What is going on at the CDC? Health agency ethics need scrutiny

Officials at the Centers for Disease Control and Prevention have their hands full these days. An epidemic of obesity has hit Americans hard, raising the risks for heart disease, stroke, type 2 diabetes and certain types of cancer. Childhood obesity is a particular prevalent problem.

Last year, World Health Organization (WHO) Director General Margaret Chan said the marketing of full-sugar soft drinks was a key contributor to rising obesity rates among children, suggesting restrictions on sugar-rich beverage consumption.

Though the beverage industry has strongly objected, several U.S. cities have been passing, or trying to pass, taxes on sugary sodas to discourage consumption. Since Berkeley, California became the first U.S. city to levy a soda tax in 2014, consumption dropped more than 20 percent in some areas of the city, according to a report published August 23 by the American Journal of Public Health.

{mosads}A Mexican soda tax correlated with a similar drop in soda purchases, according to research published earlier this year. One would expect the efforts would be heartily applauded by the CDC. And indeed, earlier this year a CDC research report said more aggressive measures were needed to convince Americans to cut back on sugary drinks.

But behind the scenes, mounting evidence suggests that rather than cracking down on the soda industry, high-ranking officials within the CDC’s National Center for Chronic Disease Prevention and Health Promotion are instead cozying up to beverage giant Coca-Cola and its industry allies, even in some cases aiding the industry as it argues that sodas are not to blame.

At least one internal ethics complaint over industry influence was lodged this month, according to a source inside the CDC. And more may be coming as a group of scientists within the CDC reportedly are attempting to push back against a culture cultivating close ties with corporate interests.

One recent focus of scrutiny has been the ties between Michael Pratt, Senior Advisor for Global Health in the CDC’s disease prevention unit, and Coca-Cola’s brainchild — the nonprofit corporate interest group called the International Life Sciences Institute (ILSI.)  ISLI was founded by Coca-Cola scientific and regulatory affairs leader Alex Malaspina in 1978, and continues to advocate for the agenda of beverage and food industries. Some in the scientific community see ILSI as little more than a front group aimed at advancing the interests of those industries with little regard for public well-being.

Still, ILSI’s money and influence are well known at the CDC, and Pratt’s work with ILSI is a prime example. Documents show that Pratt has a long history of promoting and helping lead research backed by Coca-Cola and ILSI.

One item at the top of the agenda for Coca-Cola and ILSI is gaining acceptance for the concept of energy balance. Rather than focusing on reducing consumption of sugar-laden foods and beverages to help control obesity and other health problems, policy makers should be focusing on a lack of exercise as the primary culprit, the industry says. That type of strategic spin is expected from companies that make money off those sugary foods and drinks. They’re protecting their profits.

But it’s harder to understand how the CDC can sign off on Pratt’s involvement in the industry effort. This public employee, presumably  drawing a taxpayer-funded paycheck, has spent the last few years working in a range of roles near and dear to the industry: He co-authored a Latin America health and nutrition study and related papers funded in part by Coca-Cola and ILSI; he has been acting as a scientific “advisor” to ILSI North America, serving on an ILSI committee on “energy balance and active lifestyle.”

Until his activities came under scrutiny, he was listed as a member of the ILSI Research Foundation Board of Trustees (his bio was removed from the website earlier this month). Pratt also served as an advisor to an international study of childhood obesity funded by Coca-Cola. And for roughly the last year or more he has held a position as a professor at Emory University, a private research university in Atlanta that has received millions of dollars from Coca-Cola entities.

The CDC says Pratt’s temporary assignment at Emory has ended. But now Pratt is headed to the University of San Diego (UCSD) to take the role of Director of the UCSD Institute for Public Health. And coincidentally — or not — ISLI is partnering with the UCSD on a “unique forum” related to “energy balance behavior” planned for November 30 to December 1 of this year. One of the moderators is another CDC scientist, Janet Fulton, Chief of the CDC’s Physical Activity and Health Branch.

When asked about Pratt’s work for these other outside interests, and asked if he had received approval and ethics clearance for the activities, CDC spokeswoman Kathy Harben said only that Pratt will be doing his work at UCSD while on annual leave from the CDC. If the public wants to know if Pratt has properly disclosed conflicts of interest and received approvals for his outside work, we have to file a Freedom of Information request, Harben said.

That is not an especially promising suggestion given that documents recently supplied by the CDC related to employee ties to Coca-Cola were only turned over after large swaths of communications were blacked out. Those emails pertained to former Pratt colleague Dr. Barbara Bowman, who was director of the CDC’s Division for Heart Disease and Stroke Prevention until departing the agency this summer amid scrutiny of her ties to Coca-Cola. Bowman was instrumental in helping direct CDC funds to a pet project that ILSI is working on with the U.S. Department of Agriculture to develop a “branded foods database.”

Email communications obtained that were not redacted showed that Bowman, a former Coca-Cola nutritionist, maintained a close connection with the company and ILSI as she rose in rank at the CDC.   The emails show that Bowman was happy to help the beverage industry cultivate political sway with the World Health Organization (WHO) as it tried to beat back regulation on sugary soft drinks. The emails showed ongoing communications regarding ILSI and beverage industry interests. Bowman “retired” in late June after those emails became public.

ILSI has a history of working to infiltrate public health organizations. A report by a consultant to WHO found that ILSI was infiltrating the organization with scientists, money and research to garner favor for industry products and strategies. ILSI was also accused of attempting to undermine WHO tobacco control efforts on behalf of the tobacco industry.

So should the public be concerned? The CDC says no. But we at the consumer group U.S. Right to Know believe the answer is an emphatic yes.  The mission of the CDC is to protect public health, and it is problematic for agency officials to collaborate with a corporate interest that has a track record of downplaying the health risks of its products. Questions about the alliances and the actions of some CDC officials are growing, and it is time the public received some answers.

Carey Gillam is a veteran journalist, formerly with Reuters, who directs research for U.S. Right to Know, a nonprofit consumer education group focused on food safety and policy matters.