Aug 112015

Questionable honesty, poor organisation and planning, lack of transparency, a non-identity, lack of gravity and failure to grasp the scientific context have set the Coca Cola Company at odds with stakeholders it should be engaging. Poor planning and a confused understanding of current scientific belief has undermined the company’s attempts to legitimately engage in the world of wellness.

Coca Cola is attracting criticism for its ‘hands-off’ support of a new initiative the Global Energy Balance Network. Zero points for the name for a start. It sounds like something you’d be doing with your chakras under a mystical new age pyramid hat. But then Coke can’t be to blame for that in its hands-off role, can it? Can it..? What’s gone/going wrong here? Why has Coca Cola blundered into the minefield described here in the New York Times?

Probably, precisely because wellness is not its core business. In ethical healthcare where separation of education and promotion is well policed, this situation would not have arisen, certainly not in the developed markets. However, given the increasing desire of consumer brands to play in the unregulated wellness zone, the opportunities for miss-steps such as these are rife.

The first mistake Coca Cola appears to have made is in not realising that ‘hands-off’ means exactly that. That the company did not just gift or grant a contribution to setting up the GEBN, and in fact was materially involved in its registration gives critics ammunition to question Coke’s honesty

The group’s president, James O. Hill, a professor at the University of Colorado School of Medicine, said Coke had registered the website because the network’s members did not know how.

This is scarcely believable. That a body in receipt of a bucketful of start-up funding can’t hire an IT guy to do a task that takes about 15 minutes to understand and complete points to it being hopelessly under-resourced, badly planned and/or – more pertinently – not really serious about its declared aims.

Second, although the GEBN does now declare The Coca Cola Company’s ‘gift’ in the about us area, it seems there was a bit of an oversight initially… 

The group’s website also omitted mention of Coke’s backing until Dr. Yoni Freedhoff, an obesity expert at the University of Ottawa, wrote to the organization to inquire about its funding. Dr. Blair said this was an oversight that had been quickly corrected. “As soon as we discovered that we didn’t have not only Coca-Cola but other funding sources on the website, we put it on there,” Dr. Blair said. “Does that make us totally corrupt in everything we do?” 

Not necessarily, Dr Blair but it shows terrible project management, sounds a little murky and again points to poor organisation and planning (and your response could have been a little less defensive). But the real issue here is transparency, or lack of. And reference to ‘private philanthopists’ is not going to go unnoticed by critics, cranks and conspiracists in their attacks on the corporate machine.

Third, the name is terrible. The overall identity is poor. The website is minimalist – and not in a useful way, eg enabling accessibility – but in a done-quickly, done at home, WordPress kind of way. It doesn’t give the impression that this organisation is really serious or substantive. It looks token. In short it lacks gravity.

Fourth – and this is the crux – critically Coca Cola and/or the GEBN and/or the PR agency seem not to have properly appraised the volume of noise around the issues of sugar, weight, diet, obesity and diabetes, and have jumped in feet first seemingly looking to start a conversation, when in fact the conversation is already raging. They have overlooked the science and current context.

This paper alone would have given GEBN pause for thought. It reports  systematic reviews that reported financial conflicts of interest or sponsorship from food or drink companies were more likely to reach a conclusion of no positive association between sugar-sweetened beverage consumption and weight gain than reviews that reported having no conflicts of interest. Implication: ‘hands-off ‘should have absolutely meant hands-off. Because of start-up carelessness, the GEBN is irredeemably tainted.

This website, though unattributed (learnings for GEBN there), is obviously a vehicle for the UK’s sugar industry. A quick examination of this site by a competent healthcare communications agency with the aim of gaining contextual understanding for the desired positioning of GEBN, would have identified a whole host of worst practices not to be replicated, not least its completely unreferenced position statements.

A quick Google would have turned up the website for the Action On Sugar group. There is no need even to go beyond the home page to get a sense its veracity. It hits the reader with a faculty of over 20 obviously well connected academic faculty. This kind of immediate gravitas should have given the GEBN pause for thought before diving right on in with its very much more limited faculty.

