Mary Moran, Inc.
Submitted by James Love on 19. May 2010 - 3:24
Dr. Mary Moran was a member of the WHO Expert Working Group on R&D financing. According to one WHO official, she was also hired by the World Health Organization to write key sections of the report, managed the selection criteria, ended up giving her own proposal the highest rating, and was asked by the WHO to address the May 13th consultations with WHO member states. Yesterday Dr. Moran approached me in part to ask that she not be identified as an employee of the George Institute. "I rent office space from the George Institute, I'm not an employee," she said. Mary said that she works for a for-profit firm that she owns.
Malini Aisola subsequently asked Dr. Moran if her for-profit consulting firm had pharmaceutical company clients. Dr. Moran declined to answer the question.
G-FINDER grant from Gates Foundation
According to the 2008 Gates Foundation's IRS Form 990, the grant to the George Institute for the G-FINDER project was $1.524 million. Its not clear from the 990 form how many years of activity are covered by this grant.
Dr Moran
Maybe she should ask George institute to amend their webpage accordingly
Mary Moran, Inc.
It is true that Dr Mary Moran is no longer a member of the George Institute, a not for profit NGO based in Australia. She now runs her own for profit firm called PharmaConsulting Inc. Since establishing the company she has been successful in shifting projects initially won by the George Institute to her private firm. Most recently, she has moved the Gates Foundation-funded GFINDER project from the Institute to her drug company consulting business. GFINDER is supposed to provide unbiased reports on global investment in R&D for neglected diseases. Gates clearly does not see any conflict of interest in having such reports produced by a for profit company with drug company clients. It will be interesting to see whether those who have freely provided the George Institute with information on their R&D investments will do the same for PharmaConsulting Inc.
Please Retract: Mary Moran, Inc.
Mary Moran is lead author on the G-FINDER report series, one upon which many of us working on illnesses affecting neglected populations rely. The above accusation against Dr. Moran's professional & academic integrity carries grave consequences, not only for Dr. Moran's own career, but for members of the community who make decisions and carry out advocacy and scholarship based upon her published works.
I oppose, in the strongest possible terms, the making of such an accusation in a public forum and ask you to please issue a public retraction and apology along with a clear substantiation of the basis upon which the above accusation was made.
Thank you,
Mike Gretes, PhD (Biochemistry)
Reply to Dr. Gretes
Dear Dr.Gretes. I'm not sure what to say. Mary approached me and Dr. Zafar Mirza of the WHO to say she works for a for-profit consulting firm, and does not want to be identified as working for the George Institution. Perhaps you would want to follow-up with her.
As for the part about her evaluating her own proposal for funding R&D, well, its hard to retract, since this is on the public record, and not really in dispute. She was hired by the WHO and used by the EWG to evaluate the proposals submitted to the EWG. The highest rated funding proposal was the Industry Research and Development Facilitation Fund (IRFF). This was a six page proposal she had written in 2005, and had never submitted in the EWG public review process. Indeed, on Monday evening she appeared at a Global Health Council event at the InterContinental Hotel with Novartis and IAVI to push a modified version called PDP+. She wears a lot of hats these days. Member of the EWG. Staff to the EWG. And spokesperson for the leading funding proposal endorsed by the EWG. I have no idea what her consulting business involves, or who her client are. Malini Aisola wrote to Dr. Moran on Tuesday of this week, asking her if she had clients in the pharmaceutical industry. Dr. Moran refused to reply. KEI did not allege she had pharmaceutical industry clients. We asked if she had clients. Given her role at the WHO these days, it seems like a reasonable question to ask. I assume that Dr. Moran will clarify this more this week, and we will be happy to report what she says, if she has something to say.
James Love, Director, KEI
Reply to James Love
Dear James,
While I'd be happy to learn more about the issues here, my concern with your initial post is not with the factual basis of the matters at hand, but rather the manner of their presentation. Specifically, the phrase:
"... she was also hired by the World Health Organization to write key sections of the report, managed the selection criteria, ended up giving her own proposal the highest rating..."
Rather than a dispassionate presentation of facts, the phrase above reads as an attack on Mary's credibility. What else, apart from "what we have here is a gaming of the system," is a reader being asked to conclude? Moreover, the post heading "Mary Moran, Inc." is easily interpreted as inflammatory, and readily suggests, when paired with the phrase above, Mary herself to be an unscrupulous money-making enterprise.
