One of the ways in which health research is funded is by corporations. We all know that pharmaceutical companies, for example, fund research into their own drugs to obtain FDA approval. But other food, nutrition, and health industries also fund research. The advantage of this system is that it funnels large amounts of money into research programs, which helps sustain them. However, there are obvious potential downsides, mainly corporations using their funding to put their thumb on the scale of scientific research.
Recently Coca-Cola was found to be doing just that. A report published by Cambridge researchers and others examined 87,013 pages of documents obtained through freedom of information act (FOIA) requests. Much of these documents were e-mails between Coca-Cola and researchers they were funding. They found:
Provisions gave Coca-Cola the right to review research in advance of publication as well as control over (1) study data, (2) disclosure of results and (3) acknowledgement of Coca-Cola funding. Some agreements specified that Coca-Cola has the ultimate decision about any publication of peer-reviewed papers prior to its approval of the researchers’ final report. If so desired, Coca-Cola can thus prevent publication of unfavourable research, but we found no evidence of this to date in the emails we received. The documents also reveal researchers can negotiate with funders successfully to remove restrictive clauses on their research.
We have to acknowledge the good and bad here. Researchers could negotiate to remove restrictive parts of an agreement, and the study authors could find no actual examples of Coca-Cola quashing research findings it didn’t like. The provisions themselves, however, are highly problematic, and seem designed to give Coca-Cola the power to do just that, to prevent publication without cause of any research it chose.
These findings highlight the need for comprehensive regulation ensuring the validity and transparency of corporate-funded health research. Any argument that corporations have a right to the results of research they fund is outweighed by the critical societal need for full confidence in the integrity of published research. This includes the fact that the published literature is a fair representation of all research results, and is not distorted by corporate or other narrow interests. Perhaps the worst type of distortion is the study not published – because there is no way to know what isn’t there. Any subsequent researcher doing a literature review may not be able to detect that certain studies were omitted.
It is increasingly recognized that doing research on people, and even animals, is a privilege. Society has a compelling interest in regulating such research. Further, research done by publicly funded institutions or researchers, even if that research itself is privately funded, should be in the public domain.
We also have to look beyond who has the right to any one study. Scientific research, in a very real way, exists as a whole. This is embodied in the peer-reviewed scientific literature. That literature is like a living organism, and in some ways needs to be treated that way. Society is best served when the whole of the literature follows agreed-upon rules, and fairly represents reality. In any narrow interest is able to distort the literature for its own ends, the entire organism is compromised.
The negative effects go beyond the specific question addressed by the influenced research. Such distortions reverberate throughout the literature, and also negatively affect public confidence in the entire scientific enterprise. This, perhaps, has the greatest negative societal effects. If large numbers of citizens and their representatives can ignore or dismiss the findings of scientific research, because they believe “science” is corrupt or only serves corporate interests, then the result is widespread science denial. This is exactly what we are currently seeing in the world, with devastating consequences.
There is significant denial of vaccine science, medical research in general, climate science, HIV science, psychiatry, and evolutionary science. Whenever someone prefers an ideological or convenient belief over the findings of science, they can point to Coca-Cola or other examples as evidence that “science” itself cannot be trusted.
I know this is a “meta” argument – that we must protect the integrity of all science in order to foster public confidence science itself, but recent experience supports this conclusion.
There are also many straight-forward steps we can take to promote the integrity of the scientific process and therefore public confidence in it. All of these rules already exist in one context or another, but they should be universal and enforced.
First – science requires complete transparency. Funding sources, and any relationship that might create a conflict of interest, should be fully disclosed.
Second – scientific findings also have to be complete and not cherry-picked in any way to give a reliable picture of reality. This means that no one gets to hide research findings they don’t like. You don’t get to peek at the results as the researcher is ongoing (except for safety monitoring), and you don’t get to decide whether or not to disclose the results.
Third – corporate or private grants for research should be unrestricted in specific ways. It’s fine if they are directed toward certain questions or areas of research, but funders should not control the scientific details, or what happens with the results. Nor should they be allowed to restrict transparency.
There are also multiple levels at which such science-ethics rules can be enforced. Journal editors can make any requirements they wish as criteria for being published. They can require full transparency, and that certain ethical guidelines were adhered to. Institutions can also enforce such rules, accepting private funding only when specific institution-wide guidelines are followed. Individual researchers should also be held to a standard of professional ethics, which should not allow for conducting research outside of these guidelines. Violating these rules could, for example, serve as reasons to be ejected from a professional society.
Finally, government should bake these essential scientific guidelines into any science it touches – any researcher, lab, institution, organization, publication, or research that it funds. It can also simply be made illegal to have any clause in a contract for funding of scientific research that requires breaking one of these established ethical guidelines. Simply put – you cannot contractually require someone to behave unethically.
We are certainly part of the way there in enacting such regulations to improve the integrity and transparency of scientific research. But we need to go all the way, and we need to do so in such a way that public confidence in the entire scientific enterprise will be promoted. Nothing can stop conspiracy theorists who are immune to reality, but conspiracy thinking and science denial can be marginalized and minimized by aggressive regulation of scientific ethics and transparency.