Open Medicine, Vol 7, No 4
(2013)
ANALYSIS
AND COMMENT
Federal
government food policy committees and the financial interests of the food
sector
Norm
Campbell, Kevin J Willis, Gavin Arthur, Bill Jeffery, Helen Lee Robertson,
Diane L Lorenzetti
Norm
Campbell, MD, is a Professor in the Departments of Medicine, Physiology and
Pharmacology, and Community Health Sciences, University of Calgary, Calgary,
Alberta. He was on the steering committee of and was a member of the Sodium
Working Group of Health Canada, and is a member of the sodium subgroup of the
Food Expert Advisory Committee of Health Canada. Kevin J. Willis, PhD,
is Executive Director of the Canadian Stroke Network. He was a member of the
Sodium Working Group of Health Canada and is a member of the sodium subgroup of
the Food Expert Advisory Committee of Health Canada. Gavin Arthur, PhD,
is a research consultant based in Courtenay, British Columbia. Bill Jeffery,
LLB, is the National Coordinator of the Centre for Science in the Public
Interest and a member of the Steering Committee of the Conflicts of Interest
Coalition. Mr. Jeffrey was a member of the Sodium Working Group of Health
Canada. Helen Lee Robertson, MLIS, is a librarian at the Health Sciences
Library, University of Calgary, Calgary, Alberta. Diane L. Lorenzetti is
a Research Librarian in the Department of Community Health Sciences, University
of Calgary, and the Institute of Health Economics, Edmonton, Alberta.
Competing
interests: None declared. The opinions stated in this commentary are those of
the authors and not of their employers or institutions.
Correspondence: Dr. Norm Campbell, 3280 Hospital Drive NW, Calgary AB
T2N 4Z6; 403-210-7961; fax 403-210-9837
Chronic non-communicable diseases (NCDs)—cancer and cardiovascular
disease in particular—are major causes of death and disability. Physical
inactivity, the widespread consumption of unhealthy food, the use of tobacco
products, and excessive alcohol consumption are the leading domestic and global
causes of NCDs.1 The
report of the 2010 Global Burden of Disease study of the Institute for Health
Metrics and Evaluation ranked dietary factors* the highest among risk factors
for both death and disability in Canada and throughout the world.1 In light
of the global burden of disease attributable to dietary factors and the
economic implications of diet-related disease, the World Health Organization
recommends implementation of a variety of public health policies to facilitate
healthy dietary choices.2
Although several countries are implementing substantial regulatory
reforms and are closely monitoring industry compliance with healthy-food
policies and the safety and health of their food supply, Canada is not. The
United Kingdom has introduced restrictions on advertising unhealthy foods to
children and is actively monitoring the sodium content of foods and the food
industry’s compliance with policies to reduce sodium-containing additives.3 Other
countries are developing regulatory limits on trans fats and sodium-containing
additives,3
and Norway subsidizes healthy foods to make them more affordable. The Canadian
federal and provincial governments’ approach to healthy-food policy is based
largely on food industry volunteerism; this has been mostly ineffective.4
With more than $100 billion in annual sales, the food sector is one of
the largest industries in Canada.5
Researchers and advocates have voiced their concern that the financial
interests of the food sector may be constraining the government’s ability to
develop and maintain healthy-food policies.4,6,7 Box 1
outlines some of the concerns that have been expressed recently in news media
and scientific journals. The international Conflicts of Interest Coalition was
formed in 2011 to advocate for safeguards against conflict of interest in the
public policy development process, particularly in regard to the United
Nations’ “Political Declaration of the High-level Meeting of the General
Assembly on the Prevention and Control of Non-communicable Diseases” and the
World Health Organization’s “Global Action Plan for the Prevention and Control
of NCDs 2013–2020.” The World Health Organization has stressed the importance
of reinforcing conflict of interest safeguards in its own policy and program
development process.
We examined relevant Health Canada web pages to determine the extent to
which individuals and organizations with financial interests in the food sector
are represented in federal food policy committees (Table 1). Of the 9
committees identified, the Expert Advisory Group on National Nutrition
Pregnancy Guidelines and the Health Products and Food Branch Advisory Committee
did not provide sufficient information on their websites to enable this
evaluation. Two of the remaining 7 committees (the Natural Health Products
Program Advisory Committee and the Food Guide Advisory Committee) did not
provide information on their websites on the financial interests of their
members (Table 2). In the remaining 5 committees, the percentage of members
with reported direct or indirect financial interests in the food sector ranged
from 38% to 77%, and in 3 committees 50% or more of the members reported
financial interests (Table 2). Members with direct financial interests in the
food industry constituted more than 30% of 3 committees, and 23% and 7%
respectively of the remaining committees. Five of the 7 committees evaluated
did not have publicly available minutes to allow for the potential impact of
these financial interests to be assessed.
