Intensified marketing and expanding consumption of ultra-processed foods (UPFs) that contain high sugar, salt, trans-fats and other additives and sugar sweetened beverages in Sub-Saharan Africa (SSA) are associated with rising obesogenic environments and non-communicable diseases, termed by some an ‘industrial pandemic’ due to its commercial drivers and cross border nature. This review paper addresses the question of how far SSA, positioned at an early point of a rising wave, is controlling this growing health challenge. It presents information on responses underway in SSA on (i) generating and sharing evidence and information as a form of discursive power; and on engaging (ii) on policy, regulation and other institutional measures; and (iii) at structural level, on taxes on UPFs and sugar sweetened beverages (SSBs) and investment measures, including to promote healthy food system alternatives, particularly in urban areas. While there is clear policy recognition of the need to respond effectively, the findings suggest that the response is not yet matching the scale or pace of the challenge. The paper examines the challenges in and options for implementing regulatory, policy, tax, and institutional interventions to prevent the health harms of UPFs and SSBs.
Health equity in economic and trade policies
Corporate fast-food retailers (FFRs) represent a key retail channel through which both ultra-processed foods and intensively produced animal source foods are consumed and normalised within corporate-industrial food systems. These dietary patterns are strongly associated with increased risks of diet-related diseases and contribute significantly to environmental degradation, including greenhouse gas emissions, land use change, and biodiversity loss. Despite the growing significance of FFRs, there has been limited analysis of their financial strategies and implications for global food system transformation. The authors conducted a global analysis of market data from 54 countries and financial data of publicly listed FFRs, examining trends in FFR sales (2009–2023), market dominance, and the financial performance of leading publicly listed firms (1980–2023). While sales in high-income countries were stagnating, leading firms maintained stable net profit margins and delivered relatively high shareholder returns, facilitated by financial strategies such as franchising and private equity ownership. U.S.-based corporations dominated the global market, with substantial expansion into countries outside the global North. These trends reflect the consolidation of power within the corporate food regime. The global expansion of corporate FFRs underscore their growing influence over diets and food systems, with critical implications for public health, ecological sustainability, and social justice. Policies targeting structural leverage points, for example, democratising corporate governance, reducing the influence of private equity, and re-orienting agri-food subsidies, are essential to countering the entrenchment of this model and supporting more democratic and sustainable food systems.
There are three innovations with Global Health Watch 7 (GHW7). First, almost all of the chapters involved writing groups and contributions representing the geographic breadth of People’s Health Movement (PHM). As an exercise in ‘movement building,’ writing groups were encouraged to use their chapters as opportunities to discuss and engage across these geographies, allowing activists to learn with each other. PHM published with a solidarity publisher (Daraja Press) where each chapter could be posted for free download and distribution as soon as it was completed, and is now downloadable as a single book PDF or as an on-demand print version in English and Spanish. GHW7 comes to life with contributions from over one hundred activists around the world, sharing experiences and analysis on issues affecting people’s health in the contexts they live in and efforts to progress towards greater health justice.
This commentary addresses the global health security threats posed by increased critical minerals mining in Africa driven by the clean energy transition and 2050 net-zero emissions targets. The Democratic Republic of Congo houses over 55% of global cobalt reserves and produces 75% of global cobalt, while Guinea contains the world's largest bauxite reserves, South Africa holds over 70% of platinum, and Zimbabwe has the largest untapped lithium deposits. The author argues that without appropriate safeguards, expansion of mining operations increases risks of mining-associated infectious disease outbreaks with epidemic and pandemic potential. Several studies report linkages between habitat encroachment from mining activities and outbreaks of emerging/re-emerging infectious diseases, with examples from DRC and Uganda. The recent emergence of a more severe strain of the 2023 Mpox outbreak in DRC has for example been traced to the Kamituga mining area. The author recommends expanding Environmental, Social, and Governance standards to include biosecurity risk analysis under Environmental Impact Assessments; increased stakeholder representation in the Mineral Security Partnership; integration of spill-over/emergence/spread (SES) risk analysis into the draft Pandemic Accord, and leveraging earth observation technologies and pathogen surveillance for early detection and prevention of mining-associated health security threats.
This blog post discusses how conflicts in Gaza, Sudan, and Ukraine, affecting 2.4 billion people worldwide, create conditions where bacteria develop immunity to existing drugs through the destruction of infrastructure, forced population movements, and environmental contamination. Heavy metals used in weapons (zinc, lead, mercury, chromium, antimony, and barium) released during bombings are easy inducers of antimicrobial resistance. Examples from Iraq, Afghanistan, Libya, Syria, and Gaza show recurrent outbreaks of multi-resistant bacteria among military personnel and civilians. AMR is said to have already resulted in 5 million deaths in 2019, with projections suggesting humanity could return to a "pre-penicillin era" if current trends continue. The author argues that the systemic scope of AMR is underestimated, with hyper-reductionist interpretations dominated by financial interests in food, pharmaceutical, and bio-surveillance industries reluctant to change course. Microorganisms are observed to know no geopolitical borders and to strengthen their ability to spread silently during uncontrolled chaos of war, with spill-over effects in neighbouring countries and regions affected by ongoing conflicts.
