Is your government under the influence of the makers of so-called ‘unhealthy commodities’ — alcohol, tobacco and junk food?

New research ranks France as the #1 country at keeping industry at bay when it makes policies to regulate these items, followed by Belgium, Lithuania and Estonia. Rounding out the top 10 are Germany, South Korea, Czech Republic, Norway, Finland and Costa Rica.

These countries lead what the authors of the study call the Corporate Financial Influence Index (CFII). It is based on six ways that governments protect policy-making from manufacturers, or at least make the process transparent. These include mandatory disclosure of donations to national election campaigns, a ban on political donations from domestic or foreign interests, and oversight of officials suspected of unconstitutional, illegal, or unethical activity.

Overt and covert activity

The CFII, which builds on indexes already compiled by the World Bank and other academics, is an imperfect tool, admits study co-author Luke Allen from the London School of Hygiene and Tropical Medicine. “For example, if I was Mr Coca-Cola and Nepal was talking about taxing sugar-sweetened beverages, I would want to undermine that policy being implemented and I would leverage all the power available to me. Some of that would be overt — putting adverts in newspapers and lobbying politicians — and some of that would be covert — paying money and inviting people to go on holidays at my expense. We’re restricted in that we can only look at publicly available information.”

After analysing data from 172 countries, researchers concluded that for every 10% increase in corporate influence, policy implementation fell 2.2%, explains Allen in a Zoom interview. Although the research wasn’t designed to conclude exactly how much influence occurs in each country, “we can be confident that in countries where corporations find it easier to influence policy makers, implementation scores are lower,” he adds.

The study, published in the journal Social Science & Medicine in March 2022, was authored by Allen and researchers from Bilkent University in Turkey and Karolinaka Institute in Sweden.

It also ranked countries’ performance at adopting 12 of the 16 measures that the World Health Organization (WHO) calls the ‘best buys’ for preventing and controlling noncommunicable diseases (NCDs). Also known as chronic diseases, NCDs are responsible for 74% of all deaths worldwide, making them the number one cause of death and disability.

Turkey is best at policy implementation

Topping the researchers’ list of policy implementing countries are Turkey, UK, Norway and Iran, followed by Senegal, Saint Lucia, Italy, Indonesia, Finland, and Brazil.

Overall, countries are slowly buying into best buy policies, the study shows. “The average country had fully or partially implemented 5.8 (52.3%) of policies in 2015, 6.5 (59.4%) in 2017, and 6.6 (59.6%) in 2020.” But Allen notes that the world is still not on track to meet UN Sustainable Development Goal 3.4 — to reduce premature mortality from NCDs by one-third by 2030.

He says one of the main takeaways of the research is “if corporate influence is related to about a fifth of reaching your (SDG) target, we should probably be doing a lot more to think about how we can carefully be looking in each country at the activities of corporations as they try to undermine or forestall effective legislation.”

For example, a recent WHO study found that marketing of breast-milk substitutes continues to grow despite the passing of an international code in 1981 to regulate the practice.

That countries are off-track to meet the SDG target is echoed in the just-released WHO NCDs Progress Monitor. It finds that simple and effective tactics to prevent and treat NCDs are not being adopted widely enough around the world.

Covid-19 opportunity 'squandered'

Allen says that it looked like the Covid-19 pandemic could be an opportunity to make progress fighting NCDs, as government intervention to save lives became generally more acceptable. Public health issues were also making headlines daily and the public’s health literacy rose. “Countries did use that as an opportunity to talk about NCD policy… In the UK the prime minister got Covid, like many other world leaders, and was saying ‘my obesity was a risk factor’.”

But at the same time, “corporations really stepped up their games in terms of marketing and sales and people’s habits have changed — they’re consuming a lot more bad stuff at home. Governments have kind of given up, particularly in the western world … I felt like it was a squandered opportunity,” Allen says.

While governments are slowly increasing their investment in best buys overall, the study shows that they are not tightening alcohol policies. “I don’t really know what’s happening there,” says Allen. “It seems to be widespread across all regions — not major policy reversals but just this slipping away from full to partial implementation of policies.”

In a recent article about corporate lobbying during Covid-19 the alcohol industry was found to be one of the most successful at influencing policy. But as the NGO Movendi noted, such efforts pre-date the pandemic: “The alcohol industry world-wide has a long history of aggressively lobbying against alcohol tax increases as a public health strategy while calling for lower taxes on its products.”