Rethinking conflict of interest: From individual to structural understandings

Across global and national levels, it seems clear there is a movement toward a greater focus on public–private partnerships. However, there is abundant evidence that commercial actors are driven by profit motives, be they in opposition or alignment to population health. It seems therefore of particular importance to advance a research and translational agenda surrounding the assessment of institutional conflicts of interest in order to best discern suitable partners and the best parameters for engagement in ways that do not jeopardize population health or shift harm from one population to another. This chapter examines different conceptions of conflict of interest and how such conceptions can inform different approaches to health governance. The chapter presents a threefold typology encompassing individual, institutional, and structural understandings.