Commercial determinants of health List

The themes and how we work

Our work is organised around five connected themes, each illustrated by — not summed up by — a selection of published work.

Understanding and measuring the drivers. We collaborate with others to develop the concepts and frameworks that make commercial power visible and measurable: how health-harming industries operate, where power concentrates, and how it shapes the conditions for health long before anyone reaches a clinic.

Key outputs:

  • Freudenberg N, Lee K, Buse K, et al. Defining priorities for action and research on the commercial determinants of health: a conceptual review. American Journal of Public Health, 2021;111(12):2202–2211. doi:10.2105/AJPH.2021.306491
  • Lee K, et al. (incl. Buse K). Measuring the commercial determinants of health and disease: a proposed framework. International Journal of Health Services, 2021. doi:10.1177/00207314211044992
  • Buse K, Tanaka S, Hawkes S. Healthy people and healthy profits? Elaborating a conceptual framework for governing the commercial determinants of non-communicable diseases. Globalization and Health, 2017;13:34. doi:10.1186/s12992-017-0255-3

Health-harming products: tobacco, food and beyond. We trace how specific industries and their products, marketing and political practices produce ill health and widen inequities — from the political economy of tobacco to the corporate shaping of children's food environments.

Key outputs:

  • Bandara S, et al. The political economy of tobacco in Zimbabwe: an analysis of stakeholder perspectives. PLOS Global Public Health, 2025;5(6):e0004805. doi:10.1371/journal.pgph.0004805
  • Sircar NR, Bialous SA. Tobacco industry's human rights makeover: an archival review of British American Tobacco's human rights rhetorical veneer. Tobacco Control (2024). DOI: 10.1136/tobaccocontrol-2022-057337
  • Fisher L, Dahal M, Hawkes S, Puri M, Buse K. Barriers and opportunities to restricting marketing of unhealthy foods and beverages to children in Nepal: a policy analysis. BMC Public Health, 2021;21:1351.
  • Neiloy Sircar & Stanton Glantz, Defeating Juul’s Effort to Rewrite San Francisco’s E-Cigarette Regulations, American Journal of Public Health (2021). DOI: 10.2105/AJPH.2020.305993

Partnerships, conflicts of interest and the rules of engagement. We examine when, whether and how public actors should work with industry — the design and limits of public–private partnerships, and the safeguards needed to manage conflicts of interest.

Key outputs:

  • Buse K, Walt G. Global public–private partnerships: Part I — a new development in health?; Part II — what are the issues for global governance? Bulletin of the World Health Organization, 2000;78(4):549–561; 78(5):699–709.
  • Patay D, et al. (Buse K, senior author). Fifty shades of partnerships: a governance typology for public–private engagement in the nutrition sector. Globalization and Health, 2023;19:11. doi:10.1186/s12992-023-00912-1
  • Buse K, Hawkes S. Sitting on the FENSA when engaging with Big Industry. The Lancet, 2016;388(10043):446–447.

Regulation, taxation and the law. We study the levers that constrain commercial harm — fiscal measures, legal and treaty tools such as the WHO Framework Convention on Tobacco Control, and the limits of rights-based and regulatory approaches.

Key outputs:

  • Marten R, et al. including Buse K Sugar, tobacco, and alcohol taxes (STAX): indispensable tools to achieve the Sustainable Development Goals. The Lancet, 2018. doi:10.1016/S0140-6736(18)31219-4
  • Jones A, Wu HYJ, Buse K. The United Kingdom's sugar tax hits the regulatory sweet spot. BMJ, 2021;372:n463. doi:10.1136/bmj.n463
  • Neiloy Sircar & Stella Bialous, Assessing the links between human rights and global tobacco control through statements made on global fora, BMC Public Health (2021). DOI: 10.1186/s12889-021-10451-2

Contesting the corporate narrative. Commercial actors do not only shape products and policies — they shape the story: how a problem is defined, who is blamed, and which solutions seem realistic. We expose this "corporate pollution" of health discourse and build counter-narratives.

Key outputs:

  • Van Schalkwyk M, Petticrew M, Hawkins B, Buse K. Reclaiming the narrative: countering the corporate pollution of health discourse. Health Promotion International, 2024;39(6):daae182. doi:10.1093/heapro/daae182
  • Maani N, van Schalkwyk M, Petticrew M, Buse K. The pollution of health discourse and the need for effective counter-framing. BMJ, 2022;377:o1128. doi:10.1136/bmj.o1128
  • Sircar N, Fleming ME, Bialous SA. Does a human rights-based approach to harm reduction support commercialized harm reduction? Frontiers in Public Health, 2022;10:1001036. https://research.monash.edu/en/publications/does-a-human-rights-based-approach-to-harm-reduction-support-comm; doi:10.3389/fpubh.2022.1001036

From analysis to action

Like the rest of the Department, we do not treat evidence as an end in itself. Our analysis sets out concrete agendas for action — blueprints for challenging corporate power and rebuilding local food systems, tests for when a "partner" is really a risk, and specific policy calls from ending corporate sponsorship of sport to reforming the rules of engagement at global summits.

We work to move these agendas into global and regional norms — including WHO's evolving agenda on the commercial determinants — and to support governments, civil society and advocates to resist industry interference and act. This work has been supported over the years by a range of sources, including the World Bank, DFID and WHO.

Key outputs:

  • Lacy-Nichols J, Jones A, Buse K. Taking on the commercial determinants of health at the level of actors, practices and systems. Frontiers in Public Health, 2023. doi:10.3389/fpubh.2022.981039
  • Carriedo A, Labbe M, Alafia S, Buse K. Ultra-processed foods: challenging corporate power and promoting local food systems to reclaim health. Globalization and Health, 2026;22:49. doi:10.1186/s12992-026-01212-0
  • Barquera S, Carriedo A, Buse K. Health partnerships risk legitimising harmful industries. BMJ, 2026;393:s629. doi:10.1136/bmj.s629
  • Buse K, Barquera S, Wetzel M. Let's end corporate sponsorship of sporting events. BMJ, 2024;386:q1744. doi:10.1136/bmj.q1744

Rooted in the region

The commercial determinants are increasingly a Malaysian and Southeast Asian agenda as well as a global one. Writing in The Star, our team has shown how Malaysia's own systems shape obesity: the roughly RM500–600 million a year in sugar subsidies that keep sweetened drinks cheap; car-dominated cities, with passenger cars rising from about 11 million in 2010 to more than 17 million in 2023; and the marketing that helped childhood obesity more than double between 2010 and 2020. More than half of Malaysian adults are already overweight or obese, at a projected cost of nearly 3% of GDP. Our prescription is systemic rather than individual: redirect subsidies towards local produce, adopt an "obesity in all policies" test, ban junk-food marketing to children, use procurement and zoning to reshape food environments, and manage the conflicts of interest that let commercial actors dominate the policy table.

Key information

  • Topic leads: Dr Neil Sircar, Dr Shashika Bandara, and Professor Kent Buse
  • Focus: Global, with a growing focus on Malaysia and Southeast Asia
  • Global engagement: Contributor to WHO's World Report on Social Determinants of Health Equity (2025) and WHO informal expert groups on the commercial determinants of health
  • Past funding for related work: A range of sources over the years, including the World Bank, DFID and WHO
  • Full body of work: Dr Neil Sircar | Dr Shashika Bandara | Professor Kent Buse