PMAC2027 is organized around the overarching theme of Commercial Determinants of Health (CDoH). Within this architecture, Sub-theme 3 moves the conference from diagnosis to solutions. PS3.3 addresses how states and societies redesign markets so that commercial incentives work for, rather than against, health, equity, and sustainability. The session is not only about taxing harmful products. It is about market design for health: reducing returns to harmful practices while deliberately increasing returns to healthier production, equitable access, responsible innovation, climate-friendly systems, and local economic value. In this sense, economic incentives can help translate policy intent into practical behavior change by firms, investors, public purchasers, and consumers.

This session is timely because many commercial incentives still point in the wrong direction. Unhealthy products may become cheaper relative to healthier alternatives; manufacturers may prioritize high-margin products over low-price essential goods; public procurement may reward the lowest short-term price rather than health, environmental, or social value; and digital or financial markets may reward engagement, scale, and profit without adequate regard for health outcomes. Better incentive design can change these signals at scale.

Why this session matters

The CDoH agenda requires moving beyond a simple distinction between 'good' and 'bad' companies. Many sectors that shape health - food, transport, energy, housing, finance, digital technology, pharmaceuticals, logistics, and health services - are essential to modern life. The policy challenge is to discipline harmful incentives while mobilizing productive capabilities toward public value.

PS3.3 is designed to help governments and partners ask a practical design question: what combination of economic tools will shift commercial practice toward healthier, fairer, and more sustainable outcomes? The session will emphasize policy packages and market design for health rather than single instruments, because taxes, standards, regulations, subsidies, procurement rules, disclosure requirements, and market-shaping tools often work best when aligned.

Analytical framing

The session can be organized around six mutually reinforcing incentive channels:

• Corrective price incentives. Excise taxes, tiered levies, minimum pricing, and other fiscal tools can reduce demand for harmful products and encourage producers to reformulate or shift portfolios. These tools are relevant for tobacco, alcohol, sugar-sweetened beverages, unhealthy foods, and other products where market prices fail to reflect health costs. Their public health value increases when paired with transparent revenue use, inflation adjustment, and complementary regulation.
• Positive production and access incentives. Subsidies, tax benefits, co-financing, procurement preferences, and reimbursement rules can expand access to healthier and pro-poor products. This includes nutritious foods, essential medicines, vaccines, diagnostics, assistive technologies, and other goods that are socially valuable but commercially under-supplied for low-income populations. Equity should be built into the demand side of market shaping so that firms have reasons to supply affordable products for groups that markets often neglect.
• Procurement, standards, and regulatory incentives. Governments can use purchasing power and standards to reward healthier, safer, and more sustainable production. Examples include nutrition standards for school and hospital meals; green or climate-friendly criteria in public tenders; extra scoring for certified sustainable products; and regional regulatory harmonization or mutual recognition arrangements, such as good manufacturing practice standards, that create positive incentives for manufacturers to improve quality and expand into wider markets.
• Market-shaping incentives for innovation and public goods. Pooled procurement, advance purchase commitments, outcome-based contracts, and subscription or delinked payment models can stimulate products that markets under-reward. These tools are relevant for vaccines, diagnostics, essential medicines, and antimicrobial stewardship. The discussion should also extend beyond pharmaceutical R&D to One Health incentives, including export standards, responsible-use certification, procurement requirements, and supply-chain governance that encourage reduced and responsible antibiotic use in animal production.
• Investment, corporate governance, and technology incentives. Disclosure rules, due diligence, lending conditions, listing requirements, ESG metrics, blended finance, and outcome-linked contracts can influence what firms produce, market, and scale. Digital and technology firms also respond to monetization rules, advertising restrictions, platform liability, data governance, and procurement criteria. The session should ask how health outcomes can become visible and material in investment, technology, and corporate decision-making.
• SME, local market, trade, intellectual property, and competition incentives. SMEs and local producers often cannot compete with large manufacturers on scale alone, even when they deliver social, environmental, or local economic value. Targeted credit, technical assistance, preferential procurement, tax incentives, competition safeguards, and trade facilitation can help them meet health, quality, and sustainability standards. In health technologies, intellectual property, licensing, local manufacturing, procurement, and competition policy must be calibrated so innovation and equitable access advance together.