Open letter: Conflict of Interest at the Third Biennial Conference of the African Research University Alliance

Open letter to: Member Universities and Centres of Excellence within ARUA

23 November 2021

RE: CONFLICT OF INTEREST AT THE THIRD BIENNIAL CONFERENCE OF THE AFRICAN RESEARCH UNIVERSITY ALLIANCE (ARUA), GLOBAL PUBLIC HEALTH CHALLENGES: FACING THEM IN AFRICA (17 – 19 NOVEMBER 2021)

We are a group of concerned public health practitioners and academics working in the fields of child health, nutrition, non-communicable diseases (NCD’s) and health promotion.

We are pleased that the Third Biennial Conference of the African Research University Alliance (ARUA) on Global Public Health Challenges: Facing them in Africa to be held from the 17th to the 19th of November will include topics relating to food governance, systems, and access to nutritious food as well as discussions on the role of NCDs in global health.

We understand access to nutritious food to be a key driver of global public health.i We also note the role of diet-related non-communicable diseases in exacerbating the Covid-19 pandemic worldwide, and in Africa. ii Finally, the role of the private sector in influencing food environments in Africa cannot be overstated, iii with corporate political activity and progressive health policies relating to the diets frequently at odds.iv

We note that Professor Lindiwe Sibanda (UP) as one of the main conference speakers will be providing opening remarks. We also note from the biography connected to this conference that Professor Sibanda is a serving member of the Nestlé International Board of Directors. We are concerned that URUA does not recognize this as a conflict of interest.

Nestlé is an international company with a product portfolio that includes infant feeding products, soft drinks, coffee and tea products. Nestlé is a behemoth in the food and beverage industry, reporting CHF 7.3 billion profit for the first half of 2021 (ZAR 122.9 billion/ NGN 3293.4 billion/ 4530 CFA billion). Nestlé controls the world’s most valuable food and drinks portfolio.v Per its own admission, more than 60% of Nestlé’s food and beverage portfolio are deemed unhealthy products.vi Nestlé has also been accused of engaging in harmful corporate practices including the use of child slave labour, vii illegally promoting- breastmilk substitutes, viii unfair labour practices, ix and massive water usage sourced from water-scarce areas.x We only list allegations levelled against Nestlé in 2021. We do not purport to take a position on these allegations, but we are concerned by the gravity and scope of these allegations.

Specifically, in South Africa, we have documented repeated violations by Nestle of the R991xi xii regulations related to infant formula marketing and recently academics and civil society voiced opposition to a recent Nestle sponsored event for mothers which was subsequently cancelled.xiii

We note the Carnegie Corporation which is funding this conference is committed to avoiding conflicts of interest as per its 2009 Code of Ethics.xiv We believe the member universities of ARUA share in this commitment. Public Health England defines conflict of interest as an inability to contribute impartially to a programme of work, research, governance or oversight functions.xv The WHO described a conflict of interest as a set of circumstances where there is a potential for a secondary interest to unduly influence or be reasonably perceived to unduly influence the independence or objectivity of the primary interest. xvi The World Public Health Nutrition Association classifies possible conflicts of interest as any engagement with commercial producers of unhealthy foods, and specific industry involved in infant feeding products, ultra-processed foods and sugar-sweetened beverages (all part of Nestlé’s product portfolio).

As academics and professionals, we may think we are immune to conflicts of interest, yet a Cochrane review found that industry funding leads researchers to favour corporations either consciously or unconsciously. xvii While a conflict of interest does not necessarily equate to collusion or corruption it is often “difficult to distinguish subtle, unconscious bias from deliberately concealed impropriety”. xviii It is also important to recognise that perceived conflicts of interest may be as damaging as actual conflicts as they may “tarnish the reputation of scientists, organisations or corporations”. As such governments, universities and international organisations such as the WHO, have put measures in place to prevent and mitigate conflicts of interest.

