Introduction

Challenge

Non-communicable diseases (NCDs) and the climate crisis jointly pose unequal burdens on the health of citizens, with implications for economies and sustainable development. Most of the premature death and disease from these causes happens in low- and middle-income countries (LMICs) and within these countries, falls most heavily on the poorest and most vulnerable communities. Among the key drivers of these harms are global industries that manufacture and distribute unhealthy products, including tobacco, alcohol, junk foods and fossil fuels. Their direct and indirect impacts on health and their activities in shaping policies to advance interests constitute the commercial determinants of health. The substantial evidence-base about these diverse impacts and about how to regulate such industries to promote health is largely confined to high-income countries.

Context

In Sub-Saharan Africa (SSA), the relationship between such commercial actors and public health is not well understood. The entire region is strategically important to commercial actors both as a source of raw materials and as key markets for future growth. The region confronts particular challenges in seeking to regulate business impacts on health, including resource constraints, competing priorities, the influence of donors and international organisations, and the power of global corporate actors.

Research location

In an ambitious programme of research in South Africa, Ghana and Kenya, ACORDS will undertake research to inform policies to address these challenges, focusing on the alcohol, junk food and fossil fuel industries.

Project aims

The overall aim of this new collaboration is to explore how commercial actors influence population health in SSA, and to inform the development of policies that can effectively promote health and sustainable development. Conducted over a four-year period from July 2024, our mixed methods research will be organised across four linked work packages to address the following objectives: 

1. To map the health impacts of commercial actors and show how strategic links between alcohol, food and fossil fuel industries influence policies to advance their own interests. 
2. To use economic modelling and evaluation to inform policies to effectively regulate unhealthy commodity industries. 
3. To examine how health policy processes can be strengthened to manage conflicts between health goals and the interests of these three industries. 
4. To explore how such research can inform efforts to tackle inequalities in health and in power distribution, working in collaboration with communities and civil society