Planetary health: countering commercial and corporate power
Authors: Enkelejda Sula-Raxhimi, Camille Butzbach, Astrid Brousselle
Journal: The Lancet Planetary Health (2019)

That the insufficient response to climate change and pollution is jeopardising human life and livelihood,1Watts N Amann M Ayeb-Karlsson S et al.The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health.Lancet. 2018; 391: 581-630Summary Full Text Full Text PDF PubMed Scopus (584) Google Scholar accounting for 7 million deaths annually,2WHO9 out of 10 people worldwide breathe polluted air, but more countries are taking action.http://www.who.int/news-room/detail/02-05-2018-9-out-of-10-people-worldwide-breathe-polluted-air-but-more-countries-are-taking-actionDate: May 2, 2018Date accessed: May 8, 2018Google Scholar is no longer in doubt. Pollution, whether produced locally or transported via air and international trade,3Zhang Q Jiang X Tong D et al.Transboundary health impacts of transported global air pollution and international trade.Nature. 2017; 543: 705Crossref PubMed Scopus (599) Google Scholar is the main cause of death worldwide. The strong correlations between pollution, climate change, and deleterious effects on planetary health are the result of the global economic model.4Kickbusch I Allen L Franz C The commercial determinants of health.Lancet Glob Health. 2016; 4: e895-e896Summary Full Text Full Text PDF PubMed Scopus (278) Google Scholar, 5Freudenberg N Galea S Cities of consumption: the impact of corporate practices on the health of urban populations.J Urban Health. 2008; 85: 462-471Crossref PubMed Scopus (20) Google Scholar Such anthropogenic tendencies exacerbate social and health inequalities, with the most disadvantaged people1Watts N Amann M Ayeb-Karlsson S et al.The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health.Lancet. 2018; 391: 581-630Summary Full Text Full Text PDF PubMed Scopus (584) Google Scholar in low-income countries—women in particular—being disproportionately affected by floods, heat waves, bitter cold, and air pollution.1Watts N Amann M Ayeb-Karlsson S et al.The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health.Lancet. 2018; 391: 581-630Summary Full Text Full Text PDF PubMed Scopus (584) Google Scholar Solutions exist and yet inertia-plagued public policies impede timely implementation of measures urgently needed to counteract pollution and climate change. How can such effects not be considered enough of a threat, in public discourse and actions, to trigger an urgent and immediate embracing of radical measures? Studies6Moloney S Horne RE Low carbon urban transitioning: from local experimentation to urban transformation?.Sustainability. 2015; 7: 2437-2453Crossref Scopus (48) Google Scholar reveal the absence, disconnection, and contradictions of government strategies at different levels. Commercial interests and the influence of corporate lobbies over public policies4Kickbusch I Allen L Franz C The commercial determinants of health.Lancet Glob Health. 2016; 4: e895-e896Summary Full Text Full Text PDF PubMed Scopus (278) Google Scholar, 5Freudenberg N Galea S Cities of consumption: the impact of corporate practices on the health of urban populations.J Urban Health. 2008; 85: 462-471Crossref PubMed Scopus (20) Google Scholar, 7Wright C Nyberg D Climate change, capitalism, and corporations. Cambridge University Press, Cambridge2015Crossref Scopus (151) Google Scholar are identified as the biggest challenge to governments' lack of engagement, and lack of transparency regarding funding directed towards overturning or silencing such policy initiatives remains a major concern.4Kickbusch I Allen L Franz C The commercial determinants of health.Lancet Glob Health. 2016; 4: e895-e896Summary Full Text Full Text PDF PubMed Scopus (278) Google Scholar, 5Freudenberg N Galea S Cities of consumption: the impact of corporate practices on the health of urban populations.J Urban Health. 2008; 85: 462-471Crossref PubMed Scopus (20) Google Scholar, 7Wright C Nyberg D Climate change, capitalism, and corporations. Cambridge University Press, Cambridge2015Crossref Scopus (151) Google Scholar Corporate power is at the heart of the world's economic system; wealth accumulation takes precedence, overriding population health.4Kickbusch I Allen L Franz C The commercial determinants of health.Lancet Glob Health. 2016; 4: e895-e896Summary Full Text Full Text PDF PubMed Scopus (278) Google Scholar, 5Freudenberg N Galea S Cities of consumption: the impact of corporate practices on the health of urban populations.J Urban Health. 