This year’s Civil Society Policy Forum was looking at how commercial events can determine health outcomes. As a community pharmacist I was interested to see how commercial decisions impact on health and how this can be countered. 

This is important to ensure civil society has the tools to ensure the best decisions are being taken for the best health outcomes. Commercial organisations’ first commitment is to their shareholders, not necessarily to public health. There is a need to understand and be aware of how this impacts on decision making.

After some opening remarks from HE Baroness Patricia Scotland and an introduction to the Forum by Anne Gallagher we got into the detailed discussion.

Firstly, we had Jenn Lacy-Nichols from the Melbourne School of Population Health presenting on her work which focuses on methods to monitor the political practices of corporations. 

She was presenting on the need to strengthen the evidence base on which we build our policies and strategies. Jenn gave an example of how the soft drinks industry sought to position itself as part of the solution to obesity and how this led to their involvement and input into government strategies fighting obesity. 

Secondly, Camila Maranha P. de Carvalho from the Fluminense Federal University of Brazil presented on how to prevent and manage conflicts of interest in nutritional programs. 

Camila works with others researching global ethics and how conflicts of interest can affect public health. She presented on how her work has demonstrated how conflicts of interest affected decisions on tobacco control and health promotion and how these same tactics are used today by other organisations.

Thirdly, we had Robin Ireland speaking about how commercial marketing has developed in sport over the last few decades and how this was not necessarily for the benefit of public health. He is the former Chief Executive of the Health Equalities Group charity based in Liverpool. 

Robin also discussed the need for developing partnerships and dialogue to help address the problem, though he was very aware conflicts of interest needed managing. In his presentation he discussed how commercial marketing and promotion in sport affect the public perception on current issues and what is good for our health. He went on to say academia and civil Society have a huge role to play in addressing these issues.

Finally, Shona Hilton from the University of Glasgow spoke on the theme of raising awareness and advocacy. Shona is Professor of Public health Policy at the University, and her focus was on the need to improve the timely translation of scientific knowledge into policy and practice. She discussed the influence of commercial industries and the media and how this affected public policy, not always for the better.

During the discussion, the role of academia and external/commercial finance was discussed and how this can be seen as a privatisation of public institutions and their research. This can lead to an influence on both what is researched and how it is used. 

It was also mentioned that public institutions such as universities having to balance their need to be open and transparent with commercial sensitivities. This was important in the context of research funding from government for the public benefit and the use of such research to produce, for example covid-19 vaccines, then pharma companies charging commercial rates for the final product.

As an outcome of the Forum, four draft recommendations were agreed by those in attendance.

Recommendation 1: strengthen the evidence base

Commonwealth Governments budget for country-specific, regional and global research to build the evidence-base to better document the impacts of Commercial Determinants of Health on their populations.

Recommendation 2: develop tools and capacity to address the Commercial Determinants of Health 

Commonwealth governments strengthen legislation and governance structures to minimize opportunities for commercial actors to influence policy development, and to support the participation of civil society in democratic policy making.

Recommendation 3: convene partnerships and dialogue

Commonwealth governments partner with civil society to identify and implement strategies that minimize the negative impacts of Commercial Determinants of Health and highlight strategies to foster health promoting commercial practices (while ensuring that the latter are not used to compensate for health harming practices).

Recommendation 4: raise awareness and advocacy

Commonwealth governments support independent monitoring and reporting mechanisms to share information about the impacts of Commercial Determinants of Health on peoples and society.

Finally, and as an overview, for pharmacy it is vitally important to be aware of how corporations and commercial entities are a key factor in determining the health of citizens.

The way we practice and how we are influenced is essential, if, as professionals we are to seek better health for our patients and customers. Governments set policy and strategy, but this is and has always been influenced by many actors with “skin in the game” and we need to ensure as pharmacists we play our full part.