Conflicts of Interest in Medicines Safety and Regulation

Excerpt

Conflict of interest is a well known and growing controversy in many areas of healthcare, not least in medicines safety and regulation. The direction of these concerns seems to be both narrow and conservative: narrow in the sense of being dominated by financial interests, and conservative in excluding many experts from contribution to debate and decisions. A recent publication[1] provoked my interest. It concerned the global donor agencies and, after the authors had delved into donors’ background dealings and their decision making, they came to the conclusion that sometimes donor investments, board member interests and lack of alignment with real public health needs represented conflicts that should be addressed. They also quoted some conflict of interest definitions. In US law, a conflict exists when there is “a real or seeming incompatibility between one’s private interests and one’s public or fiduciary duties”. Wikipedia’s definition is also quoted as when “an individual or organisation is involved in multiple interests, one of which could possibly corrupt the motivation for an act in another”.[2] Furthermore, a WHO definition includes “… when a partner’s ability in one role is impaired by his or her obligations in another role or by the existence of competing interests. Such situations create a risk of a tendency (sic) towards bias in favour of one interest over another or that the individual would not fulfil his or her duties impartially … A conflict of interest may exist even if no unethical or improper act results from it. It can create an appearance of impropriety that can undermine confidence …” None of these definitions is confined to financial interest but the article by Stuckler et al.[1] largely is! …