More reaction to the Global Fund's partnership with Heineken

1. NEWS
20 Feb 2018
Member of the Fund's Board says that Norway cannot support this type of partnership

As more reaction to the Global Fund’s partnership with Heineken flowed in, a member of the Global Fund Board has said publicly that he is opposed to the partnership.

According to an article published on 6 February 2018 on the website of ADD Alcohol, Drugs and Development, which is run by the Norwegian aid organization FORUT, Jon Lomøy, Director General of the Norwegian Agency for Development Cooperation, and a Global Fund Board member representing the Point Seven delegation, said in a statement to the media that “the Norwegian authorities cannot support this type of partnership with an alcohol company. This is not compatible with our development policy.”

Lomøy added that “it is too early to say what happens to Norway’s contribution [to the Global Fund] if the Fund maintains its cooperation.” He said that Norway would raise this issue with the Global Fund either bilaterally or through the Board.

The Point Seven delegation represents donors from Denmark, Norway, Netherlands, Sweden, Ireland and Luxembourg.

Two well-known persons from Sweden also weighed in on Twitter:



Pierre Andersson is a journalist and also a policy advisor for IOGT-NTO, Swedish branch of the IOGT-International, the temperance movement. Anders Nordström is the Ambassador for Global Health at the Swedish Ministry of Foreign Affairs, and an alternate member of the Global Fund Board.

As we reported in GFO 330, IOGT-International was one of three organizations that sent an open letter to the Global Fund expressing “deep concerns” about the Global Fund’s partnership with Heineken and its implications for global health. The other two organizations were the Global Alcohol Policy Alliance and the NCD Alliance.

The partnership was announced in January at the annual meeting of the World Economic Forum in Davos, Switzerland, along with partnerships between the Global Fund and Unliver, a multinational manufacturer of food products and other consumer goods, and Lombard Odier, a private banking and asset management company.

Lancet letter

In a letter to The Lancet, published on 9 February, two researchers called the decision of the Global Fund to enter into partnership with Heineken in African countries “puzzling and disturbing.”

Robert Marten and Ben Hawkins of the London School of Hygiene and Tropical Medicine, and the University of York, said that the partnership “provides Heineken with legitimacy and credibility to continue aggressively marketing its potentially harmful products to consumers, while establishing the company as a responsible partner to governments.” The researchers stated that engaging with the alcohol industry “presents a clear conflict of interest with the Global Fund’s objective to address the burden of HIV and AIDS.”

Marten and Hawkins said that the evidence of alcohol’s role as a structural driver of cases of HIV is growing. They cited the World Health Organization’s Global Status Report on Alcohol and Health 2014, which stated that a “strong association exists between alcohol consumption and HIV infection and sexually transmitted diseases” and that ”there is a clear causal effect of alcohol consumption on HIV/AIDS patients’ adherence to antiretroviral treatment.”

“The partnership with Heineken is antithetical to the Global Fund’s core interests,” the researchers said. “By cooperating with, supporting, and legitimising the alcohol industry, the Global Fund is endangering its own credibility and risks losing public trust.”

Marten and Hawkins said that they respect and admire the work of the Global Fund, including its zero-tolerance policy for corruption and misappropriation, “but we recommend that it consider similar policies for partnering with the alcohol industry. Given the obvious conflict of interest between alcohol marketing and HIV prevention, and the wider effects this conflict has on undermining effective alcohol policies, we respectfully call on the Global Fund to reconsider its partnership with Heineken.”

BMJ blog

In a blog dated 8 February on the website of the British Medical Journal, three researchers associated with the People’s Health Movement said that “the alliance with the alcohol industry could undermine alcohol policy implementation in Africa and interventions to reduce alcohol-related risky behaviour” and weakens the message that harmful use of alcohol increases the risk factors of both HIV and tuberculosis.

 

The researchers were David G. Legge of La Trobe University in Melbourne, Ronald Labonte of the University of Ottawa, and David Sanders of the School of Public Health, University of the Western Cape, South Africa.

The researchers also commented on the other two partnerships. They said that the alliance with Lombard Odier will develop new financial products that will allow investors to maximize the tax benefits associated with corporate philanthropy. “Tax avoidance and tax competition already have a punishing impact on fiscal capacity in countries dealing with AIDS, TB and malaria,” the researchers said. “Reducing corporate tax is a further assault on public revenues and public funding for effective public health protection and universal health coverage.”

