Big Food and the World Health Organization: A qualitative study of corporate political activity in global-level non-communicable disease policy

Introduction: There is an urgent need for effective action to address the over ten million annual deaths attributable to unhealthy diets. Food industry interference with policies aimed at reducing non-communicable diseases (NCDs) is widely documented at the national level but remains under-researched at the global level. Thus, this study explores how ultra-processed food industry actors attempt to influence NCD policy at the World Health Organization (WHO).
Methods: A combination of inductive and deductive thematic coding of internal industry documents, academic literature, and interviews with key informants from international organisations and global civil society was used to identify action-based strategies ultra- processed food industry actors employ to influence global-level policy.
Results: Ultra-processed food industry actors have attempted to influence the WHO and its policies through three main action-based strategies: coalition management, involvement in policy formulation, and information management. Coalition management includes the creation and use of overt alliances between corporations—business associations—and more covert science- and policy-focused intermediaries, the hiring of former WHO staff, and attempted co- option of civil society organisations. Industry involvement in policy formulation is operationalised largely through the lobbying of Member States to support industry positions and business associations gaining access to WHO through formal consultations and hearings. Information management involves funding and disseminating research favour able to commercial interests, and challenging unfavourable evidence.
Conclusion: We provide novel insights into how ultra-processed food industry actors shape global-level NCD policy and identify a clear need to guard against commercial interference at global and national level to advance NCD policy. In their approach, the political behaviour of multinational food corporations bears similarities to that of the tobacco industry. Increased awareness of, and safeguarding against, commercial interference at the national as well as the global level have the potential to strengthen the crucial work of the WHO.