Brussels, 12 June 2024
A pioneering report from the WHO Regional Office for Europe clearly outlines how certain powerful industries are causing ill health and premature deaths across Europe and Central Asia, including through their interference and influence on the prevention and control of non-communicable diseases (NCDs) such as cardiovascular disease, cancer and diabetes, and their risk factors – tobacco, alcohol, unhealthy diets and obesity. The report calls on governments to put mechanisms in place to identify conflicts of interest and protect public policies from industry interference.
Belgian Deputy Prime Minister and Minister of Social Welfare, Frank Vandenbroucke, launched the report at a day-long event in Brussels, organised by the Federal Public Service (FPS) Department of Health, Food Chain Safety and Environment, in collaboration with the WHO European Forum on Commercial Determinants of Non-Communicable Diseases.
The new report, “Commercial determinants of noncommunicable diseases in the WHO European Region”, reveals the various tactics employed by industry to maximize profits and undermine public health. These practices fuel inequalities and the incidence of cancer, cardiovascular disease, chronic respiratory diseases and diabetes, and pose a major obstacle to preventive policies. The report identifies actions for governments, academia and civil society to reduce the disproportionate influence of the commercial sector in the health policy sphere.
Unhealthy Products: The Big 4
Four corporate products – tobacco, ultra-processed foods, fossil fuels and alcohol – are responsible for 19 million deaths worldwide per year, 34% of all deaths. In Europe alone, these industries are responsible, in whole or in part, for 2.7 million deaths per year. The report explains how the consolidation of these and other sectors into a few powerful multinational corporations has given them considerable influence over the political and legal landscape in which they operate, enabling them to block public interest regulations that would affect their profit margins.
“Four industries are killing at least 7,000 people every day in our region. The same big commercial players are blocking regulations that would protect our populations from harmful products and marketing, and protect our health policies from industry interference,” said Dr Hans-Henri P. Kluge, WHO Regional Director for Europe. “Industry tactics include exploiting vulnerable populations through targeted marketing tactics, misleading consumers and making false claims about the benefits and environmental friendliness of their products. These tactics threaten public health gains from the past century and prevent countries from reaching their health goals. WHO/Europe will work with policymakers to strengthen tactics to protect our populations from and mitigate the impacts of harmful industries. Today we present clear evidence of harmful commercial practices and products and say: we must always put people before profits.”
Industry Playbook
The report clearly shows that commercial actors in diverse sectors, including fossil fuels, tobacco, alcohol, food and meat, engage in nearly identical practices to shape structures, policies and information environments. Their primary goals are to generate profits, maximize sales of their products and promote consumption. The pharmaceutical and medical device industries, in their own ways, are engaged in shaping public policy to favor their own products and profits. To this end, the big industries spend significant resources to oppose public interest regulation, shape scientific evidence and public debate, and externalize the costs of the damage they cause to people and the environment, thereby increasing the burden of NCDs.
This set of tactics, collectively known as the “industry playbook,” is designed to influence all systems – health, political, economic, media – for their own profit, resulting in significant health and societal harm. To date, measures by national governments and intergovernmental organizations have been insufficient to prevent or limit these harmful commercial practices.
Deceptive tactics
The report features a series of case studies that demonstrate how corporations’ broad and thorough grip on public policy and policymaking impacts all areas of people’s lives. The report describes how “big corporations” overtly and covertly delay, block and thwart NCD policies, such as tobacco control measures and mandatory health and nutrition labeling on food and alcohol products. In addition to tactics to obstruct health protection policies, the report also documents some of the industry’s harmful practices regarding disease control, such as unfair pricing and availability of cancer drugs and the promotion of unregulated and evidence-based screening tests. Common “industry playbook” tactics include everything from political lobbying, spreading misinformation and disinformation in the media, harmful financial practices and targeted marketing strategies aimed at children and adolescents.
Failure to regulate the industry’s harmful practices has allowed commercial power and influence to grow while public wealth and power eroded, perpetuating the industry-driven health burden, particularly of NCDs, which account for 90% of deaths in the European region.
“We really need to rethink,” said Minister Vandenbroucke. “For too long we have thought that risk factors were mainly related to individual choices. We need to reframe this issue as a systemic problem. Policies must combat the ‘environment of overconsumption’, limit marketing and stop meddling in policy-making.”
“Our current efforts are still not enough to regulate commercial actors’ harmful health practices, especially those of industry that harm health. I urge all newly elected MEPs and policymakers to recognise the scale of the problem and the far-reaching impact that industrial practices have on public health and our democratic process.”
The report calls on the 53 member states of the European region to address the major threat of NCDs by addressing the impact of commerce at all levels – individuals, the environment, public policy and political and economic systems – and by implementing stronger regulations in a range of areas, including:
the sale of products harmful to health, monopolistic practices, transparency, lobbying, funding and conflicts of interest, taxation of multinational corporations, job security and working conditions, exploitation of vulnerable groups in times of crisis, funding and support to ensure the independence of civil society organisations.
Furthermore, the report recommends that trade agreements that prioritize public health and more health-friendly interpretations of economic law are needed to ensure that public health does not continue to lose out to outdated and limited economic measures.
Some countries have achieved success despite strong industry opposition: in Estonia, a coalition of health care partners, including dentists, nurses and doctors, helped push for legislation on taxing sugary drinks; in Kyrgyzstan, the Women’s Council played a key support role in introducing tobacco control measures, while in Slovenia, mobilisation of national and international civil society organisations helped secure the passage of tobacco legislation. More needs to be done to help policy makers and public interest groups counter the power, resources and lobbying of industry.
Presenting the report, Dr Gauden Galea, Strategic Advisor to the Regional Director for Noncommunicable Diseases and Innovation at the WHO Regional Office for Europe, said: “The unscrupulous practices of big companies did not appear overnight, nor will they easily go away. This is a long-term effort that requires, first and foremost, political will. It is clear that the actions of big companies are having a negative impact on public health, creating unnecessary illness and suffering. The various case studies in the report show the scale of industry interference currently taking place in the region and that current mechanisms to prevent NCDs are completely unfit for purpose. Countries have to report their progress at the UN High-level Meeting on NCDs in September 2025, but time is running out. Every effort is needed – Member States, civil society, academia and international organizations – to uphold public policies and protect future generations from preventable chronic diseases.”
