Can CDC in the US takings millions from pharma industry be unbiased?

The image of the Centers for Disease Control and Prevention (CDC) in the US as an independent public health watchdog has taken a beating.

Rema Nagarajan
  • Updated On May 20, 2015 at 03:53 PM IST
Read by: 100 Industry Professionals
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NEW DELHI: The image of the Centers for Disease Control and Prevention (CDC) in the US as an independent public health watchdog has taken a beating. An article in the latest issue of the British Medical Journal reveals how this leading national public health institute renowned the world over receives millions of dollars in industry gifts and funding, both directly and indirectly.

The CDC’s recommendations come with the disclaimer stating: “CDC, our planners, and our content experts wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products ... CDC does not accept commercial support. Several questions have been raised over the years about CDC taking money from pharma companies and vaccine manufacturers. In this context, the BMJ article questioned the science CDC cites, the clinical guidelines it promotes, and the money it is taking.

According to the article, in 1983, CDC was authorised to accept ‘gifts’ from industry and other private parties and in 1992 a legislation was passed by US Congress to encourage relationships between the CDC and industry through a non-profit, the CDC Foundation..

The CDC Foundation raised $52 million in 2014, of which $12 million was from corporations. The CDC itself in fiscal year 2014 received $16 million in conditional funding from sources such as corporations, individuals, and philanthropy, including the CDC Foundation. Conditional donations are earmarked for specific projects.

“For example, in 2012, Genentech earmarked $600,000 in donations to the CDC Foundation for CDC’s efforts to promote expanded testing and treatment of viral hepatitis. Genentech and its parent company, Roche, manufacture test kits and treatments for hepatitis C. Incidentally, the CDC issued guidelines in August 2012 recommending expanded (cohort) screening of everyone born from 1945 to 1965 for hepatitis C virus though the science behind cohort screening has been questioned and much debated, stated the article.

As an example of the kind of conflict such donations were creating the article elaborated: “In 2010, the CDC, in conjunction with the CDC Foundation, formed the Viral Hepatitis Action Coalition, which supports research and promotes expanded testing and treatment of hepatitis C in the United States and globally. Industry has donated over $26m to the coalition through the CDC Foundation since 2010. Corporate members of the coalition include Abbott Laboratories, AbbVie, Gilead, Janssen, Merck, OraSure Technologies, Quest Diagnostics, and Siemens—each of which produces products to test for or treat hepatitis C infection.”

Conflict of interest forms filed by the 34 members of the external working group that wrote and reviewed the new CDC recommendation in 2012 show that nine had financial ties to the manufacturers. A report by the Office of the Inspector General found that CDC’s external advisors played an influential role in decision-making for the federal government and that there was a systemic lack of oversight of the ethics program with 97% of disclosure forms filed by advisors found to be incomplete, and 13% of advisors who participated in meetings not filing any disclosure at all.

Other pharma manufacturers who gave donations to the CDC Foundation included Janssen which gave $1.5m in 2012-13, and in 2011-12 contributors included Merck ($915,149), Genzyme ($762,000), Sanofi-Aventis ($600,000), and Abbott Laboratories ($550,000).

The BMJ pointed out that CDC was also criticised for its role in a series of studies into an epidemic of chronic kidney disease among men working in the sugar fields of central America. “The sugar industry is paying $1.7m to fund the studies, and critics say the fact that the research is being funded by the men’s employers raises concerns about how far it will probe industry’s role in the disease outbreak,” stated the article.

BMJ quoted the chief executive of a community health centre in the US which sees half a million patients annually as saying that though CD might claim that the money does not affect their recommendation, “multiple studies clearly—and repeatedly—show that who sponsors a study, or issues a guideline, makes a difference”.
  • Published On May 20, 2015 at 03:49 PM IST
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