CDC Division for Heart Disease and Stroke Prevention

CDC SPIDER: Scientists complain of corporate influence at health agency

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Posted on by Stacy Malkan

By Carey Gillam

Concerns about the inner workings of the U.S. Centers for Disease Control and Prevention (CDC) have been mounting in recent months amid disclosures of cozy corporate alliances. Now a group of more than a dozen senior scientists have reportedly lodged an ethics complaint alleging the federal agency is being influenced by corporate and political interests in ways that short-change taxpayers.

A group calling itself CDC Scientists Preserving Integrity, Diligence and Ethics in Research, or CDC SPIDER, put a list of complaints in writing in a letter to the CDC Chief of Staff and provided a copy of the letter to the public watchdog organization U.S. Right to Know (USRTK). The members of the group have elected to file the complaint anonymously for fear of retribution.

“It appears that our mission is being influenced and shaped by outside parties and rogue interests… and Congressional intent for our agency is being circumvented by some of our leaders. What concerns us most, is that it is becoming the norm and not the rare exception,” the letter states. “These questionable and unethical practices threaten to undermine our credibility and reputation as a trusted leader in public health.”

The complaint cites among other things a “cover up” of the poor performance of a women’s health program called the Well-Integrated Screening and Evaluation for Woman Across the Nation, or WISEWOMAN. The program provides standard preventive services to help 40- to 64-year-old women reduce their risks for heart disease, and promote healthy lifestyles. CDC currently funds 21 WISEWOMAN programs through states and tribal organizations. The complaint alleges there was a coordinated effort within the CDC to misrepresent data given to Congress so that it appeared the program was involving more women than it actually was.

“Definitions were changed and data ‘cooked’ to make the results look better than they were,” the complaint states. “An ‘internal review’ that involved staff across CDC occurred and its findings were essentially suppressed so media and/or Congressional staff would not become aware of the problems.”
The letter mentions that Congresswoman Rosa DeLauro, a Democrat from Connecticut, who has been a proponent of the program, has made inquiries to CDC regarding the data. A spokesman for her office, confirmed as much.

The complaint also alleges that staff resources that are supposed to be dedicated to domestic programs for Americans are instead being directed to work on global health and research issues.

And the complaint cites as “troubling” the ties between soft drink giant Coca-Cola Co., an advocacy group backed by Coca-Cola, and two high-ranking CDC officials – Dr. Barbara Bowman who directed the CDC’s Division for Heart Disease and Stroke Prevention until retiring in June, and Dr. Michael Pratt, senior Advisor for Global Health in the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) at the CDC.

Bowman, retired after revelations of what the complaint called an “irregular” relationship with Coca-Cola and the nonprofit corporate interest group set up by Coca-Cola called the International Life Sciences Institute (ILSI). Email communications obtained through Freedom of Information Act (FOIA) requests by USRTK revealed that in her CDC role, Bowman had been communicating regularly with – and offering guidance to – a leading Coca-Cola advocate seeking to influence world health authorities on sugar and beverage policy matters.

Emails also suggested that Pratt has a history of promoting and helping lead research funded by Coca-Cola while being employed by the CDC. Pratt also has been working closely with ILSI, which advocates for the agenda of beverage and food industries, emails obtained through FOIA showed. Several research papers co-written by Pratt were at least partly funded by Coca-Cola, and Pratt has received industry funding to attend industry-sponsored events and conferences.

Last month, Pratt took a position as Director of the University of California San Diego Institute for Public Health. Next month, ILSI is partnering with the UCSD to hold a 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. Pratt is on annual leave from the CDC during his stint in San Diego, according to the CDC.

The forum fits into the messaging of “energy balance” that Coca-Cola has been pushing. Consumption of sugar-laden foods and beverages is not to blame for obesity or other health problems; a lack of exercise is the primary culprit, the theory goes.

Experts in the nutrition arena have said that the relationships are troubling because the mission of the CDC is protecting public health, and yet certain CDC officials appear to be close with an industry that, studies say, is linked to about 180,000 deaths per year worldwide, including 25,000 in the United States. The CDC is supposed to be addressing rising obesity rates among children, not advancing beverage industry interests.

CDC spokeswoman Kathy Harben would not address what the agency might be doing, if anything, in response to the SPIDER complaint, but she said the agency makes use of a “full range of federal ethics statutes, regulations, and policies” that apply to all federal employees.”

“CDC takes seriously its responsibility to comply with the ethics rules, inform employees about them, and take steps to make it right any time we learn that employees aren’t in compliance,” Harben said. “We provide regular training to and communicate with staff on how to comply with ethics requirements and avoid violations.”

