The recent publication of pharmaceutical industry funding to some of the World Health Organisation’s scientific advisers on flu has rekindled a debate on conflicts of interest. The reality is that there is no interest without conflicts.
Commercial funding to experts has the potential to bias their judgment, and any failure to disclose it fully naturally raises suspicion that they may be selectively promoting the products of their “sponsors”. That was one reason why the WHO was wrong to delay disclosure of the interests of those on its flu emergency committee until its work was complete.
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However, if transparency is the starting point for any debate about conflicts, it has too often also served as the endpoint. The mere fact that scientists receive funding from companies – whether for travel, consultancy or academic research – does not mean they should be excluded from policy debates and the drafting of guidelines.
Funding from any source – public and charitable sectors as well as companies – has the potential to bias judgment, including through concerns that strong views could jeopardise future support. Many other factors, such as personal career advancement, may also distort researchers’ objectivity.
In the medical and public health spheres in particular, it is logical that those working to develop drugs and vaccines are in close contact with each other. No useful treatment can be devised without tight collaboration between companies, academics, doctors and patients.
In the case of the WHO’s flu experts, the amount of support disclosed has proved modest. Yet excesses in other cases may occur, so regular scrutiny is required. There should be full, timely and consistent disclosure of all such interests, rather than the widely varied transparency criteria used by different organisations and academic journals.
This should form the basis for a rigorous debate about how to manage conflicts each time any panel that is drafting policy meets. The decisions should be taken both by peers involved in scientific panels, and by external assessors.
Whenever the conflicts of interest on the part of some individuals are judged very significant, this should not preclude their opinions being heard, but such experts should not be allowed to vote or decide on any final committee recommendation.
Ultimately, those without any conflicts probably also have less value to bring to the debate.
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