Tackling the Intersecting Commercial Determinants of Chronic Diseases and Global Warming

Photos: CUNY Forum, September 268, 2025, at the CUNY Graduate Center Left: Etienne Krug, WHO, and Nevin Cohen, CUNY Urban Food Policy Institute.  Right: Paula Johns, ACT Brasil; Etienne Krug, WHO, Jessica Fanzo, Columbia Climate School; and Nicholas Freudenberg, CUNY School of Public Health.  

In the last several months, political leaders, scientists, and activists from around the world gathered to assess progress and map strategies to tackle several global challenges to human and planetary well-being. 

• In May 2025 the Seventy-eighth World Health Assembly (WHA in Geneva, Switzerland, from May 19 to 27, 2025 to discuss global health priorities and conclude negotiations on a pandemic agreement. 

• In July, the Global Conference on Climate and Health met in Brasília, Brazil to synthesize evidence on the health consequences of climate change to identify health co-benefits of slowing such changes. By making health equity and social participation essential to the climate action agenda for the health sector, the meeting also hoped to contribute to the success of COP30. 

• In late September in New York at the UN High-Level Meeting on the Prevention of Noncommunicable Diseases and Mental Health (NCDs), government leaders, health officials, and civil society groups met to set a new vision for the prevention and control of NCDs and the promotion of mental health and wellbeing . A new Political Declaration laid out their recommendations but the United States vetoed the document. 

• In November, United Nations Climate Change Conference 2025 met in Belém, Brazil. The 30th meeting of the Conference of Parties (COP30) brought countries together to negotiate and agree on strategies to combat climate change and its impacts. Opposition from wealthy countries and fossil fuel industry representatives led one observer to conclude that the COP30 showed “a shared desire for global action and increasingly polarized interests.” 

In each meeting, corporations and their representatives played a major role. At the World Health Assembly, the pharmaceutical industry lobbied aggressively to ensure that the WHO Pandemic Treat, designed to improve international coordination and cooperation on the prevention, preparation, and response to future pandemics, served their interests. At the World Health Assembly and the UN NCD meetings in New York, food industry representatives sought to limit any new obligations to produce healthier food. The NCD Alliance, a coalition of groups advocating for stronger policies to prevent and manage chronic disease, objected to proposed changes, noting “the deletion of clear public health commitments to eliminate industrially produced trans-fatty acids, reduce levels of saturated fats, free sugars and sodium in processed food and beverages, and provide front-of-pack labelling (FOPL) for nutritional information significantly weakens the declaration.” 

And at both the July Climate and Health meeting and the November Climate Change meeting, both in Brazil, fossil fuel industry representatives flooded the events. At the COP30 meeting in Belem, more than 1,600 fossil fuel lobbyists and 300 from the agricultural industry registered for the event, according to an analysis by a Kick Big Polluters Out, a coalition of environmental and social justice groups. In the last four years, more than 5,000 fossil fuel lobbyists have attended U.N. climate negotiations, with 90 of the corporations responsible for nearly 60% of all global oil and gas production. 

On September 26, 2025, during the UN NCD meetings, the CUNY Urban Food Policy Institute and the CUNY sponsored a forum on “Tackling the Common Corporate Drivers of Global Warming and Noncommunicable Diseases”. The goal of the forum was to consider strategies to reduce harmful corporate influences on human and planetary health, using the previous and approaching international gatherings as evidence to synthesize what is known about effective strategies and to inform new thinking. 

Speakers at the forum included Etienne Krug, Director for Health Determinants, Promotion, and Prevention; Paula Johns, ACT Brasil, President and founder, Alejandro Calvillo, Director, El Poder del Consumidor, Mexico; Jessica Fanzo, Professor of Climate and Director of the Food for Humanity Initiative at the Columbia Climate School; and Nicholas Freudenberg, Distinguished Professor Emeritus of Public Health at the CUNY School of Public Health. Nevin Cohen, the Director of the CUNY Urban Food Policy Institute and Associate Professor, CUNY School of Public Health, served as the moderator. Interested readers can view this video of the forum. 

