Not All Industry-Affiliated Groups Are Created Equal: Some Conditions Under Which Science and Industry May Coexist Ethically and for the Public Good

The INEBRIA Position Statement on the Alcohol Industry illustrates a longstanding tendency to regard the alcohol industry as a single monolithic entity, motivated solely by the pursuit of profit. From this perspective, any individual or group that accepts industry funding risks compromising its “independence, objectivity, integrity and credibility” (International Network on Brief Interventions for Alcohol & Other Drugs, 2015, p. 1). Although the original INEBRIA position statement primarily focuses on brief intervention practice and research, Andréasson and McCambridge’s (2016—this issue) editorial in this volume argues that INEBRIA’s position of discouraging individuals and groups from “seeking or receiving funding from, and indeed having any relationships with the alcohol industry” (International Network on Brief Interventions for Alcohol & Other Drugs, 2015, p. 1) applies equally well to alcohol researchers and “indeed to all research involving consumption of hazardous products” (Andréasson & McCambridge, 2016, p. 537). We agree with many of the concerns expressed in the INEBRIA position statement. However, we are troubled by its absolute black-or-white tone that tars all industry-related groups with the same broad brush, making no distinctions among industry-affiliated research organizations that differ in policies, procedures for review and funding of research, and methods of safeguarding the scientific independence and objectivity of such research.

The authors of this commentary have all been involved as scientific peer reviewers for the Alcoholic Beverage Medical Research Foundation (ABMRF), a nonprofit foundation that since 1982 has funded research on the medical, behavioral, and social effects of consuming alcoholic beverages, with support from U.S. and Canadian (and recently South African) brewing companies. Based on published, peer-reviewed research funded by ABMRF, and our own experiences, we believe that the organizational structure of the ABMRF may offer guidance for models in which funds from the alcohol industry can be used to support independent alcohol research, using methods that maximize transparency, avoid real or perceived conflicts of interest, and promote public health. We acknowledge that many organizations that accept industry funding do not adhere to the rigorous safeguards that ABMRF has had in place since its inception. However, in this commentary, we focus on ABMRF, an organization with which we are all familiar. Our goal is to offer ABMRF as an example of how academia and industry can work together with integrity and for the public good. In this commentary, we address two common criticisms of alcohol industry funding: its limited size and the inherent conflict between the values of science and industry. We conclude with a call for more empirical research on this complex ethical issue.

Limited size of industry funding makes major impact unlikely

Some critics have argued that the relatively limited industry funding of alcohol research is “unlikely to … lead to scientific breakthroughs or reduce the burden of alcohol-related illness” (Babor, 2009, p. 34).

ABMRF has supported investigator-initiated biomedical and psychosocial studies by more than 570 investigators at more than 260 academic institutions in the United States, Canada, and South Africa (Mitchell & Ambler, 2014). Although “scientific breakthroughs” are difficult to define, the impact on the field and the knowledge gained have been significant. ABMRF support has resulted in more than 2,350 scientific publications (Mitchell & Ambler, 2014). The priority given to new investigators has contributed to the career development of many leading addiction scientists (including a past director of the National Institute on Alcohol Abuse and Alcoholism [NIAAA] and the current director of the National Institute on Drug Abuse). ABMRF grantees have been highly successful in obtaining continued external funding for their research following their initial ABMRF support. Within the Research Society on Alcoholism (RSA) alone, ABMRF grantees have been awarded 4 RSA lifetime achievement awards, 9 distinguished researcher awards, and 16 early career investigator awards. Although support for any single research study may not lead to groundbreaking findings, the seeds sown by ABMRF to these researchers have facilitated research careers devoted to reducing the burden of alcohol-related illness and supported the development of innovative research and important breakthroughs. Such external funding can also aid new alcohol researchers in showing their promise to the tenure and promotion systems at their institutions, further seeding the base of alcohol research in North America. Although we agree with Babor (2009) that the overall level of funding has been limited and therefore has restricted the number of meritorious applications that could be funded, we believe that the amount provided over the years has had considerable impact in furthering the field of alcohol research and the careers of alcohol researchers.

