Commercial determinants of health: The Lancet launches new journal

The Lancet journal launched a seminar for the launch of the new journal on the commercial determinants of health, which aims to understand the role of commercial actors on public health, and the solutions available to reduce the negative impact that these companies can have on human health.

Commercial determinants of health are defined as the systems and practices through which commercial actors influence levels of health and equity in a population. An interest in commercial determinants of health therefore involves seeking to understand the multifaceted and complex ways in which commercial actors, through their activities, can impact public health and health equity.

Public health and profit logic: the example of Covid-19

Public health and private sector interests can sometimes be competing interests, as highlighted in an open letter signed by more than 200 people including Ban Ki-moon, the former UN Secretary-General. Indeed, during the COVID-19 pandemic, the sale of vaccines and the profit motive of pharmaceutical companies selling vaccines and tests to the highest bidders have reinforced health inequalities between rich and poor populations, increasing the human toll of the pandemic by a million more deaths.

Understanding the health situation beyond individual responsibility

Similarly, the tobacco, alcohol, fossil fuel and processed food industries alone are responsible for at least a third of deaths worldwide. The development of non-communicable diseases, such as cancer or diabetes, is partly attributable to changes in the lifestyles of populations and changes in consumption, encouraged by the industries themselves. While large companies and private actors tend to position themselves solely from the point of view of individual responsibility, the notion of commercial determinants thus seeks to reverse the paradigm, by pointing out the responsibility of these actors. For example, the eight million deaths caused by smoking cannot be explained solely by individual behavior, but rather by the strategies deployed by manufacturers to encourage the consumption of their products, making smoking an industrial epidemic. Thus, lobbying practices or advertising strategies fall within this notion of commercial determinants.

A re-establishment of the economic model and modes of governance

The journal thus calls for a rethinking of social progress, the economy, the structuring of contemporary capitalism and the role of private actors. This transformation implies in particular the primacy of the general interest, environmental sustainability, human rights, health, as well as a profound change in governance methods, including among commercial actors, held responsible for health, environment and sustainable development objectives. The seminar recalled the need for the involvement of governments, international organizations, the world of research, and civil society. It is therefore up to commercial actors to modify their profit models at all costs, and to develop new methods of financing, new business model, respectful of the environment, of the fundamental needs of society and individuals, and concerned with proper compliance with regulations.

However, while some companies can have a very positive impact on health, and must be associated with this paradigm shift, the tobacco industry cannot be part of it, as the World Health Organization points out, which postulates the existence of a "fundamental and irreconcilable conflict between the interests of the tobacco industry and those of public health ".

FT