My response to your post was motivated by (a) respect for Mary's work (focus of study, findings & methodology) and (b) desire for respectful discourse surrounding authors' credibility. However, my larger concern is for the community of researchers and advocates that work to overcome the burden of disease on the world's neglected & marginalized people. This community is small. Too small. If we do not encourage respectful, constructive discourse at all times in public fora, we threaten to drive people from this community. Quite apart from damage to careers of individuals living in high-income countries, a diminished community will be weakened in its capacity to work in solidarity with the marginalized, neglected people we are in this game to fight for.
mg
Are conflicts of interest ever important enough to discuss?
Dear Michael Gretes,
Your enthusiastic evaluation of Mary's work is noted. Does this extend to the work she did for the EWG?
The phrase "what we have here is a gaming of the system" was your choice of words. You could certainly quote what I say, if you want a balanced discourse.
Mary did take a job to evaluate proposals, and then rated her own proposal for funding the highest of all. Is it impolite to point that out?
Do you know what the Industry Research and Development Facilitation Fund (IRFF) proposal involved? An 80 percent subsidy for outlays to for-profit firms, and a zero subsidy for outlays to non-profit firms. This highly rated proposal does not provide any details of the governance structure, except for a statement that it should be "outside government or international bureaucracies," and a half a sentence on the qualifications of an advisory board. Not only was I not impressed with this proposal, which lacked operational detail and any serious justification for providing such an open ended subsidy to the pharmaceutical industry, but I found it very surprising that it was the highest rated funding proposal by the EWG, and that she was the person doing the evaluation. I find it even more astonishing that Mary has repeatedly, including on May 13, and last week, justified killing off the proposals that the IFPMA lobbied against, on the grounds that they "scored poorly" and were not well thought out. Makes one wonder not only about the criteria, but also about the politics of the EWG.
If it is damaging to anyone's career to mention this, it is because the action itself invites criticism, not that I am willing to discuss it.
One issue that could be easily put to rest concerns the issue of the clients of her for-profit firm. I reported that Mary refused to answer a simple question about this from Malini Aisola. Since you have what seems like a good relationship with Mary, perhaps you could ask her to clarify the record on this point, unless you think such information would be unimportant.
James Love, Director, KEI
Parting remarks
Dear James,
In fact I do not know Mary personally; in any case I can offer no inside track on her affairs. I apologize if my "system gaming" remark seemed to put words in your mouth, that was certainly not my intention. I wished only to point out one possible, possibly unwanted interpretation of your initial post.
But I think this point has by now become well-worn; it seems we will have to agree to disagree on whether the initial remarks were appropriate or inappropriate for a public forum. I have nothing else to add to my response, nor any desire to engage further on this point.
Finally, while my issue was the way (to my eyes, at least) it seemed Mary was being negatively, personally characterized, and I did not intend to comment on the substance of or any criticism of her proposals, if your readers are interested in hearing Mary's own words she is quoted at modest length in an interview with Martin Enserink of Science Magazine:
http://news.sciencemag.org/scienceinsider/2010/05/another-global-health-...
mg
Parting remarks
Dear Michael,
You put quote marks around something I did not say, and some people might get confused by that sort of thing. In general, we are operating with the assumption some people will want to know about the interests of people who are evaluating proposals submitted to the WHO. Obviously other people would prefer that such issues not be discussed. The WHO EWG was quite a mess, it turns out, and not just for the reasons reported here. Mary will share part of the blame for the failures of the EWG, but there are plenty of others who contributed to the problems.
James Love, Director, KEI
Personal attack!
To Mr. Love:
Was Dr. Moran the only reviewer in this process? If so, that is a huge flaw on the part of the WHO as well. You should know however, that it is common practice that journal editors publish their own research in the journals they edit. This work is of course peer-reviewed by others as well.
My understanding is that Dr. Moran was one, among many reviewers in the WHO process, and you have repeatedly, only mentioned her name. Could you please clarify why no one else's name in that process is mentioned in your blog?
How much time did you give Dr. Moran to reply to Malini Aisola's question? Could you clarify?
And out of curiosity, could you please let me know where one can find information regarding specific proposals that the IFPMA lobbied against.
I understand that you clearly dislike for-profit systems. In terms of neglected diseases, for-profit systems are well-established entities that can provide rapid access to much needed treatment. Organisations such as DNDi have successfully worked with for-profit entities such as Sanofi-Aventis to deliver cheap medicines to those in need. I do not wish to defend the pharmaceutical industry in any way, however, if they can be used to benefit poor people in any way, I would use them because it would be much faster than setting everything up anew.
