A row over the involvement of The Amsterdam Group in a book on alcohol and health issues has focused attention on the drinks industry's involvement in funding research. Ben Cooper examines the delicate relationship between the industry and the scientific community and its effect on the highly charged alcohol policy debate.

Drinks executives generally do not turn to the British Medical Journal (BMJ) for glowing endorsements of their work but a recent news article will have caused dismay nonetheless. For once the story did not warn of the dangers of drinking alcohol, but its ramifications are still far reaching in regards to the whole alcohol policy debate.


"We support the general principle of disclosure and we're very strongly in support of the Dublin Principles"

A book providing an overview of health research into alcohol consumption published by the International Life Sciences Institute (ILSI) failed to disclose funding from the drinks industry through The Amsterdam Group (TAG).

Although the BMJ and the journal, Addiction, reported that TAG wanted the funding source to be made clear, the controversy inevitably reflects badly on the industry. "We are scrupulously careful about what we do in the way of research," says TAG's Richard Owen. "We had very clearly and repeatedly asked them to include where the funding had come from. We are very disappointed."

Like most social aspects organisations the group supports the Dublin Principles, a code agreed in 1997 between researchers, the industry and many other concerned bodies governing alcohol research. Arguably the code's most important tenet is complete transparency regarding funding. "We support the general principle of disclosure and we're very strongly in support of the Dublin Principles," says Gaye Pedlow, alcohol policy director at Diageo, a TAG member. Asked what TAG has learned from this experience, Pedlow replied, "choose partners who are happy with our commitment to disclosure," leaving little doubt as to their current mood.

The ILSI controversy will die down but it is not surprising that it has attracted adverse attention. It is a regrettable truth that alcohol, if misused, causes harm but what degree of harm, whether alcohol is wholly to blame, whether health warning labels change drinking behaviour or what level of consumption constitutes abuse are complex questions which can only be answered by biomedical or social research. The way this research is conducted and interpreted determines legislation, public health policy and the drinks industry's own self-regulatory activities.

"The alcohol field is so politicised; it's a minefield," says Martin Plant, director of the Alcohol and Health Research Centre who believes ILSI was "misguided".

A huge amount of research is therefore undertaken, funded by a wide variety of private and governmental organisations including the industry itself. To imagine that many other organisations funding research are not subject to political and ideological agendas would be naïve but the drinks industry, with its clear vested commercial interests, is arguably subject to the most scrutiny.

However, the drinks industry is not alone in having to grapple with this. "This is not an alcohol-only issue," says Pedlow. "When it comes to the funding of research, disclosure is just as much an issue for food, pharmaceutical and of course tobacco companies."

Marcus Grant

This view is endorsed by Marcus Grant, director of the International Center for Alcohol Policies (ICAP), a research organisation which is completely open about its industry funding. In Grant's view, transparency is simply the principle under which all research funding should operate whether from private or public sources.

But why does the drinks industry become involved in research especially as it is potentially such a PR minefield? While one would hope there is a strong element of social conscience, it would be absurd to contend that self-interest is not a prime motivating factor.

Pedlow says the industry looks to "fill in gaps in existing research". For instance, the industry has funded research into potential positive health outcomes from alcohol consumption and the health effects of moderate rather than excessive consumption. But these are also both areas where the results could, if favourable, serve the interests of the alcohol industry well.

There are some who feel that in itself makes it morally questionable. Others accept it as part of the way the industrial world works. It is only the idea of unfavourable results being suppressed that would receive wholesale moral opprobrium. But another key provision in the Dublin Principles stipulates that "researchers should be free to disseminate and publish the results of their work".

However, the Dublin Principles do allow for the involvement of sponsors in the editorial process. Critics of the code, like David Jernigan of the Marin Institute, a privately funded alcohol research body which has no links with the drinks industry but has some association with the temperance movement, believes this definitely introduces a bias into the research.

This complex issue has as much to do with scientific ethics as it does directly with the alcohol policy debate. Grant argues that input from industry professionals is much the same as peer review at a university. He says that in many instances such consultation will benefit the research and whenever it could be beneficial it should be done. "On some editorial groups it would be helpful," says Grant. "In other circumstances it might not be. One should be quite pragmatic. It's an empirical rather than moral question."


What all sides agree on is that whatever the involvement is it should be explicitly communicated

Interestingly, neither Marcus Grant nor David Jernigan says he believes in absolute objectivity when it comes to research. "I don't believe in absolute objectivity," says Jernigan. "We all have to state our interests. It promotes a kind of transparency in research which is critical." The Dublin Principles would ensure this though Jernigan feels they are inadequate and, unlike Marcus Grant and Martin Plant, is uncomfortable with any industry involvement at all.

Such differing views underline the thorny nature of this issue. Ultimately, terms such as "at arm's length", a phrase frequently used by all sides in this connection, mean very different things to different people. What all sides at least appear to agree on is that whatever the involvement is it should be explicitly communicated.

People will still contend that commercial interests bias research and if a commercial sponsor of a project has any involvement other than possibly writing the cheque, the research is compromised. These are accusations which drinks companies, just like those in the pharmaceutical, motor, civil aviation and many others industries, probably just have to live with.

But it is extremely ironic that this particular controversy might have been avoided if the industry had actually brought more financial pressure to bear on ILSI. The large, successful companies involved in TAG deal with suppliers all the time, they know how to talk tough and use their buying power. They also employ vast teams of lawyers to ensure that contracts are watertight.

Why on earth they could not have demanded an undertaking from ILSI that they would comply with the Dublin Principles, making it a stipulation in the contract and a condition of payment remains something of a mystery. One imagines that in future such a precondition will be a matter of course.