The first step in managing conflicts of interest is disclosure and transparency at the individual and institutional level in order to screen and identify individuals/institutions with conflicting interests. xix While this is indeed a necessary first step, it is not sufficient to eliminate the COI, and where serious conflicts of interest arise between an individual’s private interests and public duties, it may become necessary to prohibit that individual from taking on positions of influence, and/or participating in key decision-making processes. Alternatively, the individual or institution should be asked to divest and rid itself of any interest that may undermine its integrity and independent judgement.

We are therefore concerned that Professor Sibanda’s leadership role in the conference, including hosting a workshop in her role as Director of the ARUA Centre of Excellence in sustainable food systems, while simultaneously holding a remunerated xx board of directors position with Nestlé constitutes a conflict of interest which may further compromise food and nutrition security on the African continent

Please clarify how this conflict has been investigated and how the conflict of interest will be managed.

Yours Sincerely,

List of Signatories:

Name Institutional affiliation
 

Dr Chantell Witten

South African Civil Society for Women’s Adolescent’s and Children’s Health –

SACSoWACH

Prof Tanya Doherty Health Systems Research Unit, South African Medical Research Council
 

Prof Karen Hofman

SAMRC Centre for Health Economics and Decision Science, PRICELESS SA,

Wits School of Public Health

 

Prof Susan Goldstein

SAMRC Centre for Health Economics and Decision Science, PRICELESS SA,

Wits School of Public Health

Lori Lake Children’s Institute, University of Cape Town.
Dr Sara Jewett Nieuwoudt School of Public Health, University of the Witwatersrand
Prof Ameena Goga HIV Prevention Research Unit, South African Medical Research Council
Prof Maylene Shung-King School of Public Health and Family Medicine, UCT
Dr Catherine Mathews Health Systems Research Unit, South African Medical Research Council
Prof Rina Swart Dietetics and Nutrition, University of the Western Cape
 

Prof Mark Tomlinson

Institute for Life Course Health Research, Dept Global Health, Stellenbosch

University

Catherine Pereira-Kotze School of Public Health, University of the Western Cape
Prof Chris Scott Paediatrics and Child Health, UCT
Dr Louis Reynolds Paediatrics and Child Health, UCT; People’s Health Movement
 

Prof Arvin Bhana

Health Systems Research Unit, South African Medical Research Council,

Centre for Rural Health, College of Health Sciences, UKZN

Dr Gillian Schermbrucker Paediatrics and Child Health, UCT
 

Dr Zoe Duby

Health Systems Research Unit, South African Medical Research Council;

School of Public Health & Family Medicine, University of Cape Town

 

Dr Wiedaad Slemming

Division of Community Paediatrics, University of the Witwatersrand;

SACSoWACH

Ms. Pumla Dlamini SACSoWACH Co-Chair
Ms Emmanuelle Daviaud Health System Research Unit, South African Medical Research Council
Raul Mercer MD MSc Working group on Commercial Determinants of Child Health / CAP 2030
Precious Robinson SACSoWACH Chairperson
Dr Elizabeth Goddard Paediatrics and Child Health, UCT
Mary Kinney School of Public Health, University of the Western Cape
Prof. Ingunn Marie Stadskleiv

Engebretsen

 

Centre for International Health, University of Bergen, Norway

Jane Badham Global Nutrition Consultant
Simela Petridou La Leche League South Africa
Tamryn Frank School of Public Health, University of the Western Cape, South Africa
Stefan Peterson Karolinska Institutet
Leslie London School of Public Health, University of the Cape Town
 

Dr Annibale Cois

Division of Health Systems and Public Health, Department of Global Health,

Stellenbosch University

Prof Amy Slogrove Paediatrics and Child Health, Stellenbosch University
Dr Rahmat Bagus General Practitioner, IBCLC, La Leche League Leader South Africa
Dr Gabriel Urgoiti RX Radio SA
Dr Elmarie Malek Paediatrics and Child Health University of Stellenbosch
Joan Truby La Leche League South Africa
Prof Desiree Lewis Women’s and Gender Studies Department, University of the Western Cape

 