The SPIDER group complaint ends with a plea for CDC management to address the allegations; to “do the right thing.”

Let’s hope someone is listening.

This article was originally published in Huffington Post. 

What Is Going on at the CDC? Health Agency Ethics Need Scrutiny

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Posted on by Carey Gillam

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. 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.

(This article first appeared in The Hill – http://www.thehill.com/blogs/pundits-blog/healthcare/293482-what-is-going-on-at-the-cdc-health-agency-ethics-need-scrutiny)

CDC Official Exits Agency After Coca-Cola Connections Come to Light

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Posted on by Carey Gillam

Barbara bio pic (1)

By Carey Gillam

A veteran leader within the Centers for Disease Control and Prevention announced her immediate departure from the agency on Thursday, two days after it came to light that she had been offering guidance to a leading Coca-Cola advocate who was seeking to influence world health authorities on sugar and beverage policy matters.

In her role at CDC, Dr. Barbara Bowman, director of CDC’s Division for Heart Disease and Stroke Prevention, has been involved in a range of health policy initiatives for the division charged with providing “public health leadership.” She began her career at the CDC in 1992.

Bowman’s boss, Ursula Bauer, Director, National Center for Chronic Disease Prevention and Health Promotion, sent an email to staff members after my June 28 story in this blog revealed the Coca-Cola connections. In that email, she confirmed the accuracy of the report, and while she defended Bowman’s actions, she said the “perception that some readers may take from the article is not ideal.” She also warned employees to avoid similar actions, saying the situation “serves as an important reminder of the old adage that if we don’t want to see it on the front page of the newspaper then we shouldn’t do it.”

Bowman’s exit was announced through internal emails. Bowman told colleagues in a CDC email sent Thursday that she had decided to retire “late last month.” She made no reference to the revelations about her connections with Coca-Cola or any other concerns.

Bauer sent a separate email applauding Bowman’s work with CDC. “Barbara has served with distinction and has been a strong, innovative, dedicated and supportive colleague. She will be greatly missed by our center and CDC,” Bauer said in the email.

Bowman’s departure comes at a time when several questions about Bowman and her department are dogging the agency, according to sources inside the CDC. In addition to the questions about ties to Coca-Cola, which is actively trying to push back on policies regulating or reining in soft drinks, there are questions about the efficacy and transparency of a program known as WiseWoman, which provides low-income, under-insured or uninsured women with chronic disease risk factor screening, lifestyle programs, and referral services in an effort to prevent cardiovascular disease. The departure also comes a day after the organization I work for – U.S. Right to Know – filed another FOIA seeking additional communications.

The Coca-Cola connections date back decades for Bowman, and tie her to former top Coca-Cola executive and strategist Alex Malaspina. Malaspina, with Coca-Cola’s help, founded the controversial industry group International Life Sciences Institute (ILSI). Bowman also worked early in her career as a senior nutritionist for Coca-Cola, according to sources, and she co-authored an edition of a book called Present Knowledge in Nutrition as “a publication of the International Life Sciences Institute.”

ILSI’s reputation has been called into question several times for the strategies it has employed to try to sway public policy on health-related issues.

Email communications obtained by U.S. Right to Know through state Freedom of Information requests revealed that Bowman appeared happy to help Malaspina, who formerly was Coca-Cola’s top scientific and regulatory affairs leader, and the beverage industry cultivate political sway with the World Health Organization. The emails showed Malaspina, representing the interests of Coca-Cola and ISLI, complaining that the World Health Organization was giving a cold shoulder ILSI. The email strings include reports of concerns about Coca-Cola’s new Coca-Cola Life, sweetened with stevia, and criticisms that it still contained more sugar than daily limit recommended by WHO.

The communications came as the beverage industry has been reeling from a series of actions around the world to rein in consumption of sugary soft drinks due to concerns about links to obesity and type 2 diabetes.

A critical blow came last June when World Health Organization (WHO) Director General Margaret Chan said the marketing of full-sugar soft drinks was a key contributor to rising child obesity around the world, especially in developing countries. WHO published a new sugar guideline in March 2015, and Chan suggested restrictions on sugar-rich beverage consumption.

Mexico already implemented its own soda tax in 2014, and many cities in the U.S. and around the world are currently considering such restrictions or disincentives, like added taxes, while others have already done so. The Mexican soda tax has correlated with a drop in soda purchases, according to research published earlier this year.

