Dean Jeffrey Flier began the May HMS Faculty Council meeting by introducing Joseph Loscalzo, head of the Department of Medicine at Brigham and Women’s Hospital and the Hersey professor of the theory and practice of physic, to present the recommendations of the Faculty of Medicine’s Committee on Conflicts of Interest and Commitment.

COI Policy Review

Loscalzo first described the conflicts-of-interest (COI) policy review process, saying that the committee was made up of 34 members, including faculty, students and academic and administrative deans. The group formed three subcommittees: research, implementation and compliance and education. The policy has also been reviewed by reaction groups. Topics considered during the review included financial interests (research, education and interactions with industry); conflicts of commitment; and compliance with policy and implementation challenges.

The key recommendations include establishing a central reporting system; engaging in public disclosure; prohibiting the receipt of gifts, meals and sponsorship of travel by industry; reconstituting the Standing Committee on COI for policy and issue review; providing education and training on the updated policy; and developing a monitoring program to assist with faculty education and compliance. The committee also proposes that service on for-profit boards of directors of biomedical companies be reviewed for potential conflict of interest and that faculty participation in industry speakers bureaus be prohibited.

The proposed policy recommendations would continue to allow for industry funding of continuing medical education (CME), but with limitations on the amount of funding allowed by any one company. In addition, advertising and exhibitions at CME courses may continue, provided the exhibitions take place in separate rooms from HMS and HSDM CME content, with separate entrances and exits from those used by course participants. Further, if industry provides programs not accredited by HMS and HSDM CME, they must be marketed separately from the Harvard program, and they must not be held in competing locations and times with any HMS or HSDM CME-accredited content. No co-promotion of HMS or HSDM content and industry content would be permitted.

The committee is also recommending the development of additional curricula for medical students to ensure education in critical decision-making.

With regard to clinical research, the committee recommends keeping the current restrictions on conducting clinical research if the faculty member has a financial interest in the business; reducing the current de minimis limit from $20,000 to $10,000 (in keeping with changes in broader national policies); narrowing the definition of “clinical research” to no longer include the most minimal risk research; and requiring a six-month washout period from financial interest before starting participation in a clinical research study.

With regard to basic research, the committee recommends maintaining the current policy that a faculty member cannot hold equity in a business that sponsors his or her research but that an exception can be added for projects supported by the Small Business Innovation Research Program or the Small Business Technology Transfer Program, which by definition would require faculty ownership.

Global Health Delivery

Dean Flier then introduced Paul Farmer, head of the HMS Department of Global Health and Social Medicine and the Maude and Lillian Presley professor of global health and social medicine, to speak on the topic of the research university and global health. Farmer defined the three “Ds” that lead to improved health outcomes—discovery, development and delivery—and focused his talk on delivery, which he described as one of the biggest challenges in global health.