Commercial determinants of health and cancer prevention in South Africa

Aim Commercial determinants, encompassing marketing strategies, corporate social responsibility, and lobbying, significantly contribute to avoidable cancer deaths globally. In South Africa, 30-50% of cancers are preventable, but SA focuses mainly on tobacco control, ignoring major causes of cancer such as alcohol, obesity, and ultra-processed foods. This paper highlights the role of these commercial determinants in contributing to cancer in SA. It outlines strategies and barriers in addressing these determinants. Approach While conventional approaches focus on individual responsibility relating to risk factors like tobacco, alcohol, and unhealthy diets, the role of industries in promoting these risk factors remains inadequately addressed. The paper explores the marketing and non-marketing methods employed by industries, such as tobacco, alcohol, and ultra-processed products, to maximise profits while neglecting public health consequences. Findings The article sheds light on industry tactics, including strategic partnerships, sponsorship, and diversionary narratives during crises, aimed at safeguarding profits. It emphasises the less-explored realm of non-marketing strategies, such as political lobbying, industry-funded research, and the ‘revolving door’ phenomenon where industry insiders become policymakers. Conclusions The article advocates for a paradigm shift in cancer prevention policies, urging the government to implement a comprehensive suite of measures that include increased taxation on harmful products, strict restrictions on marketing, enhanced product labelling, and eliminating conflict of interest in health research and policies. Addressing the commercial determinants necessitates not only recognising their impact but also adopting a multi-level governance approach that prioritises public health over corporate profits. The paper concludes by emphasising the urgency of recognising the links between alcohol, food regulation, and cancer prevention. The overarching goal is to shift power relations, fostering governance for the collective good and ensuring equitable access to preventive measures, especially for vulnerable populations.