Health-harming products cause illness, suffering and death among many people. Better regulation is needed for production and sales.

Text: Dietmar Schobel

An estimated 2.7 million deaths, and therefore around a quarter of all mortality in the European Region of the World Health Organization (WHO) every year, are attributed to only four commercial products. These are alcohol, tobacco, processed food and beverages, and fossil fuels, which can trigger noncommunicable diseases such as cardiovascular diseases, cancer, chronic respiratory diseases and diabetes, among other illnesses.

These shocking figures have been published in a recent report by the WHO Regional Office for Europe. Presented in June 2024, it focusses on the “Commercial determinants of noncommunicable diseases” and provides an overview of all important products that are detrimental to health. The document also points out that health-harming industries “not only cause death and disability but also widen health inequities”. After all, “socially and economically vulnerable populations are at a higher risk of death and disability” from preventable diseases arising from consuming these products than the general population.

Effective measures

“Effective measures must be taken to improve this situation across all populations and also to restrict the availability of unhealthy products,” explains Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine. The public are paying the price, in their money and their health, of the vast profits made by those who manufacture these deadly products. Besides higher tax rates on health-harming products, not to raise money but to drive reformulation or shifts to healthy alternatives, these measures could also include subsidies for healthy food such as fresh fruit and vegetables. Legislation that reduces the availability and marketing of unhealthy products is also needed, as are clear labels that enable people to quickly recognise the potential risk to health. Mandatory specifications for healthier forms of processing and product composition can make an important contribution as well.

Effective measures must restrict the availability of unhealthy products.

MARTIN MCKEE, PROFESSOR AT THE LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE

This may all sound simple in theory, but in practice these measures face fierce opposition from major multinational corporations. Big Tobacco, Big Oil, Big Food and Big Pharma throw all their weight and financial power behind maximising their profits through lobbying and marketing. Above all, this involves as far as possible preventing or at least watering down or delaying all government measures aimed at reducing the sales of health-harming products.

The playbooks are often similar

Despite the fact that these products are very different in their design, the playbooks of the global corporations are often very similar. They also include withholding studies on the relationship between their products and the health risks, or deliberately misleading the general public. Tobacco companies that have disputed the damage to health incurred by smoking are one example here, and a similar approach has been adopted by energy giants Exxon, Chevron, Shell and BP. According to German news magazine “Der Spiegel”, the managers of these latter companies received detailed information about the greenhouse effect and its consequences back in the 1980s.

The aforementioned WHO report also contains many case studies that provide a detailed analysis and illustration of how the industries work. One of these studies addresses higher taxes on sugar-sweetened beverages, which play a major role in the global rise in overweight and obesity. Mexico decided to introduce such a tax in 2014, and there has been huge interest in similar measures across Europe ever since.

However, industry lobbyists insist that this is not evidence-based, effective, or necessary – and they issue false warnings of negative impacts on employment, the economy and vulnerable populations. The false claim that tax on sugar-sweetened beverages is incompatible with national and supranational law, and typically unsuccessful threats of legal action, are other strategies commonly employed. By June 2022, only one third of the 53 countries in the WHO European Region had implemented higher taxes on sugar-sweetened beverages. According to the WHO report, Norway repealed its “long-standing excise tax on sweetened soft drinks” in 2021, although as Martin McKee notes, “the similar tax in the UK has been linked to reduced sugar consumption, lower rates of childhood obesity, and better dental health”.

A good example

According to public health experts interviewed by Healthy Europe, the measures taken to reduce tobacco consumption in many countries over the past years and decades are an example of how the influence of harmful commercial determinants of health can be successfully reduced. Besides higher taxes and health warnings on tobacco products, these measures also particularly include a ban on marketing and advertising, and on consumption in public places. The Framework Convention on Tobacco Control passed in 2003 by the World Health Organization was an important springboard here, and it is now legally binding in 182 ratifying countries. “Since then, it has been possible to lower the number of smokers from 60 or 65 percent to under 20 percent in many countries,” emphasises Martin McKee, while noting “that there is still much to do”.

The profits benefit just a few, while the costs have to be borne by the community.

CAROLINE COSTONGS, DIRECTOR OF EUROHEALTHNET

Nevertheless, tobacco consumption still remains one of the biggest global health problems, and in recent years new health-harming products have been launched on the market. These electronic nicotine delivery systems and smokeless tobacco products are highly popular above all with young people, even though there is growing evidence that they are as harmful as cigarettes, at least for heart disease. EuroHealthNet is a partnership of public health bodies in Europe which works at EU level in Brussels to reduce health inequalities and limit the production and sales of products that are detrimental to health. Director Caroline Costongs remarks: “The European Beating Cancer Plan aims for a ‘tobacco free generation’, but its legislative proposals face significant delays. Existing tobacco legislation needs to be revised to include vapes and other nicotine-based products. EuroHealthNet calls on the new European Commission to consider the impact of industry influence in all its aspects, and urgently bring forward regulation in this area.” She continues: “the profits from these unhealthy products benefit just a few, while the costs for the damage to the environment and health resulting from them have to be borne by the community.”

We need courageous decisions

Nason Maani is Lecturer in Inequalities and Global Health Policy at the University of Edinburgh and runs the podcast “Money, Power, Health”, where he provides information on how our health is influenced by commercial forces. He believes: “Ultimately, individual measures will not be sufficient to stem the health-harming influence of our neoliberal economy. Rather, we have to implement alternative concepts like a Circular Economy, Doughnut Economy or Wellbeing Economy, because profits do not necessarily have to be unhealthy. To achieve this, politicians need the courage to swim against the tide on certain occasions. The decisions that have to be taken will not always please the masses.”

Politicians need the courage to swim against the tide.

NASON MAANI, LECTURER AT THE UNIVERSITY OF EDINBURGH