A pioneering new report from the WHO Regional Office for Europe spells out clearly how specific powerful industries are driving ill-health and premature mortality across Europe and Central Asia, including through interfering in and influencing prevention and control efforts for non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, diabetes and their risk factors including tobacco, alcohol, unhealthy diets and obesity. The report calls on governments to implement mechanisms to identify conflicts of interests and protect public policies from industry interferences.
Belgian Deputy Prime Minister and Minister of Social Affairs and Public Health, Frank Vandenbroucke, launched the report at a day-long event in Brussels, mid-June, in partnership with WHO European Forum on Commercial Determinants of NCDs, hosted by the Federal Public Service Health, Food Chain Safety and Environment.
The new report, ‘Commercial determinants of non-communicable diseases in the WHO European Region’, sheds light on the wide range of tactics industries employ to maximize profits and undermine public health. Those practices fuel inequality and rates of cancer, cardiovascular and chronic respiratory diseases, and diabetes, and create a major barrier to prevention policies. The report identifies actions for governments, academia, and civil society to reduce the disproportionate influence of the commercial sector in the health policy sphere.
Unhealthy Products: The Big Four
Four corporate products – tobacco, ultra-processed foods (UPFs), fossil fuels, and alcohol – cause 19 million deaths per year globally, or 34% of all deaths. In the European Region alone, these industries are wholly or partly responsible for 2.7 million deaths per year. The report explains how consolidation of these industry sectors and others, into a small number of powerful transnational corporations, has enabled them to wield significant power over the political and legal contexts in which they operate, and to obstruct public interest regulations which could impact their profit margins.
“Four industries kill at least 7,000 people in our region every day. The same large commercial entities block regulation that would protect the public from harmful products and marketing, and protect health policy from industry interference,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Industry tactics include exploitation of vulnerable people through targeted marketing strategies, misleading consumers, and making false claims about the benefits of their products or their environmental credentials. These tactics threaten public health gains of the past century and prevent countries from reaching their health targets. WHO/Europe will work with policymakers to strengthen tactics to protect against and reduce harmful industry influence. Today, we provide indisputable evidence of harmful commercial practices and products and we say: people must take precedence before profit, always.”
The Industry Playbook
The report shows clearly how commercial actors across diverse sectors, including fossil fuel, tobacco, alcohol, food, and meat among others, engage in near-identical practices to shape structural, policy and information environments. Their main goals are to generate profit, maximize product sales and drive consumption. Pharmaceutical and medical device industries, in their own way, engage in shaping public policy to favor their products and profits. To this end, big industry spends significant resources to oppose public interest regulation, shape scientific evidence and public discourse, and externalize the cost of the harms they cause onto people and their environments, thereby fueling the burden of non-communicable diseases.
This ensemble of tactics, referred to collectively as the ‘industry playbook’, is designed to influence entire systems – health, political, economic and media – for their own interests, leading to significant health and social harm. To date, actions by individual governments, and intergovernmental organizations have been insufficient to prevent or restrict these harmful commercial practices.
Deceptive Tactics
The report features a series of case studies illustrating the breadth and depth of the corporate capture of public policy and policymaking, impacting all areas of people’s lives. It describes how ‘big industry’ uses overt and covert methods to delay, deter and block NCD policies, such as tobacco control measures and mandatory health and nutrition labelling for food and alcohol products. In addition to the tactics to derail health protection policies, the report documents some of industry’s harmful practices around disease management, such as the inequitable pricing and availability of cancer drugs, and the promotion of non-evidence-based and unregulated screening tests. Common ‘industry playbook’ strategies include everything from political lobbying and spreading misinformation and disinformation in the media, to harmful financial practices, and targeted marketing strategies directed at children and young people.
Failure to regulate industry’s harmful practices has allowed commercial power and influence to grow while public wealth and power have declined, perpetuating industry-driven health harms and especially the burden of NCDs, which accounts for 90% of deaths in Europe.
“We really have to re-think,” said Minister Vandenbroucke. “For too long we have considered risk factors as being mostly linked to individual choices. We need to re-frame the problem as a systemic problem, where policy has to counter “hyper-consumption environments”, restrict marketing, and stop interference in policy making.
Our current efforts are still insufficient in regulating the harmful practices of commercial actors on health, and especially those of health harming industries. I urge all newly elected European parliamentarians and policy-makers to recognize the scale of this problem and the far-reaching impact that industry practices have on public health and indeed our democratic processes.”
