Mike Daube

The Foundation for a Smoke-Free World was announced four months ago, with a September 12^th statement from the Philip Morris International company that “PMI currently expects to support the Foundation by contributing approximately USD 80 million per year, depending on the Foundation’s requirements and operations, over the next 12 years, beginning in 2018”. The Foundation’s website states that “The Foundation has secured initial funding of approximately US$80 million annually over the next 12 years, beginning in 2018, from Philip Morris International (PMI)…”.

The September PMI announcement stated that (note present tense) “The Foundation is an independent body, governed by its Board of Directors”. The Foundation’s website also states that “The Foundation has, constituted in its bylaws, an independent research agenda, independent governance”, etc. It provides links to its Certificate of Incorporation, which refers to the overarching role of the Board of Directors who “shall be the members of the Corporation for all purposes”. The Bylaws, which are cited in Dr Yach’s article as a means of ensuring independence, also refer to the Board of Directors and staff, including a President who “shall be the chief executive officer of the Corporation”.

The Bylaws state that “Directors shall be elected at each Annual Meeting of Directors, or if such meeting is not held or Directors are not elected thereat, at a special meeting of Directors called for that purpose”, but from my reading it is not clear how the initial Directors are selected or by whom they are ‘elected’.

A recent BMJ Opinion article by Dr Derek Yach, President of the “Foundation for a Smoke-Free World”, sets out his perspectives on the Foundation’s establishment and processes.

Until very recently the website did not list any Directors. The information available from the website under ‘Leadership’ related to Dr Yach, at times described as “founder and President-designate” – as in a letter to WHO (although in his Opinion piece as elsewhere he has been named as “President” –  and again more recently, as in the “Pledge Agreement co-signed with the PMI CEO); with recent additions of a Chief Operating Officer and Chief Financial Officer; Vice President, Strategic Partnerships, Vice President, Agriculture and Livelihoods; and Program Director, Health & Smoking Control.

The Foundation has posted a February 1 statement on its website announcing the appointment of five Directors: an executive in the Alliance for a Green Revolution in Africa (AGRA); a “former US ambassador and chairman emeritus of the Healthy Weight Commitment Foundation” – albeit also like Dr  Yach a former senior executive with PepsiCo; a consultant on sovereign wealth; a “physician who specializes in sports medicine and preventive medicine”; and the Managing Director of a venture capital fund who has also previously worked with PepsiCo.

The Foundation, however, already seems to have made a range of decisions about its plans and directions, as well as announcing a research program, inviting public input, and calling for grant “letters of intent”.

The PMI funding is reported (including by both Foundation’s website and PMI) to start in 2018. A recent Lancet article by Dr Yach reports (as does his BMJ Opinion article): “Declaration of Interests – DY was reimbursed by PMI for initial travel and time specifically related to the development of the Foundation. The relationship was terminated prior to the establishment of the Foundation and the Foundation’s bylaws preclude DY or other Foundation staff or board members from accepting any remuneration from PMI.”

It would be helpful if the Directors of the Foundation could provide answers on their website to the following questions:

1. Who appointed the Directors?
2. The media release announcing “the appointment of an initial group” of five Directors lists and refers to five Board members, but the Foundation’s website now refers to Dr Yach as “President and Chair, Board of Directors”. Is Dr Yach a member of the Board, and when was he elected Chair?
3. The same media release announcing the appointments is dated February 1, but the LinkedIn entry for one Director, Zoe Feldman, shows Board membership from September 2017, while that for another Director, Lisa Gable, shows Board membership from October 2017. Ms Gable’s LinkedIn entry also notes that she currently serves as Chair of the Compensation Committee. When were the Board and its Committee members appointed or elected?
4. When was Dr Yach appointed President, and by whom?
5. Prior to the February 1 announcement, who made decisions on issues such as appointment of a President (or President-designate), the Foundation’s priorities, funding, staffing and other matters?
6. If PMI funding started in 2018, who funded the Foundation’s activities hitherto, including salary and office costs, public relations and management consultancy agencies?
7. Is it fair to assume on the basis of his Competing Interest statements that Dr Yach received no direct or indirect reimbursement or support from PMI for any activities from the establishment of the Foundation in September through to 2018?
8. Will the Directors be able to reconsider decisions made thus far?
9. In the interests of transparency, will the salaries and any other remuneration for Board members and senior staff members and advisers be made public?
10. Similarly in the interests of transparency and to address concerns raised about the independence of the Foundation, will the Foundation release all correspondence and notes of discussions with the Philip Morris company ahead of the Foundation’s establishment, and commit to doing so on a continuing basis?
11. In his BMJ Opinion article, Dr. Yach asserts that “We firmly support the major provisions of the Framework Convention on Tobacco Control”. How is this consistent with Article 5.3 and its Guidelines, as well as the clearly expressed view from WHO and the WHO FCTC Secretariat that the Foundation should be treated in the same way as other tobacco industry-funded initiatives, including that “WHO will not partner with the Foundation. Governments should not partner with the Foundation and the public health community should follow this lead”.
12. Dr Yach also asserts that “The Foundation is informed by the principles and criteria for accepting tobacco industry funding first articulated in a Tobacco Control paper by Cohen, et al. (2009)”. Will the Board correct this assertion in light of the December 20 statement from Professors Cohen and Eissenberg (“Criteria not met for tobacco industry-supported research”) noting that the Foundation’s claim is “incorrect in several details” and concluding that “due to lack of independence, the potential for conflicts of interest, and clear public relations gains, the foundation does not represent a tobacco industry-supported funding model that should be acceptable to the research community”?

Professor Mike Daube AO is Professor of Health Policy at Curtin University, Western Australia.