Power, Profit, and Planetary Health: How Commercial Forces Shape Our Future

Markets, capital, and commercial systems are powerful determinants of health, shaping risks and behaviors across populations. They drive harm through unhealthy commodities, environmental damage, and misinformation, but also enable innovation and access to care. The issue is not whether commerce belongs in health, but how it is governed. With strong, evidence-based regulation, transparency, and accountability, we can curb harm and align incentives so commercial forces actively advance health, equity, and planetary sustainability.

Sub-Theme 2 offers a system-level framework for understanding how macroeconomic structures, commercial practices, and political economy dynamics interact to shape policy environments, markets, power dynamics, and public discourse within a rapidly changing global political economy marked by geopolitical tension, a vast technological acceleration, inequalities in regulatory and financial power, an increasingly polarized discourse, and shifts in global health financing. It examines both the conditions under which commercial systems undermine health equity and those in which markets can support health promoting outcomes when incentives and governance arrangements are aligned with public value.

Six Interlinked Questions

1. How do macroeconomic drivers and concentrated power influence health?
   

   How do financial systems, corporate structures, and wealth concentration shape markets, agendas, and the distribution of risks and benefits across populations?

2. How do incentives and market structures translate into health pathways?
   

   How do market concentration and business models influence what products and environments are promoted, what risks are externalized, and whose health is prioritized — and how do market failures within health service delivery and financing shape access, equity, and financial protection?

3. What is the commercial playbook — and why does it travel across sectors?
   

   How do lobbying, litigation, marketing, standard-setting, and strategic narrative management operate as a coordinated and transferable set of practices across industries?

4. Who amplifies influence and shapes narratives at scale?
   

   What roles do intermediaries — trade bodies, consultancies, PR firms, and digital platforms — play in extending commercial influence across policy, science, and public norms?

5. How do interrelated mega-trends reshape the conditions under which commercial determinants operate?
   

   How are resource scarcity, climate change, conflict, and forced displacement driving the commercialization of essential goods — and why do their health consequences fall disproportionately on the most vulnerable populations and states?

6. How do commercial forces shape health leadership, institutional capacity, and talent pipelines?

   How does the "revolving door" between public and private sectors influence regulatory independence and the capacity of health institutions to act in the public interest — and what governance mechanisms can better manage these dynamics?