O'Neill Institute for National and Global Health Law, 500 First Street NW, Washington DC, 20001, USA.
Health Promot Int. 2021 Dec 13;36(Supplement_1):i39-i52. doi: 10.1093/heapro/daab143.
The tobacco, alcohol, beverage, processed food, firearms, gambling, fossil fuel and mining industries, inter alia, are implicated in fostering negative commercial determinants of health. They do this by shaping our environments, tastes, knowledge and politics in favour of the unlimited consumption and unencumbered promotion of their deadly and dangerous products. To shift the determinants of health, emphasis should be put on preventing industry actors whose profit lies in harming health from wielding influence over the institutions and actors of global and national governance. The tobacco control experience and the implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC) provide a unique, comprehensive and fully substantiated guide for how this may be done. Just as the tobacco industry was a pathfinder for other harmful industries in developing tactics for expanding the depth and reach of the market for their deadly products, the WHO FCTC experience is the obvious pathfinder for countering the commercial determinants of health across all sectors and industries. Although they are desirable for countering negative commercial determinants of health, the WHO FCTC's lesson is not that commercially driven epidemics must be tackled with legally binding treaties. Rather, given the challenges to treaty-making, the key lessons are those that show how it is possible to address the harms of other commodities, even in a treaty's absence. What is needed is the national implementation of measures providing for intersectoral governance and protection from industry interference which will then assist in unlocking measures for reducing the supply of and demand for unhealthy commodities.
烟草、酒精、饮料、加工食品、枪支、赌博、化石燃料和采矿业等,都涉及助长不利于健康的商业决定因素。它们通过塑造我们的环境、口味、知识和政治,来促进对其致命和危险产品的无限消费和不受限制的推广。为了改变健康决定因素,应重点防止那些将利润建立在损害健康基础上的行业参与者对全球和国家治理的机构和行为者施加影响。烟草控制经验和世界卫生组织烟草控制框架公约(WHO FCTC)的实施为如何做到这一点提供了独特、全面和充分证实的指南。正如烟草行业是其他有害行业在制定扩大其致命产品市场深度和广度的策略方面的先驱一样,WHO FCTC 经验显然是对抗所有部门和行业健康商业决定因素的先驱。虽然这些经验对于对抗不利的商业决定因素是可取的,但 WHO FCTC 的经验教训并不是说必须通过具有法律约束力的条约来应对商业驱动的流行病。相反,鉴于条约制定的挑战,关键的经验教训是展示如何在没有条约的情况下解决其他商品的危害。需要的是采取措施提供部门间治理和保护,防止行业干扰,这将有助于推动采取减少不健康商品供应和需求的措施。