Public Health Schools Must Guard Against Conflicts of Interest.

Schools of public health are increasingly dependent on external funding to pursue research that advances the health of populations—a challenge that requires extra protections against potential conflicts of interest posed by corporate and other entities, write two School of Public Health scholars in a JAMA Viewpoint article.

Dean Sandro Galea and Richard Saitz, professor and chair of community health sciences, write that schools of public health have little choice but to accept external funding for research in these times of reduced federal and state dollars, as divesting from such sources would mean limiting the public health mission that requires engaging with multiple sectors, as well as narrowing the scope of work.

Still, they say, no funding should be accepted if it threatens a school’s “core mission” or explicitly constrains the school’s capability to do its work without interference from funders. Further, schools should not accept money if doing so pushes them to be “something that is not consistent with their mission to promote the health of the public. This is easier said than done,” they acknowledge.

“The challenge is that potential sources of funding may have quite different engagements in sectors that may promote, or harm, the health of the public,” they write. For example, food companies may produce food that is health-promoting, while at the same time, marketing food that is calorie-high or nutrient-poor.

“No funding comes with absolutely no strings, and wisdom arises in recognizing which conflicts would interfere with the integrity of the scholarly and educational mission of the school of public health,” they conclude.

Saitz and Galea recommend several ways that schools of public health can manage potential conflicts of interest, including having a “robust mechanism” for review of all external funding; an objective review of the funders’ history, actions and relationships; and a publicly disclosed statement of principles and operating procedures around funding reviews.

“While it would be easy to suggest that a school of public health should not accept any extramural funding, or more specifically, that schools should have no ties to industry, such approaches are both infeasible and inconsistent with the goal of public health to engage with all sectors toward improving population health,” they write.

“As more schools . . . accumulate experience with what works and what does not, the collective capacity to grapple with potential COI (conflicts of interest) will improve.”

—Lisa Chedekel