Commercial determinants of health in low- and middle-income countries

Much of the conceptual and empirical scholarship regarding the commercial determinants of health has been often focused on health and policy in high-income countries. However, there is a need for scholarship that focuses on commercial determinants of health globally. There are several factors that can make low- and middle-income countries particularly vulnerable to commercial forces in ways that impact on health. Commercial actors are often multi-national, and so have health impacts and commercial strategies that extend far beyond the national context, mainly driven by global and regional trade agreements. Moreover, low- and middle-income countries may have regulatory and taxation policies that make them vulnerable to the influence of multi-national corporations. Finally, low- and middle-income countries have to address the potential trade-offs between potential economic growth from an expanding commercial base compare to the potential harms from the same commercial forces. This chapter examines some of these important differences; discusses efforts to describe some of these differences in the literature; and identifies significant data, research, and governance gaps.