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Should we use regulation to demand improved public health outcomes from industry? Yes

BMJ 2008; 337 doi: (Published 02 October 2008) Cite this as: BMJ 2008;337:a1750
  1. Stephen D Sugarman, Roger J Traynor professor of law
  1. 1School of Law, Berkeley, CA 94720-7200, USA
  1. sugarman{at}

    Preventable chronic diseases are a major threat to health worldwide. Stephen Sugarman argues that setting targets for companies will produce innovative solutions, but Stig Pramming (doi:10.1136/bmj.a1761) believes collaboration is the best way to improve health

    Current approaches to some of our most pressing public health problems—voluntary cooperation with business and requiring companies to change how they operate—are not moving us effectively or efficiently in the socially desired direction. Let’s instead call for businesses themselves to figure out how to improve public health outcomes through a promising new regulatory approach: performance based regulation. This will enable the most innovative and nimble aspects of private enterprises to be called in. Through performance based regulation, the government tells businesses what outcomes it wants from them and leaves them to work out the best ways of attaining those regulatory targets.

    Fresh thinking

    Old fashioned public health regulation of business orders companies to do things like put graphic pictures of illness on cigarette packs, include calorie counts on fast food menus, install air bags in cars, and train pub workers not to sell drinks to people who are likely to …

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