24 December 2017:
Philip Morris International’s $1 billion fund to help stop smoking is being debated and examined by academics and health leaders worldwide.
New Delhi: Philip Morris International is attempting to distribute nearly $1 billion for research on reducing smoking. But the grant is being called a “billion dollar bribe” of “blood money,” a “wolf in sheep’s clothing,” a “smokescreen,” a “public relations stunt” and the “height of hypocrisy.” The American Cancer Society has even called it a “new twist out of the tobacco industry’s deadly playbook”, while the World Heart Federation says it is a “vehicle for the tobacco industry.” One anti-smoking group said “the tobacco epidemic will never be ended by its perpetrators.” Another found it so unbelievable they said it “truly sounds like fake news.”
The money in question has been promised by the tobacco giant to the newly-formed Foundation for a Smoke-Free World. The Foundation is offering money for research on the cessation of smoking and alternative livelihoods for tobacco farmers.
In replies to The Wire, there appears to be a consensus: A number of top universities in the US and UK have said they will not be accepting this research funding as it clashes with their ethics policies. Columbia University remained non-committal on the issue. However, one scholar at Harvard’s prestigious T.H. Chan School of Public Health told The Wire that they are “discussing” if it violates their 15-year-old policy of rejecting funding from the tobacco industry. He added, however, that the university’s ban on tobacco industry funds remained firmly in place.
The Wire first broke this story last week, detailing the contents of an email and its recipient-list of 344 people, many of whom have been leaders in the global public health debate, and against tobacco. The email sent by the foundation’s president, Derek Yach, targeted senior officials at the WHO and other prominent international organisations. Despite the foundation’s claims that it maintains its independence from its donor, the email has also been sent to three employees of PMI.
The Wire also reported that some of the 344 recipients had replied to Yach’s mailing-list, publicly asking to be removed from it.
The new foundation has divided the global public health community. While some see this as an irreconcilable conflict of interest, others think the foundation should not be judged prematurely. The World Health Organization (WHO) said it will “not partner with the Foundation” and has asked governments of all countries to do the same.
And likewise, despite a 2002 policy of the Harvard School of Public Health (HSPH) prohibiting tobacco industry funding, the issue appears to have opened a can of worms at the school.
“Faculty at the HSPH voted to reject all funding from the tobacco industry. We are now discussing whether support from this foundation falls under that ban,” said Daniel Wikler, a professor of ethics at HSPH and a recipient of Yach’s emailed solicitation, in reply to The Wire’s queries. The issue of funding does not yet have an internal consensus and Wikler says, “Unless and until this is decided in the negative, I would have to obey that rule.”
In a second email on Sunday, he was more categorical: “HSPH is not considering this. The ban on accepting tobacco industry money is 100% unchanged.” But staff at the school continues to “take a close look at the foundation”, he added, because it “may well become a factor that would have to be taken into account in efforts to reduce (and perhaps eventually eliminate) the #1 risk factor worldwide for premature mortality. Thus they can’t be ignored, and ought to be studied closely.”
Wikler says he may have received Yach’s emails inadvertently as he has known him for several years and has corresponded with him about this new foundation.
On its part, the foundation says it has “fully insulated itself from the influence of the tobacco industry” and asked WHO to reconsider their disassociation with it. In a reply to The Wire, Yach said, “The email was part of an effort to be as inclusive as possible when recruiting for letters of intent for early scoping grants that will help shape our global research priorities.”
The Wire contacted all the academic institutions targeted in the leaked emails. With the exception of Harvard and Columbia, the rest replied saying they would not be accepting funding linked to the tobacco industry and directed to their already established policies on conflict of interest and ethical research.
Harvard formal policy against accepting tobacco industry funding
On January 24, 2002, Harvard’s school of public health agreed on a policy to not “accept any grant or anything else of value from any tobacco manufacturer, distributor, or other tobacco-related company.” They also listed such companies: Philip Morris USA and Philip Morris International, along with its parent company Altria.
Two years later, in 2004, Harvard’s medical school also issued a policy prohibiting the acceptance of funding from the tobacco industry for research or any other purpose. Their policy, which The Wire has a copy of, states that the “prohibition will apply to funding from companies that make or market tobacco products or from entities supported by such companies.”
Harvard’s school of public health adopted their policy against tobacco industry funding even before the Framework Convention on Tobacco Control was adopted by the World Health Assembly in 2003. Fifteen years since instituting a formal ban on tobacco-funded research, the university is “now discussing whether support from this Foundation falls under that ban.”
A 2002 article in the Harvard Crimson, the university’s official daily newspaper, explained that their 2002 policy “formalises an unofficial policy that has existed since 1998.” Their formal policy against tobacco funding, in fact, allowed Harvard to receive funding from a landmark 1998 court settlement against the tobacco industry. HSPH’s decision and a subsequent policy in 2002 was part of a joint decision of 31 universities to reject tobacco industry funding in 2001. In 1989, Harvard also announced that it would divest all its stock in tobacco companies.
