It has been less than two years since phrases like “flatten the curve”, “contact tracing”, “social distancing” and many others related to the Covid-19 pandemic entered the lexicon and became part of everyday communication. People everywhere have learned more about epidemiology, virology, and immunology than they ever expected they would.
And yet, despite the increased attention to public health, few people can name the world’s leading cause of death. That is not an accident.
Non-communicable diseases (NCDs), especially heart disease, stroke, cancer, and diabetes, account for over 40 million deaths per year, strain health-care systems, and impose significant social and economic costs. But they do not attract nearly the same attention as infectious diseases like Covid-19, even though they are largely preventable.
It has long been known that tobacco use, alcohol consumption, and diets that are high in fats, sodium, and sugars increase the incidence of NCDs. But, despite some progress in recent years, particularly in reducing tobacco use, these risk factors do not receive the attention they deserve in discussions worldwide. That is partly because the companies that manufacture, promote, and sell these products play a major role in shaping how the public perceives NCDs.
Tobacco, alcohol, and food companies have a long history of downplaying their products’ effects on public health. And, since the start of the pandemic, they have used Covid-19-related marketing campaigns and corporate social-responsibility initiatives to divert public attention further.
A study covering 18 countries, conducted from March to July 2020, collected more than 280 examples of ways Coca-Cola, McDonald’s, Nestlé, and PepsiCo exploited the public-health emergency to market unhealthy products to vulnerable populations. In Brazil, Nestlé and Danone donated ultra-processed foods to a government programme to provide food to low-income residents. Coca-Cola contributed its sugary drinks for food parcels in South Africa. And Colombian food manufacturer Alpina promoted a high-sugar yogurt as essential to improve the immune system.
Similarly, according to a recent report, tobacco companies used pandemic-related corporate social-responsibility activities to expand access to senior government officials and repair their public image. In one audacious example, Philip Morris International donated ventilators to hospitals in Greece and Ukraine.
The incoherence of a system that works hand in hand with some of the biggest contributors to NCDs while trying to respond to Covid-19 should provoke general outrage. But these activities have gone largely unnoticed and unremarked.
It is true that in some cases, corporations have stepped in to deliver goods or services that governments failed to provide. But the state’s inability to fill these gaps must not permit corporations to whitewash the harms they cause. When Big Tobacco or Big Food influence governments with donations of food or medical equipment and other high-profile goodwill initiatives, public-health efforts to combat NCDs become futile.
The World Health Organization recently documented corporations’ contribution to poor health outcomes and rising inequities worldwide. To tackle the NCD pandemic, their influence on policymaking should be strictly regulated. Governments must fulfill their obligation to protect their citizens from the harmful activities of third parties – including multinational food, beverage, and tobacco industries. Failure to monitor these corporate activities amounts to a violation of their citizens’ fundamental human right to health.
The experience of Big Tobacco offers some insight into how the international community can approach industry interference in public health. Following the adoption of the Framework Convention on Tobacco Control, which entered into force in 2005, governments around the world recognized that the industry had been engaging in a concerted effort to undermine and subvert tobacco-control efforts, and some countries adopted measures to address the problem.
In light of the tactics corporations have deployed during the Covid-19 pandemic, legal measures must be adopted to de-normalise activities that, masquerading as displays of “social responsibility”, offer short-term benefits to communities that come at the expense of public health. Governments must not only ensure public awareness of the harms caused by tobacco, alcohol, and unhealthy foods; they must also establish measures to limit policymakers’ interactions with these industries.
As WHO Director-General Tedros Adhanom Ghebreyesus recently put it, “If tobacco was a virus, it would long ago have been called a pandemic and the world would marshal every resource to stop it. Instead, it is a multi-billion-dollar business profiting from death and disease.” His comment applies no less to other products that contribute to NCDs.
Governments must take decisive action to counter the role of the private sector in undermining public health. Even when corporations step up to help a community, officials should ensure that this aid does not address problems by creating new ones.
Andrés Constantin, an associate with the Healthy Families Initiative, is Acting Assistant Director of the Health Law programs at the O’Neill Institute and an adjunct professor of law at Georgetown University.
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