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This paper is about the future role of the commercial sector in global health and health equity. The discussion is not about the overthrow of capitalism nor a full-throated embrace of corporate partnerships. No single solution can eradicate the harms from the commercial determinants of health—the business models, practices, and products of market actors that damage health equity and human and planetary health and wellbeing. But evidence shows that progressive economic models, international frameworks, government regulation, compliance mechanisms for commercial entities, regenerative business types and models that incorporate health, social, and environmental goals, and strategic civil society mobilisation together offer possibilities of systemic, transformative change, reduce those harms arising from commercial forces, and foster human and planetary wellbeing. In our view, the most basic public health question is not whether the world has the resources or will to take such actions, but whether humanity can survive if society fails to make this effort.

Original languageEnglish
Pages (from-to)1229-1240
Number of pages12
JournalThe Lancet
Issue number10383
Early online date23 Mar 2023
Publication statusPublished - 8 Apr 2023

Bibliographical note

SF has received research grants from the Australian Research Council and the National Health and Medical Research Council. AL has received grant funding from the International Development Research Centre, Canada, for research to support the Ghanian Government’s efforts to regulate the marketing of unhealthy foods to children. ABG is European editor of Tobacco Control and a member of the Royal College of Physicians Tobacco Advisory Group, the Council of Action on Smoking and Health, WHO International Expert Groups on Commercial Determinants of Health and on Smoking and COVID-19, the European Respiratory Society Executive Committee, and the Framework Convention Alliance Strategy Development Working Group; she has received travel support from WHO, the Prince Mahidol Award, the UK Prevention Partnership, and the European Health Forum Gastein; she has received research grants from Bloomberg Philanthropies, the UK Prevention Research Partnership, WHO Europe, the Dutch Lung Fund, the Heart Foundation, the Dutch Cancer Society, the Thrombosis Foundation, the Diabetes Fund, The National Institute for Health Research, Cancer Research UK, UK Research and Innovation, and the Global Challenges Research Fund; and she has consulted for the World Bank for a UK case study on illicit tobacco. MD has received travel support from WHO and research grants from Heathway, the Victorian Responsible Gambling Foundation, the Australian Research Council, and the National Health and Medical Research Council. All other authors declare no competing interests.

ASJC Scopus subject areas

  • General Medicine


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    Gilmore, A.



    Project: Research council

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