TY - JOUR
T1 - Illustrating the impact of commercial determinants of health on the global COVID-19 pandemic
T2 - Thematic analysis of 16 country case studies
AU - Freeman, Toby
AU - Baum, Fran
AU - Musolino, Connie
AU - Flavel, Joanne
AU - McKee, Martin
AU - Chi, Chunhuei
AU - Giugliani, Camila
AU - Falcão, Matheus Zuliane
AU - De Ceukelaire, Wim
AU - Howden-Chapman, Philippa
AU - Nguyen, Thanh Huong
AU - Serag, Hani
AU - Kim, Sun
AU - Carlos, Alvarez Dardet
AU - Gesesew, Hailay Abrha
AU - London, Leslie
AU - Popay, Jennie
AU - Paremoer, Lauren
AU - Tangcharoensathien, Viroj
AU - Sundararaman, T.
AU - Nandi, Sulakshana
AU - Villar, Eugenio
N1 - Funding Information:
Funding: This work was supported by a contract from the World Bank, and by an Australian National Health and Medical Research Council Investigator Fellowship (Baum, grant number 20099223 ). The funding sources had no role in the design, collection, analysis, interpretation, or writing of the manuscript.
Publisher Copyright:
© 2023 The Authors
PY - 2023/8
Y1 - 2023/8
N2 - Previous research on commercial determinants of health has primarily focused on their impact on non-communicable diseases. However, they also impact on infectious diseases and on the broader preconditions for health. We describe, through case studies in 16 countries, how commercial determinants of health were visible during the COVID-19 pandemic, and how they may have influenced national responses and health outcomes. We use a comparative qualitative case study design in selected low- middle- and high-income countries that performed differently in COVID-19 health outcomes, and for which we had country experts to lead local analysis. We created a data collection framework and developed detailed case studies, including extensive grey and peer-reviewed literature. Themes were identified and explored using iterative rapid literature reviews. We found evidence of the influence of commercial determinants of health in the spread of COVID-19. This occurred through working conditions that exacerbated spread, including precarious, low-paid employment, use of migrant workers, procurement practices that limited the availability of protective goods and services such as personal protective equipment, and commercial actors lobbying against public health measures. Commercial determinants also influenced health outcomes by influencing vaccine availability and the health system response to COVID-19. Our findings contribute to determining the appropriate role of governments in governing for health, wellbeing, and equity, and regulating and addressing negative commercial determinants of health.
AB - Previous research on commercial determinants of health has primarily focused on their impact on non-communicable diseases. However, they also impact on infectious diseases and on the broader preconditions for health. We describe, through case studies in 16 countries, how commercial determinants of health were visible during the COVID-19 pandemic, and how they may have influenced national responses and health outcomes. We use a comparative qualitative case study design in selected low- middle- and high-income countries that performed differently in COVID-19 health outcomes, and for which we had country experts to lead local analysis. We created a data collection framework and developed detailed case studies, including extensive grey and peer-reviewed literature. Themes were identified and explored using iterative rapid literature reviews. We found evidence of the influence of commercial determinants of health in the spread of COVID-19. This occurred through working conditions that exacerbated spread, including precarious, low-paid employment, use of migrant workers, procurement practices that limited the availability of protective goods and services such as personal protective equipment, and commercial actors lobbying against public health measures. Commercial determinants also influenced health outcomes by influencing vaccine availability and the health system response to COVID-19. Our findings contribute to determining the appropriate role of governments in governing for health, wellbeing, and equity, and regulating and addressing negative commercial determinants of health.
KW - Comparative study
KW - COVID-19
KW - Health equity
KW - Privatisation
KW - Social determinants of health
UR - http://www.scopus.com/inward/record.url?scp=85163440491&partnerID=8YFLogxK
U2 - 10.1016/j.healthpol.2023.104860
DO - 10.1016/j.healthpol.2023.104860
M3 - Review article
C2 - 37385156
AN - SCOPUS:85163440491
SN - 0168-8510
VL - 134
JO - Health Policy
JF - Health Policy
M1 - 104860
ER -