A quick search to gain a perspective on how the issue of weight loss and exercise are communicated in the mainstream consumer context would have turned up plenty of content, eg here and here. Opinion clearly goes against the grain of the position the GEBN is purporting to hold. A quick summary of the kind of consumer guidance put out by the likes of the Harvard School of Public Health would have given a hint of the way the issues facing its industry are framed.

What to do?

It looks like Coke has set off on an unsustainable path with GEBN. For the reasons covered above the initiative looks flawed and doomed to failure. It looks to be very far from being a source of independent education, instead being a quite poorly disguised defensive promotional medium designed to build an alternative support for its product positioning. So far its social media outreach has certainly underwhelmed and failed to engage. The Coca Cola Company is not unused to reputational challenge and clearly invests heavily in an admirable CSR program, but this half-step into the world of health and wellness looks ill-advised, badly planned and poorly executed, flies in the face of mainstream medical opinion and would probably benefit from being aborted.


Earned media is just that. Ethical pharma knows this, when consumer players extend into health and wellness they have to understand there is no crossover with paid and owned. An unrestricted grant is quite literally what it says.

Honesty is inherent to earned media. Coca Cola’s hand in registering the GEBN may well have been carelessness but it raised doubts about degree of involvement, damaging the new body’s legitimacy.

Another mistake was the failure to declare Coca Cola’s link. Again, possibly carelessness, but a lack of transparency hands the legitimacy to your opponents asking the questions.

The identity of GEBN is weak, both in terms of appearance and in how the depth of the faculty compares to other bodies exercising a voice in the same space. It lacks gravitas and gravity.

The science and contextual understanding are absent. This points to both a failure to understand that the wellness space is inherently linked to the mainstream health care arena. A specialist health care communications agency would have built a foundation of the science and in this case recommended a far more carefully nuanced strategy.


Aug 042015

The constant knee-jerk response to the NHS’ perennial financial tribulations – more here – usually takes the form of a politicised barrage of criticism about how ‘Dave and his cronies’ are deliberately starving the health care system of cash in order to somehow force it into being rescued by a cabal of privateers crouched slavering in the wings waiting to pounce and bleed dry what is patently not a cash cow. Empirically this makes no sense, but it’s worth having a look at just how ‘cash-starved’ the NHS really is. Figure 1 below from independent think tank The King’s Fund shows UK spend vs a number of developed countries, including some – often cited by the political left as examples of progressive health care utopias – who are ahead in terms of overall expenditure. Indeed, those countries (excluding the US for its obvious outlier status) spend a maximum of about 15% more overall on health (not the 40-50% trotted out by the usual suspects). Nevertheless, 15% (or an additional 1-2% of GDP) is a very significant amount and would undoubtedly dig the NHS out of a hole, but where is that money coming from? The figure clearly shows that almost without exception (the exception being Norway, which can reap the rewards of decades of prudent investment of its oil revenues) all of those countries have a higher private component of health care expenditure. Indeed, if all private components were removed it would look as if the UK spends no less of its public money on health (in fact possibly on the contrary it might even spend more) than other developed states.

Private-public health care spending in OECD

Figure 1. Private-Public Health Care Spending in OECD (The King’s Fund)

Data published by The World Bank (see summary in Figure 2, and original data at bottom of this post) would indeed seem to support this viewpoint. While the data for % GDP health, and by implication health care spend per capita are lower in the UK vs other high income OECD countries, UK public spending on health is clearly shown to be higher. What else can explain this gap other than the under contribution of the private sector hinted at in Figure 1?

Back to Figure 1, and another way of interpreting this chart is to look at those countries that spend overall less than the UK but almost invariably have a higher private component. Of course we are told nothing here about health outcomes but I doubt that the populations of Korea or Ireland are significantly more sick than Britons. So, this could well be an indicator that a higher increased private health care expenditure component is an efficient way of driving down overall costs with no detriment to outcomes. But why let reasonable questioning stand in the way of ignorant apoplexy and a rational debate on the future of the NHS?

