Conflicts of interest in public health: a guide to online investigations

In years past, the tobacco industry created front groups to write journal articles contesting the relationship between smoking and cancer, and to fight cigarette regulation as a matter of consumer rights. Some of the groups’ organizers have since shifted their business model to other industries. For example, the American Enterprise Institute’s Roger Bate, who created a front organization called “Africa Fighting Malaria” to defend industry practices in the continent around pharmaceuticals and chemicals, has written widely-cited editorials in prominent newspapers like The Wall Street Journal. More recently, the processed food industry created “Americans Against Food Taxes”, a group that’s generated a number of news articles and–through the American Legislative Exchange Council (ALEC)–drafted model food policy bills pre-written by the industry and introduced into Congress by elected representatives. How do we know if and when such forces are influencing our public health news and laws? In this post, we look at some of the online resources available to find the origins of public health news and legislation, and explore networks of influence and conflict.

Who’s writing the law?

The Center for Responsive Politics created one of the first websites to keep track of the exchange of money between politicians and private groups, entitled OpenSecrets. Especially after the Citizens United v. Federal Election Commission Supreme Court ruling of January 2010, private groups have been able to increase their direct financing of political candidates. OpenSecrets contains details of the financing of individual candidates, as well as profile details of political action committees (PACs, which raise money for candidates), interest groups and lobbying organizations. For example, if we look at their page on Altria (formerly Philip Morris), we find details of Virginia Senator George Allen’s receipts of $37,999 from the tobacco manufacturer in 2011 (see picture below).


A more recent initiative of OpenSecrets is the creation of the website Influence Explorer. Unlike OpenSecrets, it focuses less on election funding than on the other ways that private groups affect legislation, such as company communications to government institutions. For example, it tracks drug company lobbying papers sent to the FDA. Recently it also exposed that Koch Industries (run by the ultra-conservative Koch brothers, who have funded dozens of Tea Party initiatives) violated the Foreign Corrupt Practices Act by using bribes to get business deals and even had an “inside man” at the Environmental Protection Agency. The website has three useful apps: the Inbox Influence tool, which lets you see the political contributions of the people and organizations that are mentioned in emails you receive (e.g., off in the margins of your Gmail); the Checking Influence tool, which shows where your shopping dollars go (e.g., when you buy online, it lets you see the lobbying and campaign contributions of the retailer); and perhaps most useful, the Poligraft tool, a bookmarklet that reveals the political connections of people or organizations in any website that you’re reading, such as in the margins of this recent news article on food safety (below).

Ever since it was revealed that the entity known as the American Legislative Exchange Council (ALEC) had assembled corporations to write bills for elected representatives, the Center for Media and Democracy put together another website called “ALEC Exposed”, which contains a list of the various bills that have been authored by the front group, and an analysis of what the bills do. According to ALEC itself, “in the 2010 session, 42 states either introduced or announced ALEC’s Freedom of Choice in Health Care Act. Eight states (Virginia, Idaho, Utah, Arizona, Georgia, Louisiana, Missouri and Tennessee) passed the ALEC model as a statute, and two states (Arizona and Oklahoma) passed the ALEC model as a constitutional amendment.” This model bill was designed to thwart federal efforts towards an individual health insurance mandate or public insurance option. Similar bills have been passed by ALEC in the areas of social welfare spending, consumer protections, and education, among other topics.

Who works with whom?

We all know that influence doesn’t just work through officially-disclosed financial transactions during elections. We recently published an article in PLoS Medicine, for example, which revealed the Gates Foundation to be the largest shareholder of Coca-Cola while simultaneously funding programs that diverted developing country farmers towards contracting for Coca-Cola. This is in the context of accumulating evidence that soda consumption contributes to diabetes, and that diabetes rates are dramatically increasing in low- and middle-income countries. We first learned about the potential conflict of interest by mapping out the relationships between Coca-Cola and Gates Foundation members on the NNDB Mapper, a tool that tracks connections among people and organizations.

Similar mapping tools are now available to construct maps in more detail, such as through Transparency International’s Influence Networks website, which not only links people and institutions, but also gauges the strength of evidence indicating what relationships seem to be strong or weak. Another free network tracking tool is LittleSis, which tracks social, financial and political ties among prominent politicians. LittleSis doesn’t produce nice maps, but provides more details on lobbyists than the other two websites.

Who’s funding whom?

When anti-apartheid and anti-sweatshop campaigners first started their divestment campaigns on college campuses, they had to find out which companies their universities had invested in (from mining companies in South Africa to Nike in the Philippines). To do so, they used the U.S. Securities and Exchange Commission (SEC) EDGAR system, a very user-unfriendly database of national tax filings. Here, for example, you can see that Harvard University invested over $2 million of its endowment in stock for the South African gold mining company AngloGold this year (image below).

But it’s hard to navigate the EDGAR system to sort through hundreds of corporate filings and find the investment information. Thankfully, the CorpWatch organization created a web interface called CrocTail, which allows you to search for tax information from SEC filings about several hundred thousand U.S. publicly traded corporations and their foreign subsidiaries. The folks who created CrocTail also run the broader internet website Crocodyl, which provides more detailed corporate profiles by industry. For instance, we can check out the healthcare industry and see recent investigations into individual groups, such as the fraud conviction history of executives at the Hospital Corporation of America.

Putting it altogether

We can’t all afford to spend our days keeping track of the myriad financial transactions influencing our news and local politics. But a few key websites help do that job for us, and are easy to keep logged into our RSS readers for the occasional review. Our favorite is Corporations and Health Watch, a website contributed to by such distinguished public health professors as Nicholas Freudenberg and William Wiist. The site focuses on the lobbying efforts of a few key industries: tobacco, alcohol, firearms, auto, food and pharmaceutical companies. We’d recommend it as a great source to keep track of events that don’t make it into most newspapers.


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