Addressing the commercial determinants is critical to emerging economies

Abstract

Addressing the commercial determinants is critical to emerging economies Economic growth in emerging economies has moved millions out of poverty. World Bank data show that some 2.8bn people-40 per cent of the world's population-now live on between $2 and $10 a day. This "fragile middle" is now the world's biggest income group. That is why they are also the target of consumer goods companies including processed food, tobacco, alcohol and sweet soft drinks-which means an exponentially expanding market of unhealthy products that shift lifestyles and contribute to the increase of non communicable disease (NCDs). Nearly four out of five deaths (80%) from NCDs now occur in low-or middle-income countries; the rate of increase of childhood overweight and obesity has been more than 30% higher than that of developed countries. This requires rapid and determined political action by government both at home and in the international arena. When the health ministers from Brazil, Russia, India, China and South Africa met at the end of 2014 in Brazil, they prioritized the need for action on NCDs within their countries. The impact of NCDs on their economies is staggering: the World Bank has calculated that in a single decade, developing countries are expected to lose 84 billion dollars of productivity from the death and disability caused by NCDs. Significant global agreements now exist and countries are challenged to address the determinants of NCDs through regulation in the face of significant pressure from global industries. There is still a long way to go to implement the Framework Convention on Tobacco Control FCTC and only a few countries have moved to counteract the flooding of their consumer markets with unhealthy commodities, for example through taxing products high in sugar content. The health sector lacks the power to regulate the global players; this requires a whole of government approach as well as joint action across borders. Poor health and health shocks are leading causes of chronic poverty and impoverishment. Especially CVD and diabetes have become a leading threat to people's health in most of the emerging economies, hitting the productive younger age group in the "fragile middle". In countries with very few formal safety nets and lack of universal health coverage households often need to sell assets, use their savings or borrow at high interest rates in order to receive health care. WHO has drawn attention to the fact that 100 million fall into poverty trying to access health care. Many emerging countries have now realized that universal health coverage is critical component of economic growth, social cohesions and poverty reduction. But as governments build health systems and work on structural reforms including social protection and universal health coverage-they need to also urgently regulate unhealthy commodities in order to break the vicious cycle of disease and poverty. The WHO Commission on the Social Determinants of Health addressed the complexity of health determinants through the concept of the social ...

Defining the commercial determinants of health: a systematic review

“…These environments were said to lead to malnutrition, stunting, overweight, obesity, and diabetes within the same populations [44]. Emerging global economies [14,16,23,26], and the poor and "fragile middle" [14] countries were said to be worst affected.…”

“…Tobacco industry discussions often referenced the WHO Framework Convention on Tobacco Control (FCTC), comparing it with other industries. Kickbusch [14] emphasized that while FCTC implementation has commenced, few governments have begun counteracting the influence of other unhealthy commodity industries. Authors described a 'hierarchy' of harmful industries, where tobacco is portrayed as the 'worst' industry, whilst others were 'not as bad'.…”

Benchmarking the transparency, comprehensiveness and specificity of population nutrition commitments of major food companies in Malaysia

“…Prevention of diet-related NCDs requires consideration of the production, marketing, and consumption of commercially produced ultra-processed food products [11,12]. The scope for preventive action for improving population nutrition therefore extends to actions by commercial food producers.…”

Social determinants of health associated with childhood accidents at home: An integrative review

“…The studies that evaluated SDH Sex among children who suffered AH, either in the general context (19)(20)22,25,(28)(29)31,42) or in specific cases, such as poisoning or intoxication (18,21,(26)(27)(28) , burn (40,48) , drowning (33) , falls (35,37) and asphyxia/strangulation/suffocation in bed (38) showed a higher ratio of males. Thus, it is possible to affirm that male sex is related to the occurrence of AH in childhood in all studies (8) . In many cases, the difference in the occurrence of AH between the sexes is related to the proportion of time the child is supervised, with boys more often not supervised than girls (25) , emphasizing once again the association between the proximal and intermediate SDH.…”

“…Considering these facts, the broader context of health, which allows a more in-depth analysis of the risks for the occurrence of AH with children, should consider the complexity of the determinants of health. They are the conditions in which people are born, grow, live, work and age, shaped by the distribution of financial resources and power, as well as general resources, at the local, national and global levels (8) . Therefore, this set of factors must be organized and analyzed from the perspective of the Social Determinants of Health (SDH), to characterize the individuals' particularities and reflect their insertion in a space-time, as conditioning factors of AH in childhood (9) .…”