UN Summit on non-communicable diseases
Who is muddling up 'civil society'?
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Is the World Economic Forum a civil society organisation? WEF boss Klaus Schwab (left) may think so. Olivier Reynaud of WEF (right) with UN chiefs
Our news team reports: Will the UN summit on non-communicable diseases, being held in New York on 19-20 September, be unduly influenced by that sector of industry whose interests conflict with those of public health? Judging from preliminary meetings held in Moscow and in New York, this now seems likely.
A lead player in significant UN initiatives is the World Economic Forum, whose founder and CEO Klaus Schwab is pictured above, left. The WEF is a not-for-profit foundation. Does this make it a civil society organisation? As quoted on the WEF website, Klaus Schwab sees it as 'the "glue" between different stakeholders in society… I feel that governments today alone cannot address global challenges nor can business alone and nor can non-governmental organizations… We… create platforms for the three main pillars of society, that is, government, business and civil society, to interact and confront the issues which we have on the global agenda'. So what is WEF, government, business, or civil society? With the superglue metaphor in mind, maybe Klaus Schwab thinks it stands up all three pillars.
'Actually, the main concerns of the WEF are money and power' says Association Council member Geoffrey Cannon, who has experience of international meetings organised by the WEF. 'It is not so secretive as the Bilderberg Group, but its overall purpose at a global level is much the same. This is to accelerate economic globalisation, involving unimpeded flow of money and trade. The WEF now is probably engaged in some way with most major initiatives designed to shape international power politics. Now that the UN is so impoverished, the WEF is a heavier hitter than any UN agency. It organises 'public-private partnerships' and other alliances with UN agencies, national governments, highly-geared private foundations, and powerful non-government organisations. These are designed to promote the interests of what was once called 'the new world order', now increasingly dominated by transnational industry. That's its main job'.
Who will stand at the Summit?
So how does this affect the UN summit on non-communicable diseases? A clear indication was given at the preliminary 'interactive hearing' held in New York on 16 June. This mixed together civil society and other non-governmental organisations, academics, and people from industry. So, what is a 'civil society organisation' (CSO)? The term has now largely replaced 'non-governmental organisation' (NGO), because industry is non-governmental. It is generally now used to refer to non-profit organisations concerned with the public interest, that have no significant conflicts of interest, such as industry or government funding or other influence.
Says Association president Barrie Margetts: 'This is what makes civil society organisations a third force, in the public health and other fields. Governments have their job to do. So does industry. Civil society organisations have a different job. They can do this job, in the public interest, which is different from the commercial interest, provided that they are independent from government and industry'.
That seems clear enough. But it isn't. In all relevant public policy areas, corporations have set up or funded not-for-profit organisations, which may have charitable status, to represent their interests, as individual firms, or as part of industry sectors, or on behalf of commercial interests in general. Some may have the name of a firm in their title. But increasingly often, the name sounds like that of a professional or public interest organisation. In response, in 2006 the UN Standing Committee on Nutrition, on behalf of relevant UN agencies, issued a policy on engagement with the private sector, which can be accessed here. This makes a distinction between business interest NGOs (BINGOs) and public interest NGOs (PINGOs). A BINGO is in part defined as an organisation whose majority funding is from industry, making it not a civil society but a private sector body. A well-known example in the area of food and nutrition is the International Life Sciences Institute. In the more general field of public policy, so is the World Economic Forum.
For the UN Summit and the preliminary New York meeting, the job of supervising civil society participation, as agreed by the World Health Organization, is that of a 'civil society taskforce' of seven people. Of these, three are high-ups in the global professional organisations concerned with diabetes, heart disease, and cancer, two are from tobacco control organisations, and one is concerned with primary health care including essential drugs policy. The seventh member is Olivier Reynaud, World Economic Forum senior director in charge of 'global health and healthcare'. He is pictured above smiling at right, with Pan American Health Organization assistant director-general Socorro Gross-Galiano, and Pan-American Health and Education Foundation president Edward Kadunc.
Cynical observers of the New York 'interactive hearing' were not surprised to find that little attention was paid to distinguishing speakers from inside and outside industry, the general idea being that 'we are all in this together'. No distinction was made between business interest and public interest NGOs. Commenting, Barrie Margetts warns: 'Industry has its own interests, and the sector of industry most engaged with the UN Summit has interests that conflict with those of public health. Putting business interest bodies together with public interest groups, will ensure a bad result, which will do little to help the world's impoverished populations now suffering from chronic diseases, as well as infectious diseases and nutritional deficiencies'.
After the New York meeting, over 50 civil society organisations agreed the statement below. It has been sent to the President of the UN General Assembly, other member state representatives, and to UN officials.
Box 1
Statement of concern on lack of clarity on role of industry
for June UN interactive hearing and
September UN High Level Meeting 2011
Our organisations strongly support the objective of raising the profile of NCDs globally. This statement concerns the lack of clarity regarding the role of the private sector at the upcoming Civil Society Interactive Hearing in New York and UN High Level Meeting (UN HLM) in September. We call on the UN to:
1.Recognise and distinguish between industry including business-interest not-for- profit organisations (BINGOs) and public interest non-governmental organisations (PINGOs) that are both currently under the 'Civil Society' umbrella without distinction.
2. Develop a 'code of conduct' that sets out a clear framework for engaging the food and beverage industry and managing conflicts of interest, and which differentiates between policy development and implementation.
