Industry has no role in public health policies, concludes analysis

BMJ 2013; 346 doi: (Published 12 February 2013) Cite this as: BMJ 2013;346:f943
  1. Jacqui Wise
  1. 1London

There is no evidence that self regulation by industry or public-private partnerships helps to prevent the harmful effects of tobacco, alcohol, and highly processed food and drink, a damning international analysis has found.

The study, published in the Lancet, said industry should have no role in the formation of policy on non-communicable diseases as there is no evidence to support such an approach.1 Instead, regulation or the threat of regulation, is the only way to achieve change.

The study, published as part of a series on non-communicable diseases, concludes that international corporations are major drivers of non-communicable disease epidemics through aggressive marketing of tobacco, alcohol, and ultra-processed food and drink. In addition, the “unhealthy commodity” industries use strategies similar to those used by tobacco companies to undermine public health policies.

Voluntary self regulation is the default approach of many governments and the United Nations. England’s public health strategy, which relies heavily on the voluntary action of the food and alcohol industries through “responsibility deals,” has been widely criticised by public health experts.2

The Lancet article said that there is little objective evidence that such approaches or public-private partnerships, such as the one announced in 2012 between the International Diabetes Federation and Nestlé, deliver health benefits.

The study, led by Rob Moodie from the University of Melbourne, Australia, showed that public regulation and market intervention are the only evidence based mechanisms to prevent harm caused by the unhealthy commodity industries. The researchers call for evidence based approaches such as legislation, regulation, taxation, pricing, bans, and restriction of advertising and sponsorship to reduce death and disability from non-communicable diseases.

The researchers examined market data for commodity sales from the EuroMonitor’s Global Market Information database, which covered 80 countries from 1997 to 2010. Consumption of tobacco, alcohol, and several categories of packaged food is rising most rapidly in low and middle income countries. Saturation of markets in high income countries has caused the industries to penetrate emerging markets rapidly, in the same way as the tobacco industry has done.

The article said there is evidence that alcohol and highly processed food industries use tactics similar to those used by tobacco companies to undermine public health interventions. They do this by distorting research findings, co-opting policy makers and health professionals, and lobbying politicians and public officials to oppose healthcare reform. For example, a meta-analysis of research publications showed that studies sponsored exclusively by food and drinks companies were between four and eight times more likely to have conclusions that favoured the financial interests of the sponsoring company than favoured those not sponsored.3 In another study , researchers found that the alcohol company SABMiller helped the governments of Lesotho, Malawi, Uganda, and Botswana to write their national alcohol policies. The researchers found that all four documents were highly similar in their wording, and they considered that the documents were designed to serve the industry’s interests at the expense of public health.4

Ian Gilmore, the Royal College of Physicians’ special adviser on alcohol, commented: “The study drives a final nail in the coffin of the theory that involving the alcohol industry in public health measures like responsibility deals and self-regulation will end in anything other than failure. The study shows that the reverse is true—that the industry uses similar strategies to the tobacco industry to undermine public health policies and programmes, and is unlikely to promote any policies which would reduce sales. Any government serious about public health should in future divorce its public health activities from industry involvement.”


Cite this as: BMJ 2013;346:f943