The post-Ricciardi* era in conflict of interests’ ridden Italy.
After Walter Ricciardi’s stepdown, more resignations follow in the Italian National Health Institute ISS (Istituto Superiore di Sanita’ - ISS). The symptom may be removed, but certainly not the cause of the disease.
Italy is still waiting for a "remedy" to cure its cronic conflict of interests’ plague. A bill proposal on "Rules on transparency in the relationship between manufacturing companies, health care operators and health organizations" (DDL no. 491, April 2018) has been lodged and signed by 5 Star Movement MEP Baroni with a wide support by all party leaders.
On December the 09th 2018, an interview by TV programme “Le Iene" publicly questioned whether the ISS president Walter Ricciardi was fit for its role. It emerged how his institutional health-related research and monitoring work was blatantly in conflict with the private consultancies he had been providing to pharmaceutical companies, as well as honorary roles still held in their “scientific” lobbying groups. His resignations followed shortly after.
These allegations have previously emerged during the assessment of a complaint lodged in 2016 lodged by Walter Ricciardi against the president of codacons Carlo Rienzi and were confirmed by the Court of Justice.
Ricciardi’s stepdown from ISS triggered three more resignations, as reported by newspaper Repubblica on December the 20th in an article titled “Three more out of ISS, Health Minister Grillo goes mad”.
Those who resigned were: Giuseppe Remuzzi, director of the “Mario Negri” pharmacology institute and member of ISS’s board, Armando Santoro, member of ISS’s Scientific Committee, and Francesco Vitale, chairman dean of the medical school of Palermo University and member of ISS’s Scientific Committee. According to the press, their motivation to resign was "because they would consider the scientific independence of the institution - which is one of the main public health research institute in Italy and Europe - no longer guaranteed".
In the context of this chain of events, the essence of the bill proposal on conflict of interest in the health sector, raises even more to prominence.
Bill proposal No. 491, also known as "Sunshine Act" begins with these very words:
From the perspective of prevention and the fight against corruption, transparency is one of the basic principles that regulate relationships between private and public interests.
http://www.senato.it/leg/18/BGT/Schede/Ddliter/49379.htm
Over the last decade, France, the United Kingdom, Australia, USA have comprehended the importance of regulating conflict of interest in the health sector, and have established an institutional framework to foster transparency, based on sound codes of ethics and conduct.
The first signatories of the bill proposal state:
In the European Union there is not yet a specific legal framework governing these relationships, although more than one hundred parliamentarians from the 47 member states of the Council of Europe signed the recommendations on conflicts of interest in the health sector and explicitly referred to the need for a European Sunshine Act. […] Italy has moved on with the Legislative Decree n.33, in March 4, 2013, subsequently amended by the Legislative Decree n. 97, in May 25, 2016, imitating The British 'Freedom of Information Act' for access to documents. Articles 45 to 48 of the Legislative Decree n.33 of 2013 redefined the role of the National Anti-Corruprion Authority (ANAC) in the sanctioning activity though some critical issues are still unresolved. […]
Following the investigation carried out by the non-profit organization of investigative journalism ProPublica, the American public opinion pushed for a clarification which revealed an estimation of $320 millions in donations in favour of 18.000 physicians in 2009 and 2010.
The people themselves requested the clarification in name of the basic human right for transparency and objectivity.
Despite the Legislative Decree there is still a lot of work to do in Italy as demonstrated by the sponsorization of Glaxo-Smith-Kline (one of the largest multinational drug companies) of the political event in the health sector “Global Health – Italy, driver of Best practice”, held in the Hall for Parliamentary Acts in Rome.
If transparency reveals the truth we wonder why one of the largest multinational drug companies collaborates in an institutional setting for an event in which politics and business come together and the Bill 'Sunshine Act' and the new bill on 'Provisions on vaccine prevention' are starting their legislative process. We hope this is just a coincidence.
In order to spread transparent practices it is necessary that all financial transactions and relationships of interest are made public, resulting in multiple positive effects for all: physicians aware of the risks would make wiser decisions, while citizens aware of the ties between pharmaceutical companies and health professionals would be able to make better informed choices.
Italy needs change, as promised in the electoral campaigns.
Not the symptom but the cause of the desease needs to be removed.
Of course the right to reply is guaranteed. The Editorial Staff of 'Informazione Libera Press' remains available to anyone who wants to express his opinion on the issue.
* President of the Italian National Health Institute (Istituto Superiore di Sanita’ - ISS) from September 2015. He resinged on January 2019 in open conflict with the current Italian government’s health policy orientations.