At the forum, and at a subsequent discussion that day with panelists and others active in addressing corporate influences on health, participants sought to answer three questions:

1. What is the rationale for addressing the common corporate influences on multiple global health crises?

2. What are the major obstacles to more unified action on common drivers?

3. What are promising strategies to tackle these common drivers?

To spark further discussion, research, and action, this report summarizes the answers to these questions.

1. What is the rationale for addressing the common corporate influences on multiple global health crises?

Recent research documents that:

• Under and overnutrition cause 11 million deaths per year, and nearly half of the deaths of children under age 5
• Tobacco causes 8 million deaths/year
• Air pollution from burning fossil fuels causes 8 million deaths/year
• Inadequate water supply, sanitation, and hygiene cause 3.5 million deaths/year, § Alcohol causes 2.6 million deaths/year
• Toxic chemicals and pesticides cause 2 million deaths/year
• Suboptimal breastfeeding driven by promotion of breastmilk substitutes causes 823,000 deaths/year.

Practices and products of the weapons and military, automobile, tech and social media, financial services, gambling, and other industries also contribute to premature mortality and preventable illnesses. Four corporate products – tobacco, ultra-processed foods, fossil fuels, and alcohol – cause 19 million deaths per year globally, or 34% of all deaths. Tackling each of these industries and causes of death separately ignores the growing evidence that common corporate practices, policies, and structures contribute to each, making a unified and aligned approach to this fundamental cause of ill health and health inequities more effective path to improving global health and equity. 

In the latter part of the twentieth century, scientific, health care, and public health systems relied heavily on the beliefs that biomedical and behavioral interventions were the most promising strategies for improving population health. Powerful business and government actors supported this approach. But in the past 50 years, the cascade of global health crises – the rising burden of chronic non-communicable diseases, mental health conditions, and new infectious diseases such as HIV, Covid-19, and Ebola, growing income and wealth inequality, the rise of precarious work, and the health and environmental consequences of global warming — suggest new approaches are needed. 

Researchers and activists have identified several common drivers of the rising prevalence of NCDs and global warming, including: 

• Unhealthy diets, especially those high in highly-processed products, and lack of physical activity are key determinants of cardiovascular diseases, diabetes, and certain types of cancers. The food industry has promoted unhealthy diets, and the automobile and other industries have promoted products and lifestyles that encourage sedentarism. The result is a syndemic of the adverse effects of climate change and unhealthy diets.
• Agricultural practices that increasingly characterize the global food system favor products and practices that contribute to unhealthy diets and increasing use of fossil fuels, as well as deforestation, drought, and fires, processes that play out globally but in specific ways in Africa and other continents.
• Both these industries depend heavily on the use of fossil fuels. Industrial agriculture depends on chemical fertilizers, globalized food trade, and heavy machinery. The automobile and other transportation industries produce products that rely on petroleum-based fuels, releasing CO2 and other pollutants. These industries also promote policies and systems that increase use of fossil fuel and discourage less harmful alternatives .
• Urbanization enables promotion, marketing and sales of unhealthy foods and less active transport. While urbanization may also present opportunities for alternatives to unhealthy diets and sedentarism , enacting these practices requires overcoming the power of these two industries, often concentrated in cities.
• High levels of stress can support unhealthy diets and sedentary lifestyles, further promoting these lifestyles and worsening rates of NCDs and climate change. Growth and monopolization of the food and fossil fuel industries can contribute to income and wealth inequality, also a source of psychosocial stress.
• Globalization, often initiated and shaped by multinational corporations, leads to monopoly concentration in food, transportation, fossil fuel, and other sectors, deregulation and privatization of formerly public services, trends that increasingly elevate the power of food, transportation, and fossil fuel industries, rather than government, to influence health, climate, and other policies.

