Abstract
Equatorial Guinea, the most prosperous country in Africa, still bears a large malaria burden. With massive wealth from oil reserves, and nearly half its population living in island ecotypes favourable for malaria control, only poor governance can explain continued parasite burden. By financially backing the country's dictator and other officials through illicit payments, the oil company ExxonMobil contributed to the state's failure. Now ExxonMobil, having helped perpetuate malaria in Equatorial Guinea, gives money to non-governmental organizations, charitable foundations, and universities to advocate for and undertake malaria work. How, and on what terms, can public health engage with such an actor? We discuss challenges in the identification and management of conflicts of interest in public health activities. We reviewed the business and foundation activities of ExxonMobil and surveyed organizations that received ExxonMobil money about their conflict of interest policies. Reforms in ExxonMobil's business practices, as well as its charitable structure, and reforms in the way public health groups screen and manage conflicts of interest are needed to ensure that any relationship ultimately improves the health of citizens.
Similar content being viewed by others
References
US Department of State. (2008) Human Rights Report: Equatorial Guinea. Country Reports on Human Rights Practices, http://www.state.gov/g/drl/rls/hrrpt/2008/af/118999.htm, accessed 12 September 2011.
Central Intelligence Agency. (2010) The World Factbook, https://www.cia.gov/library/publications/the-world-factbook/geos/ek.html, accessed 12 September 2011.
Center for Economic and Social Rights. (2009) Equatorial Guinea. Fact Sheet no. 9, http://www.cesr.org/downloads/equatorial%20guinea%20WEB.pdf, accessed 12 September 2011.
OECD. (2008) African Economic Outlook: Equatorial Guinea, http://www.oecd.org/dataoecd/12/56/40577917.pdf, accessed 12 September 2011.
World Health Organization. (2008) World Malaria Report, http://www.who.int/malaria/publications/atoz/9789241563697/en/index.html, accessed 12 September 2011.
Global Fund to Fight AIDS, Tuberculosis and Malaria. (2011) Equatorial Guinea Malaria Grant Portfolio, http://portfolio.theglobalfund.org/en/Grant/Index/GNQ-506-G02-M, accessed 12 September 2011.
Kaneko, A., Taleo, G., Kalkoa, M., Yamar, S., Kobayakawa, T. and Björkman, A. (2000) Malaria eradication on Islands. Lancet 356 (9241): 1560–1564.
Kleinschmidt, I. et al (2009) Marked increase in child survival after four years of intensive malaria control. The American Journal of Tropical Medicine and Hygiene 80 (6): 882–888.
Marathon Oil. (2009) Marathon and partners announce dramatic results of Malaria Control Project on Bioko Island, http://www.prnewswire.com/news-releases/marathon-and-partners-announce-dramatic-results-of-malaria-control-project-on-bioko-island-in-equatorial-guinea-61868362.html, accessed 6 October 2011.
Calain, P. (2008) Oil for health in sub-Saharan Africa: Health systems in a ‘resource curse’ environment. Global Health 4: 10.
Basedau, M. and Lacher, W. (2006) A paradox of plenty? Rent distribution and political stability in oil states. SSRN eLibrary, http://papers.ssrn.com/sol3/papers.cfm?abstract_id=909189, accessed 11 November 2011.
World Bank. (2002) Equatorial Guinea. Second Petroleum Technical Assistance Project (Credit 2408-EG), http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2002/08/02/000094946_0207220918196/Rendered/PDF/multi0page.pdf, accessed 12 September 2011.
International Monetary Fund. (2003) IMF Country Report. No. 03/385, Article IV Consultation, http://www.imf.org/external/pubs/ft/scr/2003/cr03385.pdf, accessed 12 September 2011.
Ministry of Mines, Industry, and Energy. (2010) Oil production in Equatorial Guinea, http://www.equatorialoil.com/oilproduction.html, accessed 12 September 2011.
