Commercial determinants of noncommunicable diseases

Summary

This report from the WHO looks at the commercial determinants of noncommunicable diseases (NDC) across the WHO region of the EU. It covers how commercial interests contribute to NCDs linked to various products including processed food and alcohol. It also assesses the strategies these commercial actors use to negatively influence NCD-related policies at several levels of government. The report strongly calls for financial reforms and strict regulations to address the unequal distribution of power that benefits industry actors and negatively impacts public health. 

The report’s main goal is to explain the common practices which commercial actors use to influence national and international policy. The authors aim to encourage policy actors to acknowledge how this influence negatively impacts public health in the hopes of invigorating them to take action. 

The report covers a wide range of issues across thirteen chapters. It begins with conceptualising the commercial determinants of NCDs and focuses broadly on the common practices commercial actors use to influence policy. It explores marketing strategies which glamourize and normalise the use of unhealthy products such as processed foods and alcohol. This section includes a case study of industry opposition to the UK’s food marketing restrictions. It also assesses the impact of lobbying on public health policies related to NCDs with a case study on opposition to limits on sugary drinks. The report offers suggestions for regulatory actions and legal measures related to marketing and lobbying. 

The report also provides a section on how commercial actors cast doubt on research evidence to negate negative health effects of products. This includes funding industry-favourable research, spreading misinformation and undermining public health guidelines. A case study of how industry-funded youth education programmes distort evidence in the UK is used to illustrate these points. 

Additionally, the report explores how financial practices such as tax avoidance, profit shifting and tax havens deprive governments of revenues that are necessary for public health funding initiatives. Several case studies illustrate this point, including a look at how COVID-19 vaccine manufacturers used share buybacks to transfer profits to shareholders and pay lower tax rates. It calls for significant financial reforms and stricter regulations to guarantee commercial actors pay their fair share to support public health efforts. 

The final chapter of the report looks at how people’s voices and the actions of citizens and civil society can combat the commercial determination of NCDs. Case studies offer examples of effective civil society interventions like the role of the Women’s Council of the Kyrgyz Republic in supporting tobacco control legislation. It offers examples and support for the idea that people’s voices matter in these issues and that efforts to join up citizen activists groups and civil society organisations can have significant influence on policy.  

It concludes with a strong call to take seriously the influence commercial actors have on the number of deaths and illness related to unhealthy products such as tobacco, alcohol, and processed food. It provides several calls to action including efforts to identify corporate-funded research which creates misinformation on the use of these products and for governments to enforce the regulations that already exist to prevent the impacts of NCDs. 

Reference

WHO, 2024. Commercial determinants of noncommunicable diseases in the WHO European Region. Copenhagen, WHO Regional Office for Europe.

Read more here. See also the TABLE explainer What is ultra-processed food? And why do people disagree about its utility as a concept?