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In May 2007, the Instituto Carso de la Salud-now Instituto Carlos Slim de la Salud (ICSS)-was endowed with US$500 million to focus on priority health issues in Latin America, notably issues of 'globalisation and non-communicable diseases'. ICSS was soon criticised, however, on the grounds that its funding was derived from tobacco industry profits and that its founder Carlos Slim Hélu remained an active industry principal. Collaboration with ICSS was said to run counter to the WHO Framework Convention on Tobacco Control. The Institute's then Executive President Julio Frenk disputed these charges. This research employs an archive of tobacco industry documents triangulated with materials from commercial, media, regulatory and NGO sources to examine the financial relations between Slim and the tobacco industry. The paper analyses Slim's continuing service to the industry and role in ICSS. It demonstrates a prima facie conflict of interest between ICSS's health mission and its founder's involvement in cigarette manufacturing and marketing, reflected on ICSS's website as a resounding silence on issues of tobacco and health. It is concluded that the reliance of international health agencies upon the commercial sector requires more robust institutional policies to effectively regulate conflicts of interest.

Medical and health science schools occupy a prestigious place in U.S. society. When they express a position on tobacco use--either by action or silence--that expression is consequential. Recognizing this, the tobacco industry has worked to sustain and exploit relationships with academic health sciences institutions. Corporate contributions to medical research are more visible, but institutional investments in tobacco stocks are also crucial to these relationships. The American Medical Association divested (sold) its tobacco holdings in 1986, urging others to do the same. Yet, as late as 2004, at least five of the leading dozen medical schools have not divested, and those that have seem reluctant to publicize their actions. The authors use internal tobacco industry documents and secondary source material to describe and analyze Philip Morris's response to two cases of threatened academic divestment. In each case, the world's largest tobacco company succeeded in minimizing the impact of divestment activities--in the first, by muting the consequences of a divestment, and in the second, by convincing university decisionmakers to recommend against tobacco stock divestment. In addition to arguing that tobacco divestment would lead to other pressures or be ineffective, the company exploited university concerns about losing corporate research funding as a key element of its antidivestment strategy. If academic medical centers regard protection of the public's health as a primary mission, divestment from tobacco holdings is essential; profiting from tobacco either through investments or research funding undermines this mission. Silent divestment squanders opportunities for ethical leadership and public dialogue.