THE PERILS OF PARTNERSHIP: Industry Influence, Institutional Integrity, and Public Health


  • A novel critique of public-private partnerships and multistakeholder initiatives in public health.

  • The book draws on widely-accepted concepts: institutional integrity, separation of powers, and antitrust.

  • Marks argues the default should be arm's length relations between public health agencies and corporations.

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About the Book

Countless public health agencies are trying to solve our most intractable public health problems—among them, the obesity and opioid epidemics—by partnering with corporations responsible for creating or exacerbating those problems. We are told industry must be part of the solution. But is it time to challenge the partnership paradigm and the popular narratives that sustain it?

In The Perils of Partnership, Jonathan H. Marks argues that public-private partnerships and multi-stakeholder initiatives create “webs of influence” that undermine the integrity of public health agencies; distort public health research and policy; and reinforce the framing of public health problems and their solutions in ways that are least threatening to the commercial interests of corporate “partners.” We should expect multinational corporations to develop strategies of influence—but public bodies can and should develop counter-strategies to insulate themselves from corporate influence in all its forms. Marks reviews the norms that regulate public-public interactions (separation of powers) and private-private interactions (antitrust and competition law), and argues for an analogous set of norms to govern public-private interactions. He also offers a novel framework to help public bodies identify the systemic ethical implications of their current or proposed relationships with industry actors.

Marks makes a compelling case that the default public-private interaction should be at arm’s length: separation, not collaboration. He calls for a new paradigm that avoids the perils of corporate influence and more effectively protects and promotes public health. The Perils of Partnership is essential reading for public health officials and policymakers—but anyone interested in public health will recognize the urgency of this book.


“This is a beautifully written and powerfully argued account of a deeply corrupting pattern of influence that has emerged within too much of public life. Marks is uniquely positioned to understand the problem; this book carries that understanding to anyone troubled by the compromise we have allowed to emerge everywhere. He has given us a lens through which to see not just the academy, but institutions generally.” 

—LAWRENCE LESSIG, Roy L. Furman Professor of Law and Leadership, Harvard Law School

“Jonathan Marks is the go-to expert on the hazards of public-private partnerships. His account of the perils reads easily, is well referenced, is clear and to the point, and applies to partnerships with drug, food, and any other corporations. Anyone who cares about the ethical implications of such partnerships for public health will find this book invaluable.”

—MARION NESTLE, Paulette Goddard Emerita Professor of Nutrition, Food Studies, and Public Health, New York University

“At a time when traditional sector boundaries between news / entertainment, universities / for-profits, banking / investment, agriculture / chemical companies and hospital / drug companies are eroding, Jonathan Marks has written a compelling analysis of how partnerships between government agencies and corporations have imperiled the mission of public health. His multidisciplinary analysis explores the meaning and function of government agencies, and with philosophical sophistication establishes the moral justification for protecting the integrity of their social mandates against predatory private partnerships.”

—SHELDON KRIMSKY, Lenore Stern Professor of Humanities & Social Sciences, Tufts University