Abstract
In March 2018, the US media started to unfold an alarming story on potential bias in science funding. By now, most alcohol researchers have heard about the ten-year MACH 15 clinical trial investigating whether a daily drink leads to better health in older males at risk of heart disease. The study has become famous for its scope, method, and the fact that leading beverage producers have contributed USD 67.7 million out of a total budget of 100 million dollars.
The contributions by Anheuser-Busch InBev, Heineken, Diageo, Pernod Ricard, and Carlsberg are channelled through the Foundation for the National Institutes of Health, which is an independent non-profit body that raises funds to support NIH research. The money is disseminated by one of the 27 NIH centres, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the leading alcohol research funding agency.
One would expect that the combination of such a massive amount of industry money and the scope of the study already involves a great deal of ethical landmines – but more was yet to come!
In March, The New York Times broke the news that officials at the NIAAA had solicited funding for the MACH 15. The newspaper revealed that NIAAA officials had in fact, and against NIH regulations, courted the alcohol industry in late 2013 and early 2014 to fund the ten-year study. The emails and the travel vouchers that the newspaper had obtained showed that “the institute waged a vigorous campaign to court the alcohol industry, paying scientists to travel to meetings with executives, where they gave talks strongly suggesting that the study’s results would endorse moderate drinking as healthy” (Rabin, 17 March 2018).
Shortly after, NIH director Francis Collins promised that the NIH would investigate whether health officials had violated federal policy against soliciting donations when they met with alcohol companies to discuss the funding (Rabin, 20 March 2018). According to the information in the media, two prominent scientists and a senior federal health official had even pitched the project during a presentation at the luxurious The Breakers Palm Beach hotel in Florida in 2014. Public health advocates rushed to demand that the NIH pull the plug on the study.
New funding strategy?
On 2 April, STAT (Statnews.com) reported a parallel story suggesting that the NIAAA had not only opened up this channel of funding for a study on possible health benefits from drinking, but it also seemed to be strategically denying funds to researchers investigating topics that could be damaging to the industry. The NIAAA’s director George Koob had allegedly told a science advisor at a liquor lobbying group for alcoholic beverage producers that the agency would stop funding research into the effects of alcohol advertising, a line of study that the industry is not fond of.
The STAT news site reports that Michael Siegel of Boston University had in 2015 been called to meet the NIAAA director Koob – a meeting in which Siegel and his colleague had been yelled at for their research on alcohol marketing. According to the statement by Siegel, Koob had made clear that the NIAAA would pull back from the research, conducted in cooperation with Siegel’s colleague David Jernigan from Johns Hopkins University (and now at BU). After the meeting the two scholars were described as “Shocked by the encounter”, retreating to an NIH cafeteria “asking each other what had just happened – and why” (Begley, 2018).
On 17 May, the NIH reported a halt to the enrolment in the study on moderate alcohol consumption while officials investigated how the funding for the study was raised and whether the study was still worth pursuing (Joseph, 2018). Collins was concerned about the reputation of the NIH: “if we are putting ourselves in a circumstance where that could be called into question, I felt like we had to look at that very seriously and come up with another strategy” (Joseph, 2018). There is no doubt that the National Institutes of Health has seriously damaged its credibility and is wise to take a timeout and examine these matters.
The Swedish Alcohol Commission
But the global alcohol industry’s great interest in policy and research never rests. The day after, on 18 May, the alcohol industry in the Nordics declared its latest move. The Swedish Spirits & Wine Suppliers (Sprit & Vinleverantörsföreningen SVL) and the Swedish Brewers Association (Sveriges Bryggerier) declared that they had appointed a new Alcohol Commission. The task of the Alcohol Commission is to shed light on how Swedish alcohol policy functions and how it can develop. The Commission will review Swedish alcohol policy, examine how it can be improved and suggest how to strengthen the controlled retail sale (Alkoholkommissionen, 2018).
“It’s problematic that there is no debate on alcohol policy [in Sweden]”, says the managing director Anna de Greer at the SVL, as an answer to why a new Commission is needed (SVL, 18 May, 2018). From a Finnish perspective, this sounds strange. Sweden’s alcohol consumption has decreased steadily, and alcohol has, together with tobacco and drugs, been integrated into the Swedish governmental structure to the degree that there seems to be a great consensus regarding the importance of these questions for society. The turbulence of Finnish alcohol policy, which is fuelled by a questioning of the evidence and well-established facts, is a path that started exactly with a similar move of opening up discussion and thinking of other and “better” ways of developing alcohol policy. Based on the Finnish experience, I’m afraid that the Swedish initiative will translate to ways that are advantageous for the industry.
For the general public it may be close to impossible to identify and interpret stakeholders’ and senders’ intentions of the NIH study or Alkoholkommissionen. These are both actors who will communicate information on alcohol use and alcohol policy aimed at influencing policymaking. Maybe a simple rule of thumb to follow is that, just as the public health community has no business to tell the alcohol industry how to brew its beer and distil its alcohol, the alcohol industry has no business influencing publicly funded alcohol research and public health policy, neither in the United States nor in Sweden.