24 March 2023
Researchers from SPECTRUM have contributed to a new Lancet series, ‘People, profits, and health’, focused on the commercial determinants of health.
These relate to the ways in which businesses and business interests influence human and planetary health and equity.
Impact on health and inequities
Many commercial entities contribute positively to health and society, for example through the creation of jobs or products essential to health.
However, the products and practices of some companies – particularly the largest transnational corporations – are responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity.
For example, the products of just four industries – tobacco, fossil fuels, ultra-processed foods and alcohol – are responsible for at least a third of global deaths.
The Lancet series authors also identify a broader range of commercial practices beyond the production and promotion of harmful products that harm the health of people and the planet, and contribute to inequities across society.
Cycle of harm
The series authors describe the cycle of harm that can evolve from commercial activities.
Influential companies use their wealth and power to shape regulations and policies in their favour.
These favourable policies allow them to promote products that damage health, weaken standards that protect health, and restrict access to products and services essential to health by charging inflated prices. All this can damage human and planetary health, creating a cost burden.
Favourable policies also protect companies from this cost burden. Instead, these costs – for example, treating non-communicable diseases or clearing corporate waste – are largely met by the states and individuals affected. This reduces the resources available to pay for medicines, health care, food, and housing.
The result is that states become increasingly impoverished and health systems are increasingly unable to cope.
Significant change needed
The authors argue that significant, systemic change is needed, and offer policymakers and practitioners a toolbox to help them respond.
Some of these changes might include:
- Governments to legislate higher standards for marketing of harmful products, including via social media.
- Governments moving to ensure the corporations that are damaging our health and planet start to meet their true costs, including by ‘polluter pays’ approaches.
- Businesses to commit to stopping lobbying against pro-health policies, including using third parties such as fake grassroots (astroturf) organisations and think tanks to push political agendas.
- Improved rules on transparency and ways to address conflicts of interest in policy making.