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Trade, investment and commercial determinants of health

The increasingly interconnected and interdependent global economy and the dynamic nature of trade across borders have important implications for health everywhere. Economic policies for the past four decades have largely embodied neoliberal agendas that are subject to increasing empirical, ethical, and theoretical scrutiny, with widely accepted concerns over their impact on inequality, poverty, and environmental damage. Economic integration and trade and investment liberalization are defining features of contemporary globalization, first creating, and now revamping, global supply chains, creating both health opportunities and risks. How trade and investment treaties impact health outcomes within and between countries continues to be politically and empirically debated. A related outcome of global market integration is the increased size and power of transnational corporations, where a few often dominate in different economic sectors, from food and drinks products, to banking and finance, to extractive industries, to health technologies including pharmaceuticals. Of particular concern is the rise in noncommunicable diseases (NCDs), ‘vectors’ (social/societal determinants) for which include such globalization-related pathways as trade (and trade treaties), foreign investment (and investment treaties), and economic growth and urbanization associated with global economic integration. These ‘commercial (or corporate) determinants of health’ describe the policies and practices of private actors engaged in the production and marketing of unhealthy commodities (tobacco, alcohol, ultra-processed foods and beverages), or in extractive industries that create health damaging environmental impacts.

Papers submitted under this section will explore these economic and trade-related health topics, and provide research, commentary, and discussion needed to inform future health-equity-enhancing macroeconomic policies and trade and investment rules. The papers will also explore the related power and influence on health exerted by the policies and practices of multinational and transnational corporations.

  1. The health and wellbeing impacts of commercial activity on Indigenous populations is an emerging field of research. The alcohol industry is a key driver of health and social harms within Australia. In 2016 Woo...

    Authors: Alessandro Connor Crocetti, Beau Cubillo (Larrakia), Troy Walker (Yorta Yorta), Fiona Mitchell (Mununjali), Yin Paradies (Wakaya), Kathryn Backholer and Jennifer Browne
    Citation: Globalization and Health 2023 19:38
  2. Corporate power has been recognized as an important influence on food environments and population health more broadly. Understanding the structure of national food and beverage markets can provide important in...

    Authors: Alexa Gaucher-Holm, Benjamin Wood, Gary Sacks and Lana Vanderlee
    Citation: Globalization and Health 2023 19:18
  3. Share buybacks, when a corporation buys back its own shares, are recognised as having potentially harmful impacts on society. This includes by contributing to economic inequalities, and by impeding investments...

    Authors: Benjamin Wood and Gary Sacks
    Citation: Globalization and Health 2023 19:3
  4. The commercial determinants of health include a range of practices to promote business interests, often at the expense of public health. Corporate political practices, such as lobbying and campaign donations, ...

    Authors: Jennifer Lacy-Nichols and Katherine Cullerton
    Citation: Globalization and Health 2023 19:2
  5. There is growing attention to intra-regional trade in food. However, the relationship between such trade and food and nutrition is understudied. In this paper, we present an analysis of intra-regional food tra...

    Authors: Anne Marie Thow, Amerita Ravuvu, Siope Vakataki Ofa, Neil Andrew, Erica Reeve, Jillian Tutuo and Tom Brewer
    Citation: Globalization and Health 2022 18:104
  6. There is growing recognition that current food systems are both unhealthy and unsustainable, and are increasingly shifting toward the supply and marketing of unhealthy, ultra-processed foods and beverages. Lar...

    Authors: Ella Robinson, Christine Parker, Rachel Carey, Anita Foerster, Miranda R Blake and Gary Sacks
    Citation: Globalization and Health 2022 18:93
  7. The political activities of industry stakeholders must be understood to safeguard the development and implementation of effective public health policies.

    Authors: Alexa Gaucher-Holm, Christine Mulligan, Mary R. L’Abbé, Monique Potvin Kent and Lana Vanderlee
    Citation: Globalization and Health 2022 18:54
  8. It is widely accepted that intellectual property legal requirements such as patents and data exclusivity can affect access to medicines, but to date there has not been a comprehensive review of the empirical e...

    Authors: Brigitte Tenni, Hazel V. J. Moir, Belinda Townsend, Burcu Kilic, Anne-Maree Farrell, Tessa Keegel and Deborah Gleeson
    Citation: Globalization and Health 2022 18:40
  9. The United States requires a patent linkage system in other countries as part of free trade agreements. However, introducing a patent linkage system could be a significant barrier to the timely approval of gen...

    Authors: Nahye Choi, Kyung-Bok Son, Joonsoo Byun and Dong-Wook Yang
    Citation: Globalization and Health 2022 18:34
  10. While there is a growing body of legally-focused analyses exploring the potential restrictions on public health policy space due to international trade rules, few studies have adopted a more politically-inform...

    Authors: Penelope Milsom, Richard Smith, Simon Moeketsi Modisenyane and Helen Walls
    Citation: Globalization and Health 2022 18:32
  11. Noncommunicable diseases contribute to over 70% of global deaths each year. Efforts to address this epidemic are complicated by the presence of powerful corporate actors. Despite this, few attempts have been m...

