To date, there has been little debate among NGOs or the broader public about the ramifications of pharmaceutical industry funding of health charities and NGOs. Nor have the implications of these arrangements for an organisation's activities and credibility received much attention.

HAI and HAI members have a policy against taking industry money. HAI's aim is to promote open discussion between NGOs who accept industry funding and others who are opposed to it and to explore viable alternatives to company sponsorship. HAI works to broaden the discussion about sponsorship, to raise awareness about the effects of privatization and to call for more advocacy at the World Health Organization (WHO) and at national level so that sponsorship is clearly recognised as a form of promotion. HAI also calls on the drug industry to be more transparent about which groups they sponsor.

HAI remains sceptical of the belief that industry and health-promoting NGOs can form real partnerships. The question remains: do drug companies and health NGOs actually share the same interests? Many NGOs receiving industry money may not realise that their funding is part of a public relations strategy or tied to the marketing budget for a specific product or product line. Sponsoring well-targeted NGO groups, especially patient groups, allows industry to promote their products to consumers using methods unavailable to drug companies acting on their own. Patient groups, for example, can be used by companies to spread awareness about new drugs at a pre-launch stage; they can reach consumers directly, bypassing doctors; and they can provide a more credible endorsement for a product than could be achieved if it came directly from the company itself. Funding NGOs may also help to soften criticism against a product or company because sponsored groups, concerned about future funding, may feel unable to speak out.

Pharmaceutical companies are mastering public relations skills with increasing finesse as their budgets for PR demonstrate. As a result, any NGO that believes a company is contributing funds simply because it's the right thing to do, doesn't see how the larger game of winning public approval for corporate actions is being played. There is a real danger that well-intentioned NGOs and Inter-governmental organizations (IGOs) can become unwitting collaborators in advancing a company's own agenda. There is a "strategic corporate sponsorship" being used to buy political influence. Such sponsorship presents a danger to democratic, transparent decision-making by allowing companies to gather intelligence about activist groups, to whitewash the image of embattled companies or industries, to manipulate important public debates, and to divide and silence critics.

Sponsorship has also led to a change in the way decision-making is done at very high levels and is done subtly. While money doesn't change hands, it does talk--and at the highest levels. The tangled web of industry "charity" and policy making raises questions about how much influence industry has about who drafts policy and which experts get quoted and published.

One of the problems is that industry funding often remains hidden. While some NGOs and IGOs advertise their link with industry, many keep it under wraps. Often it is difficult for the public to know if an NGO/IGO receives industry funding even after reviewing its brochures or attending an open meeting. In some cases, companies take advantage of this large loophole in the regulation of pharmaceutical promotion to use NGOs to promote their products. This leads to confusion and mistrust within the NGO community as organisations search for allies or try to position themselves within a health area.

HAI's work on the issue will continue as newspaper headlines continue to tout the latest "partnership" deals promising to improve human health such as Public Private Partnerships. Whether corporate sponsorship is used as a marketing tool or as part of a larger political agenda, it is time for the members of the NGO/IGO community to take a critical look at this growing phenomenon and decide where they stand on the issue and what they want to do to address their concerns about it. NGOs/IGOs have a crucial role to play in ensuring that with or without sponsorship, public health is what gets promoted.