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Angela_Macario

Bold new series in The Lancet calls for urgent coordinated action to prioritise health over profit

28th March 2023

Global health journal The Lancet published on 23 March a three-paper series being heralded by many as ground-breaking. People, profits, and health shines a scorching light on the impact of some business practices on human and planetary health and calls for urgent action to combat the commercial determinants that are driving the global NCD epidemic, poverty, and environmental and social destruction.

The third and final paper leaves readers with an unsettling conclusion: “...the question is not whether the world has the resources or will to take such actions, but whether humanity can survive if we fail to make this effort.”

Professor Rob Moodie, series convenor and Professor of Public Health Melbourne School of Population and Global Health at the University of Melbourne, says that we are at a crunch point in history, and now is the time for transformative change to create a healthier and more sustainable world. He and other series authors highlight the harmful practices that some industries and companies employ - like creating fake grassroots organisations and think tanks to help push their agendas through lobbying, and threatening opponents who aim to reduce profits in the defence of population health - but they also illustrate a more ethical alternative in which business co-exists alongside health, without harming it.

“This series isn’t anti-business, it’s pro-health. It’s important that we acknowledge that many businesses play vital roles in society, but we also need to recognise the practices and products of some are making people and the environment sick,” said Moodie. “With the rise of non-communicable diseases such as heart disease, cancer and diabetes and the escalating climate crisis, urgent action is needed to address the way businesses contribute to these problems, and in particular, industries that sell harmful products.”

The series develops a conceptual model of the commercial determinants of health that provides a simple means of understanding this complex issue. It highlights that industries that produce tobacco, alcohol, highly processed foods, and fossil fuels are responsible for over a third of preventable global deaths each year. At the same time, it recognises that these are not the only industries that are making negative contributions to human and planetary health and equity, including many others that are often overlooked, such as real estate and social media.

The model goes beyond definition and explanation, also offering an action agenda to guide a way forward. It calls for transformative change involving all areas of society and a mobilised population. It also calls for a governance system that prioritises public interests over profits, and challenges contemporary capitalism to increase compatibility with health and equity.

“The papers outline the solutions, showing that governments have the responsibility to develop policies that benefit the public interest of all rather than the commercial interests of a few. They also make clear that civil society must call for that change,” says Liz Arnanz, Policy & Advocacy Manager at NCD Alliance.

The series demonstrates that in order to achieve a healthier world and reduce inequality, governments across the world need to prioritise systems and policies that will bring about a global rebalancing of power. These include:

  • Adopting wellbeing economies and governance approaches that prioritise the health of people and planet
  • Higher standards for marketing of harmful products, including honest product labelling and protections for people from predatory marketing tactics including via social media
  • Policies that provide secure funding for preventive health and the whole health system, discourage harmful product consumption, reduce wealth inequalities, and ensure corporations are accountable for the full health, social and environmental costs of their activities.

“Achieving the change that the series is calling for will require regulating health-harming industries by monitoring and preventing their interference in policy making, but also by reshaping wider system forces such as our economic models in public interest,” says Arnanz.

The People, profits, and health series will be officially launched at a webinar on Tuesday 28 March. Register to join Richard Horton, Editor-in-Chief of The Lancet, and Selina Namchee Lo, Consulting Editor at The Lancet, along with a panel of authors and civil society and business leads, as they discuss the commercial sector's impact on health and its future role in global health and health equity. Discussions will be followed by a live Q&A session with the audience.

You can access the full series here or see the series infographic here.