Vicky Reynell La Leche League South Africa
Prof Mignon McCulloch
Dr Wanga Zembe
Maryse Arendt BFHI coordinator Luxembourg
Nzama Mbalati Healthy Living Alliance (HEALA)
Elisabeth Sterken, MSc Dt. Director INFACT Canada/IBFAN North America
Tony Waterston, MD FRCPCH International Society for Social Pediatrics and Child Health
Dr Christine Magendie PCP
Dr Dr Seth Christopher Yaw Appiah Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Jeffrey Goldhagen International Society for Social Pediatrics and Child Health
Dr Lucy Reynolds International Society for Social Paediatrics and Child Health
Suné Greeff Eastern Cape Department of Health
Jenny Wright Milk Matters
Lebogang Ramafoko Tekano Atlantic Fellows for Health Equity
Scott Drimie Department of Global Health, Stellenbosch University
Delena Strydom IBCLC – Panorama Breastfeeding Clinic
Koketso Moeti amandla.mobi
 

Judy Kirkwood

IBCLC and Midwife, Developer of the The Best Start Feeding Initiative. Shark

Latch – breastfeeding technique (patent and TM)

Nicolette Henney Dietitian
Tobie Muller IBCLC, La Leche League Leader South Africa
Hettie Grove SACLC
Julia Gane La Leche League Leader South Africa, Physiotherapist
Prof Neil McKerrow Paediatrics & Child Health, KZN
Carol Browne Independent nutrition consultant
Anna Shevel Good Food Network
Aadielah Maker Diedericks Southern African Alcohol Policy Alliance
Prof Uta Lehmann Director, School of Public Health, University of the Western Cape
Prof Nicola Christofides School of Public Health, University of the Witwatersrand
Dr Tanya Ruder Division of Community Paediatrics, University of the Witwatersrand
Dr Anri Manderson The Hoedspruit Hub, Limpopo
Alison Baker South African Certified Lactation Consultant
Dr Nandi Siegfried Chief Specialist Scientist, SA Medical Research Council
Tanya Thomas LLL Leader South Africa
Leana Habeck IBCLC The Breastfeeding Clinic
Brenda Pierce IBCLC
Dr Nanette Jolly Medical Doctor, IBCLC, La Leche League Leader South Africa
Ana Frawley Lactation Consultant
Barbara Chambers IBCLC, CFT
Lynn Shier IBCLC, LACSA, Midwife
Pauleen Nelson IBCLC, LACSA, Midwife
Dr Nadine Harker Specialist Scientist, SAMRC
Mervyn Abrahams National Department of Health, SA

 

Alan Rosenberg South African Organic Sector Organization
Dr Christiane Horwood Centre for Rural Health, UKZN
Lynette Smit SACLC, IBCLC, CFT
Liezel Engelbrecht Dietitian
Melissa Zwart SACLC
Kari Oosthuizen SLT & LLL representative
Nicole Meyer La Leche League Leader South Africa
Lenore Spies Public Health Nutrition Consultant
Maya Bhardwaj University of Pretoria
Zani Smith Dietitian & SACLC
Dr Michelle De Jong University of the Western Cape
Ulla Walmisley University of the Western Cape
Claire Moffatt SACLC
Dorle Verrinder RD IBCLC
Lindie Pitt Doula
Katinka Fourie IBCLC
Carey Haupt RD SACLC MSc(Med)
Dr Khaleed Sayed MBChB, Dip of Obs
Dr Natasha Ramjee MO in Paediatrics, Mowbray Maternity Hospital
Ceferino Cenizo Earth And Man Foundation
Claire Bracher M.Sc nursing RN. RM. IBCLC
Luyanda Majija Communication Manager, Vital Strategies
 

