In today’s Open Medicine, Steven Lewis brings forth provocative commentary on the appointment of Dr. Bernard Prigent, vice-president of medical affairs for Pfizer Canada, to the governing council of the Canadian Institutes of Health Research (CIHR). He outlines a number of arguments against the appointment that centre around conflict of interest, and places a spotlight on the diverging agendas of pharmaceutical companies (whose primary obligation is to serve their shareholders) and CIHR (which must, as a publicly funded institution, serve the public interest). He recounts notable dark episodes when public safety was compromised by products that were highly profitable for pharmaceutical companies, and expresses the general concern that Dr. Prigent’s appointment heralds a new era of potentially troubling industry influence on Canada’s health research agenda.
Lewis is not alone in his views: between November 25 and December 25, 2009, over 4300 people signed an online petition calling for the withdrawal of the appointment. Vocal concern led to a review of the appointment in two hearings by the House of Commons Standing Committee on Health; after spirited debate, a motion to recommend the withdrawal of the appointment was defeated.
As the defeat shows, there are also defenders of the appointment, and they range beyond the members of the Standing Committee. To broaden our readers’ understanding of the debate, Open Medicine invited the president of the CIHR, Dr. Alain Beaudet, who recommended Dr. Prigent for the appointment, to provide a commentary to accompany Lewis’s article. Karen Spierkel, CIHR’s director of communications and public outreach, provided an official response for the agency that highlighted the following points (quoted directly):
The CIHR Act specifies that Governing Council members are appointed by the Governor in Council. [Open Medicine note: The Governor in Council is the Governor General of Canada.] Section 7(4) of the CIHR Act outlines the appointment criteria as “the Governor in Council shall appoint as members of the Governing Council women and men who are able to contribute to the achievement of the objective of the CIHR in the overall interests of Canadians. The Governor in Council shall consider appointing women and men who reflect the highest standards of scientific excellence and women and men who reflect a range of relevant backgrounds and disciplines.”
Dr. Prigent has been appointed for his skills, experience and personal competencies. He is an experienced strategic decision maker, with a keen understanding of research and development partnerships between public and private institutions. CIHR has just renewed its Strategic Plan and a key action is to refine activities with respect to commercialization.
Dr. Prigent’s extensive experience in commercialization and pharmaceutical development will be critical to moving this forward and to achieve our mandate with respect to cures and treatments and facilitating commercialization.
Dr. Prigent will not be able to influence CIHR funding to specific research proposals. As a member of Governing Council, Dr. Prigent will make high level budget decisions; however, he will not make decisions with respect to which researchers/projects will be funded, as this is the responsibility of the Scientific Council, based on the advice of individual peer review panels.
All Governor in Council appointments must observe the Conflict of Interest Act, the Ethical Guidelines for Public Office Holders and the Guidelines for the Political Activities of Public Office Holders as a condition of appointment. These documents, along with general background on the Governor in Council appointment process, are available at the following link: http://www.appointments-nominations.gc.ca/prsnt.asp?page=Process&lang=eng
These points were reinforced by Dr. Beaudet when he and Dr. Prigent spoke on the appointment to the members of the Standing Committee. Because the first of the two committee meetings is the only public forum in which Dr. Beaudet and Dr. Prigent have discussed the appointment and answered questions about it, the Open Medicine editors here present extracts from that meeting for the reader’s benefit. The extracts have been carefully selected to present in an unbiased way what Dr. Beaudet and Dr. Prigent had to say. The entire transcripts of both committee meetings are available from the House of Commons website in PDF form at http://www2.parl.gc.ca/content/hoc/Committee/402/HESA/Evidence/EV4275165/HESAEV47-E.PDF and http://www2.parl.gc.ca/content/hoc/Committee/402/HESA/Evidence/EV4302528/HESAEV49-E.PDF .
CIHR’s stance is clearly that the strategic enhancement of commercialization activities is the central element supporting this appointment, and that in this realm Dr. Prigent is a highly competent individual. The CIHR statement also touches on the guidelines in place to at least partially manage conflict of interest when it arises.
Open Medicine’s editorial team intentionally stops here in presenting this controversy, respecting the conflicting views on this issue. As health care providers, teachers and researchers, we increasingly need to make informed decisions around transparency, accountability and conflict of interest. Through the commentary and Standing Committee extracts we seek simply to inform the scientific community and stimulate reflection and thoughtful dialogue among stakeholders on the challenges of reconciling potential conflict of interests with the contributions that industry partners can make in moving scientific discoveries into the applied health care marketplace.
Acknowledgments
We thank Lesley Barry for her contributions to the development of these articles on the CIHR appointment.