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Confronted by compelling peer-reviewed scientific evidence of the harms of smoking, the tobacco industry, beginning in the 1950s, used sophisticated public relations approaches to undermine and distort the emerging science. The industry campaign worked to create a scientific controversy through a program that depended on the creation of industry–academic conflicts of interest. This strategy of producing scientific uncertainty undercut public health efforts and regulatory interventions designed to reduce the harms of smoking. A number of industries have subsequently followed this approach to disrupting normative science. Claims of scientific uncertainty and lack of proof also lead to the assertion of individual responsibility for industrially produced health risks.

In this article, I document strategies used by alcohol producers to influence national and global science and policy. Their strategies include producing scholarly publications with incomplete, distorted views of the science underlying alcohol policies; pressuring national and international governmental institutions; and encouraging collaboration of public health researchers with alcohol industry–funded organizations and researchers. I conclude with a call for an enhanced research agenda drawing on sources seldom used by public health research, more focused resourcing of global public health bodies such as the World Health Organization to counterbalance industry initiatives, development of technical assistance and other materials to assist countries with effective alcohol-control strategies, and further development of an ethical stance regarding collaboration with industries that profit from unhealthy consumption of their products.

Strong, evidence-based practice requires that objective, unbiased research be available to inform individual clinical decisions, systematic reviews, meta-analyses, and expert guideline recommendations. Industry has used seeding trials, publication planning, messaging, ghostwriting, and selective publication and reporting of trial outcomes to distort the medical literature and undermine clinical trial research by obscuring information relevant to patients and physicians. Policies that promote transparency in the clinical trial research process, through improved and expanded disclosure of investigator contributions and funding, comprehensive publicly available trial registration, and independent analysis of clinical trial data analysis may address these subversive practices by improving accountability among industry and investigators. Minimizing marketing's impact on clinical trial research and strengthening the science will protect medical literature's integrity and the public's health.

I have documented the shift in youth alcoholic beverage preference from beer to distilled spirits between 2001 and 2009. I have assessed the role of distilled spirits industry marketing strategies to promote this shift using the Smirnoff brand marketing campaign as a case example. I conclude with a discussion of the similarities in corporate tactics across consumer products with adverse public health impacts, the importance of studying corporate marketing and public relations practices, and the implications of those practices for public health.

Blockchain technology is a decentralized database that stores a registry of assets and transactions across a peer-to-peer computer network, which is secured through cryptography, and over time, its history gets locked in blocks of data that are cryptographically linked together and secured. So far, there have been use cases of this technology for cryptocurrencies, digital contracts, financial and public records, and property ownership. It is expected that future uses will expand into medicine, science, education, intellectual property, and supply chain management. Likely applications in the field of medicine could include electronic health records, health insurance, biomedical research, drug supply and procurement processes, and medical education. Utilization of blockchain is not without its weaknesses and currently, this technology is extremely immature and lacks public or even expert knowledge, making it hard to have a clear strategic vision of its true future potential. Presently, there are issues with scalability, security of smart contracts, and user adoption. Nevertheless, with capital investments into blockchain technology projected to reach US$400 million in 2019, health professionals and decision makers should be aware of the transformative potential that blockchain technology offers for healthcare organizations and medical practice.

Background It is unclear whether an ‘obesity survival paradox’ exists for pneumonia. Therefore, we conducted a meta-analysis to assess the associations between increased body mass index (BMI), pneumonia risk, and mortality risk. Methods Cohort studies were identified from the PubMed and Embase databases. Summary relative risks (RRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random effects model. Results Thirteen cohort studies on pneumonia risk (n = 1,536,623), and ten cohort studies on mortality (n = 1,375,482) were included. Overweight and obese individuals were significantly associated with an increased risk of pneumonia (RR = 1.33, 95% CI 1.04 to 1.71, P  = 0.02, I 2  = 87%). In the dose–response analysis, the estimated summary RR of pneumonia per 5 kg/m 2 increase in BMI was 1.04 (95% CI 1.01 to 1.07, P  = 0.01, I 2  = 84%). Inversely, overweight and obese subjects were significantly associated with reduced risk of pneumonia mortality (RR = 0.83, 95% CI 0.77 to 0.91, P  < 0.01, I 2  = 34%). The estimated summary RR of mortality per 5 kg/m 2 increase in BMI was 0.95 (95% CI 0.93 to 0.98, P  < 0.01, I 2  = 77%). Conclusions This meta-analysis suggests that an ‘obesity survival paradox’ exists for pneumonia. Because this meta-analysis is based on observational studies, more studies are required to confirm the results.

This study reviews aid flows to the health sector in Somalia over the period 2000-2006. In close collaboration with the Health Sector Committee of the Coordination of International Support to Somalis the authors collected quantitative and qualitative data from twenty-six international agencies operating in Somalia, including bilateral and multilateral donors.The paper reaches three main conclusions. First, aid financing to the health sector in Somalia has been constantly growing, reaching US 7-10 per capita in 2006. Although this is a considerable amount compared to other fragile states, it may still be insufficient to address the population’s needs and to meet the high operational costs to work in Somalia. Secondly, contributions to the health sector could and should be more strategic. The focus on some vertical programs (e.g. HIV/AIDS and malaria) seems to have diverted attention away from other important programs (e.g. immunization and reproductive health) and from basic health system needs (infrastructure, human resources, etc.). The third conclusion is that more analytical work on health financing is needed to drive policy decisions in Somalia. Similarly to other fragile states, quality information on health sector financing is scanty, thus affecting the policy making process negatively.

This study reviews: (1) how levels of donor financing of the health sector in Somalia varied over the decade 2000-09, (2) which health interventions were prioritized by donors, and (3) how evenly health sector aid was distributed to the different zones of Somalia. The overall aim of the study was to create evidence for donors, implementers, and health specialists involved in allocation of financial resources to the Somalia health sector. The results of the study are based on quantitative data collected from 38 Development Assistance Committee (DAC) donors and implementing agencies active in Somalia. Quantitative data were collected between March and May 2007 and in March 2010, with response rates of 96 and 95 percent, respectively. The report is organized in five chapters. Chapter one provides the background to the study, along with its aims and objectives, and contextualizes the study area, Somalia. Chapter two provides the conceptual framework for the research by looking at aid financing trends in developing countries, in the health sector, in fragile states, and in Somalia. Chapter three describes the methodology, the data collection process, types of data collected, and methodological limitations. Chapter four presents the quantitative findings in terms of total health sector aid financing, and expenditure by disease and by zone. Chapter five offers conclusions linked to the four primary study objectives and provides recommendations for future funding.