This stream is initiated by Maggie Davis, Department of Health (HD), UK.
Health Promotion Sponsorship and Collaboration
The work of the Commission on the Social Determinants of Health has helped to articulate the political to practice actions that are needed to promote and maintain health. This gives an opportunity for health promoters to reflect further on their role in shaping the world that we live in for future well being, as well as act on healthy lifestyles now.
It is recognised that health promotion needs to work on the macro level to address global issues and on the national policy and local action levels (reference Bangkok Charter).
It remains the case that action on these levels requires work across sectors and by a range of stakeholders (international agencies, governments, professions, academia, NGO, business interest and communities).
Increasingly the role of commerce and business in either maintaining or damaging health is being understood, not only at the professional level, but also by the wider public.
High profile organisations and entrepreneurs, such as Gates and Soros, attract public attention and are generally thought to be a force for good. Other companies with global reach, such as Coca Cola and McDonald’s, are frequently associated with health harming products and cultural imperialism. However, even those companies that have health benefits at heart can be perceived as being problematic as, with budgets that can exceed the GPR of the countries they are donors to, there is a possibility of imposing priorities and even of subverting democratic processes by undermining national decision making. Anti-capitalist protestors, now a feature of G20 summits, are perhaps symptomatic of public unease at the disconnect between people and the power to make decisions about trade issues that effect their lives. This has clearly been exacerbated by the recent economic crisis which has reinforced and illustrated the interconnectivity of business interest across the globe and the potential for this to have catastrophic impacts on people’s lives.
Within this context, it is clear that health promoters need to make themselves fully aware of the political and social aspects of commercial enterprise and explore their roles as advocates for health and as change agents. In order to be able to make informed decisions about whom we should work with and how, it is essential that we apply intellectual rigour and political situational analysis to come to a view of what is best available knowledge.
In connection with commercial enterprise, there are many examples of success by the health lobby. This largely falls into two approaches;
The first is where there is out and out opposition to a specific company in general, or particular activities of a company. This might include media campaigns and boycotts and an example might be the email campaign against Nestle’s claim for $6million from Ethiopia at a time of impending famine.
The second approach is to work with a company, as either a partner or a critical friend, to help them to change their practice (usually in terms of labour or unhealthy products). An example of this might be the reduced salt formulae for Heinz beans in the UK.
There are no examples, as far as I am aware, where companies with non-health supportive behaviours have made changes because of “buying” the use of their logo or promotional material at a conference or on a publication.
It has to be the case that business would wish to work with us because there is something in it for them. This may be a win-win situation, for example, where we can help them to be better corporate citizens or employers and their reputation is enhanced or their workforce is more productive in return. It is at best naive to enter into a relationship with a commercial enterprise without being fully aware of what the potential trade offs are.
As health promotion is a value driven profession with a strong ethical base, it is clear that there are considerable reputational risks in getting the relationship wrong and it is, therefore, important for IUHPE to be clear about its rules of engagement with commerce and business which aims to:
• Promote meaningful dialogue with business and enterprise in order to promote health developing and maintaining behaviours.
• Ensure that we do not promote businesses that do not share our core principles and ethics or exhibit health damaging behaviours.
This means we need robust ethical frameworks that allow us to raise funds for projects and conferences that do not compromise our reputation or undermine our core aims. This discussion is intended to clarify the issues for IUHPE in working with business and develop guidance for the Union and its members for the future.
Questions for IUHPE
1. By what criteria do we select profit-making organisation that it is appropriate to take funding from?
2. By what criteria do we select profit-making organisation that it is appropriate to enter into dialogue, or to do joint work with?
Conclusion
There are risks and benefits in working with profit making organisations. It would be helpful to articulate these more fully and to develop clear ground rules for what is acceptable engagement. It is hoped that discussion through this forum will bring us to a position where there is no ambiguity about our position as a Union in relation to this complex issue.
Maggie Davies, Department of Health (DH), UK.
