International Journal of Health Policy and Management

International Journal of Health Policy and Management

Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool

Document Type : Original Article

Authors
Rob Ralston 1, 2
Sarah E. Hill 1, 2
Fabio da Silva Gomes 3
Jeff Collin 1, 2
1 Global Health Policy Unit, Social Policy, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
2 SPECTRUM Consortium (Shaping Public Health Policies to Reduce Inequalities and Harm), London, UK
3 Department of Noncommunicable Diseases and Mental Health, Pan-American Health Organization/World Health Organization, Washington, DC, USA
10.34172/ijhpm.2020.52
Abstract
Background
With multi-stakeholder approaches central to efforts to address global health challenges, debates around conflict of interest (COI) are increasingly prominent. The World Health Organization (WHO) recently developed a proposed tool to support member states in preventing and managing COI in nutrition policy. We analysed responses to an online consultation to explore how actors from across sectors understand COI and the ways in which they use this concept to frame the terms of commercial sector engagement in health governance.

 
Methods
Submissions from 44 Member States, international organisations, non-governmental organizations (NGOs), academic institutions and commercial sector actors were coded using a thematic framework informed by framing theory. Respondents’ orientation to the tool aligned with two broad frames, ie, a ‘collaboration and partnership’ frame that endorsed multi-stakeholder approaches and a ‘restricted engagement’ frame that highlighted core tensions between public health and food industry actors.

 
Results
Responses to the WHO tool reflected contrasting conceptualisations of COI and implications for health governance. While most Member States, NGOs, and academic institutions strongly supported the tool, commercial sector organisations depicted it as inappropriate, unworkable and incompatible with the Sustainable Development Goals (SGDs). Commercial sector respondents advanced a narrow, individual-level understanding of COI, seen as adequately addressed by existing mechanisms for disclosure, and viewed the WHO tool as unduly restricting scope for private sector engagement in nutrition policy. In contrast, health-focused NGOs and several Member States drew on a more expansive understanding of COI that recognised scope for wider tensions between public health goals and commercial interests and associated governance challenges. These submissions mostly welcomed the tool as an innovative approach to preventing and managing such conflicts, although some NGOs sought broader exclusion of corporate actors from policy engagement.

 
Conclusion
Submissions on the WHO tool illustrate how contrasting positions on COI are central to understanding broader debates in nutrition policy and across global health governance. Effective health governance requires greater understanding of how COI can be conceptualised and managed amid high levels of contestation on policy engagement with commercial sector actors. This requires both ongoing innovation in governance tools and more extensive conceptual and empirical research.

Highlights

Commentaries Published on this Paper

  • Preventing and Managing Conflict of Interest in Nutrition Policy: Lessons for Alcohol Control; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  •  The World Health Organization, Corporate Power, and the Prevention and Management of Conflicts of Interest in Nutrition Policy; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  •  Star Trek Offers Insights That Illuminate Actor Engagement in Global Nutrition Governance; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  • “Conflicted” Conceptions of Conflict of Interest: How the Commercial Sector Responses to the WHO Tool on Conflict of Interest in Nutrition Policy Are Part of Their Standard Playbook to Undermine Public Health; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  • Purveyors of the Commercial Determinants of Health Have No Place at Any Policy Table; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  • Tackling NCDs: The Need to Address Alcohol Industry Interference and Policy Incoherence Across Sectors; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  • Should Public Health and Policy Communities Interact With the Food Industry? It Depends on Context; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  • WHO’s Attempt to Navigate Commercial Influence and Conflicts of Interest in Nutrition Programs While Engaging With Non-State Actors: Reflections on WHO Guidance for Nation States; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  • Conflict of Interest in Nutrition: Where’s the Power?; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

          Abstract | PDF

 

  • It Is Not Enough to Assess Conflicts of Interest When We Bring the Commercial Sector to the Policy Table; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

         Abstract | PDF

 

  • Is It Possible to Solve the Conflicts Over Conflict of Interest?; Comment on “Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool”

        Abstract | PDF

Keywords
Nutrition
Health Governance
Conflict of Interest
Commercial Sector
Global Health
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International Journal of Health Policy and Management
Volume 10, Issue 5
May 2021
Pages 255-265

  • Received Date 06 December 2019
  • Revised Date 04 April 2020
  • Accepted Date 05 April 2020
  • First Published Date 01 May 2021
  • Published Date 01 May 2021