Your blog, unfortunately, is written in such a way, that leaves me to only read a personal attack on Dr. Moran and no one else. Mary Moran is one researcher only, and she certainly does not have the power to corrupt an entire system, as your blog seems to want its readers to believe.
Reply to Personal attack!
Dear Anonymous:
It is pretty clear that Dr. Moran played a special role in the EWG, but that said, I agree with you that others share the responsibility for what happened, or did not happen, in the EWG. For example, the decision to have Dr. Moran take the lead in the evaluation of her own proposal was one supported by the WHO, the Chair of the EWG and many of its members. For the record, the most controversial incentive mechanisms proposals in the EWG were based upon market incentives to influence for-profit firms. Maybe you should read more of the proposals before jumping to conclusions about what people "clearly dislike".
James Love, Director, KEI
Reply to anonymous author of the comment "Personal attack!"
Dear Anonymous. We do encourage people to sign their name to comments. With respect to your comments and questions, I can offer the following:
1. Your comment that "you clearly dislike for-profit systems" certainly is wrong as regards KEI and its staff. A large part of the work at KEI has been to explore incentive systems and business models that better align the interests of for-profit firms and consumers. The several Prize Fund proposals that KEI supports focus on new ways of using the market and the profit motive to stimulate investments in drug development. Doing something different is not the same as being against "for-profit systems." KEI is often critical of monopolies, and supportive of competition.
2. I asked Dr. Moran directly about whether she had clients in the pharmaceutical industry. During our exchange, I did not receive an answer despite repeating my question.
In June 2009, Dr. Moran wrote to the ip-health list, and reported that the Health Policy Division of the George Institute did not have private pharmaceutical clients, but also noted that:
3. I cannot comment in detail on the policies of academic journals. Regarding the WHO Expert Working Group (EWG), it is well established fact that Dr. Moran was very much involved in guiding its work on identifying and evaluating innovation financing mechanisms and that much of the Final Report was written/co-ordinated directly by her. Dr. Moran herself apparently received one or more contracts from the WHO for her work on the EWG. A large part of the work examining fund raising and innovation incentive mechanisms was contracted to the Health Policy Division of the George Institute under the oversight of Moran.
Note that Moran has not shied away from taking ownership and publicly defending the work product of the EWG:
http://www.scidev.net/en/editor-letters/who-group-championed-the-unconventional-as-well.html
http://lists.essential.org/pipermail/ip-health/2010-April/014834.html
Journals are increasingly requiring authors to comply with conflict of interest policies and to clearly state competing interests (see for example http://www.icmje.org/format.pdf). For instance, Moran (here referred to as MM) shared the following information in relevance to a February 2009 paper published in PLoS Medicine:
In contrast, her role in the WHO EWG did not seem constrained by conflict of interest scrutiny.
As explained above, she was the sponsor of the Industry Research and Development Facilitation Fund (IRFF), one of 3 PDP funding proposals (see http://keionline.org/node/751) recommended by the EWG. She also had a consulting relation with International AIDS Vaccine Initiative (IAVI), a group that received an unsolicited high rating for a proposal that was never formally submitted to the EWG.
Moran has since joined hands with proponents of the two other proposals, IAVI and Novartis to advocate for a super-PDP or PDP+ proposal that combines the elements of the 3 proposals into "something better." On Monday, May 17, still representing the George Institute and barely relieved of her duties as the EWG Report's chief architect, Moran was part of the official launch of the PDP+ proposal which she acknowledges was perhaps premature: "When we presented this in Geneva on Monday, it was probably a bit early. People were expecting a completed idea, but we just wanted to say, "Folks, there are the issues that we want your input on.""
4. For information about IFPMA's influence over the EWG and proposals it favored, I refer you to start by reading:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2962123-1/fulltext
http://www.nature.com/nm/journal/v16/n2/full/nm0210-133.html
http://scidev.net/en/news/harsh-criticism-for-who-s-drug-access-ideas.html
http://www.ip-watch.org/weblog/2010/05/18/developing-countries-blast-who-report-on-ip-demand-credible-approach/
http://keionline.org/node/718 and http://keionline.org/node/763
If you followed the 2010 WHA, you will notice that outrage and criticism emanating from Member States over the EWG's conclusions (and the ability of the pharmaceutical industry to assert its influence) and pressure from the public health community (http://www.ip-watch.org/weblog/2010/05/20/latest-chairs-draft-issued-on-...) forced lengthy consultations towards charting a new plan to meet the objectives initially entrusted to the failed EWG effort. KEI's statement on the very encouraging outcome of these discussions is available at http://www.keionline.org/node/847
You may not agree, but I believe that within the context of her participation on the WHO Expert Working Group on R&D Financing and the deciding role she played in recommending proposals that could determine the extent to which millions of patients in developing countries will receive access to the medicines they need, and given the disclosure this week that Dr. Moran was operating a for-profit consulting firm, it was appropriate to clarify if Dr. Moran has clients in the pharmaceutical industry. These are exactly the questions that academic journals ask these days, without the questions themselves being described as attacks.
