Do Large Corporations Destroy Our Health?

Martin McKee is Professor of European Public Health at the London School of Hygiene and Tropical Medicine where he co-directs of the European Centre on Health of Societies in Transition (ECOHOST), a WHO Collaborating Centre that comprises the largest team of researchers working on health and health policy in central and eastern Europe an d the former Soviet Union. He is also research director of the European Observatory on Health Systems and Policies. He has published over 530 papers in peer-reviewed journals and he is author or editor of almost 40 books.

We talk about non-communicable diseases, controversial practices of food and tobacco industry, social inequalities in health.

Large corporations are driving the non-communicable diseases epidemic, taking advantage of free trade agreements."

What is the greatest Europe's health problem now?

Europe has achieved great progress in health in the past two decades but many problems remain. It is difficult to say what is the greatest one because they all affect different groups differently. Across Europe, we see a persisting east west gap, with people in central and eastern Europe dying much earlier than their western counterparts. Although both are improving, a wide gap remains and it is hardly closing at all. In western Europe, we are seeing a risk that past progress may be undermined by ideologically driven austerity policies. These policies are inflicting further damage on economies, in contrast to the USA, which has adopted a stimuls package, but they are also leading to a reversal in previous declines in suicides.

Another area where past progress is at risk is tobacco control, as seen by resistance to measures known to be effective in reducing smoking further, in particular large pictorial health warnings and standardised packaging. Moreover, the tobacco industry is exploiting electronic cigarettes to get around advertising bans and to make images of smoking acceptable again. Sadly, too many politicians, whether in the European Parliament or in some national governments, have been too willing to accept the arguments, and the hospitality and other types of encouragement, of the tobacco industry.

Tobacco industry is exploiting electronic cigarettes to get around advertising bans and to make images of smoking acceptable again."

Life expectancy in Russia amounts only 69 years, in Switzerland it reaches 83 years. Even among rich european countries there are still lot of examples of health inequties. Which tools should be used in public health to fight with this sort of disparities?

The first thing we need is better data – in many countries we have very little information on the scale of social inequalities in health. Then we need leadership in public health, to develop and implement the policies to close the gap. If we look at the east west gap, the most important things to tackle are tobacco, alcohol, and health care, in particular the management of chronic disorders such as high blood pressure

What influence on health has a financial crisis, how health indexes are changing in the austerity times?

The main health problem is the rise in suicides in countries worst affected. Those who have lost their jobs or are at risk of doing so are most vulnerable. However, in some countries, such as Greece, we are also seeing outbreaks of infectious disease.

What European Commision and national health systems should do to minimize this austerity impact on health?

The European Commission should adopt EU-wide banking regulation to prevent a crisis like this happening in future and should consider issuing Eurobonds to raise funds for countries most affected. It is essential that funding for health systems is not cut, especially given that greater employment in the health sector will support economic growth. However, health systems can achieve savings on spebding on expensive branded medicines.

Epidemic of Non-Communicable Diseases is spreading very quickly around the world. What drives this trend? What are the other factors and which solutions would you propose?

Large corporations are driving the epidemic, taking advantage of free trade agreements.

People just like to eat fat (and fast) food, to drink sweet soft drinks, to drink alkohol. Should we forbid them to do that? Most of them wouldn't be happy...

It is not a matter of stopping people doing anything. It is simply a matter of giving people choice. At present, about 90% of the European food market is dominated by about 6 mega corporations that have massive marketing power. We should place healthier food from small producers on an even playing field and we should stop the corporations exploiting children through aggressive marketing.

About 90% of the European food market is dominated by about 6 mega corporations that have massive marketing power."

What is your "to do list" to improve health in Europe in the next decade?

First, improve the quality of the data. Second, strengthen public health laedership

January 2014 (Artur Olesch)