2. What are the major obstacles to more unified action on common drivers of NCDs and global warming?

El Poder del Consumidor is a Mexican civil society association which defends consumer rights. Its first campaign is focused on the obesity epidemic in Mexico and called for a ban on marketing of junk food to children. The Brazil Shadow Report, released by ACT Promoção da Saúde in Brazil in September 2025, identifies urgent fiscal, regulatory, and intersectoral actions Brazil and other nations need to take to reduce inequalities and accelerate progress towards reducing deaths from non-communicable diseases caused by alcohol, tobacco, and other industries.  These and other groups are promoting the action needed to tackle common drivers. 

Currently, both public health and activist responses to the role of corporate influences on health often focus on a single industry — the ultra-processed food, fossil fuel, or pharmaceutical industry, for example — rather than the shared marketing, lobbying, product design, or (dis)information strategies these industries use. As a result, campaigns to modify regulatory or tax policies are siloed, missing opportunities for shared action. Some academics and advocates have encouraged the public health community to develop a public health playbook to counter the shared harmful practices employed by multiple industries. Such a guide could assist those seeking to counter harmful industry practices to anticipate and counter their actions.       
Since the 1970s, as articulated by US President Ronald Reagan and UK Prime Minister Margaret Thatcher, corporate actors have forged and promoted new business, political, and ideological practices that have consolidated their power, giving them a greater voice in shaping governance, politics, and markets. Market consolidation, financialization, deregulation, and privatization, sometimes referred to as neoliberalism, have amplified business voices and diminished the influence of voters, government, and social movements. 
More recently, democracy, the value of scientific evidence, and the rights of citizens to participate in the decisions that shape their health have come under attack in such diverse countries as the United States, Russia, Hungary, Turkey, and Brazil. In many cases, these new opponents of democracy join forces with corporate interests who also oppose any efforts to limit their power. These forces promote the disempowering idea that collective action is futile. As Maggie Thatcher famously said, there is no alternative to the current political and economic arrangements, and therefore, resistance is futile. Especially in the last few years, this mantra has led many current, former, or future academics and activists to despair of making a difference. 

3. What are promising strategies to tackle these common drivers?

Several scholars and activists have recently reviewed strategies to mitigate or reduce harmful commercial influences on health. The recommendations below focus on approaches that address the underlying causes of harm across industries.

1. Support legislation, regulation, and other policies that operate across industries to reduce or deter harmful practices such as monopoly concentration, aggressive lobbying, deregulation, and unrestricted or unreported campaign contributions.
2. Look for incremental as well as transformative changes and find ways to link the two. Some activists propose “radical incrementalism”, pushing for fundamental change, but recognizing that initial changes may be modest improvements at best. However, these gains can open windows of opportunity for action seeking future bigger changes.
3. Forge broad coalitions that include social movements, civil society groups, and government agencies and officials, and develop policy agendas that can be pursued at multiple levels and across industries
4. Create organizational infrastructures and social networks that provide safe spaces to discuss differences, consider alternative strategies, and critically analyze successes and failures.
5. Pursue strategies that grow the public sector so it can more effectively compete with the private sector to shape policy and influence business and government practices.
6. Include activists and social movement leaders in charting strategies to confront common drivers of corporate harm. Their ability to use both conventional and disruptive strategies offers a wider repertoire of responses than government alone can mount.
7. Challenge the “there is no alternative” framing with the message “another world is possible” by highlighting activist responses to current threats, the perils of the global health status quo, and successes in bringing about change at local and national levels.

Participants in the CUNY Forum and in the following discussion on September 26 were Etienne Krug, Paula Johns, Alejandro Calvillo, Jessica Fanzo, Nicholas Freudenberg, Nevin Cohen, Juliette McHardy, Marion Nestle, Emma Thompson, Rositsa Ilieva, Liv Collins, Craig Willingham, Francesca Felici, and Laura Cury. Many thanks for their contributions and insights. This summary was prepared by Nicholas Freudenberg, who takes responsibility for its content.