Although commercial entities can contribute positively to health and society there
is growing evidence that the products and practices of some commercial actors notably
the largest transnational corporations are responsible for escalating rates of avoidable
ill health, planetary damage, and social and health inequity; these problems are increasingly
referred to as the commercial determinants of health. The climate emergency, the non-communicable
disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed
food, fossil fuel, and alcohol) already account for at least a third of global deaths
illustrate the scale and huge economic cost of the problem.
This paper is about the future role of the commercial sector in global health and
health equity. The discussion is not about the overthrow of capitalism nor a full-throated
embrace of corporate partnerships. No single solution can eradicate the harms from
the commercial determinants of health the business models, practices, and products
of market actors that damage health equity and human and planetary health and wellbeing.
But evidence shows that progressive economic models, international frameworks, government
regulation, compliance mechanisms for commercial entities, regenerative business types
and models that incorporate health, social, and environmental goals, and strategic
civil society mobilisation together offer possibilities of systemic, transformative
change, reduce those harms arising from commercial forces, and foster human and planetary
wellbeing.