Commercial Determinants of Noncommunicable Diseases in the WHO European Region

Commercial Determinants of Noncommunicable Diseases in the WHO European Region - June 2024

By World Health Organisation (WHO)
View webpage WHO with link to report

This very relevant report highlights the substantial impact of commercial determinants on noncommunicable diseases (‎NCDs)‎ in the WHO European Region. Nearly 7500 deaths per day in the Region are attributed to commercial determinants, such as tobacco, alcohol, processed food, fossil fuels and occupational practices. These commercial products and practices contribute to 25% of all deaths in Europe.

In this report, the WHO:

• describes how commercial interests exacerbate Non Communicable Diseases (NCDs), such as heart disease, cancer, chronic respiratory disease, and diabetes;
• describes key strategies used by commercial actors to negatively influence NCD-related policies at the national and international level;
• calls for urgent and coordinated action to address the commercial determinants of NCDs;
  • it advocates for building coalitions based on the values of equity, sustainability, and resilience;
  • public health actors are urged to develop competencies in economic and legal frameworks, enforce transparency, and manage conflicts of interest effectively;
• underscores the need for robust financial reforms and strict regulation to curb industry power and protect public health.

Highlights for fossil fuel advertising

Regulating the marketing of harmful products (and industry opposition)
In chapter 2 'Marketing strategies increase exposure to NCD risk factors and negatively affect NCD care', the WHO states: "Regulating the marketing of harmful products and brands is a crucial response to safeguarding public health from commercial interests. Specifically, children and vulnerable populations need to be protected from exposure to the marketing of harmful products and brands. Many international organizations, including WHO, advocate for regulatory measures to protect populations, particularly children, young people and vulnerable groups, from the adverse health consequences of marketing practices by large corporations that manufacture or promote products that are harmful to health."

The WHO also lists major barriers to the adoption and implementation of legal measures to protect the public from harmful marketing: the powerful opposition by commercial industries. Although the WHO doesn't mention fossil fuel advertising in this chapter, most applies to fossil fuel marketing as well.

Casting doubt
In chapter 6 'Casting doubt on evidence: manipulating research evidence related to NCD causes, prevention and management', the WHO describes how the four industries (tobacco, alcohol, processed food and the fossil fuel industry) have bought their influence in science to cast doubt on the harm of their products and industries.

Corporate Social Responsibility (CSR)
In chapter 7 'Corporate social responsibility and its negative impacts' the WHO writes about child marketing by the fossil fuel industry: "The gambling, alcohol, firearms and fossil fuel industries deploy similar child and youth-oriented programmes as part of their CSR practices." Also, it describes that the fossil fuel industry (and the other industries) took advantage of the COVID-19 crisis in their CSR strategy.

Fragments from the text

"Corporate Social Responsability (CSR) is based on the principle that corporations should not simply pursue profit, but also have social and other responsibilities to wider society."

"However, in the case of
industries whose products and practices are health-harming or environmentally destructive, their engagement in CSR is not simply philanthropic or altruistic but plays several important strategic roles. These include
defending the industry against criticism; deflecting attention from the harm caused by their practices and
products; presenting the industry as part of the solution and not the problem; and, ultimately, preventing policy-makers from regulating their practices. "

"A comparative analysis of the CSR campaigns of the soda and tobacco industries provides important insights into their commercial purposes. The study found that such campaigns arose because of increasing pressure on these industries and policy-makers were becoming more aware of the harmful nature of these products. As a result, these industries were faced with a mounting threat of stronger regulations. In response, the industries sought ways to improve their corporate and product images to prevent legal and regulatory action that might harm future revenue in direct or indirect ways."

"Sometimes such commercial actors explicitly acknowledge that the purpose of their CSR programmes is to
help avoid regulation unfavourable to their business interests. The programmes also have a range of other  effects, including helping to build brand loyalty among children and young people, spreading misinformation about the negative health effects of products, and normalizing product use."

"An analysis of tobacco industry internal documents summarized the purposes of industry-funded youth
smoking prevention programmes:
…to serve the industry’s political needs by preventing effective tobacco control legislation, marginalizing public health advocates, preserving the industry’s access to youth, creating allies within policymaking and regulatory bodies, diffusing opposition from parents and educators, bolstering industry
credibility, and preserving the industry’s influence with policymakers."

"The role of CSR in manipulating and undermining policy is well-documented across different industries. One of its purposes is policy
substitution, where CSR, including voluntary self-regulation, is used to prevent or delay the implementation of effective public health policies, such as the regulation of marketing. For example, when opposing the WHO FCTC restrictions on marketing, the tobacco industry saw youth access schemes as a way to ‘‘make a significant gesture that would divert attention from the FCTC, moderate the WHO’s moves toward the FCTC, and bring the tobacco companies together against the FCTC’’"