Legge, Labonte and Sanders said that the new partnership with Unilever will assist the Global Fund in financing the protection of young women from HIV while advertising Unilever’s soap. “The role of hand-washing in preventing AIDS, TB, and malaria is minor compared with sexual exploitation and gender-based violence (reflecting inequality between women and men), poor housing, a lack of urban infrastructure, and weak health systems,” they said.

In conclusion, the researchers said that the Global Fund apparently believes that it can address the challenges of HIV, TB, and malaria while accepting funds from corporate investors and the alcohol and food industries. “But are the Global Fund’s important efforts in fighting AIDS, TB, and malaria worth the risks that private partnerships might bring to health systems, alcohol policy implementation and NCDs?,” they asked.

Wemos Health Unlimited

As we reported, in response to the criticism about the partnership with Heineken, Seth Faison, Director of Communications for the Global Fund said:

“Ending epidemics requires overcoming the ‘last mile’ challenges that can prevent life-saving health products from getting to remote clinics. A new partnership between Heineken and the Global Fund enables Heineken’s supply chain experts to provide expertise to Global Fund logistics planners on how to improve the supply chain.”

In a post on its website on 12 February, Wemos Health Unlimited, a civil society organization that aims to improve public health worldwide, said that although they saw the added value of well-functioning, existing logistical channels, partnerships with private sector parties have serious pitfalls.

“Partnerships such as these work in parallel systems, which undermine the role and responsibilities of local governments,” WEMOS said. “This is usually accompanied by shifts in budget and personnel, redirected from local institutions to the new parallel system. This compromises the effectiveness of local government and weakens the public’s confidence in their government.”

Wemos said that the Global Fund should invest in the development of logistical supply chains within the health system of the recipient countries, not in parallel with it, and not with a partner who also delivers beer.

Other reactions

The website of IOGT-International quotes a spokesperson for three Alcohol Policy Alliances covering West, East and Southern Africa as saying:

“We are concerned about alcohol industry conduct in our countries and regions; as they try to hook our people to their products, they also try and pre-empt or undermine effective public health regulations of alcohol. This partnership is just another example of false philanthropy that doesn’t benefit the African people.”

On 9 February, Andrew Harmer wrote in a blog that “the Global Fund to fight AIDS, TB and Malaria has entered into a partnership with a company whose one product –– alcohol –– is a risk factor in each of the diseases the Fund exists to champion. I’m going to shout now: Peter Sands, WHAT ARE YOU DOING!”

“Politically and economically, this is a spectacularly bad decision,” Harmer said. “It is the Global Fund’s Mugabe moment…. In October 2017, Dr Tedros thought it a good idea to appoint Robert Mugabe as a WHO Goodwill Ambassador, an astonishingly ill-judged appointment. The outcry was loud and, to his credit, Tedros rescinded that appointment and won the respect of the global health community for listening and acting appropriately. Sands would do well to follow Tedros’ lead.”

One person commented in a post on the Linked-In website that if the Global Fund had a Framework of Engagement with Non-State Actors similar to the one that the World Health Organization has, the partnership with Heineken would have been classified as “high-risk.” The WHO framework is available here.

In addition, Els Torreele of Médecins Sans Frontières tweeted:

Not the first time

This is not the first time the issue of partnerships between the Global Fund and the alcohol industry has come up. The Global Fund included SABMiller, a major supplier of beer in South Africa, as a sub-recipient in a Round 9 grant.

In a round table discussion in the Bulletin of the World Health Organization on 1 January 2012, Richard Matzopoulos et al said this was cause for concern “because it reflects the successful attempt of a highly profitable industry to position itself as committed to public health objectives. In reality, the liquor industry’s aggressive marketing of its products is irrevocably linked with major health harms throughout the world, in South Africa in particular.”

The discussion included the following response from the Global Fund: “[The Fund] does not have any objections to collaborating with corporations (with the exception of tobacco, producers of arms and those involved in pornography) that conduct, finance or otherwise support evidence-based, effective interventions to prevent, treat or provide care for any of the three diseases.”

In a third article in this discussion, two authors from the Department of Health at the University of Bath said:

“At the heart of the problems described in this round table discussion is the apparent failure by both the Global Fund and the Government of South Africa to recognize and adequately address the potential conflict between corporate interests and public health goals…. The Global Fund is being naïve in simply exempting tobacco and arms producers from its remit. The products sold by these corporations may be unique, but their conduct is unlikely to be and these two issues should not be confused.”

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