Economic and labour policies significantly impact health and well-being through financial and environmental mechanisms. The rapid rise of generative artificial intelligence (AI) presents challenges to economic stability, with the potential to perform non-routine cognitive tasks and create new efficiencies. While offering opportunities for innovation, AI's labour-displacing potential raises serious concerns about economic equity and social health. The authors propose an AI-capital-to-labour ratio threshold that could trigger a self-reinforcing cycle of recessionary pressures beyond market correction. They call for a proactive global response that reorients economic systems towards collective well-being, as outlined in the World Health Assembly resolution Economics of health for all and the United Nations' Global Digital Compact. Integrated strategies combining fiscal policy, regulation, and social policies are critical to ensuring generative AI advances societal health while mitigating potential harm from excessive job displacement.
Commercial sex and mining have long been interwoven. With the spread of neoliberal capitalism, social relations around the mine site have become increasingly commodified. This ethnographic study examines the experiences of female sex workers in the mining town of Solwezi, Zambia. Women's stories offer insight into the lives of those excluded from the conventional women's economic empowerment narrative that has been widely adopted by the mining industry and what this means for their wellbeing and health. Despite the rhetoric, economic empowerment is not easily attained and women often remain heavily reliant on mine workers given limited and unequal opportunities within the labour market. In Solwezi, women who have been abandoned by a mine-working husband may find that sex work is the one opportunity available to them. Alternatively, women have migrated from across the country to participate in commercial sex work in Solwezi. Men, especially mine workers with twice-monthly pay cheques, have become a sought-after commodity, by both sex workers and wives. This has increased their power in their relationships, entrenches inequality, and increases the potential for abuse in these relationships. Despite these dynamics, sex working women continue to be neglected in Solwezi and by the broader development community. When they are considered, generally attention is directed towards HIV prevention. The authors note that these interventions fail to consider the complex social, political, and economic context that can affect women's living and working conditions.
The COVID-19 pandemic has forced a reflection on the origins of supplies in African healthcare market and underscored the need for an increase in local manufacturing of medical supplies. Several African countries’ health markets have been heavily reliant on imports. This article demonstrates how the African healthcare market has had a high import dependency and the role that the African Continental Free Trade Area (AfCFTA) could play to reverse this. It is estimated that African countries import between 80% and 94% of medical supplies, 75% of testing kits, between 70% and 95% of pharmaceuticals, and 99% of vaccines. During the COVID-19 pandemic, countries imposed export restrictions which impacted the flow of medical supplies to African countries. This finding highlighted the limited production capabilities on the African continent and reiterated the need to strengthen continental value chains and local manufacturing capacity for public health on the continent. Local innovations sought to minimize the impact of these supply chain disruptions. Using case studies on the local production of COVID-19 testing kits and personal protective equipment, the article highlights progress made toward health market reform. It calls attention to the implementation of the AfCFTA to strengthen the supply, manufacturing, and trade of medical resources. The article highlights countries that have African-made pharmaceuticals and vaccinations and the importance of regional hubs to expand these products in African healthcare markets. The author concludes by discussing investments made to expand local manufacturing of health products.
This paper aimed to assess community members’ perceptions regarding health risks associated with potentially toxic elements and cyanide pollution in Kwekwe City. An explorative cross-sectional study was conducted with key stakeholders and industrial settlements’ residents. Face-to-face interviews with key informants and focus group discussions with residents and workers were used to gather data. A thematic approach was utilised in data analysis. Study participants, who played a crucial role in the research process, perceived that industrial pollution principally linked to cyanide, mercury and chromium posed significant environmental and health risks. This participatory approach in risk perception assessment is critical in providing insight into the scope of the problem and formulating intervention strategies. However, given that qualitative study results lack generalisability and replicability, quantitative studies need to be undertaken to determine environmental levels of toxic chemical pollutants as a complementary measure.
The World Bank’s 2024 Global Economic Prospects report, indicates that global economic growth will stabilize in 2024 at a pace that is insufficient for progress on development goals.The needs for adaptation, Africa’s priority, remain underestimated, particularly for universal access to energy. To address these daunting challenges, the report asks where is the money? External resources are substantial, but with problematic accessibility, conditionalities and ineffective utilisation. Debt has become an impossible option, as Africa’s external debt has already tripled since 2009, and is compounded by a complex structure that renders traditional relief mechanisms obsolete. Foreign Direct Investment (FDI) and participation in global financial markets remain disproportionately low. To move forward, the foundation calls for a radical reboot of the current multilateral financial system and more effective organisation and use of domestic resources. According to the African Union, the mobilisation of the continent’s domestic resources is expected to cover up to 90% of the financing required for Agenda 2063. This means drying up illicit financial flows, strengthening tax systems- African states cannot afford tax holidays for foreign companies-, leveraging remittances, sovereign funds, pension funds and private wealth, monetising Africa’s green assets – biodiversity, critical minerals, carbon-sinking potential. This is argued to demand a paradigm shift that avoids any trade-off between climate and development, that moves beyond the aid and charity model to a cooperative, deal- making one, and that puts ownership in Africa.