Paradigm Shift: New Ideas for a Structural Approach to NCD Prevention; Comment on “How Neoliberalism Is Shaping the Supply of Unhealthy Commodities and What This Means for NCD Prevention”

Document Type : Commentary


School of Regulation and Global Governance, Australian National University, Canberra, ACT, Australia


It is a well-documented fact that transnational corporations engaged in the production and distribution of health-harmful commodities have been able to steer policy approaches to address the associated burden of non-communicable diseases (NCDs). While the political influence that corporations wield stems in part from significant financial resources, it has also been enabled and magnified by what has been referred to as global health’s neoliberal deep core, which has subjected health policy to the individualisation of risk and responsibility and the privileging of market-based policy responses. The accompanying perspective article from Lencucha and Thow draws attention to neoliberalism in the NCD space and the way it has historically structured patterns of thinking and doing that foreground economic interests over health considerations. In this commentary, we explore how shifting from a focus on material power to discursive power creates space to see the NCD agenda as a battle of economic ideas as well as dollars, and consequently the importance of public health engagement in the next vision for the economy.


Main Subjects

  1. United Nations General Assembly. Progress on the Prevention and Control of Non-Communicable Diseases. Published 2017.
  2. Yang JS, Mamudu HM, John R. Incorporating a structural approach to reducing the burden of non-communicable diseases. Global Health. 2018;14(1):66. doi:10.1186/s12992-018-0380-7
  3. Glasgow S, Schrecker T. The double burden of neoliberalism? Noncommunicable disease policies and the global political economy of risk. Health Place. 2015;34:279-286. doi:10.1016/j.healthplace.2015.06.005
  4. Freudenberg N. The manufacture of lifestyle: the role of corporations in unhealthy living. J Public Health Policy. 2012;33(2):244-256. doi:10.1057/jphp.2011.60
  5. Stuckler D, McKee M, Ebrahim S, Basu S. Manufacturing epidemics: the role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco. PLoS Med. 2012;9(6):e1001235. doi:10.1371/journal.pmed.1001235
  6. Gilmore AB, Savell E, Collin J. Public health, corporations and the new responsibility deal: promoting partnerships with vectors of disease? J Public Health (Oxf). 2011;33(1):2-4. doi:10.1093/pubmed/fdr008
  7. Lencucha R, Thow AM. How neoliberalism is shaping the supply of unhealthy commodities and what this means for NCD prevention. Int J Health Policy Manag. 2019;8(9):514-520. doi:10.15171/ijhpm.2019.56
  8. Rushton S, Williams OD. Frames, paradigms and power: global health policy-making under neoliberalism. Glob Soc. 2012;26(2):147-167. doi:10.1080/13600826.2012.656266
  9. Peretti J. Fat profits: how the food industry cashed in on obesity. The Guardian. August 7, 2013.
  10. Glasgow SM. The Politics of Non-Communicable Disease Policy. Farnham: Ashgate; 2012.
  11. Quinn D. Beyond Civilization: Humanity's Next Great Adventure. Broadway Books; 2000.
  12. Denniss R. Curing Affluenza: How to Buy Less Stuff and Save the World. Black Inc; 2017.
  13. Lelieveld J, Klingmuller K, Pozzer A, et al. Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions. Eur Heart J. 2019;40(20):1590-1596. doi:10.1093/eurheartj/ehz135
  14. Friel S, Bowen K, Campbell-Lendrum D, Frumkin H, McMichael AJ, Rasanathan K. Climate change, noncommunicable diseases, and development: the relationships and common policy opportunities. Annu Rev Public Health. 2011;32:133-147. doi:10.1146/annurev-publhealth-071910-140612
  15. Kubiszewski I. Beyond GDP: are there better ways to measure well-being? The Conversation. 2014.  Accessed September 23, 2019.
  16. Roy E. New Zealand 'wellbeing' budget promises billions to care for most vulnerable. The Guardian. May 30, 2019.  Accessed September 23, 2019.
  17. St Martin K, Roelvink G, Gibson K, Graham J. Introduction: an economic politics for our times. In: St Martin K, Roelvink G, Gibson K, Graham J, eds. Making Other Worlds Possible: Performing Diverse Economies. University of Minnesota Press; 2015:1-25.
  18. Cameron J. Enterprise innovation and economic diversity in community-supported agriculture: sustaining the agricultural commons. In: St Martin K, Roelvink G, Gibson K, Graham J, eds. Making Other Worlds Possible: Performing Diverse Economies. University of Minnesota Press; 2015:1-25.
  19. De Schutter O. The political economy of food systems reform. Eur Rev Agric Econ. 2017;44(4):705-731. doi:10.1093/erae/jbx009
  20. Vivero Pol JL, Ruivenkamp G, Hilton A. Transition towards a food commons regime: re-commoning food to crowd-feed the world. In: Ruivenkamp G, Hilton A, eds. Perspectives on Commoning: Autonomist Principles and Practices. London, UK: Zed Books; 2017.
  21. Tirado-von der Pahlen C. Climate change, the food commons and human health. In: Vivero Pol JL, Ferrando T, De Schutter O, Mattei U, eds. Routledge Handbook of Food as a Commons. Routledge; 2018.
  22. Raworth K. Doughnut Economics: Seven Ways to Think like a 21st-Century Economist. Chelsea Green Publishing; 2017.
  23. Hartwich OM. Neoliberalism: The Genesis of a Political Swearword. St Leonards, Australia: The Centre for Independent Studies; 2009.  Accessed September 23, 2019.
  24. Monbiot G. Neoliberalism – the ideology at the root of all our problems. The Guardian; 2016.  Published April 15, 2016. Accessed September 9, 2017.
  25. Friel S. A Time for Hope? Pursuing a Vision of a Fair, Sustainable and Healthy World. Glob Policy. 2018;9(2):276-282. doi:10.1111/1758-5899.12557
Volume 9, Issue 3
March 2020
Pages 124-127
  • Receive Date: 25 September 2019
  • Revise Date: 24 October 2019
  • Accept Date: 24 October 2019
  • First Publish Date: 01 March 2020