Maintaining trustworthiness in NIH public-private partnerships (The Daniel W. Foster, M.D., Visiting Lectureship in Medical Ethics)

Public-private partnerships (PPPs) can benefit the public, but recent National Institutes of Health (NIH) cases illustrate how PPPs may raise important concerns about conflicts of interest (COIs). A proposed PPP to accelerate new treatments for opioid addiction had to be substantially modified after it was disclosed that several private partners were opioid manufacturers being sued by state attorneys general for allegedly promoting the opioid crisis. The project will now be carried out using only public funds. Another PPP, a large clinical trial to determine the long-term effects of moderate alcohol consumption, was harshly criticized after it was revealed that five large alcohol manufacturers are providing most of the $100 million cost of the study. NIH has ordered two investigations of this trial. The high reputation of NIH should be protected in any PPP. NIH should develop comprehensive policies to assure transparency in PPPs and appropriately limit undue influence and bias.