The BMJ Today: Climate change and conflicts of interest: the sound and the fury

debs“Fury as top medical journal joins the green bandwagon” fumed the Daily Mail last week, which took exception to The BMJ’s publication of an article that, in the words of editor in chief Fiona Godlee, was not medicine or health but “pure climate science.”

“In this unequal battle with big business and political inertia we have a crucial card to play: the knowledge that much of what we need to do to tackle climate change will bring substantial benefits to health,” Godlee charged, adding that the World Health Organization should call a public health emergency.

And how prescient that comment was. Said fury came from Dr Benny Peiser of the Global Warming Policy Forum (GWPF), a think tank founded by former Chancellor Lord Lawson.

“The World Health Organization would become a global laughing stock if they were to follow the ridiculously over-the-top demands of a green alarmist editor. There is a real disconnect between what they are saying and the reality,” he was quoted as saying.

Not to be outdone, the Express followed up with an interview with Peiser. “Where is the global warming we were promised?” he queried—as if climate change science was akin to a weather forecaster predicting a week of sun in a disappointingly drizzly British summer.

But in a week when conflicts of interest garnered dozens of headlines across the Atlantic with the publication of payments to physicians by drug and device companies, there seems to be little transparency in the battle for hearts and minds in many other aspects of health and science. (On Thursday this week, The BMJ is hosting a meeting with the Royal College of Physicians about the interaction of healthcare professionals with industry.)

The GWPF has been accused of secrecy about its funding streams since it was set up in 2009 as an educational charity. But two major donors were “outed” last month on investigative blog, DeSmog UK, and both confirmed their donations to the Guardian. The two funders—Lord Nigel Vinson, a wealthy industrialist, and Neil Record, the founding chairman of a currency management company—have ties to the Institute of Economic Affairs (IEA), which has admitted to taking funding from fossil fuel companies and which has also argued against climate change mitigation.

The organisations have been accused of being thin on “evidence based reason,” and the GWPF was criticised by the Charity Commission last week. It found that GWPF’s “website could not be regarded as a comprehensive and structured educational resource sufficient to demonstrate public benefit,” adding that “the promotion of a particular view or position would not equate to education.” But such funding and concerns over potential bias were missing from the Daily Mail and Express articles.

In The BMJ, Tamasin Cave, director of the transparency campaigning group Spinwatch, highlighted concerns that the media perpetuates the idea that think tanks are independent sources of information. “While I understand the need for opinion and comment, media organisations do their audiences a disservice by not explaining these contributors’ financial backing or vested interests,” she said.

For those who follow the media profile, the IEA’s position on climate change might not come as a surprise. They have frequently led the charge for industrial interests and ideologies to trump public health intervention. And to be fair to the Daily Mail and the Express, they’re not the only media outlets that have been remiss at publishing or querying potential conflicts of interest. BBC Radio 4’s Today programme featured an interview with the IEA’s Mark Littlewood, who said that there is no evidence that uniform packaging affects the number of people who smoke. The programme failed to point out that the IEA takes money from Philip Morris, among others.

(This editor of The BMJ also notes that in a debate on BBC’s Question Time about banning smoking in cars containing kids, both the IEA’s Mark Littlewood* and Tory MP Ken Clarke, who has been vice-chairman of British American Tobacco, were featured but there was no mention of these ties.)

This intermingling of health policy and private financial interests takes many forms. In May, for instance, The BMJ sparked debate among the Indian medical community with an article entitled: “Corruption ruins the doctor-patient relationship in India.” It described how clinical investigations and procedures are abused “as a means of milking patients.” The author, David Berger, charted examples of overt corruption he saw.

The article attracted dozens of responses discussing the merits of the piece. However, one doctor pointed out that “the corresponding words for ‘corruption’ in the affluent countries are: ‘profit sharing,’ ‘ kickback,’ ‘lobbying,’ ‘grant’ from this or that company, ‘conflict of interest,’ etc (beautiful words indeed).”

In response to the article, the Times of India ran an interview with Fiona Godlee outlining her views. “I think that we have enough evidence that people who do take financial incentives or have financial relationships with commercial entities, their information is biased. I am afraid that is what the data shows and we have to act on that,” she said.

Deborah Cohen is investigations editor for The BMJ.

*This blog incorrectly said “Christopher Snowdon” was on BBC’s Question Time on publication. The blog was correctly updated to say “Mark Littlewood” on 8 October 2014. Apologies for this error.