Commercial determinants of health: case study of ultra-processed food companies in Thailand
摘要
Ultra-processed food companies in Thailand have rapidly expanded, and they play an important role in the domestic economy and public policy. These companies influence policy-making by building networks with political authorities and using various strategies to pursue their interests. Increased consumption of ultra-processed foods has been shown to be strongly associated with obesity and other non-communicable diseases (NCDs), which are a growing public health concern in Thailand. This study investigated the commercial determinants of health (CDOH) strategies of the major ultra-processed food companies in Thailand.
MethodsThis study employed document review to classify CDOH’s strategies of ultra-processed food companies in Thailand. The authors searched publicly available information by 15 ultra-processed food companies, including both national and transnational companies, between January 2019 and December 2024. In addition, 30 semi-structured interviews were conducted with field experts to provide additional insights to support the findings from the document review. Thematic analysis was used to interpret the data.
ResultsNational ultra-processed food companies in Thailand employ all seven strategies of CDOH, namely: (1) Political, (2) Scientific, (3) Marketing, (4) Supply chain and waste management, (5) Labour and employment, (6) Financial, and (7) Reputation management strategies. Transnational companies employed all but one of the seven strategies (labour and employment).
ConclusionsThe wide array of CDOH strategies used to shape public policy and opinion may hinder efforts to protect the health of Thais from obesity and diet-related NCDs. To counter this, the authors recommend systematic monitoring of CDOH strategies, stronger accountability for the ultra-processed food companies, mandatory lobbyist registration, stricter management of conflict of interest between government officials and food companies, and strict enforcement of relevant legislation.