3. Address and acknowledge these concerns ahead of the UN High Level Summit in September.
Since the major causes of preventable death are driven by diseases related to tobacco, diet, physical inactivity and alcohol drinking, we are concerned that many of the proposals to address NCDs call for 'partnerships' in these areas with no clarification of what this actually means. Public-private partnerships in these areas can counteract efforts to regulate harmful marketing practices.
It is essential that a strong and clear policy on conflicts of interest is established by the international community to provide Member States with guidance to identify conflicts, eliminate those that are not permissible and manage those considered, based on thorough risk/benefit analysis, acceptable. Transparency, although an essential requirement and first step, is not a sufficient safeguard in and of itself against negative impacts of conflicts of interest.
We propose that the following framework be used as a basis for a code of conduct for industry:
The policy development stage should be free from industry involvement, to ensure a 'health in all policies' approach, which is not compromised by the obvious conflicts of interests associated with the food, alcohol, beverage and other industries, who are primarily answerable to shareholders.
The food and beverage industry should, of course, be kept informed about policy development, through stakeholder briefings for example, but should not be in an influencing position when it comes to setting policy and strategies for addressing public health issues, such as NCD prevention and control.
While it is important for the food and beverage industries to be in dialogue during the policy development process, this should be as a means of informing the process relating to practical issues rather than as members of the policy development team.
Industries are both part of the NCD problem and the solution. It is vital therefore to engage them in the most appropriate way when implementing policy and not when developing policy, to ensure that public health policy is protected from commercial interests.
Without this approach, WHO's principles of democratic policy-making for health, its constitutional mandate of the attainment of the highest possible level of health for all, and its independence, integrity and effectiveness will be undermined (1).
Without such a policy, conflicts of interest can become institutionalised as the norm, impacting on the authority of governments. Industries with a strong interest in the outcome will increasingly assume greater roles in policy and decision shaping. This can fundamentally compromise and distort international and national public health priorities and policies.
The conflict of interest concern is not limited to the direct involvement of industry. UN agencies, including the WHO, are unanimous in recognising the important contributions NGOs make in the area of public health and are aware of the growth of these organisations in their numbers and influence in health at global, regional and national levels, including in the area of NCDs.
However, WHO and others have so far not made a clear distinction between BINGOs (business-interest NGOs and not-for-profit organisations that are set up by, representing or closely linked to, business interests) and PINGOs – public-interest NGOs. This failure to distinguish between the two groupings exacerbates any existing lack of transparency and complicates implementation of any procedures which aim to manage the role of these actors in policy and standard-setting consultations.
In the Civil Society Interactive Hearing on 16 June there was no clear differentiation between groups within civil society. The voice of civil society ought to reflect only public health interests.
The safeguards in Article 5.3 of the Framework Convention on Tobacco Control, the WHO International Code of Marketing of Breast-milk Substitutes Resolutions on Infant and Young Child Nutrition, and the Global Strategy on Diet, Physical Activity and Health, can be used, among other helpful tools, to establish measures that go beyond individual conflicts of interests, and address institutional conflicts of interest.
In summary, we call on the UN to recognise and distinguish between BINGOs and PINGOs that are currently under the 'civil society' umbrella, and to develop a 'code of conduct' framework for industry engagement that differentiates between policy development and implementation. We ask for the UN to consider our comments and take them into account for the UN High Level Meeting in September.
1, UN Joint Inspection Unit Paper. United Nations corporate partnerships: The role and functioning of the Global Compact www.unjiu.org/data/reports/2010/JIU.REP.2010.9 For%20Printing_ 17%20January%202011.pdf Beyond Pragmatism: Appraising UN-Business Partnerships: http://www.unrisd.org/80256B3C005BCCF9/%28httpPublications%29/225508544695E8F3C12572300038ED22?OpenDocument
Aktionsgruppe Babyhahrung, Germany
All India Drug Action Network
Alliance Against Conflict of Interest (AACI)
Association for Accountancy and Business Affairs
Australian Breastfeeding Association
Baby Milk Action
Biomedical Research Centre for Maternal and Child Healthcare (IRCCS)
Brazilian Institute for Consumers Defense (IDEC)
Brazilian Front for the Regulation of Food Advertising
Caroline Walker Trust
Consumers International
Berne Declaration, Switzerland
Borstvoeding vzw, Belgium
Breastfeeding Promotion Network, India
Corporate Accountability International
Centre for Science in the Public Interest, Canada
Earth Dharma Farm, USA
European Alcohol Policy Alliance – Eurocare
European Heart Network
Europe Third World Centre (CETIM)
Initiative for Health & Equality in Society, India
Institute of Nutrition, Rio de Janeiro State University, Brazil
International Baby Food Action Network (IBFAN)
Global Alcohol Policy Alliance
Health Action International, Africa
Health Action, Asia Pacific
Health Action International, Global
Health Action International, Europe
Health Consumer Protection, Thailand
International Association of Consumer Food Organisations
International Baby Food Action Network
INFACT, Canada
Initiativ Liewensufank, Luxembourg
Medicus Mundi International Network
National Childbirth Trust
National Heart Forum (UK)
Network for Accountability of Tobacco Transnationals
No grazie, pago io, Italy
Osservatorio Italiano Sulla Salute Globale, Italy
Prevention Institute, USA
StopDrink Network, Thailand
Sustain Children's Food Campaign, UK
Sweet Enough Network, Thailand
The Breastfeeding Centre, Thailand
Sindicato dos Nutricionistas do Estado de São Paulo, Brazil
Universities Allied for Essential Medicin
e
WEMOS, the Netherlands
World Alliance for Breastfeeding Action
World Cancer Research Fund International
World Public Health Nutrition Association
