Industry lobbying on WHO overshadowing public health policy, researchers suggest

Similar lobbying dates back decades, but these efforts have taken on a new, coordinated form in recent years, fueling conflicts between the U.S. and the WHO just as COVID-19 was about to hit and complicating the nation's response to the pandemic, researchers said.

"Lobbying can be a healthy part of the democratic process," said Katheryn Russ, professor of economics at UC Davis and lead author of the study. "But our findings suggest that this targeting of the WHO acts to plant doubt about the scientific and professional integrity, as well as operational capacities, of the global health governance system -- just when we need it most."

The article, published today in the May 2022 issue of Global Health Governance, is the first comprehensive study of lobbying expenditures directed at the U.S. government related to policy towards the WHO, the lead United Nations authority on health. Data uncovered through Freedom of Information Act requests -- and through analysis of other public documents and disclosures dating back to 2006 -- reveal cross-industry coordination aimed at shaping WHO operational policy and public health guidelines, as well as the funding of the WHO itself, Russ said.

"It's not about any one administration or party," Russ said. "This intensifying corporate lobbying over U.S. positions on global health is problematic because it elevates commercial interests in processes shaping global health objectives. Furthermore, these corporate entities have vast, concentrated pools of private wealth to draw on that public-interest groups lobbying for health policy cannot match."

Targeting policies on diabetes, heart disease, cancer

The study illustrates how dozens of corporate groups have acted in concert to object to WHO proposals and policy recommendations aimed at supporting countries struggling to stem a rising tide of non-communicable diseases such as diabetes, heart disease, and cancer -- diseases which have increased morbidity during the pandemic.

The WHO recommendations that were targeted by lobbyists, according to researchers, include common health-promoting policy efforts such as:

• constraining inappropriate marketing of infant and toddler formulas that can confuse parents making choices about breastfeeding and children's nutrition
• encouraging consumers to limit sugar and alcohol in their diet
• broadening access to essential medicines, including COVID-related programs
• drawing attention to the addictive effects of video games

Although not directly linked to this coalition, the tobacco industry has undertaken simultaneous lobbying in recent years on efforts to criticize the WHO for limiting input by commercial actors in shaping global health policy, with one tobacco-linked group recommending a 25% cut to U.S. funding for the organization, according to researchers.

Presidential policies and reform

During the Clinton administration, then-Senator Biden struck a deal with U.S. Sen. Jesse Helms to restore U.S. funding to the United Nations and the WHO. While the Biden Administration has reversed the U.S. withdrawal from the WHO announced by the Trump administration, the current administration has still advocated for unspecified "reform" in the midst of the pandemic, Russ said.

The coordinated industry lobby has used "reform" as a buzzword for allowing more industry influence over global health policy processes despite the commercial conflicts of interest this presents, she added.

The researchers noted that the U.S. has stronger disclosure laws than other member states of the WHO, making a similar analysis of European Union countries impossible.

"What is happening here should be a cautionary tale on the importance of strict and detailed lobbying disclosure requirements, transparency in deliberations over official U.S. positions taken in multilateral institutions, and the importance of screening for conflicts of interest at the national level before formulating global health policy positions," Russ said.

Without such protocols, the study concludes, rather than promoting a global vision of health, the U.S. could act as a conduit for intensified industry efforts to erode global health policy from within, she said.

Co-authors of the paper include Phillip Baker, a senior lecturer in food policy and international nutrition at Deakin University, Melbourne, Australia; Manho Kang, doctoral candidate in economics at UC Davis; and David McCoy, research lead at the United Nations University International Institute for Global Health based in Kuala Lumpur, Malaysia, and previously professor of Global Public Health and director of the Centre for Global Health at Queen Mary University, London.

The research received funding from Alive&Thrive/FHI 360.