With these fateful words, Mandy Rice-Davies told us all we need to know about vested interest. The year was 1963, and the UK's Conservative Government was being rocked by the Profumo Affair, a toxic mix of sex, Soviet spies and cabinet ministers. Davies was still a teenager and—quite rightly—determined not to be made a scapegoat. Her words came in reply to a barrister in the High Court who revealed that Lord Astor had denied sleeping with her, and her devastating common-sense laid bare the hypocrisy of the political establishment. She was pointing out that people—even well-educated, sophisticated, refined people—are wont to put their own interests first, regardless of the risk to others (in this case the security of the state at the height of the Cold War), and then do anything they can to hide this uncomfortable truth. Three decades later the threat is not to national security, but public health; and the vested interest is not a matter of individual peccadillos, but systemic forces. In both cases, however, the stakes are much higher than in 1963. The threat then from the Soviet Union was real enough, but it remained hypothetical. Red Army tanks never rolled across Germany, and nuclear missiles stayed silent in their silos. By contrast, the harm being wreaked by the corporate marketing of alcohol, tobacco and ultra-processed food is far from hypothetical; it is killing people in their millions now. We all know the grim statistics—one in two smokers taken out 1, ultra-processed food driving a tsunami of obesity 2 and alcohol the fourth biggest cause of preventable death in a world where half the population is teetotal 3. So proficient have these killers become that we have had to coin a new term, the ‘industrial epidemic’, to describe their lethal force 4 and, as climate scientist Stephen Emmott makes clear, what consumption of unhealthy products is doing for our bodies, inveterate consumption of everything—again driven by corporate marketing—is doing for our planet 5. That vested interest has become systemic is thanks to the fiduciary imperative, which requires corporations to put investor-returns ahead of all other concerns. It is a legal obligation, and exists for good reasons. Corporate executives spend other people's (investors’) money and so, given the human frailties underlined by Profumo, it is deemed necessary to compel them to spend it only in ways which benefit these investors. Thus vested interest is written into the DNA of corporations. The resulting single-mindedness explains their unprecedented growth: many are now bigger than countries 6. Given these realities, it is astonishing that the ‘Responsibility Deals’ ever saw the light of day. The improbable idea was that the multi-nationals perpetrating all this public health harm, including alcohol and ultra-processed food companies (although, interestingly, not the tobacco industry), would be invited into the government tent, whereupon they would magically relinquish their fiduciary duties and become part of the solution. The 1963 equivalent would have been to offer the KGB and the local escort agency desks in Downing Street. However, in these days of evidence-based public policy, common sense will not suffice and we have had to wait several years while the requisite studies were conducted testing whether King Herod might, after all, be good at child-care. Well, they have now been conducted, and conducted exhaustively, by a stellar team at the London School of Hygiene and Tropical Medicine (LSHTM) 7. This issue sees the publication of their research on the Responsibility Deal with the alcohol industry; guess what it shows? It did not work. Numerous promises were made, but it emerged that most of these were things that the companies were doing anyway. Even when genuinely new commitments were made, they delivered no appreciable public health benefit. Meanwhile, the captains of our industrial epidemics—and specifically corporate alcohol—have had their desks in Downing Street. Of course, this proximity to power has had absolutely no influence over government policy. Like Lord Astor, everyone has behaved with impeccable probity. The fact that during this time minimum unit pricing moved from being a firm Prime Ministerial commitment to a policy reject is, we are told, a pure coincidence. Well, they would say that, wouldn't they? None.
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Apr 1, 2023
Alex Philippidis 
Open Access