Under cover of darkness: Pharmaceutical and food industry payments to national paediatric associations

In 2023, the Spanish Paediatrics Association (AEP, in Spanish) received more than 294,000 euros for “services rendered” and 210,000 euros in “donations,” more than the nearly 201,000 euros in membership fees, according to its latest annual report. Although the AEP boasts of maintaining “high ethical standards and transparency,” in its report it reveals only its “sincere gratitude” to industry donors for “training” paediatricians, “research in paediatrics” and “the dissemination of important information on child health.” Although its ethics guidelines state that a “responsible and transparent” relationship between societies and industry “is key,” the AEP does not name its donors, nor does it specify the services it provides – such as placing the association’s logo on children’s products - or the reasons for donations.

Determining which private entities fund medical and scientific societies is difficult. Although the pharmaceutical industry discloses payments to healthcare organisations and professionals, Spain does not regulate such disclosures, nor is there a single, centralised database, as there is in other countries. To understand the economic ties, interested citizens must analyse the data published by each pharmaceutical company, which they often publish in inconvenient formats.

Those reports reveal, for example, that in 2016 the AEP received more than 208,000 euros in donations from the pharmaceutical companies GlaxoSmithKline (GSK), Pfizer and Viñas, more than the AEP’s foundation, the Spanish Paediatrics Foundation (FEP, in Spanish), to which Pfizer alone donated 146,000 euros in 2016. In 2023, the AEP and its foundation received 14,429.25 and 262,076.80 Euros respectively from GSK. On the Pfizer side, there is only one payment of 443,984 euros to the “Fundación Asociación Española de Pediatría”, so it’s not known whether this refers to the foundation, the association or both.

The opacity is even greater when it comes to other sectors, such as food or childcare, which do not publish their transfers to paediatric associations.

The opacity is even greater when it comes to other sectors, such as food or childcare, which do not publish their transfers to paediatric associations. In 2015 the AEP published its first - and last - report on transparency, which stated that it obtained 555,500 euros for licensing its logo to food and drink, children’s products and pharmaceutical companies. In 2018, El Salto revealed that the AEP had received close to 2.3 million euros from several companies between 2013 and 2017. The AEP has declined to answer Civio’s questions about the details of its annual income and its conflicts of interest.

AEP’s lack of transparency is neither unique nor exceptional. The other major paediatrics association in Spain, the Spanish Association of Primary Care Paediatrics (AEPAP in Spanish), referred Civio to the annual reports each pharmaceutical firm publishes on so-called transfers of value, but provided no further details. These documents report that in 2023 GSK and Pfizer paid AEPAP more than forty thousand euros, while paying AEPAP’s related Fundación Pediatría y Salud (FPS in Spanish) close to twenty thousand euros, less than they paid AEP’s foundation the same year.

Although the AEPAP’s financial links seem to be smaller, at least from what can be deduced from the GSK and Pfizer reports, its lack of transparency is more than evident. The AEPAP annual report does not even mention their financial accounts or possible conflicts of interest, instead giving a breakdown of the organisation’s activities , even though, like the AEP, it has a code of ethics that addresses conflicts of interest. This opacity is also common in other European countries, such as Ireland, Italy, Poland, Portugal and Czechia, where national paediatric associations do not disclose the details of their financial ties with industry , according to a Civio-led European Data Journalism Network (EDJnet) investigation.

After a dozen requests, most of the paediatrics organisations consulted claim that they are not subject to transparency laws and are therefore not obliged to disclose their financial relations with the private sector. But there are exceptions: in Hungary, for example, the paediatric association confirms that it has received transfers from companies such as Pfizer, GSK and Biogia Kft. This is not the case in Slovakia, where the national paediatricians’ organisation denies that it has received funding from the pharmaceutical and food industries. The German Society of Pediatrics and Adolescent Medicine (DGKJ in German) states that its funding comes mainly from the membership fees of its more than 19,000 members, although it does receive a smaller amount from industry, mainly in the form of sponsorship for its conferences. The Professional Association of Paediatricians (BVKJ, in German) went one step further and provided EDJNet with a breakdown of the pharmaceutical companies, including Pfizer, Orphalan, GSK or Sanofi-Aventis, which spent more than 50,000 euros on the BVKJ’s seminars and conferences during 2022 and 2023.