Intended for healthcare professionals

Feature Competing Interests

Centers for Disease Control and Prevention: protecting the private good?

BMJ 2015; 350 doi: (Published 15 May 2015) Cite this as: BMJ 2015;350:h2362

Re: Centers for Disease Control and Prevention: protecting the private good?

May 28, 2015
Dear BMJ Editors,
I’m writing in response to your feature article “Centers for Disease Control and Prevention: protecting the private good?”
To begin with, the subheading beneath the headline: “After revelations that the CDC is receiving some funding from industry, Jeanne Lenzer investigates how it might have affected the organisation’s decisions” creates the illusion of secrecy and controversy, when in fact there is open transparency. There weren’t “revelations” that came about from a whistle-blower exposing corruption or leaked documents: The CDC Foundation has a website— for all to see. It is a 501(c)(3) public charity with a Board of Directors with clear public-private partnership policies and guidelines governing its work. The Foundation’s audited financial statements are widely available on its website for anyone to research. There is nothing hidden that needed to be revealed: It has been there all along for any interested party to review.
Similarly, to state that “Jeanne Lenzer investigates” also creates the illusion of information that has been hidden. Now, Jeanne Lenzer is an excellent investigative reporter and her work for the Center for Public Integrity and Slate, to name but a few publications, is outstanding. That said, in this piece there really isn’t any investigation occurring. There are no documents linking the funding from private industry to the production of biased data and recommendations. There is no sourced information, either through documents, databases or interviews with on- or off-the-record sources to show a clear link between industry donations and biased research or skewed recommendations that favor the company making the donation. Without these, this piece is just one that speculates without evidence or proof. That is not investigative journalism.
You use the CDC’s “Recommendations for the Identification of Chronic Hepatitis C Infection among Persons Born During 1945-1965” as an example of potentially biased recommendations. Your article claims that these recommendations have been challenged, yet it only has a single footnote by an author who stands on the outside of the consensus of HCV public health officials, medical providers, advocates and patients on the benefits of HCV screening and treatment. You paint a picture of controversy where there is none. Indeed, the CDC’s HCV screening recommendations were reviewed by the United States Preventative Services Task Force (USPSTF), an independent, volunteer panel of nationally recognized experts in prevention and evidenced-based medicine and given a grade of “B,” indicating that these recommendations meet the qualities of their rigorous review process and have more benefits to patients than harms. As a member of the Agency for Healthcare Research and Quality (AHRQ), the USPSTF receive no industry funding and have no conflict of interest.
It is also not accurate to compare the CDC Foundation with the lobbying efforts of the National Rifle Association. Indeed, this is a fallacious argument: The fallacy of faulty comparison. The NRA is a lobbying organization that used its wealth and influence to get Congress to cut the $2.6 million in the CDC budget to stifle fire arm injury research. This is a very different action than one in which private companies donate money in a transparent manner to do unbranded research. Further, the outcomes of this research are not reviewed by industry and altered to meet their needs. If a firearms manufacturer had donated money to do research to dispute the fact that guns are a significant threat to the public’s health and controlled the release of said data, the comparison might hold up. As it stands, this comparison does not hold up.
Finally, let me say that this is an important issue and we do need to be mindful of the ways in which scientific research can be influenced by private funding. I am in complete agreement the statement: “The CDC must have the highest of moral ground. For if we are to believe them about public health matters, there can be no conflicts of interest.” Indeed, we need transparency in the funding of research and full disclosure of conflicts of interests. By all accounts, the CDC Foundation has done just that. We need good investigative journalism to ensure the integrity of medical and public health research. We do not need speculative articles with inflammatory headlines and no evidence of wrong-doing that only increase the mistrust of public servants doing good work to protect the public’s health.

Andrew Reynolds
Hepatitis C Education Manager
Project Inform

Competing interests: No competing interests

29 May 2015
Andrew L. Reynolds
Hepatitis C Education Manager
Project Inform
273 Ninth St., San Francisco, CA 94103