Kypros Kypri writes: It’s undeniable that there’s an irreconcilable conflict of interest in the alcohol industry being involved in developing health policy. And by participating in meetings involving industry representatives, scientists risk giving credibility to a fundamentally flawed process that’s unlikely to produce sound policy.
Let me explain why this is with examples of two such meetings I have […]participated in.
A direct conflict
The more recent was the Intergovernmental Committee on Drug Policy (IGCD) National Stakeholder Meeting on Alcohol Related Violence and Harm in Canberra (November 19, 2014). In an e-mail invitation, IGCD presented the meeting as:
an excellent opportunity for stakeholders to work collaboratively with experts and governments across Australia in identifying opportunities to reduce the impact of alcohol related violence and harm.
I was invited to give a presentation on the Newcastle experiment in earlier closing of pubs, and to join a panel including “representation from research, data, consumer, health, law enforcement and liquor licensing backgrounds.”
There was no mention in the invitation of alcohol industry involvement, yet there were senior representatives from the Australian Hotels Association, the Australian Liquor Stores Association, the Brewers Association of Australia & New Zealand, the Distilled Spirits Council of Australia, the Wine Federation of Australia and the industry-funded organisation DrinkWise Australia at the meeting.
These industry representatives were vocal, repeating usual lines about “individual responsibility”, “needing to work together” to address “complex problems”, saying there were “no silver bullets”, that “this industry employs thousands of Australians”, and that it’s “doing its part” and “has made enormous progress” in the effort to reduce alcohol-related harm.
There were also implicit threats that if the industry were “left out” of policy development, members would stop cooperating with authorities and might attempt to subvert efforts to reduce alcohol-related harm.
In response to a question about why we were not making better progress in getting evidence-based policy adopted in Australia, I suggested it was due, in part, to the fact that the alcohol industry has undue influence on policy makers, adding (quotation from notes I made the day after the meeting):
It is perfectly legitimate for the alcohol industry to want to make money from the sale of alcohol, a legal product. They are legally obliged to maximise value for shareholders, which typically involves selling more alcohol. If I were them I would come to meetings like this and try to shape the discourse as much as I could.
The meeting ended with each table of delegates producing a list of vaguely-defined policies on butcher’s paper. These were put on the wall and delegates were each given red stickers to place against the policies they considered “best buys”.
The IGCD secretariat then gave a summary of the outcome and we were told the finding would inform the development of the next national alcohol strategy. The alcohol industry had effectively been given a vote on the nation’s future alcohol policies.
The experience of this meeting reminded me of being on the health advisory panel for the development of the National Alcohol Strategy 2005-9. There was also an industry advisory panel.
At one stage, the secretariat presented us with a draft of the strategy document titled “National Alcohol Strategy 2005-2009: Developing our Drinking Culture”. We were advised the title had been suggested by the industry panel.
Members of the health advisory panel probably influenced the content of the document, but I was left wondering whether the nett effect of our involvement was positive. Or if we had simply given the government, which did nothing positive on alcohol in the years that followed, the opportunity to say they had consulted the experts.
If you’re not convinced there is an irreconcilable conflict of interest in having an industry that stands to profit from increased sales of a product involved in the regulation of that product, perhaps you’ll consider the track record of the industry in question here.
Like Big Tobacco, the alcohol industry systematically seeks to muddy the water around policy options by interfering with the evaluation of policy effectiveness data, funding scientists to pursue research questions favourable to industry interests, and forming alliances with supposed health advocates to pursue industry-friendly policy outcomes.
How a government decides to treat commercial interests in relation to public health depends on its values, sources of income, power in parliament, and perceived electoral position. But we have clear evidence that reducing the availability and promotion of alcohol are critical to reducing the alcohol-related disease and injury burden. And that education and information campaigns preferred by industry are generally ineffective, particularly in the absence of better controls on the availability and promotion of alcohol.
This science, which has grown substantially since Australia’s last effort to develop national strategy, is the evidence base on which the next strategy should be built. But if governments choose to prioritise commercial interests, they place health scientists in the invidious position of helping inflict damage on public health when participating in so-called policy development meetings.
Governments should listen respectfully to all legitimate interests, but they should also take action that prevents vested interests having influence on health policy.
** Kypros Kypri is Professor of Public Health, Epidemiology and Prevention of Alcohol-related Injury at The University of Newcastle.
This article was originally published on The Conversation.
Read the original article.
“The alcohol industry had effectively been given a vote on the nation’s future alcohol policies”
Doesn’t any one know anything about Stakeholder dialogues? The whole point is to bring in diverse opinions from relevant stakeholders. And the alcohol industry, for better or for worse, is a major stakeholder being the primary distributor of alcohol. To form a policy without their involvement is ridiculous and is more likely to result in adverse outcomes (see every policy failure over the last 20 years). The best policies are the ones where the industry affected has been consulted and given input. The alcohol industry wants a healthy/peaceful population as well, remember. It’s good for business.
Also, the industry can hardly claim new policy recommendations are a witch hunt/they weren’t consulted if they are in the meetings. Better to have them inside the tent pissing out than the other way around.
Read the philosophy of Habermas for further info..specifically his theories on Communicative rationality.
I was a member of the project management group responsible for the consultation process and development of the National Alcohol Strategy (2006-2009). The goal of the strategy was “to prevent and minimise alcohol-related harm to individuals, families and communities in the context of developing safer and healthy drinking cultures in Australia.” We consulted widely with community members and sought advice from a wide range of experts – grouping them into four advisory groups. One was the Alcohol Beverages and Hospitality Advisory Group. As one of the cornerstones of the strategy development process was to align recommendations with the available evidence, we were dismissive of contributions that clearly failed this test. Some such contributions came from the industry group (no-doubt for the reasons that Kyp outlined) but that was not the only source.
My recollection is that the sub text in the title was always “Towards Safer Drinking Cultures” – as a member of the project management group I would have objected to the ambiguity of a sub-title – “Developing our Drinking Culture.” It would have been even more problematic if such ambiguity was based on industry influence.
At that time I think it was appropriate to seek advice from the industry in an arms-length advisory way – representing just one source of advice in the development of an evidence-based strategy to be accepted or otherwise. But each time we consider the considerable community costs of alcohol we need to very carefully consider the nature and extent of any involvement of those with vested interests. There are many examples where involvement has been inappropriate.
It is also worth mentioning that some deviation from the evidence-base (eg. exclusion of sensible taxation reform recommendations) appeared in the final, government endorsed version of the strategy. This was disappointing but not surprising given the complexity of policy development processes.
My final point is that at the time I was very aware that the advisory process we set up was not the only opportunity for the industry to influence the final strategy.