The report is a call to action for the 53 Member States in the European Region to address the major threat of NCDs by tackling commercial influence at all levels – individual, environment, public policy, and political economic systems – and enforcing stronger regulations in a range of areas, including:
• marketing of health-harming products
• monopolistic practices
• transparency, lobbying, funding and conflicts of interest
• taxation of multinational corporations
• job security and labor conditions
• exploitation of vulnerable populations during crises
• funding and support for civil society organizations to ensure their independence.
Further, the report recommends the need for trade agreements to prioritize public health and for stronger health-oriented interpretations of economic laws to ensure public health does not continue to lose out to narrow, outdated economic measures.
Some countries have had successes despite strong industry opposition. In Estonia, a coalition of health partners, including dentists, nurses and physicians, helped advance legislation for taxation on sugar-sweetened beverages. In the Kyrgyz Republic, women’s councils played an important advocacy role in achieving the adoption of tobacco control. While national and international mobilization of civil society organizations helped ensure the passage of tobacco legislation in Slovenia. Much more needs to be done to help policymakers and public interest groups counter the power, resources and lobbying of industry.
Speaking at the launch of the report, Dr Gauden Galea, WHO/Europe Regional Strategic Advisor on Non-Communicable Diseases and Innovation, said, “The insidious practices of powerful industries did not appear overnight, and they will not go away easily. This is a long-term effort that requires political will, first and foremost. We clearly see how big industry behavior adversely affects public health and creates unnecessary sickness and suffering. The range of case studies in our report shows the scale of industry interference happening now in our Region, and that our current mechanisms to prevent NCDs are entirely unfit for purpose. Countries must report on their progress at the UN High Level Meeting on NCDs in September 2025 and the clock is ticking. It will require all our efforts – Member States, civil society, academia and international organizations – to shield public policy and protect future generations from preventable chronic diseases.”
Dr Hans Henri P. Kluge, WHO Regional Director for Europe: “The health impacts of just four industries kill an estimated 7,000 European citizens every day. These are the tobacco, alcohol, ultra-processed foods and fossil fuel industries.
“Yet we allow these industries to profit from the deaths they cause and behave in ways that delay or hinder effective regulation of their products.
“Because of these commercial industries, our tobacco smoking rates will soon top the global ranking among WHO regions. Our drinking is already the highest in the world. Our cancer incidence is rising. And our obesity epidemic is accelerating.
“These industries mislead the world through philanthropy while selling products that cause harm.
“They fund charities that raise awareness of breast cancer and other dangers while selling alcohol which causes these harms.
“They sell tobacco to our youth, marketing unhealthy products to our children, and extract wealth from the very societies they are harming.
“Enough is enough. We must stop this – together.
“The report being launched today is part of our effort to build a movement that unites governments, civil society, and academia behind a wellbeing economy where the health of our populations takes precedence over shareholder interests, where a thriving humanity takes precedence over the accumulation of corporate wealth.
“This report is intended to grab the attention of policy makers – including the new parliamentarians of the Commission – to make rapid progress to stop commercial industry interference and achieve NCD targets.
“Each day we delay, more lives are lost. We have a moral responsibility to act.
“Let’s build capacity among policymakers to identify, prevent and mitigate industry interference on policy.
“Let us also call upon civil society to raise their voice to educate the public, and for academia to support governments and policymakers through unbiased research.
“Last but not least, I want to thank all of you who played a part in bringing out this report.
“I would like to end by quoting Minister Vandenbroucke: ‘Let’s call a spade a spade. Policy actions have been undermined by powerful industry interests at the cost of Europeans’ health.’
“This is a very good reminder for all Ministers, and indeed each and every one of us.
“I am confident of our collective dedication and resolve – to protect our societies, our communities, our families, our friends. Together, we can succeed. This is only the beginning.”
• The WHO European Region has the highest levels globally of alcohol consumption and alcohol-related harms, and the highest levels globally of tobacco use by adolescents.
• Overweight and obesity affect almost 60% of adults and nearly one in three children in the European Region and, as of 2019, not a single country was on track to meet the global target to halt the rise in adult overweight and obesity.
• Non-communicable diseases (NCDs) are the biggest cause of premature death and disability in the WHO European Region. 85% of years lived with disability in the Region are attributable to NCDs.
• Nearly 75% of NCD deaths can be attributed to the four main diseases: cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases.
• The most recently available data (2017) shows that one out of five deaths from cardiovascular diseases and cancers in the European Union were attributable to unhealthy diets, fueled by industry-influenced obesogenic environments.