Health Care Spend World Bank Data

Figure 2. Health Care Spend World Bank Data



Data from World Bank


Data from World Bank


Data from World Bank
Jul 302015

Communication between groups of people is most effective when participants are engaged, and the discussion is both inclusive and collaborative. Creating an ethos of conversation, rather than a one-sided presentation, for critical discussions can better leverage the collective intelligence of the team, make solutions to organisational problems better and more comprehensive, and improve ownership for execution of ideas.

I wrote last year of the importance of being prepared to defend your pitch – ie approaching the meeting with a view to actively engage in a deliberately stimulated dialogue, rather than hitting and hoping an unbriefed audience with a battering-ram of a deck. This piece in the Harvard Business Review looks in more detail at how to effectively define the setting and content to generate a conversation. Of course there’s always the question of giving away your thinking before the meeting (although whoever has the deck ready before the morning of the day – and isn’t there always the assumption that no-one looks at it prior anyway?).

The HBR piece speaks to the importance of engaging with the client during the development process – and this is a challenge in itself with the increasing limitations on client contact during the increasingly regimented pitch processes. However, by setting out with the intention to deliver the pitch content ahead of time it should help structure the pitch development process to build in rather more time to reflect on the content than the time it takes to drive to client HQ. And by taking the time to really challenge the internal team on the anticipated questioning it should stand the pitch team in an ideal position to go beyond knowledge demonstration, taking advantage of a captive audience, and starting to build a relationship through the chemistry of conversation.


Create a Conversation, Not a Presentation

Jul 302015

Earlier this year, a report in the New England Journal of Medicine combed through, looking to see how quickly after completion trials were reported. It found that, after the legal maximum of a year was up, just 17% of those paid for by industry had had their results published. Drug firms were not, though, the worst offenders. Only 8.1% of trials paid for by the National Institutes of Health, the American government’s main conduit for medical-research money, were reported within a year. And just 5.7% of the ones paid for by other government agencies and academic institutions were (see chart). Moreover, even though the Food and Drug Administration (FDA), the agency which monitors the website, has the power to fine companies that do not comply, it has never actually done so. More here.

Delays in reporting clinical trials

Delays in reporting clinical trials

Jul 192015

Interesting to read that, oft-criticised in this respect, the health care industry is speeding up its embrace of social media.

While we are still in the early days of brands building their social media muscle, the strongest companies are putting in place the tools, processes, and people to unlock the wide range of value potential.

Health Care Playing Social Catch-Up

Health Care Playing Social Catch-Up

Jul 092015

Fifty-five percent of millennials who live with diabetes stated they would trust a health app over a health professional for advice. The same number stated they are connecting with their doctors more frequently because of health apps. The index findings reflect a striking knowledge gap among both the general public and those living with diabetes about the causes, impact, costs and treatment options for one of America’s most prevalent chronic diseases. While nearly one in 10 Americans (29.1 million) suffer from the disease, 57 percent of the U.S. population isn’t aware that diabetes can cause other major health issues, including heart disease.

Jul 062015

Screen Shot 2015-07-29 at 3.02.32 pm

The Millennium Development Goals Report 2015 finds that dire poverty has dropped sharply, and just as many girls as boys are now enrolled in primary schools around the world. Simple measures like installing bed nets have prevented some six million deaths from malaria. But nearly one billion people still defecate in the open, endangering the health of many others.

In fact, though, how much of those gains can be attributed to the goals is unknown. The sharp reductions in extreme poverty are due largely to the economic strides made China alone. Likewise, some of the biggest shortfalls can be attributed to a handful of countries that remain very far behind, in particular India, where an estimated 600 million people defecate in the open, heightening the risk of serious disease, especially for children.

Reducing Child Mortality

Reducing Child Mortality

The New York Times has a good report here.

