NACCHO preventative health news : Unhealthy big business spreading great harm worldwide-Prof Rob Moodie

Comic

“Surely we must find a balance between unrestrained commercialism and  maximising health and wellbeing. We need business  for our individual and  collective wellbeing.”

However, the benefits unhealthy businesses bring are  outweighed by the costs – in terms of premature death, chronic illness, limited  healthcare finances, overcrowding of hospitals and loss of productivity from  unhealthy employees.”

RM

Rob Moodie is professor of public health at the University of  Melbourne THE AGE 

Illustration: Jim Pavlidis.

Two-thirds of Indonesian men smoke and more than half of Chinese men smoke.  Even more disturbing is that 40 per cent of 13-15-year-old Indonesian boys  smoke. How have these levels been reached while the world has known for more  than 50 years that tobacco is such a deadly habit?

In China, it is now estimated that 114 million people have diabetes.  South  Africa has one of the highest per capita alcohol consumption rates in the world,  with more than 30 per cent of the population struggling with an alcohol problem  or on the verge of having one.

Tobacco, alcohol, and diabetes related to overweight and obesity all have one  feature in common. They are each largely driven, and in the case of tobacco  completely caused, by powerful commercial interests in the form of transnational  corporations. It has been said that China’s booming economy has brought

Two-thirds of Indonesian men smoke and more than half of Chinese men smoke.  Even more disturbing is that 40 per cent of 13-15-year-old Indonesian boys  smoke. How have these levels been reached while the world has known for more  than 50 years that tobacco is such a deadly habit?

In China, it is now estimated that 114 million people have diabetes.  South  Africa has one of the highest per capita alcohol consumption rates in the world,  with more than 30 per cent of the population struggling with an alcohol problem  or on the verge of having one.

Tobacco, alcohol, and diabetes related to overweight and obesity all have one  feature in common. They are each largely driven, and in the case of tobacco  completely caused, by powerful commercial interests in the form of transnational  corporations. It has been said that China’s booming economy has brought with it  a medical problem that could bankrupt the health system.

We now face a major dilemma: unrestrained commercial development is pitted  against the health and wellbeing of populations. This dilemma is not new –  opponents of the abolition of slavery complained it would ruin the economy – but  it is manifesting in more obvious ways in the 21st century.

The tobacco, alcohol and ultra-processed (”junk”) food and drink industries  have been rapidly expanding in low and middle-income countries. In the past  decade, tobacco retail sales growth in these countries was 20 times that of the  developed world. For alcohol consumption it was three times; sugar-sweetened  beverages it was twice. But it isn’t only Indonesia, China and South Africa  where we find this dilemma; it is alive and well in Australia.

For years we have known that the tobacco industry promotes and funds biased  research findings, co-opts policy makers and health professionals, lobbies  politicians and officials to oppose public regulation, and influences voters to  oppose public health measures through expensive public relations campaigns. This  success has  been noticed and over the past decade alcohol and ultra-processed  food and drink companies have been emulating these very same tactics.

This is of little surprise given the flow of people, funds and activities  across the industries. For example Philip Morris owned both Kraft and Miller  Brewing; the board of SAB Miller (the second largest alcohol manufacturer)  includes at least five past or present tobacco company executives and board  members; and the Diageo executive director responsible for public affairs spent  17 years in a similar role at Philip Morris.

Economic development plays an important role in the health and wellbeing of  populations. Income, employment and education levels are all major determinants  of good health. Businesses create wealth, provide jobs and pay taxes (but as we  have seen, not all of them).  One of the best ways to protect and promote health  is to ensure people have safe, meaningful jobs. The more evenly wealth and  opportunity are distributed, the better the overall health and wellbeing of a  population.

But clearly not all businesses are good or healthy – yet we see some of them  expanding their markets and influence across the globe – seemingly with no  capacity to diminish or mitigate the harm they do. It is astonishing that an  industry such as tobacco, which is so harmful to human health, can wield so much  power.  In Indonesia, Philip Morris and its affiliate, Sampoerna, will invest  $US174 million to improve production capacities so, as Sampoerna’s president has  said, ”Indonesia would be the centre of the Marlboro brand production to cater  [for] demands in the Asia-Pacific region”.

Why do they need to expand their activities? Aren’t the existing 700 million  smokers in the  region enough? Especially when we know that more than half of  them will die prematurely, losing about 20 years of life   to  tobacco.

The major tobacco, food, and alcohol companies have assets that are greater  than many countries and can wield this power in  parliament, law courts and the  media, against the interests of the public’s health.

A new battlefront in this power play is the Trans Pacific Partnership   Agreement (TPP). This trade agreement among 12 countries (including Australia,  Japan and the US) represents about 40 per cent of the global economy.

The Australian government aims to ”pursue a TPP outcome that eliminates, or  at least substantially reduces, barriers to trade and investment” and that will  ”also deal with behind-the-border impediments to trade and investment”.

It is highly complex, has 29 chapters, is being negotiated in secret and is  provoking considerable criticism on the basis that it could greatly strengthen  the hand of some industries to sue national governments for their domestic  policies and also greatly weaken the capacity of governments to buy cheaper  generic drugs. The Nobel prize-winning humanitarian group Medicins sans  Frontieres says the TPP ”could restrict access to generic medicines, making  life-saving treatments unaffordable to millions”.

If our trade negotiators buckle under the pressure from other governments,  which are, in turn, highly influenced by transnational companies, then Australia  will have to confront some major problems. These include delayed availability of  cheaper generic drugs and increased cost of medicines; interference with our  Pharmaceutical Benefits Scheme; enshrining of rights to foreign corporations,  such as tobacco companies, to sue our government; interference with our capacity  to introduce health warnings on alcohol packaging, and the limiting of future  options for food labelling.

Surely we must find a balance between unrestrained commercialism and  maximising health and wellbeing. We need business  for our individual and  collective wellbeing. However, the benefits unhealthy businesses bring are  outweighed by the costs – in terms of premature death, chronic illness, limited  healthcare finances, overcrowding of hospitals and loss of productivity from  unhealthy employees.

This is why we have governments – to ensure a balance among the rights of  individuals, consumers, businesses and society as a whole. If, as Prime Minister  Abbott has said, Australia is open for business, then we need to make sure it’s  open for good business.  If we can’t control the vested interests of unhealthy  industries in trade agreements or in our domestic regulations, unhealthy  business will come back to bite us all.

Rob Moodie is professor of public health at the University of  Melbourne

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