We are a group of public health researchers in Karnataka, India, and would like to draw your attention to the failure to disclose a conflict of interest in the World Report “Can public—private partnerships improve health in India?” (Sept 13, 2008).1
The author, Bharathi Ghanashyam, fails to disclose that she is a trustee of the organisation that is mentioned in the report. Furthermore, some of us are aware of the negative aspects of public—private partnerships in primary health care in the case study discussed, as well as in others in the state of Karnataka. These aspects are not covered in the World Report, which mentions one case study in Karnataka while broadly discussing the possibility of expansion of public—private partnerships to the country’s entire health sector. In so doing, Ghanashyam’s report goes further than the data suggest.2—4
In another World Report, published on Nov 13, 2010, and entitled “India is failing the mentally ill as abuses continue”,5 Ghanashyam again fails to disclose that she is a trustee of the organisation she is writing about.
After raising the issue with The Lancet‘s ombudsman, we received a letter stating that, until recently, the journal did not have a policy in place to compel journalists to declare conflicts of interest. We were extremely surprised to hear this. We feel that this oversight jeopardises the journal’s reputation for transparency. Readers should be made aware of it.
SK was an employee of the Karuna trust for 3 years. The other authors declare that they have no conflicts of interest.
1 Ghanashyam B. Can public—private partnerships improve health in India?. Lancet 2008; 372: 878-879. Full Text | PDF(44KB) | CrossRef | PubMed
2 Oxfam Blind optimism: challenging the myths about private health care in poor countries. http://www.oxfam.org/policy/bp125-blind-optimism (accessed Feb 27, 2012).
3 Richter J. Public—private partnerships for health: a trend with no alternatives?. Development 2004; 47: 43-48. CrossRef | PubMed
4 Nandraj S, Muraleedharan V, Rama BV, Imrana Q, Ritu P. Private health sector in India: CEHAT. BMJ 2001; 331: 1339. CrossRef | PubMed
Failure to disclose a conflict of interest in a World Report — Editor’s reply
Journalism, like medicine, is a profession with codes of ethics and conduct. In countries with a free press, the wording of these principles can vary between professional bodies, but can be generally summed up as: accuracy, impartiality, objectivity, truthfulness, and fairness. However, as the case raised by Sylvia Karpagam and colleagues shows, these codes might not be clear to all journalists and there can be lapses in judgment.
The Lancet is a registered newspaper and commissions journalists to write for its sections devoted to news, media, and the arts. As noted in the preceding exchanges, we did not have a conflicts of interest policy in place for journalists when Bharathi Ghanashyam wrote for us. In response to this case and to our ombudsman’s ruling, we began a policy of asking all our contributors to World Report (from December, 2011) and Perspectives (from January, 2012) to declare any personal or financial conflicts of interest relating to the copy they have submitted. If deemed a non-serious conflict (eg, an unconditional bursary to pay for a reporting trip), we will publish the conflict alongside the article. If the conflicts are judged to be too great, and in breach of journalistic codes, then The Lancet will reject the article. This new policy for journalists now aligns with our long-standing conflicts of interest policy for our academic contributors, and similar policies are in place across all journals in The Lancet’s family.
We thank Karpagam and colleagues for raising this important issue and encourage other journals and media outlets to develop policies on conflicts of interest and transparency for their journalistic contributors.