Anna Coutsoudis

Professor Emeritus, School of Clinical Medicine, University of KwaZulu-Natal,

Durban

Ann Behr National Department of Health
Melissa Whitson
Simone fink Doula, Yoga Teachers trainer, Bcom
Cristel Cloete Birth & Bereavement Doula
Jean Ridler IBCLC, RM, RN
Dr Surya Ebrahim Mowbray Maternity Hospital
Sandy Bayman WOMBS Doula
Irene Bourquin WOMBS Doula Trainer, Registered Nurse/Midwife
Amanda Neito La Leche League Leader, South Africa, WOMBS Birth and Postpartum Doula
Lizl Dunn WOMBS Doula, Breastfeeding Counselor
Pamela Wilment La Leche League Leader, South Africa, WOMBS Doula
Dr Vanessa Farr Environmental Humanities South, University of Cape Town
Laura Sayce IBCLC IBCLC
Dr Sharon Nyatsanza National Council Against Smoking
Sithabile Shobowale WOMBS DOULA
Jane Pitt IBCLC – SOUTH AFRICA
Samantha Crompton RN, SACLC – The Baby Lady SA
Adriano Cattaneo Epidemiologist (retired), Trieste, Italy
Bronwyn Balcomb, RD (SA), IBCLC Registered Dietitian, South Africa

 

Anneleen De Keukelaere People’s Health Movement South Africa
David Pienaar
Dr Max Kroon Paediatrician, UCT
Ronel Sorgenfrei Registered Dietitian, South Africa
Vongani Mkhabele Registered Nutritionist, South Africa
Michael Hendricks Paediatrician, UCT
Vanessa Black Biowatch South Africa
Marion Stevens
Nikki Schaay School of Public Health, University of the Western Cape
Anton Delport School of Public Health, University of the Western Cape
Brittany Kesselman Society, Work & Politics Institute (SWOP), WIts University
Prof Susan Fawcus Department Obsterics and Gynaecology, University Cape Town
Manya van Ryneveld School of Public Health, University of the Western Cape
Estelle Wasserfall ADSA, WOMBS doula
 

Prof Minette Coetzee

Children’s Nursing Development Unit, UCT Department of Paediatrics and

Child Health

Dr Hazel Bradley School of Public Health, University of the Western Cape
 

Andrea Amos

Children’s Nursing Development Unit – Department of paeds and child

health, UCT

Prof Rachel Wynberg Department of Environmental and Geographical Science, UCT
 

Angela Leonard

Children’s Nursing Development Unit, UCT Department of Paediatrics and

Child Health

Angelika Peczak HEALA
Prof Nick Spencer International Society for Social Pediatrics and Child Health (ISSOP)
 

Florian Kroll

DSI-NRF Centre of Excellence in Food Security; UWC Institute for Poverty,

Land and Agrarian Studies

Russell Rensburg Rural Health Advocacy (RHAP)
Zolile Mlisana Retired paediatrician
Emeritus Professor Marian Jacobs UCT Department of Paediatrics and Child Health
Katinka Musavaya – IBCLC IBCLC – Maternal and Childhealth Zimbabwe
Prof Ashraf Hassen Coovadia Academic Head of Paeds Wits University
Dr Nomlindo Makubalo DCST Paediatrician Eastern Cape
Beatrix Callard APN, RN, Windhoek Namibia
Thandi Puoane Emeritus Professor
 

Prof Bruno Losch

Institute for Social Development, University of the Western Cape / DSI-NRF

Centre of Excellence in Food Security / Cirad, France

 

Prof Diane Cooper

Extraordinary Professor, School of Public Health, University of the Western

Cape

 

Prof Stephen Devereux

Institute for Social Development, University of the Western Cape / DSI-NRF

Centre of Excellence in Food Security / IDS Sussex, UK

 

Dr Simon Lewin

South African Medical Research Council and Norwegian Institute of Public

Health

 

Lisanne du Plessis

Division of Human Nutrition, Department of Global Health, Faculty of

Medicine and Health Sciences, Stellenbosch University

Marcus Solomon National Coordinator Children’s Resource Centre

 

Rifqah Roomaney PhD intern, SAMRC

 

Richard Matzopoulos

 

Burden of Disease Research Unit, South African Medical Research Council

 

Maurice Smithers

 

Southern African Alcohol Policy Alliance in SA (SAAPA SA)

 

Dr Edward Nicol

 

Burden of Disease Research Unit, South African Medical Research Council

 

Carole Dobrich

 

RN, IBCLC, International Institute of Human Lactation Inc.

