Revolving doors and conflicts of interest in health regulatory agencies in Brazil

Explaining the concepts and examples of conflict of interest and its management in the medical laboratory system of Iran: A scoping review

The occurrence of conflict of interest (CoI) is assumed to be a big challenge facing all healthcare sectors, including the medical laboratory system (MLS). Therefore, this study aimed to explain the concepts and examples of CoI and its management within this system. This scoping review was fulfilled in 2023 in Iran. To this end, the Persian and English keywords of this study were searched on the Persian and English databases based on the Medical Subject Headings (MeSH) and the Arksey and O'Malley methodological framework. All retrieved articles were then imported into EndNote X8, and their quality was evaluated via the Mixed Methods Appraisal Tool (MMAT). In total, 104 articles, of 6875 sources extracted, published from 2000 to 2023, were recruited following the identification and screening stages. Most articles had reported the maximum number of CoI examples in the MLS in diverse nations, including Iran, particularly in terms of structural, financial, objective, and subjective issues and primary and secondary interests among policymakers and higher-ranking managers of the healthcare system. Currently, CoI in healthcare systems, including the MLS, is unavoidable, but the best strategy, in preference to removing this situation, is to manage it under potential conditions before its occurrence and conversion into corruption. In view of that, it is recommended to provide effective training programs, increase transparency at work, facilitate compliance with professional guidelines, reform organizational structures and processes in the public sector, and establish policies best suited to manage CoI in the MLS of Iran.

Lobbying by omission: what is known and unknown about harmful industry lobbyists in Australia

What is unknown about commercial lobbying is far greater than what is known. These omissions distort our understanding of the extent and nature of business influence on politics. Especially when businesses engage in practices that harm health, it is crucial for public health advocates to understand corporate lobbying to counter its influence. Our study proceeded in three phases. First, based on an international audit, we developed a list of the categories of information about lobbying that could be disclosed under four groups (lobby firms, lobbyists, organizations and activities) and benchmarked Australian lobbyist registers against this list. Second, we manually extracted data from lobbyist registers in eight jurisdictions, cleaned the data and created a relational model for analysis. Finally, we classified a sample of organizations as public health organizations or harmful industries to compare their activities. We identified 61 possible categories of information about lobbying in international lobbyist registers. When applied to Australian lobbyist registers, Queensland covered the widest range of categories (13, 21%), though many lacked detail and completeness. Australian lobbyist registers provided data on 462 third-party lobby firms across Australia, currently employing 1036 lobbyists and representing 4101 organizations. Several of these represented harmful industries, with gambling interests hiring the most third-party lobby firms. Ultimately, Australian lobbyist registers do not provide enough information to understand the full extent of lobbying activities taking place. Political transparency is important for public health actors to be able to monitor corporate political activity and to protect policy-making from vested interests.

Who influences nutrition policy space using international trade and investment agreements? A global stakeholder analysis

Background

Regulation of food environments is needed to address the global challenge of poor nutrition, yet policy inertia has been a problem. A common argument against regulation is potential conflict with binding commitments under international trade and investment agreements (TIAs). This study aimed to identify which actors and institutions, in different contexts, influence how TIAs are used to constrain policy space for improving food environments, and to describe their core beliefs, interests, resources and strategies, with the objective of informing strategic global action to preserve nutrition policy space.

Methods

We conducted a global stakeholder analysis applying the Advocacy Coalition Framework, based on existing academic literature and key informant interviews with international experts in trade and investment law and public health nutrition policy.

Results

We identified 12 types of actors who influence policy space in the food environment policy subsystem, relevant to TIAs. These actors hold various beliefs regarding the economic policy paradigm, the nature of obesity and dietary diseases as health problems, the role of government, and the role of industry in solving the health problem. We identified two primary competing coalitions: 1) a ‘public health nutrition’ coalition, which is overall supportive of and actively working to enact comprehensive food environment regulation; and 2) an ‘industry and economic growth’ focussed coalition, which places a higher priority on deregulation and is overall not supportive of comprehensive food environment regulation. The industry and economic growth coalition appears to be dominant, based on its relative power, resources and coordination. However, the public health nutrition coalition maintains influence through individual activism, collective lobbying and government pressure (e.g. by civil society), and expert knowledge generation.

Conclusions

Our analysis suggests that industry and economic growth-focussed coalitions are highly capable of leveraging networks, institutional structures and ideologies to their advantage, and are a formidable source of opposition acting to constrain nutrition policy space globally, including through TIAs. Opportunities for global public health nutrition coalitions to strengthen their influence in the support of nutrition policy space include strategic evidence generation and coalition-building through broader engagement and capacity-building.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12992-021-00764-7.