2008; 85: 462-471Crossref PubMed Scopus (20) Google Scholar It holds the means of production and determines the ways in which discourse is shaped to preserve such forms of development. Povinelli calls it "geontopower",8Povinelli E Geontologies: a requiem to late liberalism. Duke University Press, Durham, NC2016Crossref Google Scholar a power over life and non-life of late liberalism, an old and outdated power that has exhausted natural and common resources to maximise shareholders' profits.7Wright C Nyberg D Climate change, capitalism, and corporations. Cambridge University Press, Cambridge2015Crossref Scopus (151) Google Scholar If public institutions are to produce and promote planetary health, their challenge is to engage seriously in finding ways to counterbalance such power in public policy. Some initiatives are on the rise, such as corporations investing in clean energy, based on the same economic growth model.7Wright C Nyberg D Climate change, capitalism, and corporations. Cambridge University Press, Cambridge2015Crossref Scopus (151) Google Scholar Experts7Wright C Nyberg D Climate change, capitalism, and corporations. Cambridge University Press, Cambridge2015Crossref Scopus (151) Google Scholar have exposed the limitations of such initiatives, which lie in the fundamental tension between the profit-maximising drive of corporations and the need for a profound decarbonisation of commercial and economic sectors (eg, energy, transportation, manufacturing) that would advance human health. Believing that a life-threatening paradigm can be reversed by the same system, means, and actors that caused it in the first place—ie, relying on business and market logic to reorient the course of climate change—is naive, ineffectual, and irresponsible. Such crucial conditions call, rather, for radical measures. To improve planetary health and produce healthy livelihoods around the world, solutions must be sought outside the wealth logic mechanisms of corporations. We aim to spark discussion on creative thinking and effective action to protect and promote our most important collective good: planetary health. We propose a framework for countering the effects of corporate power and commercial determinants of health (appendix). This framework is based on the current state of scientific knowledge, inspired by the frameworks of the Canadian Association of Public Health on ecological determinants of health9Canadian Public Health AssociationGlobal change and public health: addressing the ecological determinants of health.https://www.cpha.ca/sites/default/files/assets/policy/edh-discussion_e.pdfDate: May, 2015Date accessed: November 25, 2015Google Scholar and of the commercial determinants of health defined by Kickbusch and colleagues.4Kickbusch I Allen L Franz C The commercial determinants of health.Lancet Glob Health. 2016; 4: e895-e896Summary Full Text Full Text PDF PubMed Scopus (278) Google Scholar Here we provide strategies for transitioning societies towards a socioecological economic model. First, regulatory restrictions on carbon emissions and pollution should be established and enforced.7Wright C Nyberg D Climate change, capitalism, and corporations. Cambridge University Press, Cambridge2015Crossref Scopus (151) Google Scholar Furthermore, new economic and social development models should be implemented that reflect the importance of sustainable environments.10Brousselle A Butzbach C Redesigning public health for planetary health.Lancet Planet Health. 2018; 2: e188-e189Summary Full Text Full Text PDF PubMed Scopus (3) Google Scholar Degrowth, among others, could be considered. Regulatory and transparent funding mechanisms should be established for elections and political campaigns; politicians should engage in a politics of climate change that offers a future for their constituents, undeterred by corporate influence, and common interests for planetary health should take precedence. Additionally, a series of concerted intersectoral and interdisciplinary efforts and collaborations mobilising researchers, politicians, health practitioners, and others who have an effect on health outcomes through their actions should be encouraged and brought into the mainstream. The political role of the public health sector should be reclaimed and strengthened.10Brousselle A Butzbach C Redesigning public health for planetary health.Lancet Planet Health. 2018; 2: e188-e189Summary Full Text Full Text PDF PubMed Scopus (3) Google Scholar Health institutions must reclaim their political role in protecting and promoting planetary health. The case against tobacco corporations illustrates the positive influence of such a political role. Similarly, carbon exit success stories could be used as precedents to counterbalance commercial determinants of health. These levers should be considered seriously when challenging one of the most important determinants of health—commercial and corporate power—to preserve and promote human and planetary health. We declare no competing interests. Download .pdf (.23 MB) Help with pdf files Supplementary appendix