The fact that Alcohol and Tobacco use can make us sick is now well-known. However, it’s less known that only four industries are responsible for at least a third of all global deaths that could have been prevented. The industries include unhealthy processed foods and drinks, tobacco, alcohol, and fossil fuels. According to a series of recent reports in The Lancet, these industries collectively cause 19 million deaths each year.
This is because companies are putting profit before health. It’s not just about their products. Sugary drinks can cause obesity and cigarette cancer. Coal is also responsible for carbon emissions. In the name of economic freedom, large commercial companies around the world operate in a manner that hides their practices.
These transnational corporations are responsible for rapidly increasing sickness and mortality rates, disability, environmental damage, and growing social inequalities. The Lancet series describes “a pathological system” where a large group of commercial actors is increasingly able to harm others and make them pay for it. The Lancet series describes a “pathological system” in which a substantial group of commercial actors are increasingly able to cause harm and make others pay the costs.
If further harm is to be avoided, commercial actors will have to pay the real costs of the damage they cause. Commercial actors will be held accountable by governments. The public needs to have a say in how norms are reshaped, focusing on the rights to health and the obligation of governments to protect health.
Profit is the main reason for commercial activity. According to the logic of private industry, profit is more important than public health or well-being. The health effects of commercial activity can be positive. Most are harmful. These are called “commercial determinants” of health in public health.
Commercial practices that have these impacts can range from being legal to being illegal, obvious to subtle. These practices often overlap. Several commercial practices are harmful. Marketing, reputation management, and questioning of scientific evidence are the most obvious.
It is important because the public pays for this. They bear the global epidemic of noncommunicable diseases and the rapidly increasing climate emergency.
Marketing: Making people consume more
Commercial sectors use “dark marketing” to increase brand demand and product consumption. Fast food, ultra-processed foods (high in sugar, fat and salt), and other fast food dominate the advertising space of many countries. In South Africa, nearly half the ads seen by children or families are for ultra-processed foods and drinks.
The Lancet’s case study on Coca-Cola and its marketing of sugar-sweetened beverages in South Africa illustrates the impact that seemingly “normal” practices can have on health.
Coca-Cola, as well as other beverage companies, operate in South Africa amid alarming obesity rates. The obese Population is made up of 68% women, 31% men, and 13% children. Children aged 10-13 are consuming at least 2 servings of sugary beverages per day. South Africa is one of the 10 largest global Coca-Cola consumers.
The marketing practices of the company are aimed at poor South Africans, as they are seen as its main growth market. The company’s products can be found everywhere, from supermarkets to street vendors and even in remote rural areas. The branding is everywhere, from signs in schools and shops to TV ads, billboards and social media. Marketing has a profound impact on cultural norms. This is an aspect that is rarely discussed. It turns a deadly product into a desirable goal, much like the tobacco industries of decades ago.
Reputation Management: Covering Their Tracks
Brand loyalty is often a part of reputation management.
During the COVID-19 Pandemic, for example, big food companies distributed products that were unhealthy and had no nutritional value. Coca-Cola gave sugary drinks to Ghana. Krispy Kreme gave doughnuts to emergency workers from the US. South African Breweries claim to have recycled beer cans to make shields for healthcare workers.
Commercial interests try to influence policy so as to support harmful products and services. The sugar industry in South Africa, for example, successfully lobbied to reduce the proposed tax on sweetened drinks by half.
Philip Morris International (the world’s biggest tobacco company) has called for relaxed regulations regarding advertising of its “smokeless” products in South Africa, ahead of the new Control of Tobacco Products & Electronic Delivery Systems Bill.
In South Africa, the alcohol industry formed an Interest Group called Association for Responsible Alcohol Use to influence government policy.
Skewing Science
Commercial influences can be subtle, but they are still present. Bias is created when research is funded in a non-transparent manner. Many retail sectors try to manipulate scientific results in their favor or to hide or falsely report the results. Exxon Mobil, for instance, was found to have intentionally misled public opinion about the role of extractive industries in climate change by independent researchers.
Pharma companies use intellectual property rights to keep drug prices high. This reduces access to medicine. COVID-19 vaccinations are now affordable only for the richest countries. Two decades ago, the same thing happened with antiretroviral medications for HIV.
Tax avoidance, financial manipulation, and more
Multinational mining companies continue to cheat Africa of billions of dollars through underreporting of profits and lower taxes. Copper, for instance, is worth billions of dollars to transnational copper mining firms in Zambia. The country is estimated to lose US$3 billion a year in corporate taxes due to its tax avoidance. This represents more than 12.5% of Zambia’s entire GDP.
Some companies pollute the environment and exploit workers (for example, in the agricultural industry). These practices are harmful to human health and the environment, but they were once considered “normal.”
Look ahead
These “routine” methods of commercialization overlap and reinforce each other. Transnational corporations that have deep pockets are able to use them well in countries with weak regulations.
The costs of corporate harm are increasingly borne by individuals and their families as well as civil society and governments.
To change the system, concerted efforts will be required, such as an international convention. The change must be in the direction that prioritizes societal, environmental, health, and well-being. Health and equity will be at risk until this is addressed, causing economic damage and a decline in social development.