CDC spokeswoman Kathy Harben said earlier this week that the emails did not necessarily represent a conflict or problem. But Robert Lustig, Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, said ILSI is a known “front group for the food industry.” And he pointed out that the CDC has yet to take a stance on limiting sugar consumption, despite the WHO concerns about links to disease.

The email exchanges show that Bowman did more than simply respond to questions from Malaspina. She also initiated emails and forwarded information she received from other organizations. Many of Bowman’s emails with Malaspina were received and sent through her personal email account, though in at least one of the communications, Bowman forwarded information from her CDC email address to her personal email account before sharing it with Malaspina.

ILSI has had a long and checkered relationship with the World Health Organization, working at one time closely with its Food and Agricultural Organization (FAO) and with WHO’s International Agency for Research on Cancer and the International Programme on Chemical Safety.

But a report by a consultant to WHO found that ILSI was infiltrating WHO and FAO 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.

WHO eventually distanced itself from ILSI. But questions about ILSI influence erupted again this spring when scientists affiliated with ILSI participated in an evaluation of the controversial herbicide glyphosate, issuing a decision favorable to Monsanto Co. and the pesticide industry.

Follow Carey Gillam on Twitter: www.twitter.com/careygillam

(This article first appeared in The Huffington Post http://www.huffingtonpost.com/carey-gillam/cdc-official-exits-agency_b_10760490.html)

Beverage Industry Finds Friend Inside U.S. Health Agency

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Posted on by Stacy Malkan

This article was first published by Huffington Post. 

By Carey Gillam 

It’s been a rough year for Big Soda, sellers of those sugary soft drinks that kids (and adults) love to chug.

A June 16 decision by city leaders in Philadelphia to impose a “soda tax” as a means to discourage consumption of beverages seen as unhealthy is only the latest in a string of bad news for companies like Coca-Cola and PepsiCo, which have seen soft drink sales steadily declining. Nervous investors drove shares in those companies lower after the Philadelphia move in recognition of what is but the latest evidence that consumers, lawmakers and health experts are connecting sweetened beverages to a range of health problems, including obesity and type 2 diabetes.

Last year San Francisco passed a law requiring ads for sugary drinks to include warnings about the possible negative health effects associated with the products.

A critical blow came last June when World Health Organization (WHO) Director General Margaret Chan said the marketing of full-sugar soft drinks was a key contributor to rising child obesity around the world, especially in developing countries. WHO published a new sugar guideline in March 2015, and Chan suggested restrictions on sugar-rich beverage consumption.

Mexico already implemented its own soda tax in 2014, and many cities in the U.S. and around the world are currently considering such restrictions or disincentives, like added taxes, while others have already done so. The Mexican soda tax has correlated with a drop in soda purchases, according to research published earlier this year.

It’s no surprise that the beverage industry, which reaps billions of dollars annually from soft drink sales, has been fearing – and fighting against – this shifting sentiment.

But what is surprising is one of the places where the beverage industry has sought, and apparently garnered, some help —- from a top official with the Centers for Disease Control and Prevention, whose mission in part is to prevent obesity, diabetes, and other health problems.

Email communications obtained by U.S. Right to Know through state Freedom of Information requests detail how a leading beverage and food industry advocate last year was able to ask for and input and guidance from Dr. Barbara Bowman, director of CDC’s Division for Heart Disease and Stroke Prevention, on how to address World Health Organization actions that were hurting the beverage industry.

Bowman leads a CDC division charged with providing “public health leadership” and works with states to promote research and grants to prevent and manage risk factors that include obesity, diabetes, heart disease and stroke. 

But the emails between Bowman and Alex Malaspina, a former Coca-Cola scientific and regulatory affairs leader and founder of the industry-funded International Life Sciences Institute (ILSI), show that Bowman also appeared happy to help the beverage industry cultivate political sway with the World Health Organization.

Emails from 2015 detail how Malaspina, representing the interests of Coca-Cola and the food industry, reached out to Bowman to complain that the World Health Organization was giving a cold shoulder to the chemical and food industry-funded group known as ILSI, which Malaspina founded in 1978. The email strings include reports of concerns about Coca-Cola’s new Coca-Cola Life, sweetened with stevia, and criticisms that it still contained more sugar than daily limit recommended by WHO.

The emails include reference to the WHO’s call for more regulation on sugary soft drinks, saying they were contributing to rising obesity rates among children, and complain about Chan’s comments.

“Any ideas how we can have a conversation with WHO?” Malaspina writes in a June 26, 2015 email to Bowman. He forwards her an email string that includes top executives from Coca-Cola and ILSI and expresses worry about negative reports about products with high sugar content, and sugary soda tax plans in Europe. In the email string, Malaspina says the WHO actions can have “significant negative consequences on a global basis.”

