The world health report

Chapter 3

Influence of special interest groups on risk perceptions

Perception, understanding and framing of risks are affected, both positively and adversely, by the influences of powerful interest groups outside of government, including private for-profit corporations and public health campaigning organizations. Since scientific data do not "speak for themselves", special interest groups can play a critical role in interpreting the scientific information and hence in the framing of public perceptions of risks and risk factors. In this way such groups aim to influence public debate and government policies against or for the control and prevention of known risks.

While communicating accurate information on risks is essential to risk perception and better risk management, it is scientific information and research findings that provide the basis for risk assessment. Such information or "known facts" are nevertheless subject to interpretation and the social construction of the evidence, which largely determines how the risks are defined, perceived, framed and communicated in society(30,41). In addition, scientific uncertainties allow for widely different understandings of the same data, including distorting their interpretation in order to suit the interests of special groups. Although private for-profit and public health campaigning organizations often use similar tactics, businesses commonly promote public controversy as a means of avoiding greater government controls over risks. This strategy can be costly, as evidenced by the large financial resources that corporate interest groups commonly allocate to such activities. The tactics of industrial special interest groups, such as in the asbestos and tobacco industries, largely came to light when companies were forced to release a large number of internal documents after legal challenges by groups attempting to show that they had suffered because of these industries (42,43) (see Box 3.6).

Box 3.6 Strategies for fuelling public controversy

Policy-making is facilitated by building consensus in society, while scientific research is often characterized by uncertainties. Thus scientific debates on risks to health, particularly focusing on any assumptions and uncertainties, usually slow down policy decision-making after risk assessments have been carried out. Corporate and private-for-profit special interest groups can often benefit, therefore, by generating public controversy so as to prevent or delay regulation and control of their products. This is commonly done by emphasizing uncertainties in the original data, the methods, or the quality of the scientific conclusions.

On the other hand, public health groups campaigning for greater control of risks tend to emphasize ethical considerations and the need for stronger government policies and regulation. Both kinds of special interest groups use a number of strategies to support their position, for example by:

  • setting up independent but sympathetic policy think-tanks and research funding organizations;
  • encouraging and supporting experts who are sympathetic to their position;
  • funding and publishing research that supports the interest group's position;
  • disseminating supportive research studies in scientific publications;
  • criticizing and suppressing research that is unfavourable to their cause;
  • disseminating positive or negative interpre-tations of the risk data in the mass media, particularly the lay press;
  • using lobbying groups and advertising campaigns to encourage greater public support;
  • communicating favourable conclusions directly to politicians, government officials and bureaucrats;
  • drawing attention to political and economic benefits, such as electoral support, employ-ment and export opportunities.

Source: (43).

Special interest groups, whether public or private or for-profit or not-for-profit, are basically organized to promote and protect their own interests and it should be expected, therefore, that they will construct the evidence about health risks so as to support their position and interests (44). Industrial special interest groups are primarily motivated to protect profitable products or services and thus tend to frame and communicate associated risks by hiding or minimizing their harm. They therefore do not in any way support such actions as increased regulation or greater import--export restrictions. Disputes about the regulation of risks, particularly environmental and industrial risks, frequently involve legal proceedings at national level (45), while many risks related to international trade may come under the jurisdiction of the disputes procedure of the World Trade Organization.

By comparison, public health interest groups have the difficult task of trying to achieve greater consensus in society in order to make government risk control policies more acceptable. These groups tend to communicate and frame risks by emphasizing their harm and hence encourage policies and strategies that aim to reduce risk, including better regulation. Although public health groups tend to act independently, they are often less well coordinated at national and international levels than corporate groups; they are also more accountable to the public than are private businesses. In addition, they usually have fewer financial resources to support their activities.

The tobacco industry is a prime example of how global business operations can be promoting cigarette consumption while at the same time distorting public perceptions of the risks involved (42,46). However, many anti-smoking groups also oppose both the tobacco industry and the coordinated international action contained in the Framework Convention for Tobacco Control (FCTC) promoted by the World Health Organization (see Box 3.7).

Box 3.7 Junking science to promote tobacco

"The goal of the tobacco industry's "scientific strategy" was not to reveal the truth but to protect the industry from loss of revenue and to prevent governments from establishing effective tobacco control measures. The industry's goals of creating doubt and controversy and placing the burden of proof on the public health community in policy forums have, therefore, met with a certain degree of success. Tobacco control policies are not being implemented worldwide at the rate that current scientific knowledge about the dangers of tobacco warrants. But this scenario is changing as the negotiations for the Framework Convention on Tobacco Control continue to advance. The convention marks the first time that WHO has used its treaty-making right to support Member States in developing a legally binding instrument in the service of public health. Negotiations are progressing well, and it is likely that Member States will vote on ratification of the convention in mid-2003.

"What do the revelations about tobacco company actions mean for public health policy? In general terms, they call for policy-makers to demand complete transparency about affiliations and linkages between allegedly independent scientists and tobacco companies. Academic naivety about tobacco companies' intentions is no longer excusable. The extent of the tobacco companies' manipulations needs to be thoroughly exposed, and students of many disciplines (public health, public policy, ethics, and law, to name a few) should be provided with the evidence that is increasingly available through the tobacco industry documents [in the Minnesota and Guildford archives]."

Source: (46) p.1747.

Besides private industry and public health campaigning groups, there are many other kinds of special interest groups that aim to influence policies to control risks. With the rapid growth in global media and communications, particularly those using the Internet, many informal global networks now exist, including links between specialist groups and community-based organizations. A constant danger is that private organizations may attempt to coopt and divert such public groups and networks. Although special interest groups are often better organized in industrialized countries, similar groups in developing countries can now benefit from faster international links, easier access to published information, and membership of related trade or professional organizations. For instance, the multinational pharmaceutical companies attempt to control the development, licensing, availability and costs of many patented drugs; national family planning associations and the International Planned Parenthood Federation (IPPF) disseminate information on risks to reproductive health and promote modern methods to control fertility; special groups exist to protect people with particular diseases, such those suffering from HIV/AIDS, diabetes and cancers; and other special groups aim to avoid new risks, such as those from greatly increased global trade in manufactured products, for example, food and pesticides.

Another important aspect of policy-making occurs at the international level. Besides special interest groups that can operate on a global basis, there are a number of international organizations that clearly aim to be influential in public health, including the World Health Organization, other multilateral and specialized agencies of the United Nations, and bilateral donor agencies. In addition, many international nongovernmental organizations do play a major role in gathering evidence, disseminating information and advocating risk control policies in such areas as child labour, dangerous chemicals and the dumping of waste products.