Tuesday, June 10, 2008

Sponsored events and conflicts of interest

Regular readers of this blog will know that there are World Health Assembly Resolutions calling for care over conflicts of interest in sponsorship of health workers and programmes.

What is meant by a conflict of interest? Well, as a starting point consider that sponsors want their logos on the materials of a sponsored event and possibly materials on a stand or in a participants pack. These are opportunities that fundraisers for events will sometimes explicitely offer to possible sponsors - the opportunity to promote themselves and/or their products to a key target audience. Companies may well also want to mention their sponsorship in their materials, websites, to the media and so on to gain kudos from any good name you have and for their perceived generosity (even when the money comes from their Public Relations or marketing budget).

So if you are running an event on infant care and it is sponsored by a bank, then you would not be surprised to think the bank is hoping to give the impression it cares about the next generation - a good image for a bank - and wants to pick up a few customers. Or if it is a mobile phone company, it is wanting its name seen by participants, most of whom will use mobile phones and may remember the name next time they are considering a change or may be less likely to cross the road the next time they encounter a marketing person in the street.

Now you may not like particular banks or mobile phone companies and that may be a good reason not to have them as sponsors, but I would suggest there is not a conflict of interest here. How you care for a child or how you advise others to care for a child is not going to be affected if you feel a little more inclined to read a flier from one of the nice sponsors of your event than you might have been beforehand.

What if it is a washing powder company that promotes its products at the event? Babies are messy creatures and, while everyone uses washing powder, people do so to a greater degree when a baby is messing up its clothes and reusable nappies (if those are being used). Here the company has a direct interest in how you care for your child or advise others. They want their product to be used. Will favouring the sponsor over another company make any difference to the child and its family? Unlikely. Desite all the hype I would guess there is not that much to choose between washing powders so recommending one over another won't do much harm, other than using your time and good name.

Now what about bottle and teat companies and formula companies? Like all the types of companies mentioned so far they want their products to be used and recommended rather than competing ones. Again, despite the hype there is not really much to choose between the different commercial products on the market. Those added ingredients which companies build their marketing campaigns around have no proven benefits. And if they did, we would want to see those ingredients in all products. See:

But they are not only competing with each other. They are competing with breastfeeding. Putting 'breast is best' on labels and in small print as a grudging compliance with laws does not negate this fact.

Does it make a difference if a company complies with the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant Resolutions when considering whether there is a conflict of interest?

A code violator may be more effective at competing with breastfeeding, but a code complier is still, like the bank and the washing powder company, looking for a return on its investment. So, no, I don't see how it makes a difference. Their interest - making a profit from artificial feeding - conflicts with providing impartial advice.

What about companies seeking to profit from breastfeeding, like pump companies and nipple cream companies? They too are looking for sales, recommendations, image transfer, good PR, access.

You might not really care if a mother is more likely to use one bank over another or a mobile phone company rather than its competitor.

You might be clear that breastfeeding and independent advice for mothers who use formula should not be undermined by the presence of companies with competing objectives.

But do you want to recommend a particular breastpump, feeding bottle (for expressed breastmilk) or a nipple cream? Are you comfortable with other aspects of the business of the company that owns the particular brand or subsidiary company?

If you feel there is a conflict then there is a conflict of interest. If you don't feel there is a conflict then you are defending your sponsor. Which may be fine. But it is not a neutral position.

If you think it is not an issue because the money is for a good cause and marketing doesn't really work, then that is to misunderstand why companies invest money in sponsorship.

What's the best way through?

To have sponsors you feel comfortable with, whose ulterior motive of gaining a return on their investment does not conflict with yours.

The simplest solution is to have no commercial sponsorship like Baby Milk Action and limit what you do as a result (but we think we are more effective through having no commercial links).

If you do need sponsors then why not look to products and services that have no impact on babies and young children or, if they do, they are to be welcomed. Like a photography studio, perhaps?

As a final thought, you might think you do want formula companies at an infant care event to be able to learn about the new improved formulas they are putting on the market. If so, why not assign someone to take a look at the materials, investigate the references to see if claims are evidence based and provide an impartial briefing or presentation that puts whatever the new formula may be in context. It may be new improved, but will still provide sub-optimum nutrition compared to breastfeeding.

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