“The threat to our business is serious,” Malaspina writes in the email chain he sends to Bowman. On the email chain are Coca-Cola Chief Public Affairs and Communications Officer Clyde Tuggle as well as Coca-Cola’s Chief Technical Officer Ed Hays.

Directly he tells Bowman that officials at WHO “do not want to work with industry.” And says: “Something must be done.”

Bowman replies that someone with Gates or “Bloomberg people” may have close connections that could open a door at WHO. She also suggests he try someone at PEPFAR program, a U.S. government-backed program that makes HIV/AIDS drugs available through the sub-Saharan Africa. She tells him that “WHO is key to the network.” She writes that she “will be in touch about getting together.”

In a subsequent June 27, 2015 email, Malaspina thanks her for the “very good leads” and says “we would want WHO to start working with ILSI again… and for WHO to not only consider sugary foods as the only cause of obesity but to consider also the life style changes that have been occurring throughout the Universe.” He then suggests he and Bowman meet for dinner soon.

The fact that a high-level U.S. health official is communicating in this way with a beverage industry leader appears improper, according to Marion Nestle, author of the book “Soda Politics” and a professor of nutrition, food studies, and public health at New York University.

“These emails suggest that ILSI, Coca-Cola, and researchers funded by Coca-Cola have an ‘in’ with a prominent CDC official,” Nestle said. “The official appears to be interested in helping these groups organize opposition to “eat less sugar” and “disclose industry funding” recommendations. The invitation to dinner suggests a cozy relationship… This appearance of conflict of interest is precisely why policies for engagement with industry are needed for federal officials.”

But CDC spokeswoman Kathy Harben said the emails do not necessarily represent a conflict or problem.

“It is not unusual for CDC to be in touch with people on all sides of an issue.” Harben said.

Robert Lustig, Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, said ILSI is a known “front group for the food industry.” Lustig said he finds it “interesting” that the CDC has yet to take a stance on limiting sugar consumption, despite the WHO concerns about links to disease. Lustig directs UCSF’s WATCH program (Weight Assessment for Teen and Child Health), and is co-founder of the non-profit Institute for Responsible Nutrition.

Neither Bowman nor Malaspina responded to requests for comment.

The email exchanges show that Bowman did more than simply respond to questions from Malaspina. She also initiated emails and forwarded information she received from other organizations. Many of Bowman’s emails with Malaspina were received and sent through her personal email account, though in at least one of the communications, Bowman forwarded information from her CDC email address to her personal email account before sharing it with Malaspina.

In a February 2015 email from Bowman to Malaspina she shared an email she had received from a USDA official with the subject line “FOR YOUR REVIEW: Draft Principles from Dec 8 Public Private Partnerships Meeting.” The email from David Klurfeld, national program leader for human nutrition at the USDA’s Agricultural Research Service, quoted an article from the BMJ medical journal stressing a need for public/private partnerships, and included a quote about a “strong tide of sanctimony in British public health.” Bowman tells Malaspina: “This may be of interest. Check out the BMJ correspondence especially.”

In a March 18, 2015 email from Bowman to Malaspina she forwarded an email regarding the new policy brief to curb global sugar consumption she received from the World Cancer Research Fund International. Malaspina then shared the communications with Coca-Cola officials and others.

In a separate March 2015 email, Bowman sent Malaspina some CDC summaries of reports and says she would appreciate his “thoughts and comments.”

Bowman, who holds a PhD in human nutrition and nutritional biology, has worked at the CDC since 1992, and has held several senior leadership positions there. She was appointed director of the Division for Heart Disease and Stroke Prevention in the National Center for Chronic Disease Prevention and Health Promotion at CDC in February 2013.

Malaspina has also had a long career in his field of expertise. The veteran Coca-Cola executive founded ILSI in 1978 with help from Coca-Cola, Pepsi and other food industry players and ran it until 1991. ILSI has had a long and checkered relationship with the World Health Organization, working at one time closely with its Food and Agricultural Organization (FAO) and with WHO’s International Agency for Research on Cancer and the International Programme on Chemical Safety.

But a report by a consultant to WHO found that ILSI was infiltrating WHO and FAO 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.

WHO eventually distanced itself from ILSI. But questions about ILSI influence erupted again this spring when scientists affiliated with ILSI participated in an evaluation of the controversial herbicide glyphosate, issuing a decision favorable to Monsanto Co. and the pesticide industry.

Carey Gillam is a veteran journalist and research director for U.S. Right to Know, a non-profit consumer education group. Follow her on Twitter @CareyGillam