Governing the commercial determinants of health: the role of non-government organisations

Background and objectives: There is accumulating evidence of the ways in which commercial entities influence population behaviours, daily living conditions, and the policy and regulatory environments in ways that affect human health. While non-government organisations are increasingly involved in the governance of the commercial determinants of health, the strategies used by them to effectively influence industry practices for public health purposes has been underexplored. The objective of the research presented here is to identify which non-government organizations are involved in the governance of the food and alcohol industry in Australia and globally, and to understand the different types of direct and indirect strategies used by non-government organizations to influence commercial actors, and the conditions that facilitate or constrain their effectiveness at positively influencing commercial practices. Methods: We undertook a descriptive analysis of NGOs in Australia and globally, identified from an online search based on the typology we developed of type, issue area and governance function. In addition, a narrative review of the political science, policy studies, law, economics and public health literature identified the type of strategies used by non-government organizations to influence the practices of various industries relevant to public health. Conclusions: Non-government organizations are involved in policy agenda setting, capacity building, program implementation and monitoring and accountability governance functions. The literature identified the use of a wide range of strategies to attempt to influence commercial practices across extractive, tobacco, alcohol, food, infant formula, and medicines industries. We present these strategies in a matrix according to inside and outside tactics, targeting either industry directly or targeting government and/or intergovernmental organizations.