 

Jennifer Welch

 

IBCLC International Board Certified Lactation Consultant

 

Dale Hansson, RN, CFHN

 

BFHI Lead Assessor, Lactation Consultant

 

Janelle Maree

 

Director, Breastfeeding Advocacy Australia

 

Dr Magdalena Whoolery

 

MCH-IYCF Consultant and IBFAN Member

 

Prof Sharon Fonn

 

Wits School of Public Health

 

Ateca Kama

 

Chief Dietitian & Nutritionist, Ministry of Health and Medical Services, FIJI

 

Prof Alice Nte

 

Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

 

Milton Semenekane

 

South African Medical Research Council

 

Noloyiso Matiwane

 

North-West University

 

Hassan Mahomed

 

Division of Health Systems and Public Health, Dept of Global Health, Stellenbosch University

 

Jane Simmonds

 

South African Medical Research Council

 

Dikoloti Morewane

 

Botswana Breastfeeding Association

 

Jane Joubert

 

South African Medical Research Council

 

Dr Jane Battersby UCT

 

Mr. Phillip Mokoena

 

Global Health Advocacy Incubator

 

Makoma Bopape

 

University of Limpopo

 

Maria van der Merwe

 

Independent public health and nutrition consultant

 

Bill Jeffery

 

Centre for Health Science and Law

 

Dr Anam Nyembezi

 

Senior Lecturer, School of Public Health, University of the Western Cape

 

Tara Callow

 

Pediatric Nurse Practitioner, MSN, CRNP USA

 

Prof Di Gray

 

UCT Department of Paediatrics and Child Health

 

Ravi Ram

 

Madhira Institute & PHM Kenya

 

Sarah Motha

 

Umphakatsi Peace Ecovillage

 

Ronel Beukes

 

Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University

 

Petronell Kruger

 

Public health lawyer and researcher at PRICELESS

 

Denis Joseph Bukenya

 

Human Rights Research Documentation Center (HURIC)

 

Jamiru Mugalu

 

People’s Health Movement Uganda

 

Dr Phumza Nongena

 

UCT Department of Paediatrics

 

Prof Yousuf Vawda

 

UKZN School of Law

 

Dr Natisha Dukhi

 

Human Sciences Research Council (HSRC)

 

Ms Bongekile P. Mabaso

 

Registered Nutritionist, PhD Candidate at UCT, School of Management Studies

 

Prof Salim S. Abdool Karim

 

Director: CAPRISA

 

Laurie Schowalter

 

HEALA

 

Patti Rundall

 

Baby Milk Action, IBFAN Global Council

 

Sam Waterhouse

 

Womxn and Democracy Initiative

 

Dr Gwen Norton

 

La Leche League Leader

 

Nadine Nannan

 

Specialist scientist, SAMRC

 

Duduzile Mkhize

 

Nomajoni Ntombela

 

IBFAN Africa
Dr Irena Zakarija-Grković

 

Croatian Association of Lactation Consultants; University of Split School of Medicine, Croatia

 

Nomajoni Ntombela

 

Nophiwe Job

 

Registered Nutritionist

 

Sasha Stephenson

 

Section27

 

Sally Raine

 

La Leche League Leader South Africa

 

Prof Julia Goedecke

 

Non-Communicable Diseases Research Unit, South African Medical Research Council
Public Health Association of South Africa
Rural Health Advocacy Project
HEALA
Stuart Gillespie Non-resident senior fellow, IFPRI
Rene Williams Retreat Feeding Initiative feeding community and serving to uplift those in need. Independent non Gov
Shireen Marks

 

Retreat Feeding Community Worker exposed daily to mothers and children dealing with affordability issues regarding feeding

 

Colleen Brickles Retreat Feeding Assistant working with kids feeding daily
Dr Anna Herforth Independent researcher
Ralph Hamann University of Cape Town
Aviva Tugendhaft SAMRC Centre for Health Economics and Decision Science, PRICELESS SA, Wits School of Public Health
Dr Thandi Wessels District Paediatrician, Western Cape Dept Health, Department of Paediatrics and Child Health, Stellenbosch University
Prof Linda Richter Distinguished Professor, DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand