The World Health Organization has released a new fact sheet on commercial determinants of health. The fact sheet covers six areas:
- How companies shape our physical and social environments,
- Commercial determinants drive inequities,
- Private sector influence,
- Addressing commercial determinants,
- Recovery planning, and
- WHO Response.
The WHO employs the following definition of commercial determinants of health:
Commercial determinants of health are the conditions, actions and omissions by corporate actors that affect health. Commercial determinants arise in the context of the provision of goods or services for payment and include commercial activities, as well as the environment in which commerce takes place. They can have beneficial or detrimental impacts on health.”
The private sector influences the social, physical and cultural environments through business actions and societal engagements; for example, supply chains, labour conditions, product design and packaging, research funding, lobbying, preference shaping and others.
An example for commercial determinants of health is company choices in the production, price-setting and aggressive marketing of products such as ultra-processed foods, tobacco, sugar-sweetened beverages and alcohol. These lead to non-communicable diseases such as hypertension, type 2 diabetes, certain cancers, cardiovascular disease and obesity.
Commercial determinants of health impact a wide range of health outcomes including obesity, diabetes, cardiovascular health, cancer, road traffic injuries, mental health and malaria.
Commercial determinants of health affect everyone, but young people are especially at risk, and unhealthy commodities worsen pre-existing economic, social and racial inequities. Certain countries and regions, such as small island states and low- and middle-income countries, face greater pressure from multinational actors.
There are effective public health actions to respond to these determinants, which are key to building back better after COVID-19. Examples of actions governments around the world are taking to address commercial determinants to improve public health include:
- Twenty-nine countries with 832 million people (12% of the world’s population) have passed a comprehensive ban on tobacco advertising;
- The United Kingdom has banned junk food advertising online and before 9:00pm on television from 2023;
- Around 50 countries, including France, Brunei Darussalam, Chile, Hungary, India and Ireland, among others, have charged a tax on sugary soft drinks;
- Saudi Arabia levied a tax on tobacco products, energy drinks and soft drinks in 2017;
- In Bulgaria, companies give women over 58 weeks of maternity leave on average, which is one of the highest in the world.
The WHO responds to commercial determinants of health by,
- Addressing the wider economic factors impacting on health and health equity through the WHO work-streams on trade and health, as well as health and development;
- Promoting the use of fiscal instruments, including (alcohol) taxation policies to invest in and improve health outcomes;
- Addressing private sector engagement through different streams of work, including through the Advisory Group on the Governance of the Private Sector for Universal Health Coverage and through programmatic and treaty approaches such as WHO Framework Convention on Tobacco Control; and
- Initiating a new WHO program of action, the Economic and Commercial Determinants of Health.
The brand new WHO program has four goals:
- to strengthen the evidence base;
- to develop tools and capacity to address the commercial determinants;
- to convene partnerships and dialogue; and
- to raise awareness and advocacy.