A recent study published in the journal Public Health found that Brazil is not providing the best data for PAHO/WHO estimates in its Alcohol Policy Scoring (APS) report. This is leading to the dissemination of imprecise results worldwide.
A letter to the editor of UNIAD by Pinsky and colleagues exposes, based on solid evidence, the alcohol industry Corporate Social Responsibility (CSR) body CISA’s widespread misinformation campaign regarding alcohol harms and policies.
CISA (Information Center on Health and Alcohol) in Brazil is a lobbying and public relations front group directly funded by the alcohol industry. AMBEV, which is a part of the AB InBev group, the largest alcohol company in the world, funds CISA since 2005. Heineken, AMBEV’s main competitor in Brazil, has also begun sponsoring the front group.
CISA does not have any other funding sources disclosed. Yet, it masquerades as an independent, public interest non-governmental organization (NGO). It partners with universities and medical organizations and is the main source of information regarding alcohol issues for Brazilian people and the media.
There is strong scientific evidence illustrating the direct and inherent conflict of interest of the industry, which produces, sells and markets alcohol, engaging in public health initiatives to prevent and reduce the harm caused by their own products and practices:
- Conde and colleagues (2020) concluded that the alcohol industry uses risk management CSR in Latin American countries as a way to preserve markets by counteracting scientific evidence about alcohol related harms.
- Petticrew and colleagues (2020) found that alcohol industry CSR bodies use,
- “dark nudges” which exploit cognitive biases of people to influence them to buy harmful products, and
- “sludge” which hinder healthy behavioral change by blocking access to information on health harms of alcohol;
- Hessari and colleagues (2019) found through a comparative analysis of twitter accounts of alcohol industry funded CSR organization versus non-alcohol industry funded public health organizations that alcohol industry CSR front groups are not independent of the industry as they claim;
- Babor and colleagues (2018) show that alcohol industry CSR activities are unlikely to reduce alcohol harm but provide commercial strategic advantage for Big Alcohol;
- Mialon and McCambridge (2018) found that alcohol industry CSR initiatives do not contribute to alcohol policy measures to prevent and reduce alcohol harm, instead they are used to influence the framing of the nature of alcohol-related issues in line with industry interests;
- Herrick (2016) shows that industry CSR represents a profound threat to the sanctity and moral authority of the public health worldview; and
- Yoon and Lam (2013) identify three CSR tactics employed by the alcohol industry, which are closely tied in with the their corporate objectives:
- As a means to frame issues, define problems and guide policy debates. In doing so, Big Alcohol is able to deflect and shift the blame from those who manufacture and promote alcoholic products to those who consume them,
- Promote CSR initiatives on voluntary regulation in order to delay and offset alcohol control legislation, and
- Undertake philanthropic sponsorships as a means of indirect brand marketing as well as gaining preferential access to emerging alcohol markets.
Evidence of conflict of interest in CISA
The letter by Pinsky and colleagues provides concrete evidence of the conflict of interest in CISA.
CISA distributes their own non-peer reviewed publications, using unclear methodology to analyze public data from the national health information system, revising scientific literature, and replicating data from national surveys to support select recommendations and guidelines from the World Health Organization (WHO).
This is an alcohol industry “information strategy” resulting in imprecise information regarding alcohol. Which will then contribute to shaping social norms in a manner that is more favorable to the alcohol industry’s profit interests.
An example of CISA’s misinformation campaign is visible in their 151 page report “Alcohol and Health for Brazilians: Panorama 2020”:
- This report pays almost no attention to the importance of WHO’s proven, effective best buy alcohol policy solutions (i.e. reducing physical availability, banning advertising, and increasing the alcohol price through taxation).
- Industry self-regulation is cited as an example of effective policy that is already in place in Brazil, despite strong evidence to the contrary.
- There is no disclosure of CISA’s conflict of interest with regard to their alcohol industry funding and connection.
- In contrast, the WHO is quoted more than 120 times throughout the document, which suggests a close alignment with the WHO’s objectives.
- There is no currently agreed upon measure with regard to the concentration of alcohol contained in a standard alcoholic beverage in Brazil. But the report defines it as falling within the higher end of the range worldwide (14 g of pure ethanol), which is then accompanied by blatantly misleading quotes pertaining to the beneficial effects of alcohol use.
Other evidence of CISA’s conflict of interest noted in the letter include:
- The construction of CISA’s executive board; it consists of both professors and health researchers from Brazilian universities as well as alcohol industry representatives;
- CISA’s founder and president is a professor in a medical school and the current coordinator of the municipal drug program for the city of São Paulo that is responsible for the local government’s decisions regarding drug policies, prevention, and treatment. At the same time, he is a member of the pilot initiative steering committee in Brasilia, an AB InBev program.
- During the COVID-19 pandemic in which the media regularly consults CISA’s members, the source of CISA’s funding is never disclosed, nor are the aggressive efforts of the alcohol industry to raise alcohol sales during this period.
The alcohol industry in Brazil continues to infiltrate and have access to the government and research in a way that is problematic and needs to be monitored and curtailed,” write Pinsky and colleagues, as per UNIAD.
Ilana Pinsky, Daniela Pantani, Guilherme Messas and Zila M. Sanchez
If given the choice of profit or public health, the alcohol industry always prioritizes its private profits. This is shown by the industry’s own actions of turning the ongoing COVID-19 health crisis into the largest marketing campaign, disregarding the lethal interaction alcohol has with the pandemic.
