Your doctor has just told you you’ve got something nasty. You want to know more. Among all those hundreds of websites peddling cures under the guise of health information, where is the first place you go for some reliable advice about treatments? Well, the charities, of course; those havens of independent advice in a world of vested interests.
Unfortunately, it’s no longer that simple. Health charities have been bombarded recently with criticism for their close links with the world of commerce, particularly the pharmaceutical industry. And the independence of their views has been seriously questioned. The leading cancer charity Cancer Research UK came under fire this week from the journalist Oliver Gillie because of its connection with the pharmacist Boots (see panel facing page).
It is not the only charity under fire. The medical journal The Lancet criticised in July the UK charity Cancer Backup for not being more open about receiving £371,410 (9 per cent of its total funding) from the pharmaceutical industry each year. Donors include Roche, the manufacturers of the breast cancer drug Herceptin.
This, said the Lancet, compromises the charity’s outspoken view that Herceptin should be more widely available and it undermines the group’s credibility and raises the question: in whose interests does the group work? In response, Cancer Backup insisted that it was open about its funding, and that its opinions were formed through a board of clinical specialist advisers in which pharmaceutical companies played no part.
That is no doubt the case, but seeds of doubt are being sown that could dent public confidence. Another article in the British Medical Journal points out that many charities, supported by drug companies, are campaigning for new and expensive drugs to be made available on the NHS. The Alzheimer’s Society, for example, has been campaigning for the more widespread introduction of the drug Aricept, which happens to be manufactured by Roche, one of its funders.
All this, of course, does not mean that charities are corrupt, or the pawns of big industry. But most of the public are unaware of the extent of commercial involvement in bodies that have built their reputation on representing the public and no one else. According to the Charities Aid Foundation, corporate donors give £1 billion to charities: the drug company GlaxoSmithKline alone donated £380 million last year (including gifts in kind, such as discounted medicines).
This isn’t just cash for their coffers. The money donated is often for specific events or projects such as websites. A new trend is for smaller charities to organise “think tank” educational events for the media, using the funds donated by commercial sponsors to pay journalists to attend and to learn more about a condition. I have recently been invited to three such events and have been offered (and refused) an “honorarium” of £200 just to attend. At one, speakers openly praised the benefits of the drugs manufactured by the sponsors.
So the question arises: who benefits most from such arrangements? The suspicion is that companies wouldn’t bother to give such large amounts if it were not a subtle means of marketing their products. A European alliance of consumer organisations published a report in June criticising drug companies for their underhand techniques of promoting their medicines. The report by Consumers International said that Big Pharma’s “nice and friendly” marketing techniques, such as involvement with patient groups, were “often disguised as corporate social responsibility”.
This, it said, has been shown to create a subtle demand among consumers for the drugs, while also giving consumers a sense of trust in the pharmaceutical companies.
The pharmaceutical industry denies such subterfuge. The European Federation of Pharmaceutical Industries has a code of practice dictating how medicines are promoted, stipulating that no marketing should be disguised. Equally, the Association of the British Pharmaceutical Association has launched a new code stipulating that from this year companies should make public all the groups they support.
For their part, charities are maintaining that the independence of their views is not threatened by the nature of their funding. Cathy Pharoah, a charity analyst and the research director of the Charities Aid Foundation, says it’s in no one’s interests if charities become the pawns of industry. “Being involved with charities gives companies a lot of legitimacy. But, in turn, that legitimacy depends on the independence of charities and everyone suffers if voluntary bodies are seen as the tools of someone else.
“It’s a myth to think that charities and commerce can be entirely separate. There have to be partnerships between companies and charities because of the amount of money that many charities need to support medical research. Charities alone could never find that funding.”
The problem, then, is not so much that health charities find support from commerce, but that support is not openly spelt out penny by penny so that the public can make up its mind whether the charity is playing things straight.
Many of the big charities already post information. Cancer Backup, for example, publishes a full list of corporate donations on its website. The Alzheimer’s Society has been vocal about the need for charities to have strict and public codes on their relationships with companies.But, generally, there is a lack of transparency. A survey this year by Patient View, a research organisation for health campaigning groups, found that just 11 per cent of the 530 patient groups in the UK publicly stated that they received support from the drug industry, with only 2 per cent stating the precise amount.
Until everything is more clearly above-board, the public suspicion may grow that that you can’t trust the advice of charities any more.
Boots money casts shade over SunSmart campaign
For years, we’ve been told to protect ourselves from the sun to prevent skin cancer. It’s a campaign that has been taken up vigorously by our biggest cancer charity, Cancer Research UK, with its SunSmart campaign urging us to limit exposure to the rays.
But the integrity of this campaign has been questioned by the respected health journalist and author Oliver Gillie, who says that the charity’s stance is being compromised by its links with Boots, the company that manufactures Britain’s biggest-selling sunscreen.
Gillie is the founder of the Health Research Forum, which campaigns for health education to be based on scientific research. Unlike cancer charities and health officials, he believes that the argument is not yet won that we are better off covering up from the sun.
He draws attention to a growing body of research indicating that by depriving ourselves of the sun, and with it the vitamin D that the skin produces in sunlight, we are increasing our risk of developing breast, bowel and prostate cancer, multiple sclerosis, heart disease, rheumatoid arthritis and osteoporosis. This outweighs any risk of developing skin cancers as a result of sun exposure, he says.
Gillie questions the scientific evidence behind the SunSmart campaign, which he says is outdated. Cancer Research UK does not accept this viewpoint, saying that new evidence is constantly being evaluated by its advisory board.
What annoys Gillie is that open scientific debate on the issues may be being stultified by the charity’s links with commercial organisations that have an interest in promoting sun safety. “Last year Cancer Research UK made £84,000 from Boots’ sale of lapel badges for the charity, while Boots made its brand of suncream, Soltan, the UK’s biggest seller.”
The SunSmart campaign involved Boots’ advisers going into schools and telling parents about being safe in the sun.
Cancer Research UK maintains that its SunSmart campaign is funded by the Department of Health but that it approached Boots in 2003 so that it could spread the SunSmart messages through its shops and magazine. “On no occasion has Cancer Research UK promoted or endorsed any brand of sunscreen, says Dr Lesley Walker, Cancer Research UK’s director of cancer information. “Indeed, the SunSmart message is that sunscreen should be used as a last resort. The primary message is to avoid burning by spending time in the shade and covering up.”
Dr Walker confirmed that the amount of money raised by pin-badge sales in Boots but stressed the primary aim of the relationship was to raise sun-safety awareness. And she maintains that the line of the charity has not been influenced by commercial links.
Boots says that Cancer Research UK never asked for a financial contribution. “It was not a condition of our relationship,” a spokeswoman said.