Given that health is a key component of the MDGs, what can healthcare communicators read into these findings? Having worked extensively in the region (albeit moreso in China than India) and having developed communications programs in both markets, it is clear that from an organisational level China is streets ahead. And, the long-termism so evident there is in large part absent in India. The way pharma engages with stakeholders in both markets is quite different, with Indian strategy much more focused on traditional channels and being less invested in digital and social engagement. It would surely make sense for India to revisit its policies that so restrict multinationals from investing in the country and consider embracing partnership from the pharma sector.

Mar 302015

An interesting piece in the HBR to encore yesterday’s post…

We have become a society of specialists. Business thinkers point to “domain expertise” as an enduring source of advantage in today’s competitive environment. The logic is straightforward: learn more about your function, acquire “expert” status, and you’ll go further in your career.

But what if this approach is no longer valid? Corporations around the world have come to value expertise, and in so doing, have created a collection of individuals studying bark. There are many who have deeply studied its nooks, grooves, coloration, and texture. Few have developed the understanding that the bark is merely the outermost layer of a tree. Fewer still understand the tree is embedded in a forest.

Mar 292015

Frequently I’m contacted by recruiters casually sounding me out for names of likely candidates for their obviously hard to source positions. Fairly frequently I have agencies talk to me about starting an offering in Asia and likewise they want to understand the availability of talent on the ground or the unique qualities that might be called for to practice in the region.

First the proximate challenge, the ready availability of individuals with prior experience in Asia. It’s true that there simply aren’t many. The real reason though in my view are the blinkers that have recruiter and agency ring-fencing their candidates into subdivisions that make increasingly less sense in the real world. Health care is niche enough, without actively forcing disciplines apart.

Asia is increasingly driving the bottom line of global pharma, pharma are increasingly looking to establish themselves in the region, eg GSK Consumer’s move of its global marketing operations to Asia. Many new R&D centres have sprung up across the region over the last decade.

So with what looks to be on the surface at least a burgeoning sector, why the lack of an across-the-board spread of talent in the region. If we start by looking at the disciplines and their traditional descriptors and then pin then to an outcome-relevant framework we end up with the representation in Figure 1.

Figure 1. Integrated or Siloed?

In summary what this sets out is:

  1. Science builds the Foundation – This is the Diagnostic phase, understanding needs and gaps
  2. Creativity drives brand Recognition – This is about Exploring responses to proposed product positioning
  3. Connections create a web of BeliefConviction will follow dialogic engagement around a consistent message
  4. The economic Value story leads ultimately to commercial Success – Payers can hardly look beyond a Compelling proposition.

Siloing and hyper-specialization in any context, and as discussed in the linked piece – especially in science, diminishes effectiveness. The situation we have globally in the health care communications sector is akin to having four distinct silos with little crosstalk. In Asia Pacific in reality the situation is somewhat different given that regional and market-level work is mostly focussed on branding and PR. Figure 2 represents the state of play here. That the scientific aspects of market shaping are primarily managed globally, and health technology assessment is not yet critical to many emerging markets might explain the lack of available talent in these disciplines in the regions, but it doesn’t help with efficiently articulating a complete go to market story.

The amount of meaningful devolution to key emerging markets by pharma will ultimately shape the regional communications sector and talent availability in the region. But back to the question at the top, who’s actually struggling to hire if the sector in Asia doesn’t need full spectrum integration?

Put simply, it comes down to the big groups having a macro level perception of a pressing need for integration, which combined with any number of loose acquisitions and global networks (that are in reality so peripheral as to be in reality competitors) is seeing a knee-jerk response to get ahead of the curve. Instead of understanding the market and how they might better leverage their current regional capabilities they announce a sudden strategic imperative to ‘understand the science’ perhaps to potentiate opportunities in specialist pharma.

In the end all this achieves is a lot of over-extravagant resourcing briefs, for positions which – if they are filled – are likely to leave their new occupiers, in the absence of any realisable strategy, and any definitive uplift in client spend or strategic decision making authority, beating against an impossible wind.

Fragmented and Incomplete

Figure 2. Fragmented and Incomplete