Knock Knock, Who’s There?: The Revolving Door Between Big Pharma and the Government

By NWHN Communications Intern Negar Esfandiari

The first year of the Trump presidency has brought an almost endless slew of scandals, resignations, and exposés. It often feels like we’re watching reality TV, and sometimes it seems like we no longer even expect qualified government officials to ensure that women have the health care access and autonomy they deserve. We are committed to fighting back just as we  did recently with newly confirmed Secretary of Health and Human Services Alex Azar. 

Speaking of Azar, there’s something particularly insidious happening that heavily affects health policy. Azar first supervised the part of the government investigating pharmaceutical company Eli Lilly for criminal activity. Then he served as the company’s top lobbyist, helping to ensure that their fine was just a tiny fraction of the profits they’d made from their illegal activities. Now he’s running HHS, coming full circle through the “the revolving door” between the pharmaceutical industry and government. Meanwhile, Brenda Fitzgerald was forced to step down this week as head of the Centers for Disease Control and Prevention (CDC) after confirming that she traded tobacco stock while leading anti-smoking efforts on a national scale. Fitzgerald didn’t even receive an ethics training until two months into her term.

It is almost as if public health has been rigged to serve the corrupt interests of appointed officials.  

The industry’s infiltration of the government poses an alarming question: what credentials  and conflicts of interest do former industry employees have when they move to writing health policy for the government? The so-called revolving door provides easy access between these two worlds, and knowing how to navigate government loopholes creates more opportunity to weave in the interests of Big Pharma. On a grander scale, it’s a way to maximize future opportunities by working on behalf of those who could potentially fund them. It’s scary to think that these corporations could have a serious and biased influence over what drug-related legislation and health policy passes. 

And when former government employees make the move into the pharmaceutical industry, they have an upper hand as their sphere of influence now extends to both sides of the revolving door. Because of these deep ties between the two institutions—and chronic underfunding of the staff positions that could provide independent counsel—Congress heavily relies on the private sector, turning to lobbyists and consultants for advice about matters concerning key committees such as the House Energy and Commerce Committee, Senate Committee on Health, Labor and Pensions (HELP), and others. Even when Big Pharma’s involvement does not leave a clear paper trail of bill language, the surveillance and monitoring of the government makes this revolving door very dangerous.

Some Hill staffers still maintain their drug industry pensions and stocks, and unless they hold certain positions, they are not required to disclose these connections. We saw how well that went with Brenda Fitzgerald.  

We should feel confident in government officials’ ability to make safe, justified decisions on our health care without going through the crooked channels of the pharmaceutical industry. Outsourcing expertise to lobbyists just goes to show how little confidence these officials have in their ability to advocate for comprehensive health policy. Integrity may be the last thing we can expect from this administration, but we can’t stop demanding it. We must make it known that we will not stand for these underhanded, shady ways of controlling our health care. Our knowledge and information is one of the most powerful tools we have, and we will continue to harness that to fight back.