Motives and values of industry inherently conflict with those of science

The INEBRIA position statement asserts that there are unavoidable conflicts of interest with any funding from the alcohol industry, and many respected colleagues agree that efforts at partnerships with the alcohol industry are fraught with risks for individual investigators, their institutions, and society in general (e.g., Caetano, 2008; Miller et al., 2008). We agree that potential conflicts exist in virtually every interaction between science and industry. However, we would argue that the important issue is not whether such conflicts exist but rather how they are managed or minimized.

ABMRF has minimized these risks by insisting on a strict “hands-off” relationship between industry funders and grant recipients. Based on a National Institutes of Health–like model, investigator-initiated grant applications are reviewed for scientific-technical merit by two peer-review groups (the Medical Advisory Council for biomedical research and the Behavioral and Social Advisory Council for psychosocial research), whose recommendations are approved by a 12-member board of trustees. In our collective 68 years of service on the scientific-technical review groups and/ or the board of trustees, we know of no instances in which any industry representative influenced the scientific review process, nor any efforts by foundation administrators, trustees, or funders to alter or override the recommendations of the peer-review groups. In fact, operating procedures of the foundation do not permit the board to review decisions on individual awards, but only to provide a specific amount of funding for the overall research program. In that sense, the councils have complete control. Grantees are free to publish the findings of their research, with only a request that they send reprints after articles are published.

A second factor that has helped to protect ABMRF’s review and funding process from industry influence is the seniority and eminence of the scientists responsible for review and funding recommendations. Dr. Thomas Turner, dean emeritus of The Johns Hopkins University medical faculty and first president of ABMRF, insisted that members of the advisory councils be senior scientists with extensive peer-review experience and that funding recommendations be based on the highest standards of scientific quality. In part because of the impeccable academic and scientific reputations of Dr. Turner, second ABMRF president Dr. Mack Mitchell, and vice president Dr. Albert Pawlowski (a former senior NIAAA staffer), ABMRF has been successful in recruiting well-established senior researchers to serve on its advisory councils and board of trustees. In fact, 15 RSA presidents have served on the ABMRF councils and/or the board. In our conversations with past council members, most have indicated that a major reason they agreed to serve was the hands-off relationship between the industry funders and the scientific review process. ABMRF administrators and supporters knew that any sign of industry efforts to influence funding decisions would result in a mass exodus of advisory council members, which served as a powerful deterrent to any compromise in the total separation between funding source and the review and awarding of grants.

The alcohol industry, alcohol science, and public health: An empirical question

Our personal observations and testimonials are unlikely to influence opinions of those who believe that the economic interests of the alcohol industry irresolvably conflict with the ideals of science. We concur with Paul Lemmens (1997) that the premise of the inevitability of industry influence biasing science is amenable to empirical research. Our experiences with ABMRF suggest that industry-supported research organizations can vary substantially in the degree to which they separate funding sources from the review process and from the actual conduct and publication of the research. It should be possible to identify types of research findings that are more versus less “industry friendly” and then design empirical tests of associations among such findings, the source of funding, and (most important) the characteristics of the funding organization (e.g., transparency, safeguards against industry influence). Findings from well-designed studies should provide guidance that is more rational and evidence based than much of the rhetoric that currently surrounds this challenging issue.

Coda: The future of ABMRF

In part because of historical changes in the organization and ownership of alcoholic beverage companies, many such companies now prefer to fund industry-initiated research rather than investigator-initiated research. For this reason, beginning in 2016, ABMRF will no longer be accepting funding from the alcohol industry. Instead, ABMRF hopes to establish itself as an independent alcohol research foundation supported by donations in a model similar to the American Cancer Society.

We are concerned that one unintended consequence of an undifferentiated view that “all” industry support for alcohol research is tainted may be that potential industry funders will decide that it does not really matter whether they support a carefully managed and transparent organization that safeguards research independence, such as ABMRF, or alternative models that fund projects only in areas of specific interest to the industry. In terms of implications for the future, we believe that academia and industry can collaborate, but the structure of the relationship and the safeguards against industry influence must be clearly established to ensure that potential conflicts of interest are minimized and that individual investigators are free to reach conclusions and support policies without limitations. We firmly believe that ABMRF accomplished this goal. Future successes in implementing the ABMRF model may depend, in part, on recognition by the alcohol and public health research community that such collaboration is possible and on appropriate acknowledgment and support of those collaborations that succeed in overcoming the many challenges to industry–academia partnerships.