article, Susan Greenhalgh describes how the Coca-Cola Company came to dominate obesity policy in China even though its influence was obscured behind the public face of intermediaries (doi:10.1136/bmj.k5050).4
 

来自中国的教训

毛泽东着名地说“政治权力从枪管中长出来。”1由于他是一个在为了解放日本占领国家而进行战争期间向俄罗斯革命寻求灵感的人,他的观点是可以理解的。然而,权力可以以不同的方式发挥作用,并且在隐藏时可以最有效,决策是在闭门造车,甚至是不可见的,这样一个人做出的决定就会受到另一个人的影响而没有他们意识到。

关于被称为“健康的商业决定因素”的越来越多的文献特别关注隐藏和不可见的权力形式,大公司使用各种方法来思考什么是对其产品的健康后果的适当反应.3在随后的文章Susan Greenhal描述了可口可乐公司如何在中国主导肥胖政策,尽管它的影响力在中间人的公众面前被掩盖了(doi:10.1136 / bmj.k5050).4

Changing the conversation

In the late 1970s, Coca-Cola took advantage of the opening of Chinese society to the international community, exploiting the then extremely limited opportunities for Chinese researchers to access funds to undertake studies or to develop links with Western counterparts. It was not, however, Coca-Cola that made the approaches to Chinese researchers. Instead it was an organisation called the International Life Sciences Institute—a name that combined ideas of health, academia, and international links while also forming a memorable acronym, ILSI. Yet ILSI was established by a Coca-Cola executive with substantial funding from the company.

As Greenhalgh describes, the ILSI “Focal Point in China” (ILSI-China) has been able to exert remarkable influence on development of obesity policy by promoting a narrative that all foods and drinks, including those produced by Coca-Cola, could be part of a healthy diet. What matters, it claims, is that individuals expend the calories they ingest by taking sufficient exercise. This was also the core message of the Global Energy Balance Network, also set up by Coca-Cola and with members well represented at the Chinese conferences supported by ILSI. Coca-Cola had viewed the network as a “weapon” to “change the conversation” about obesity to one that diverted attention from their products in what it portrayed as a “war between the public health community and private industry.”5

We now know that corporations make extensive use of third parties such as ILSI to create a dominant narrative that frames how issues are viewed and sets the boundaries within which responses are seen as “reasonable,” while excluding the most effective measures—especially those that harm the interests of the corporations—from the agenda. Some have specific goals, such as the Center for Indoor Air Research, which sought to undermine the evidence on the dangers of secondhand smoke.6 Others use a broad based approach that includes promotion of individual choice over collective action, supporting often ineffective educational campaigns rather than the legal or regulatory measures that tackle price, availability, and marketing of their products.7 This is exemplified in the use of the term “nanny state” to attack many of the most effective public health measures.8 Their approach also emphasises the “complexity” of public health problems, implying that little can be done to tackle them, applying the same language to issues as diverse as junk food, gambling, and asbestos.9

This approach also downplays potential conflicts of interest. Industry funded reports contend that everyone is in some way conflicted—for example, in holding certain political views—and that as long as funding is declared any conflicts are easily managed. If everyone is conflicted, there is no cause for concern.10 Yet a wealth of evidence shows that industry funded studies tend to reach conclusions favourable to their sponsors11 and that disclosure of funding alone is inadequate, as researchers may exaggerate their findings and reviewers discount the potential for bias.12

ILSI’s activities in China are similar to those it pursues elsewhere, which have long raised concerns. In 2001 a World Health Organization report condemned its links to the tobacco industry.13 A 2002 paper described ILSI’s involvement in research partnerships as a “threat to scientific integrity.”14 Yet, despite this information being freely available, ILSI’s 18 constituent bodies continue to be influential around the world.

Changing attitudes

There are, however, signs that attitudes are changing. Recently, the food company Mars pulled out of ILSI, noting concern about its “advocacy led studies” that “mostly for the right reasons, have been criticized.”15 The new Philip Morris funded Foundation for a Smoke Free World has attracted much adverse comment,16 and many universities and public health associations have stated that they will not accept funding from it. The US National Institutes of Health has withdrawn from an alcohol industry funded project on moderate drinking and issued new guidelines for such partnerships.17 The UK Charity Commission is questioning the status of some of the think tanks that have been most active in supporting the narrative of corporations18 but refuse to publish details of their funders.19 Yet, as the recent heavily criticised decision by Public Health England to partner with the alcohol industry funded charity Drinkaware shows, this message has not got through to everyone.20

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