Several US, UK universities declining the grant
Patronage and funding have often directed research priorities and even outcomes. Universities have been the centre of research controlled by military establishments. A recent documentary from Channel 4 showed that Coca-Cola, for example, has been influencing academics who work on issues of food-safety and obesity. The massive opioid crisis in the US has come about by years of lobbying and influencing medical research on painkillers.
According to the application form for the Foundation for a Smoke-Free World’s grants, applicants were asked to declare their conflicts of interest but these conflicts were not defined in any way. Either way, conflicts are not a hard no-go in the Foundation’s review of applications: “A potential conflict of interest does not preclude you from receiving research grants,” stated the application form, which has now been taken down from their website. The Foundation says that according to its bylaws, “PMI and the tobacco industry are precluded from having any influence over how the Foundation spends its funds or focuses its activities.”
Columbia University replied to The Wire saying: “Columbia Mailman School of Public Health has no comment on this topic.”
Richard Leggatt of the Institute of Development Studies says he may have ended up on the mailing list due to preliminary inquiries he made without realising how the foundation was funded. “I will not be making any more enquiries as a result of this recent realisation,” he says and adds that his institute “applies strict ethical vetting procedures to its fundraising and would never entertain the possibility of accepting funds from any organisation directly associated with the tobacco industry as this foundation appears to be.”
“We absolutely refuse tobacco industry funding and will not engage in any way with this programme,” said Professor Robert West at the University College London.
“LSE has an ethics code and policies in place to prevent funding from sources deemed ‘high ethical risk,’ including the tobacco industry,” said Daniel O’Connor, media representative for London School of Economics and Political Science.
“I would not apply for these funds because of the direct connection to PMI,” said Cheryl Healton, dean of New York University’s College of Global Public Health. As dean, she appears to be contradicted by two faculty members – David Abrams and Raymond Niaura – who in November sent a letter to Yach saying they would be willing to explore every avenue to address the challenges of smoking, “including this.” They wrote that other tobacco companies should also be allowed a chance to fund this same foundation for a short period in the interest of creating more competition. Abrams also received Yach’s invite for grants but has not replied to The Wire’s queries.
“USC researchers who received an email announcing grants from the Smoke-Free Foundation have not applied for any of the funds and they do not intend to in the future. The university promotes the highest ethical standards for conducting research,” said Emily Gersema, University of Southern California’s media representative.
Michael Siegel of Boston University wrote a blog earlier this month calling this offer of grants a “scam.” He also received the foundation’s email but said he “would not apply to the Smoke-Free Foundation because it is essentially a public relations ploy for PMI and it is not sincere about really trying to create a smoke-free world.”
“We have not, and have no current plans, to pursue research funding directly from the tobacco industry,” said Heather Woolwine, media representative for the Medical University of South Carolina. “We plan to continue to pursue smoking cessation research with those other funding sources,” she says. However, Kenneth Cummings, a professor at the same university, and also a recipient of this email, has been in touch with the foundation, offering suggestions on what research questions the Foundation could pursue. He has not replied to The Wire’s queries.
Three members of the Wellcome Trust were also on the mailing list but the trust says they have had a “long-held stance against supporting, or investing in, activities relating to the tobacco industry.” In October, they cancelled a booking made by Yach’s foundation to use the Wellcome Trust’s venue upon learning of the foundation’s links to the tobacco industry.
Taye Tolera Balcha, the director of the Armauer Hansen Research Institute in Ethiopia says: “I also tried to analyse the pros and cons of my engagement with the Foundation including applying for funding.” He has decided he won’t be applying for funding or seeking affiliation. “The main reason is that WHO has shown unequivocal opposition to the Foundation as it is financed by PMI,” he says.
And as already reported by The Wire, Ilona Kickbusch, who is the director of the global health programme at the Graduate Institute of International and Development Studies in Geneva, has also said she has “no wish to be associated with tobacco companies and money in any way.”
Tobacco Control journal said they “still won’t publish tobacco industry-funded work, even if the funding is laundered through PMI’s new ‘independent’ foundation.” For this, they drew on their 2013 policy and said that any research and researchers funded by such organisations would be prohibited from contributing to any of their publications.
Other researchers and academics contacted by Yach and his foundation include Peter Salovey (president of Yale University), Tenley Albright (Massachusetts Institute of Technology and Gold Medal Olympic Figure Skater) and others at University of Oxford, Kings College, Imperial College, Stanford University, Brown University, Duke University and the Wharton School. They have not replied to The Wire’s emails.
Non-academic organisations who replied saying they would not apply for grants include the Union for International Cancer Control, the World Economic Forum, Chatham House and BUPA.