Catholic Relief Services. (2003) Bottom of the barrel: Africa's oil boom and the poor, http://www.crsprogramquality.org/publications/2003/6/16/bottom-of-the-barrel-africas-oil-boom-and-the-poor.html, accessed 12 September 2011.
Ministry of Mines, Industry, and Energy. (2010) Petroleum Legislation in Equatorial Guinea, http://www.equatorialoil.com/legislation.html, accessed 12 September 2011.
Energy Information Administration. (2010) Equatorial Guinea Analysis, http://www.eia.gov/countries/cab.cfm?fips=EK, accessed 12 September 2011.
WikiInvest. (2009) Net Income for Exxon_Mobil (XOM), http://www.wikinvest.com/stock/Exxon_Mobil_(XOM)/Data/Net_Income/2009, accessed 12 September 2011.
United Nations Children Fund. (2009) The State of the world's children, http://www.unicef.org/sowc09/, accessed 12 September 2011.
Wood, G. (2004) Business and politics in a criminal state: The case of Equatorial Guinea. African Affairs 103 (413): 547–567.
Open Society Justice Initiative. (2010) Corruption and its consequences in Equatorial Guinea, http://www.soros.org/initiatives/justice/articles_publications/publications/eqbriefing_20090721, accessed 12 September 2011.
Blum, J. (2004) U.S. oil firms entwined in Equatorial Guinea deals. The Washington Post, http://www.washingtonpost.com/wp-dyn/articles/A1101-2004Sep6.html, accessed 12 September 2011.
Silverstein, K. (2004) U.S. investigates oil firms’ deals in West Africa. Los Angeles Times, http://articles.latimes.com/2004/may/22/world/fg-oil22, accessed 12 September 2011.
United States Senate, Permanent Subcommittee on Investigations, Committee on Governmental Affairs. (2004) Money Laundering and Foreign Corruption: Enforcement and Effectiveness of the PATRIOT Act. Case Study Involving Riggs Bank, http://www.access.gpo.gov/congress/senate/pdf/108hrg/95501.pdf, accessed 12 September 2011.
Silverstein, K. (2011) Hold That Car. Foreign Policy, http://www.foreignpolicy.com/articles/2011/10/13/teodorin_obiang_hold_that_car, accessed 15 October 2011.
Transparency International. (2008) Report on Revenue Transparency of Oil and Gas Companies, http://www.transparency.org/policy_research/surveys_indices/promoting_revenue_transparency#2008, accessed 12 September 2011.
Transparency International. (2011) Report on Revenue Transparency of Oil and Gas Companies, http://www.transparency.org/policy_research/surveys_indices/promoting_revenue_transparency#2011, accessed 12 September 2011.
Ibrahim, M., Wolfowitz, P., Cardin, B. and Offenheiser, R. (2010) Who Else Is to Blame? Foreign Policy, http://www.foreignpolicy.com/articles/2010/06/21/who_else_is_to_blame, accessed 12 September 2011.
ExxonMobil. (2011) ExxonMobil Malaria initiative, http://www.exxonmobil.com/Corporate/community_malaria_initiative.aspx, accessed 12 September 2011.
ExxonMobil. (2011) Our partners in the fight against malaria, http://www.exxonmobil.com/Corporate/Imports/health/community_malaria_partners.aspx, accessed 12 September 2011.
ExxonMobil. (2011) Malaria initiative map, http://www.exxonmobil.com/Corporate/Imports/malaria/index.html, accessed 12 September 2011.
Influence Explorer. (2011) Exxon Mobil: Campaign finance, lobbying, regulations, federal spending, contractor misconduct. EPA Violations and Advisory Committees, http://influenceexplorer.com/organization/exxon-mobil/819555dfc3d449d2be54286f0cb385e2#epa_echo_section, accessed 11 October 2011.
Scott, A. (1958) Malaria control in a tea estate practice in Assam. Journal of Tropical Medicine and Hygiene 61 (11): 269–273.
Giglioli, G. (1974) The impact of malaria eradication on patterns of natality, mortality, and morbidity on the sugar plantations of the coastlands of Guyana, South America. West Indian Medical Journal 23 (3): 174–187.
