The WHO says corporate greed is causing millions of preventable deaths

The World Health Organization is no stranger to issuing reports. Often filled with bureaucratic language on niche topics, no one would bat an eye if a dictionary was needed to decode the confusing jargon found in a typical WHO release.

Their latest is an entirely different beast.

Nestled under the technical title "Commercial Determinants of Non-Communicable Diseases in the WHO European region” is a clear and frank report on how the profit-motive leads to 2.7 million preventable deaths a year, in Europe alone.

Most responsible are companies from the tobacco, alcohol, processed food, and fossil fuel industries, in addition to familiar actors in health care like pharmaceutical companies, and newer entrants like private equity investment firms.

How are these corporate players causing such harm?

Among the many mechanisms highlighted are: industry lobbying that weakens regulation, market concentration with monopoly-like effects, one-sided international trade and investment agreements, the subversion of science and manipulation of research, reputation-washing through corporate social responsibility initiatives, tax-avoidance coupled with extractive financial practices, and a motive to function with the lowest possible labour standards. The WHO’s report also notes how industry uses health crises or "shocks” to opportunistically maximise profits at the expense of health.

Though the list is long, each topic is summarised in just a few pages, with front loaded key points and illustrative case studies in what amounts to a surprisingly readable text.

One case study addresses increasing private equity ownership stakes in the health sector. In Germany, nearly 20% of ambulatory (or ‘community’) healthcare centres are owned by private equity firms. In Sweden, a third of primary care clinics are. Higher costs and worse patient outcomes result from this ownership model. Why? These firms often cut staff and increase fees to patients, while using the same health centres to take out debt, write-off taxes, and extract profits to pay both investors and executives.

Other chapters and cases examine alcohol labelling, gig work, patent law and industry-funded advocacy groups, among many others.

The authors of the report unite these seemingly disparate areas under a ‘commercial determinants of health’ banner. Described as “the ways in which commercial sector actors and their products and practices impact on health” the report notes “the fact that diverse commercial actors are causing avoidable harm reflects their shared underlying motivation to maximize profits.”

Importantly, this WHO release does more than bring corporate harms to light. It offers examples of how such health-harming activities can be beaten back.

For example, how Estonia advanced a sugar tax on pop and juice, or how European drug prices were brought under control for conditions like asthma and COPD, and how a ban on marketing unhealthy food in the UK is on the cusp of being won.

Yet, the report on its own will do little to change the problems it identifies. Though important, the WHO is a multinational, member-driven organisation that typically does not engage in the type of gritty politics and persuasion required to put this genie back in the bottle.

Nonetheless, there are clear implications for Canada. For example, private equity firms are taking increasing interest in our healthcare system, reputation washing under the guise of corporate social responsibility is common practice here, and precarious working conditions in Canada have long been known to contribute to death and disease.

There are also examples of organisations and movements pushing back. For example, the Canadian Association of Physicians for the Environment is calling for a ban on fossil fuel ads, supported through a House of Commons private members bill via Member of Parliament, Charlie Angus. The Decent Work & Health Network and Workers Action Centre have long called for paid sick days, and an end to exploitative temp agency work. And groups like Canadian Doctors for Medicare and the Canadian Health Coalition are advocating for universal drug coverage that will not only improve access, but bring our drug prices closer to international norms.

For a country that often compares itself to the US, at times to excuse action on health and social problems, this report offers a different—perhaps more persuasive—standard. Canadians would be well served to learn these lessons from Europe. The sooner, the better.

^{Dr. Danyaal Raza is a family physician at St. Michael’s Hospital, Unity Health Toronto and Assistant Professor at the University of Toronto.}