Malini
KEI
Mary Moran, Inc.
Dear Dr Love
Your concerns about the activities of Mary Moran are well justified. She was the subject of a highly critical report in the French newspaper Le Monde on 17 Mai. A translated version can be accessed below. Concerns about influence of the drug industry and the Gates Foundation on EWG recommendations has thrown WHO into crisis with the recent revelation that it cannot vouch for the independence of its advisors (such as Moran). At last week's WHO meeting in Geneva, there was understandable furore among representatives of many developing countries.
Mary Moran's influence over the Gfinder project and its results now needs to be subject to similar scrutiny by developing country representatives. As she is now the owner of a for profit company servicing this important Gates-funded project, she must reveal who else she is receiving money from (particularly drug companies), so that her conflicts of interest can be transparently assessed. Similarly, she should declare the amount of profit she personally derives from the Gates grant, since this would also represent an important potential conflict-of-interest.
Yves Lacroix MD
Paris
http://translate.google.com.au/translate?hl=en&sl=fr&u=http://www.lemond...
Response from Mary Moran
Well, after originally being incensed and upset, I am now more amused by the busy to and fro of inaccurate comments on me and the lively conspiracy industry this has generated.
To clarify the status of my group. I am Director of a small independent research group that works only for public health clients on neglected disease policy for global health. We are hosted in larger institutions (the London School of Economics in 2004/2005 and now the George Institute) and conduct our work there.
Clarification on our status was provided to the WHO in July 2009 after a rash of false accusations that we were employed by an industry-funded group. I quote from that letter:
“In 2006, Dr Moran moved her Health Policy unit from the London School of Economics to The George Institute for International Health. Dr Moran and her unit receive no funding or subsidies from the Institute or from other Institute funding sources and are established as a separate, self funded unit. The Institute does provide accommodation and support services to Dr Moran’s team of staff. Under this arrangement Dr Moran has the use of offices, meeting rooms and support services, and pays a fee to cover the cost of these services and infrastructure.
The unit’s revenues arise exclusively from entities such as UN agencies, The World Bank, the Wellcome Trust and the Bill & Melinda Gates Foundation. In the absence of other funding streams, the Health Policy unit is therefore entirely reliant on its ability to secure research contracts based on its reputation for independent, rigorous, quality research. The George Institute has no policies that impact on the Health Policy unit’s research, and is not involved in Dr Moran’s role as a member of the Expert Working Group.”
Do we have industry clients? No. We work only for public health clients. We have NEVER received industry funding. We have NEVER had industry clients.
Are we for profit? Some projects are conducted for profit, some at cost, and some at a loss if they involve a global health issue that we think is important and neglected. Our motivation is to work on projects that we think will have the greatest global health impact, irrespective of whether they are funded or not.
Why are we hosted rather than being stand-alone? Many donors are reluctant to provide grants to smaller independent groups and require that we be hosted in a larger institution as a condition of our receiving project grants.
Why do we have the name of LSE or the George Institute on our reports if we are not employed by them? This is a requirement of the host institutions. These require that we adhere to their policies, including publishing under their name all materials developed during the hosting arrangement. They also have final say on the public perception of our position within their organization, including our name. At the LSE, we were called the Pharmaceutical R&D Policy Project; at the George Institute we were called the Health Policy Division. These decisions are largely out of our control as they are a condition of hosting.
For M. Yves… Le Monde have already been contacted with the correct information and asked to print a retraction (one of their journalists subsequently advised that they used KEI as a source – perhaps explaining the errors in their report).
Thank you to those who sent in supportive comments. I will leave this website to others …
Mary Moran
Le Monde
Dear Dr. Moran,
What should Le Monde retract? And what did we say to Le Monde that would have required a retraction?
James Love, Director, KEI
Le Monde Reply Awaited
Dear Dr. Moran
I am interested in the answer to this question also...an answer would be appreciated at your convenience.