How Private Companies Are Transforming The Public Health Agenda
During the 1970s and 1980s, the World Health Organization and other global health leaders often strove to improve the health of the world’s poor by targeting private sector excesses. They imposed restrictions, codes, and “ethical criteria” on the marketing of infant formula, pesticides, and tobacco, unnerving executives and stifling business plans. Success hinged on the cooperation of local governments, but where policymakers implemented recommendations they achieved real results. Breastfeeding rates rose, pesticide poisonings fell, and tobacco consumption declined.
Since then, the global health establishment has been turned on its head. Over the last two decades, the private sector has emerged as the world’s top source of financing and leadership in the fight against deadly disease. The resources of some of the private industry players involved in global health today dwarf those of the WHO. Groups such as the Global Business Coalition aim to turn “business assets into disease-fighting assets”; the GBC boasts a membership of nearly 200 companies, including multinationals such as Coca-Cola, Exxon Mobil, and Pfizer. Why the interest? Firms are responding to local demands for corporate social responsibility, but they also have come to realize, as they look to emerging markets for future growth, that underwriting public health is a long-term investment. As development economist Daniel Altman recently explained, in a global economy, “these people are your consumers, your workers, your investors.” Several former WHO officials now work on public health issues for private industry. Most telling is the fact that voluntary contributions from private interests and others now bankroll four out of every five dollars of the WHO’s budget.
The problem is that the companies most active in global health projects today hail from a narrow range of industries, many of which are under fire for their negative impact on public health. These private firms are playing a double game: disrupting local communities with one hand and writing big checks to ostensibly help them with the other. Often, their core financial interests are directly at odds with the business of improving the health of the poor, in ways that are distorting the global health agenda.