大企业，贫困，专制“阻碍健康政策”

The world’s poorest countries are failing to implement public health policies on tobacco, alcohol and unhealthy foods, in part as a result of commercial influence, according to research published in柳叶刀全球健康。

在全球范围内，烟草每年导致720万人死亡。每年因饮酒而导致的330万人死亡中有一半以上来自18beplay下载 such as cancer, while excess salt or sodium intake leads to the death of 4.1 million people annually, according to the健康身体。

这些所谓的非传染性疾病（NCD）每年在世界各地丧生4100万人。WHO, and disproportionately affect people in low- and middle-income countries where more than three quarters of global NCD deaths (31.4 million) occur.

政策研究人员说，在贫困和民主较少的国家以及由于腐败或政治偏爱而面临强大的公司影响的国家，实施尤其是不足的。

The researchers from the London School of Hygiene & Tropical Medicine (LSHTM), Sweden’s Karolinska Institutet, and Turkey’s Bilkent University assessed the implementation of 19 NCD policies recommended by the WHO in 194 countries in reports published in 2015, 2017 and 2020.

他们发现，在2020年，全球各地只能完全实施三分之一policies, which include raising tobacco taxes, limiting advertising on alcohol, reformulating food products with reduced salt, fat and sugar, and providing treatment for diabetes and hypertension.

Luke Allen, a researcher at the LSHTM, said: “Our study shows that implementation of these life-saving policies tends to be lowest in the world’s poorest countries.”

“我们的研究表明，在世界上最贫穷的国家中，实施这些挽救生命的政策往往是最低的。”

LSHTM卢克·艾伦,研究员

根据艾伦的说法，发展中国家也倾向于拥有较弱的民主国家，并且对“公司渗透”或影响力的影响更大。他补充说：“我们知道这些因素与慢性疾病的决策较弱有关。”

Implementation was lowest for policies relating to alcohol, tobacco, and unhealthy foods, the study said. Low-income and less democratic countries had the lowest policy implementation.

The researchers found that, in 2020, NCD policy implementation was substantially low in countries including Equatorial Guinea, where only one policy was partially implemented, Guinea Bissau (two policies partially implemented) and Sierra Leone (two policies partially implemented).

Suvadip Chakrabarti, consultant surgical oncologist at the Apollo Cancer Centre in Kolkata, India, toldScidev.Netthat in developing countries, especially India, laws on alcohol and tobacco advertising are weak.

查克拉巴蒂说：“印度是烟草产品的第三大生产商和第二大消费者。”“与此同时，我们在全球与烟草有关的癌症方面达到了第一名。”

The study highlights the effect of corporate influence on the implementation of NCD policies in various countries. According to the researchers, “[corporations] influence policymaking processes in countries where they are deeply embedded within the fabric of society, irrespective of whether they actually wield their power.”

“Beneficial effects of democracy on NCD policymaking only hold in countries where corporate influence is held in check,” they said.

SciDev.Net与英国的烟草公司联系帝国品牌and the Belgium-based organisationTobacco Europe， 通过电子邮件,for comment but no response on the findings of the study was received from them at the time of publishing this article.

Allen believes that — given that low- and middle-income countries are experiencing the steepest rises in conditions such as obesity, heart attacks, strokes, cancers, chronic lung diseases, and diabetes — there is an urgent need to counter the commercial and political vested interests that he says are vying to undermine healthy policymaking.

Christian Kraef, a physician at the Heidelberg Institute of Global Health in Germany, toldSciDev.Net：“在贫困和民主国家中解决这些问题的一种重要且不受欢迎的方法是投资，支持和促进公民社会的参与。”

He added that a number of regional and national civil society organisations were working on and advocating for better NCD policies, such as the East Africa NCD Alliance and its member organisations.

根据查克拉巴蒂（Chakrabarti）的说法，围绕食用烟草和酒精的纠正措施普遍冷漠。他补充说：“我们应该禁止在印度（印度）出售与烟草相关的产品，但与此同时，烟草行业工人应进行康复。”

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