Picture credit: Ranta Images/Getty
Artillery Row

WHO do they think they are?

Politicians should be more sceptical about ideology packaged as “public health”

When I finally drink myself death, let it be known that it was not slow motion suicide but premeditated murder by the wine producers of Bordeaux. I will not be alone. Promoting a new report published by the World Health Organisation which claims that tobacco, alcohol, processed food and fossil fuels “cause an estimated 2.7 million deaths annually” in Europe, the WHO’s regional director for Europe, Dr Hans Kluge, said: “Four industries kill at least 7,000 people in our region every day.” Not four products. Four industries.

How has corporate manslaughter on such an epic scale been allowed to happen? According to the authors of the report, titled “Commercial determinants of noncommunicable diseases in the WHO European Region”, all “health-harming industries” use the same underhand political tactics, such as commissioning research, lobbying and threatening legal action, which allows them to operate with impunity while they trick and coerce people into using their products. The root cause of this problem is “the shift to deregulated forms of capitalism and trade liberalisation in which the promotion of free markets and economic exchange take precedence over people and their health”. The solution is for governments to stop listening to the private sector and give more money to academics and NGOs to engage in enlightened public health advocacy, such as commissioning research, lobbying and threatening legal action, in the public interest. Not only should governments regulate all “health-harming industries” as they do tobacco, but they need to start “rethinking capitalism”:

The root causes of ill health are linked with the current political economic system, which privileges and is influenced by the interests of powerful commercial actors over those of public health. Hence, the importance of addressing that political economic system, and rethinking capitalism, cannot be ignored.

If this sounds to you like Bolshie talk, you might be onto something. It is further confirmation that the modern “public health” movement is an arm of the hard left presented as an arm of medicine. It would be tempting to tell the authors to stay in their lane, but anti-capitalist nanny statism is their lane. For over a decade, such academics, mostly from Britain and Australia, have been pumping out studies about the “commercial determinants of health” and the “corporate political activity” of “unhealthy commodity industries”. The new WHO report is a sort of greatest hits collection. Last year they published a whole series of articles in the Lancet in which they claimed that there is “growing evidence that neoliberalism has been damaging to health” and called for “a normative shift away from harmful consumptogenic systems”. 

Half-baked Marxist rhetoric has been rife in the social sciences for decades, but these people have a vaguely coherent point to make and are pursuing a serious, if terrifying, agenda. Since they do not believe in human agency, they assume that people only make “unhealthy choices”, such as eating processed ham, because the system that controls them has been rigged by big corporations. They say in today’s report that “consumers do not have capacity (time or resources) to make the ‘right’ choice”. Fortunately, public health academics know what the right choice is and could impose it on a grateful population if it were not for the pesky free market. Hence their rage against capitalism, which extends to suspicion of intellectual property, international trade, share buybacks, impact assessments (because they allow businesses to engage with policy-makers) and even the EU single market.

And while they mostly complain about “unhealthy commodity industries”, they occasionally let slip that they are against all private industry. For example…

… the primary interest of all major corporations is profit and, hence, regardless of the product they sell, their interests do not align with either public health or the broader public interest.

Aside from being obviously untrue, this statement leads to the conclusion that the public interest would be best served by the abolition of private enterprise. This may be the view of some student Trots but what the hell is it doing in an official WHO document? it is a measure of how low the WHO has sunk that it is proudly publishing such nakedly political garbage. Did any of the WHO’s European member states approve this?

As for the claims about capitalism and health, if you can bring yourself to believe that corporations literally dictate what people do, I suppose you could be persuaded that “health-harming” corporations are literally killing people, but you should give their head a wobble and snap out of it. It is difficult to comment on the claim that four products are responsible for the death of 2.7 million Europeans a year because the authors provide no evidence for it, but any such estimate would require some heroic and contestable assumptions, especially for fossil fuels (which are, in any case, more than one product). The only sources the authors cite for this claim are figures showing how many people die of various diseases, but that doesn’t tell you what caused the diseases in the first place. 

Undoubtedly, some people die as a result of air pollution and obesity, but before we point the finger at capitalism and corporations, it is worth asking how many would die if the food and fossil fuel industries disappeared tomorrow? People have been using and abusing alcohol and tobacco for thousands of years, with or without capitalism. You don’t need advertising or transnational corporations to sell these products. They sell themselves.

It is not surprising that socialists are attracted to the “public health” agenda, nor that “public health” zealots are attracted to socialism. Both ideologies allow power to be concentrated in a small number of hands. What is surprising is that politicians who claim to be liberal or conservative have been so willing to advance their cause.

Enjoying The Critic online? It's even better in print

Try five issues of Britain’s newest magazine for £10

Critic magazine cover