Corporate actors have a role to play in policy, but their outsized influence on public health decision making must shift, and government actors must be held accountable for permitting playbook strategies [2, 3]. This shift can only be catalyzed by a system that includes incentives for upholding scientific integrity and firewalls that enforce principles of scientific integrity, promote transparency in policymaking, protect independent science, and punish behavior that undermines science for the public good (Table 1). These mechanisms must be consistently applied, enforced, audited, and—upon detecting new loopholes—updated.

To discourage conflicts of interest (COIs) in published research, journals, scientific societies, and academic institutions can develop and enforce strong scientific integrity and disclosure policies governing author, editor, and reviewer conflicts and funding sources. Requiring separation of industry funding and the research evaluating a product’s safety or harms is invaluable [19]. Many journals follow conflict disclosure guidelines established by the Committee on Publication Ethics and the International Committee of Journal and Medical Editors [20]. If journals discover undisclosed COIs, they can impose temporary bans on authorship or issue corrections, retractions, or letters of concern [21]. For transparency around sponsorship of clinical trials, registration on a publicly accessible database like ClinicalTrials.gov is a good start, but more must be done so researchers, journal editors, and the public can understand financial conflicts and hold researchers accountable [22].

To curb funding abuses that potentially endanger research integrity, institutions can establish firewalls between industry funders and researchers. Third-party intermediaries, like independent government agencies, can receive industry money and reallocate it to vetted researchers or organizations for conducting product testing. Some academic institutions have created systems to prevent commercial interests from unduly influencing research, including committees to manage COIs and enforcement mechanisms for ethics agreements [23]. Outside the US, some governments have launched initiatives to separate industry funding from product safety testing. For example, the Italian Medicines Agency taxes the pharmaceutical industry’s drug promotion to fund research on drug efficacy and safety [19].

To ensure the independence and integrity of science in policymaking, strong procedural firewalls can discourage inappropriate affiliations between scientific advice, stakeholder and public input, and political decisions. If real or perceived conflicts could threaten scientific integrity, decisionmakers can be recused from involvement. Candidates for political appointments, advisory committees, and other positions should be vetted, and those with direct ties to regulated industries should be excluded from consideration for regulatory roles. The US Office of Government and Ethics, which registers and tracks COIs, should also have the resources to conduct adequate monitoring and the power to work with agencies to penalize appointees for undisclosed conflicts or breaches in ethics agreements [24]. Additionally, federal agencies could require corporations to compete for regulatory compliance by setting standards for independent review of company-submitted data that affects public or environmental health. Unlike reviews by privately hired compliance entities with financial interest in giving favorable reports, peer reviews by independent organizations incentivizes transparency and accountability.

To ensure transparency of stakeholders' conflicts, stronger accountability requirements can reduce undue industry regulatory influence. Regulatory agencies’ visitor logs, meeting materials, and communications with stakeholders on policy issues can be made public. Further, groups or individuals who publicly comment, or otherwise contribute published scientific studies or unpublished data related to the health consequences of products or practices during the rulemaking phase can be required to disclose interests [25]. For example, the US Department of Labor requested that public commenters disclose funding sources for a 2013 rule to set workplace standards for silica [26]. And in 2017, the French government fined a scientist €50,000 for testifying on the costs of air pollution without disclosing that he was funded by an oil company [27].