Hedman, P., Brohult, J., Forslund, J., Sirleaf, V. and Bengtsson, E. (1979) A pocket of controlled malaria in a holoendemic region of West Africa. Annals of Tropical Medicine and Parasitology 73 (4): 317–325.
Frynas, J.G. (2004) The oil boom in Equatorial Guinea. African Affairs 103 (413): 527–546.
Holcombe, R.G. (2000) Writing Off Ideas: Taxation, Foundations, and Philanthropy in America. New Jersey: Transaction Publishers.
Burch, T., Wander, N. and Collin, J. (2010) Uneasy money: The Instituto Carlos Slim de la Salud, tobacco philanthropy and conflict of interest in global health. Tobacco Control 19 (6): e1–e9.
Brownell, K.D. and Warner, K.E. (2009) The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food? Milbank Q 87 (1): 259–294.
Shah, S. (2011) How Private Companies are transforming the Global Public Health Agenda. Foreign Affairs, http://www.foreignaffairs.com/articles/136654/sonia-shah/how-private-companies-are-transforming-the-global-public-health, accessed 12 November 2011.
Hunt, C. (2011) Analysing the ‘900 papers supporting climate scepticism’: 9 out of top 10 authors linked to ExxonMobil. The Carbon Brief, http://www.carbonbrief.org/blog/2011/04/900-papers-supporting-climate-scepticism-exxon-links#, accessed 12 September 2011.
World Health Organization. (2000) Guidelines on working with the private sector to achieve health outcomes, http://apps.who.int/gb/archive/pdf_files/EB107/ee20.pdf, accessed 12 September 2011.
Thompson, D.F. (1993) Understanding financial conflicts of interest. New England Journal of Medicine 329 (8): 573–576.
Institute of Medicine. (2009) Conflict of Interest in Medical Research, Education, and Practice, http://books.nap.edu/openbook.php?record_id=12598, accessed 23 April 2012.
US Securities and Exchange Commission. (2010) Exxon Mobil Corp EDGAR Search Results, http://www.sec.gov/cgi-bin/browse-edgar?action=getcompany&CIK=0000034088, accessed 12 September 2011.
Roll Back Malaria Partnership. (2007) Conflict of Interest Policy and Procedure, http://www.rbm.who.int/docs/constituencies/RBMcoiPolicy.pdf, accessed 12 September 2011.
African Tobacco Control Alliance. (2010) African health group welcome Gates Foundation action to shield public health policies from tobacco industry, http://www.atca-africa.org/version_anglaise/ATCA_media_release_YS1_edit.pdf, accessed 12 September 2011.
Omobowale, E.B., Kuziw, M., Naylor, M.T., Daar, A.S. and Singer, P.A. (2010) Addressing conflicts of interest in Public Private Partnerships. BMC International Health and Human Rights 10 (1): 19.
Acknowledgements
Thanks are due to Sanjay Basu and David Stuckler for their support and guidance on investigating conflicts of interest. Elizabeth Rogawski, Anne Starling, Dinsha Mistree, Matthew Price, Matt Murrill, and Steve Wing provided helpful comments.
NKS is supported by a fellowship from the Paul and Daisy Soros Foundation and NIH Medical Scientist Training Program grant GM008719.
Author information
Authors and Affiliations
Corresponding author
Additional information
The author explores a risky alliance between a petroleum giant and public health programs where the corporation is, at the same time a donor to the program against malaria and a contributing factor in the persistence of malaria in Equatorial Guinea.
Appendix
Appendix
Rights and permissions
About this article
Cite this article
Shah, N. Corporate philanthropy and conflicts of interest in public health: ExxonMobil, Equatorial Guinea, and malaria. J Public Health Pol 34, 121–136 (2013). https://doi.org/10.1057/jphp.2012.60
Published:
Issue Date:
DOI: https://doi.org/10.1057/jphp.2012.60