Multinational corporations have become the world’s deadliest vectors of disease, with everyday products – fossil fuels, ultra-processed foods, chemicals, alcohol and tobacco – linked to nearly one-third of deaths each year, a provocative new paper in the world’s top-ranked medical journal warns.
An international research team, led by a Sydney scientist, have accused companies of concealing data and influencing governments to benefit their bottom line, while contributing to a massive increase in chronic diseases – including cancers, diabetes, and neurodegenerative conditions – which account for 74 per cent of global mortality.
Their analysis of the global burden of disease data found five commercial products are key factors in 31 per cent of all deaths annually:
- Fossil fuels (including plastics manufacturing): 8.1 million deaths
- Tobacco: 7.2 million deaths
- Ultra-processed foods: 2.3 million deaths
- Chemicals (used in commerce and pesticides): 1.8 million deaths
- Alcohol: 1.8 million deaths
An additional 600,000 deaths per year are attributed to drug use, primarily opioids.
The claims are unusually feisty for an article in the venerable New England Journal of Medicine. The authors essentially equate multinational corporations to malaria-carrying mosquitoes.
“I think it absolutely stacks up. All the incentives are built in. To be able to get that level of profit in a short-term way, they have to create a policy and a regulatory environment to enable them,” said Professor Sharon Friel, director of the Australian Research Centre for Health Equity; she was not involved in the research.
“It’s a very sensible way of operating as a corporation. And that comes at a cost to the environment and society.”
In Australia between 1990 and 2023, Diabetes diagnoses rose by 115 per cent, Parkinson’s by 182 per cent, Cancer by 151 per cent and Alzheimer’s by 162 per cent.
The paper underwent unusually comprehensive legal and scientific vetting before the NEJM agreed to publish it, said lead author Dr Nicholas Chartres, a corporate harm researcher at the University of Sydney.
“They looked at every single reference because they are putting their necks on the line here,” he said. “For the NEJM to say it, is why it’s big. Clinicians read the NEJM. It is their bible.”
Digging through a trove of industry documents – records in the millions – in a San Francisco library, the authors used previous research into historical tobacco industry tactics as a blueprint to uncover three key strategies deployed by other companies.
The tobacco playbook: key tactics used by “health harming” corporations
- Knowledge capture: in which corporations suppress unfavourable study results and conduct industry-sponsored research that deflects blame from their products.
- Regulatory capture: manipulating policies through lobbying “front groups” and operating “revolving door” access to governments.
- Shaping public narratives: deploying insidious and pervasive marketing and “unbranded” campaigns targeting vulnerable populations, including children.
It was the sugar industry that funded much of the research concluding that fat was the main cause of heart disease (some published in the NEJM), contributing to decades of “low-fat” diet advice.
The US tobacco industry created a Consumer Tax Alliance to fight cigarette tax increases and waged a lobbying battle against proposed regulations on a toxic fumigant used to treat tobacco.
Opioid manufacturers recruited youth coaches and school nurses to encourage children to use opioids, the paper noted.
As anti-smoking policies kicked in, US tobacco manufacturers turned to junk food, acquiring household names like Nabisco and Kraft. The foods became ultra-processed, filled with salt, sugar, and caffeine in a mix designed to keep people craving more.
The success of tobacco companies’ lobbying efforts led to Australia effectively restricting politicians’ ability to consult them. But other potentially harmful industries are routinely consulted on policies that may affect them.
The food industry conducted extensive lobbying against a traffic-light system of food labelling, leaving us with the confusing and “deeply flawed” health-star system, said Gyorgy Scrinis, associate professor of food politics at the University of Melbourne.
“They are at the table, making policy. It’s not a secret.”
What can we do about it?
San Francisco launched a lawsuit against Kraft and other food companies earlier this year, alleging that they deceptively marketed ultra-processed foods despite knowing they were unhealthy. The State of California is suing ExxonMobil, alleging its promotion of recycling was deceptive.
But it’s unclear whether these lawsuits will succeed.
Chartres thinks the most effective solutions would be to increase transparency around who funds scientific research and pass laws barring legislators from being lobbied by the companies they regulate.
And rather than allowing companies to sponsor research on their own products, the government could impose a levy to fund independent product safety studies.
Dr Jenn Lacy-Nichols, a specialist in commercial determinants of health, said corporations’ activities can have a positive effect. Think affordable vaccines, or supply chains with stellar sustainability practices. But focusing on the “good” can create false balance.
After all, a tobacco company with excellent environmental credentials still sells cigarettes.
A Minerals Council of Australia spokesman said the council engaged ethically and transparently with the government, and member companies operate under some of the world’s strictest air quality regulations.
Alcohol Beverages Australia chief executive Alistair Coe said the paper reflected ideology and ignored that Australia’s alcohol industry was highly regulated.
“Risky drinking is declining, and underage drinking has more than halved over the past 20 years. The changing drinking behaviour is not reflected in the article.”
Chemistry Australia said Australia maintains a comprehensive chemicals management framework, and its regulatory agencies are among the world’s best.
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Liam Mannix is The Age and The Sydney Morning Herald’s national science reporter.Connect via X or email.
