Government policy-making for drugs should be free of the influence of relevant producer companies, while recognizing producer company responsibilities for reducing harm

In Chapter 9, we stressed that producer companies generally wield a great deal of economic, political, and organizational power in the policy arena, often fostering common policy interests that are not conducive to health. There are many structural factors to counter private sector influence, one of which includes redesign of governance systems that shift away from the present short-term, fast-scale economic and political systems in favour of longer timescale systems that promote sustainable health and well-being (see Stoll and Anderson, 2015).

However, as we noted in Chapter 8, and as is the case with many other ‘wicked’ public issues, reducing the harm done by drugs cannot be brought about by governments alone (see also Kickbusch and Behrendt, 2013). Whole-of-government and whole-of-society approaches to drug policy should define the relation with private sector stakeholders and establish the rules of the game for stakeholder engagement in the policy cycle through accountability for the common good, where private sector stakeholders contribute to the public health good, simultaneously to their own interests. In order to ensure societal well-being is enhanced, rather than in the hands of commercial interests, the leading role in determining the strategy of public policy for drugs should be in public sector hands. Transparency systems, controls on the revolving door and enhanced conflict of interest policies should be put in place in government, science, civil society, and the media as drivers to increase the impact of evidence-based information on decision-making.

As a reflection of this, while the World Health Organization (WHO) has cautioned that the private sector should not be trying to do the work of governments, which are properly the guardians of the public interest (WHO, 2007), it has indicated, for example, that the alcohol industry has the capacity to prevent and reduce harmful use of alcohol within its core role as a developer, producer, distributor, marketer, and seller of alcoholic beverages (WHO, 2010). As pointed out in Chapter 4, one approach for producer companies to reduce harm is to change the potency of their products (e.g. reducing the alcohol concentration of existing products) and the toxicity of their drug-delivery systems (e.g. cigarette companies shifting to electronic nicotine delivery devices). Shifts towards less harmful products could be incentivized by smart government tax policies.

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