Governing industry involvement in the non-communicable disease response in Kenya

Abstract

Background In low- and middle-income countries (LMICs), multinational companies have become increasingly involved in addressing public health challenges. Dealing with companies as partners in health sector development creates new challenges for governments. We sought to develop an approach to assess the existence and effectiveness of governance structures that can ensure that industry-led public health initiatives contribute to development. Methods We developed a governance assessment tool based on the principles of the Paris Declaration for Aid Effectiveness and other related agreements. We applied it to the case of pharmaceutical companies’ involvement in the Kenyan response to non-communicable diseases (NCDs). We gathered data for analysis through 46 stakeholder interviews and reviewing documents. Results The Kenyan government has informal norms in place regarding program governance and strategy, but it has yet to issue formal regulations. While enabling elements exist that support initiatives to develop in alignment with these norms, implementation is often hindered by a lack of resources. Currently, broad stakeholder support for filling these gaps has created a window of opportunity for action. Conclusion The application of the proposed assessment tool illustrates its viability for assisting companies and governments alike in defining governance needs for industry-led public health initiatives. Our findings in Kenya provide example considerations for LMICs working to integrate industry-led public health programs into the health system. Bilateral and multilateral donors also have important roles in strengthening LMICs’ capacities to govern multinational corporations’ contributions to NCDs in particular, and development in general.

Disclosure, transparency, and accountability: a qualitative survey of public sector pharmaceutical committee conflict of interest policies in the World Health Organization South-East Asia Region

“…Thus, while conflict of interest policy can address the relationships between individuals and industry, it is one, but not the only tool for addressing industry influence within public health initiatives and public sector decision-making more broadly [59]. For example, researchers have proposed a tool for assessing national governance of public health initiatives led by multinational corporations, which clearly outlines expectations regarding regulation, information sharing, stakeholder engagement, and accountability, among others [60].…”