The Canadian government should fund and maintain an accessible website to make pharmaceutical companies’ payments to physicians and patient groups transparent. But the government encourages these funding relationships and helps obscure their nature and extent. Furthermore, the industry’s relationships with public sector actors permeate the healthcare system creating webs of influence; a disclosure system should capture this complexity. While other high-income countries have implemented transparency requirements, their efforts sometimes resemble defensive responses to scandals. In this response to Lexchin, I discuss webs of public-private partnerships as barriers to public accountability in our health system and strategies for dismantling them.

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