    Authors: Connie Hoe, Caitlin Weiger, Marela Kay R. Minosa, Fernanda Alonso, Adam D. Koon and Joanna E. Cohen
    Citation: Globalization and Health 2022 18:17
  12. Indonesia’s stagnated progress towards tobacco control could be addressed through the implementation of a comprehensive national framework, such as the World Health Organization’s (WHO) Framework Convention of...

    Authors: Abdillah Ahsan, Rifai Afin, Nadira Amalia, Martha Hindriyani, Ardhini Risfa Jacinda and Elisabeth Kramer
    Citation: Globalization and Health 2022 18:11
  13. Papua New Guinea (PNG) experienced positive GDP growth at approximately 4.3% per year during the last decade. With increases in overall wealth within the country, PNG is facing a double burden of malnutrition:...

    Authors: Emily Schmidt and Peixun Fang
    Citation: Globalization and Health 2021 17:135
  14. Illicit trade of tobacco negatively affects countries’ tobacco control efforts. It leads to lower tobacco prices and makes tobacco products more accessible to vulnerable populations. In this study, we construc...

    Authors: Valerie Gilbert Ulep, Monica Paula Lavares and Ariza Francisco
    Citation: Globalization and Health 2021 17:130
  15. The aggressive marketing of breastmilk substitutes (BMS) reduces breastfeeding, and harms child and maternal health globally. Yet forty years after the World Health Assembly adopted the International Code of M...

    Authors: Phillip Baker, Paul Zambrano, Roger Mathisen, Maria Rosario Singh-Vergeire, Ana Epefania Escober, Melissa Mialon, Mark Lawrence, Katherine Sievert, Cherie Russell and David McCoy
    Citation: Globalization and Health 2021 17:125
  16. As African governments take measures to enhance international trade and Foreign Direct Investment (FDI) inflows, a major concern is that, these measures can make Africa more vulnerable to the strategies of the...

    Authors: Mustapha Immurana, Micheal Kofi Boachie and Kwame Godsway Kisseih
    Citation: Globalization and Health 2021 17:122
  17. Regulation of food environments is needed to address the global challenge of poor nutrition, yet policy inertia has been a problem. A common argument against regulation is potential conflict with binding commi...

    Authors: Kelly Garton, Boyd Swinburn and Anne Marie Thow
    Citation: Globalization and Health 2021 17:118
  18. The patent linkage system upgraded patent challenges to an important factor in granting timely market approval for generic drugs. We aim to understand patent challenges and identify the factors that are associ...

    Authors: Kyung-Bok Son, Nahye Choi, Boram Lee, Joonsoo Byun, Dong-Wook Yang and Tae-Jin Lee
    Citation: Globalization and Health 2021 17:116
  19. Alcohol control has emerged as an important global health challenge due to the expanding influence of alcohol companies and limited control measures imposed by governments. In the Peruvian Andean highland, the...

    Authors: Sakiko Yamaguchi, Raphael Lencucha and Thomas G. Brown
    Citation: Globalization and Health 2021 17:109
  20. Trade and health scholars have raised concern that international trade and particularly investment disputes may be used by transnational health harmful commodity corporations (THCCs) to effectively generate pu...

    Authors: Penelope Milsom, Richard Smith, Simon Moeketsi Modisenyane and Helen Walls
    Citation: Globalization and Health 2021 17:104
  21. Obligations arising from trade and investment agreements can affect how governments can regulate and organise health systems. The European Union has made explicit statements of safeguarding policy space for he...

    Authors: Meri Koivusalo, Noora Heinonen and Liina-Kaisa Tynkkynen
    Citation: Globalization and Health 2021 17:98
  22. The Regional Economic Partnership Agreement (RCEP) is a mega regional trade agreement signed by fifteen countries on 15 November 2020 after 8 years of negotiation. Signatories include the ten members of the As...

    Authors: Belinda Townsend
    Citation: Globalization and Health 2021 17:78
  23. The global milk formula market has ‘boomed’ in recent decades, raising serious concerns for breastfeeding, and child and maternal health. Despite these developments, few studies have investigated the global ex...

    Authors: Phillip Baker, Katheryn Russ, Manho Kang, Thiago M. Santos, Paulo A. R. Neves, Julie Smith, Gillian Kingston, Melissa Mialon, Mark Lawrence, Benjamin Wood, Rob Moodie, David Clark, Katherine Sievert, Monique Boatwright and David McCoy
    Citation: Globalization and Health 2021 17:58
  24. The detrimental impact of dominant corporations active in health-harming commodity industries is well recognised. However, to date, existing analyses of the ways in which corporations influence health have pai...

    Authors: Benjamin Wood, Owain Williams, Phil Baker, Vijaya Nagarajan and Gary Sacks
    Citation: Globalization and Health 2021 17:41
  25. Corporate social responsibility (CSR) is studied from many perspectives and has gained unprecedented importance in recent years, especially in emerging economies. Pharmaceutical companies play a very important...

    Authors: Tatiana Dănescu and Maria-Alexandra Popa
    Citation: Globalization and Health 2020 16:117
  26. In the business literature, the term “corporate political activity” (CPA) refers to the political strategies undertaken by corporations to protect or expend their markets, by influencing, directly or indirectl...