In addition, for 3 of the 7 committees, we were unable to locate
documented policies and procedures that would have helped them to minimize
commercial biases during the development of policy recommendations (e.g.,
precluding members from having input, veto power, or the ability to vote with
respect to policies in which they had a financial interest). However, the
strong presence of commercial interests, the lack of transparent formal
safeguards to preclude commercially self-serving influences on policy-making,
and the lack of public documentation with respect to the decision-making
processes of these committees are indicative of an environment where commercial
interests may have a negative impact on national food policy recommendations.
The use of independent external advisors can increase the rigour,
credibility, and accountability of decisions made by Health Canada. However,
these collaborations and consultations, designed to incorporate scientific
evidence into the decision-making process, must be managed in a consistent and
transparent way to assure the public that public policies and programs are not
being steered by vested financial interests. The influence that the private
sector has on the implementation of policies that support continued or
increased profits and commercial growth has already been demonstrated within
the realm of medical research, where industry-funded studies are more likely to
publish positive results than non–industry funded studies.8 The
quality and integrity of decisions made by government agencies that regulate
food and nutrition are just as vulnerable to compromise if they give industry a
privileged role. In medicine, managing conflict of interest remains a
significant challenge and the subject of much debate, especially in relation to
pharmaceutical treatments.9
Increasing government reliance on industry partnerships related to
public health seems to have created an environment rich with conflicts of
interest.10
Governments, therefore, must carefully examine how large food corporations and
their trade associations contribute to NCD prevalence through the promotion of
products that undermine health in the way that tobacco companies have long been
acknowledged to do, and must evaluate the current role of these entities in
influencing public policy.10
Our analysis is limited to information available on some federal
government websites. We could not obtain more information from committee
members nor disclose our personal observations as committee members because
committee members are required to sign confidentiality agreements that preclude
disclosure of committee deliberations. We also have not assessed other aspects
of commercial interests such as those that can occur during meetings between
commercial entities and politicians. Notably, federal politicians have spoken
out on the importance of efforts to reduce dietary sodium. That said, a 147–122
vote in Parliament on 8 May 2013 defeated a bill to mandate the recommendations
of the Sodium Working Group that were unanimously agreed to by representatives
from industry, academia, civil society, and federal and provincial governments.11 The bill
was defeated by 146 Conservative government MPs (and one other nay vote) despite
extensive support from civil society (approximately 70 groups representing
residents in nearly two-thirds of Canadian households and health professionals
that treat virtually all Canadians†) and the Canadian public (about 80% support
in multiple national surveys). In addition, despite public disclosure that the
information provided by industry on food labels is not accurate, the federal
government announced that it would no longer monitor the accuracy of labelling,
but would, rather, rely on the public to detect and report inaccuracies in food
labelling to food companies.12
Our investigation is a small step toward examining the influence of
financial interests on healthy-food policy in Canada, and more research is
needed to fully understand the issue. Further research could focus on the
extent to which the Canadian food industry sponsors research and influences its
outcome, and how the industry funds non-governmental organizations, political
lobby groups, and policy-makers. The financial interests of elected officials
before, during, and after their elected tenure should also be considered.
Government of Canada conflict of interest procedures and processes must
be made transparent and accessible to all Canadians.13
Furthermore, it is important for the maintenance of public trust that Health
Canada provide clear public records outlining how its conflict of interest
rules or guidelines are, or are not, applied.
Table 2.
Declared interests of members of Canadian federal government advisory food
committees [view]Box 1.
Reports in news media and scientific journals on actions and statements by the
Canadian government that counter efforts to implement healthy-food policies [view]
Footnotes
*The dietary factors in order of importance for mortality in Canada are
low fruit, low nuts and seeds, high sodium, high trans fat, low omega-3, low
vegetables, high processed meats, low fibre, low whole grains, low
polyunsaturated fatty acids, high sweetened beverages, low calcium, low milk,
and high red meat.
†See joint statement of non-governmental organizations at: http://cspinet.org/canada/pdf/updated.c-460.jointstatement.pdf.
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