From the CEO


Integrity in the face of conflict

Last year Emory’s $525 million profit from the marketing rights to the HIV drug Emtriva brought into clear focus some of the potential “dividends” of academic/industry collaboration in health-related research, product development, and health care. In fact, the Emtriva partnership is a classic case study in translational research: moving vital discoveries efficiently from the scientific bench to the bedside by drawing on the strengths of both the academy and industry. Yet relationships between health professionals and institutions in the nonprofit sector and partners and sponsors in the private sector are fraught with difficulties. An important factor we must recognize and manage at every step is conflict of interest (COI). COI can exist where the primary interests of an individual or institution (for example, the pursuit of knowledge or the education of students) run up against significant secondary interests (such as pecuniary gain).
     As a university and health system, we have special obligations to ensure the integrity of everything we do. The reliance of students and trainees on their teachers and mentors requires the commitment of educators to the best interests of their students. The pursuit of knowledge and new discoveries requires scientific integrity, collaboration, and free sharing of information. Human vulnerability in light of disease and injury creates a moral imperative for the integrity of caregivers. Even the appearance of COI can undermine a patient’s, a student’s, or the public’s trust in our vital work.
     COI is not new. Longstanding sources of conflicts requiring management within academia and health care include hubris, the desire for academic promotion, competition for sponsored research support and “interesting cases,” the push to be the first to publish discoveries, an aspiration for higher pay and revenues, and other competing secondary interests. The recent growth of collaboration with private industry is only the latest challenge in earning and maintaining public trust in the integrity of research, training, and clinical care.
     It is vitally important for everyone in our community to understand COI and be proactive in identifying and managing conflicts. COI policy and its enforcement have evolved quickly during the past several years, but they are still works in progress. Often the issues are complex and far from straightforward or clear-cut. New ground is broken regularly. Therefore, informed voices from a variety of perspectives and a continuous and healthy dialogue are necessary, as is complete compliance in areas where policies are clear and settled. As always, I hope and expect that you will find in the pages of Momentum good and useful information that keeps us moving forward in managing COI and in all of our work together.

Michael M E Johns



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