    Authors: Mélissa Mialon, Camila Corvalan, Gustavo Cediel, Fernanda Baeza Scagliusi and Marcela Reyes
    Citation: Globalization and Health 2020 16:107
  27. Health systems are struggling with unprecedented drug spending and governments have devised various policy options to manage high-priced medicines. Meanwhile, some pricing and reimbursement processes are curre...

    Authors: Kyung-Bok Son
    Citation: Globalization and Health 2020 16:98
  28. The recent innovation activities of global top-tier pharmaceutical companies in accordance with global and regional health concerns were investigated in order to identify their innovations contributing to popu...

    Authors: Ye Lim Jung, JeeNa Hwang and Hyoung Sun Yoo
    Citation: Globalization and Health 2020 16:80
  29. Different terms are described in the literature that refer to commercial determinants as drivers of ill-health. The aim of the present review was to provide an overview of the commercial determinants of health...

    Authors: Melissa Mialon
    Citation: Globalization and Health 2020 16:74
  30. With a 264 million population and the second highest male smoking prevalence in the world, Indonesia hosted over 60 million smokers in 2018. However, the government still has not ratified the Framework Convent...

    Authors: Abdillah Ahsan, Nur Hadi Wiyono, Meita Veruswati, Nadhila Adani, Dian Kusuma and Nadira Amalia
    Citation: Globalization and Health 2020 16:65
  31. We present a systematic review describing ex-ante and ex-post evaluations of the impacts of intellectual property provisions in trade treaties on access to medicine in low and middle income countries. These ev...

    Authors: Md. Deen Islam, Warren A. Kaplan, Danielle Trachtenberg, Rachel Thrasher, Kevin P. Gallagher and Veronika J. Wirtz
    Citation: Globalization and Health 2019 15:88
  32. In late 2018 the United States, Canada, and Mexico signed a new trade agreement (most commonly referred to by its US-centric acronym, the United States-Mexico-Canada Agreement, or USMCA) to replace the 1994 No...

    Authors: Ronald Labonté, Eric Crosbie, Deborah Gleeson and Courtney McNamara
    Citation: Globalization and Health 2019 15:35

    The Correction to this article has been published in Globalization and Health 2019 15:44

  33. A key component of ‘obesogenic environments’ is the ready availability of convenient, calorie-dense foods, in the form of hyper-palatable and relatively inexpensive ultra-processed products. Compelling evidenc...

    Authors: Fabrizio Ferretti and Michele Mariani
    Citation: Globalization and Health 2019 15:30
  34. There has been growing interest in understanding the role of agricultural trade policies in diet and nutrition. This cross-country study examines associations between government policies on agricultural trade ...

    Authors: Kafui Adjaye-Gbewonyo, Sebastian Vollmer, Mauricio Avendano and Kenneth Harttgen
    Citation: Globalization and Health 2019 15:21

    The Correction to this article has been published in Globalization and Health 2019 15:28

  35. Unhealthy dietary patterns have in recent decades contributed to an endemic-level burden from non-communicable disease (NCDs) in high-income countries. In low- and middle-income countries rapid changes in diet...

    Authors: Soledad Cuevas García-Dorado, Laura Cornselsen, Richard Smith and Helen Walls
    Citation: Globalization and Health 2019 15:15
  36. The food industry can influence individual and population level food consumption behaviours, shape public preferences and interfere with government policy on obesity prevention and NCDs. This paper identifies ...

    Authors: Nongnuch Jaichuen, Sirinya Phulkerd, Nisachol Certthkrikul, Gary Sacks and Viroj Tangcharoensathien
    Citation: Globalization and Health 2018 14:115
  37. The inclusion of patent linkage mechanisms in bilateral and plurilateral trade and investment agreements has emerged as a key element in the United States’ TRIPS-Plus intellectual property (IP) negotiating age...

    Authors: Kyung-Bok Son, Ruth Lopert, Deborah Gleeson and Tae-Jin Lee
    Citation: Globalization and Health 2018 14:101
  38. Medical tourism is a term used to describe the phenomenon of individuals intentionally traveling across national borders to privately purchase medical care. The medical tourism industry has been portrayed in t...

    Authors: Krystyna Adams, Jeremy Snyder, Valorie A. Crooks and Nicole S. Berry
    Citation: Globalization and Health 2018 14:70
  39. Underweight is a major cause of global disease burden. It is associated with child mortality and morbidity, and its adverse impact on human performance and child survival is well recognized. Underweight is a m...

    Authors: Tuhinur Rahman Chowdhury, Sayan Chakrabarty, Muntaha Rakib, Sue Saltmarsh and Kendrick A. Davis
    Citation: Globalization and Health 2018 14:54
  40. A key mechanism through which globalization has impacted health is the liberalization of trade and investment, yet relatively few studies to date have used quantitative methods to investigate the impacts of gl...

    Authors: Krycia Cowling, Anne Marie Thow and Keshia Pollack Porter
    Citation: Globalization and Health 2018 14:53