One Health Cannot Actually Succeed without
Confronting Commercial Determinants of Health
Dr. José M. Zuniga, President/CEO, Fast-Track Health
One Health rests on a deceptively simple proposition: human health, animal health, and the health of our shared environment are inseparable. Infectious diseases cross species. Air and water pollution ignore jurisdictional boundaries. Agricultural practices influence nutrition, antimicrobial resistance, biodiversity, and climate. Decisions made in one sector reverberate across many others. Yet One Health discussions often omit a powerful force connecting these systems: commerce.
Commercial activity can advance health. Pharmaceutical and biotechnology companies develop vaccines, diagnostics, and treatments. Food producers nourish billions of people. Agricultural innovation can improve yields while reducing water and land use. Energy companies can accelerate the transition to cleaner technologies. Digital platforms can extend health information and services to previously underserved communities.
Profit and public health are not inherently incompatible. Markets can mobilize capital, ingenuity, production capacity, and distribution networks at a scale governments and civil society cannot easily replicate. The extraordinary development of vaccines during the COVID-19 pandemic demonstrated what collaboration among scientists, governments, manufacturers, and investors can accomplish. Harnessed responsibly and equitably, commercial enterprise can help translate scientific discovery into population-level health gains. But commercial activity can also shape health adversely.
The term “commercial determinants of health” describes the ways in which private-sector practices, products, and influence affect health outcomes. These effects extend well beyond tobacco and alcohol. They encompass food systems that make highly processed products more available and affordable than nutritious alternatives; industrial practices that contaminate air, water, and soil; the siting and operation of warehouses that expose workers and surrounding communities to increased traffic, air pollution, noise, and occupational hazards; intensive animal production that can contribute to antimicrobial resistance; and business models that externalize environmental and health costs while privatizing profits.
The challenge is not commerce itself; it is the imbalance between commercial power and public accountability. Companies frequently operate across borders, shifting capital, production, products, and influence among jurisdictions, while the authorities responsible for protecting health remain divided among municipalities, ministries, and national regulatory systems. Human health, veterinary health, agriculture, trade, environment, and finance agencies often work within separate mandates, budgets, and data systems. Industry can act globally and rapidly; public institutions are expected to respond locally and incrementally.
Many of the barriers to One Health are therefore artificial. We maintain bureaucratic divisions between human, animal, and environmental health even when the evidence tells us that the underlying risks are connected. We finance downstream medical treatment while underinvesting in prevention, environmental protection, and resilient food systems. We reward agencies for defending institutional territory rather than sharing authority, even when coordination would produce better and more equitable outcomes. We permit disagreements over who owns data or who must pay to collect it to prevent information from being used for the public good.
Other impediments are more deliberate. Regulatory capture can weaken oversight. Lobbying and political donations can delay protective policies. Trade and investment rules may be invoked to challenge public health measures. Corporate sponsorship can shape research priorities and public narratives, privileging evidence and messages that align with commercial interests. “Personal responsibility” is too often emphasized while the commercial engineering of price, availability, convenience, and desire remains conveniently unexamined.
Calling attention to these practices is not anti-business. It is pro-accountability. Responsible companies should not be placed at a competitive disadvantage because less responsible competitors can shift their health and environmental costs onto communities. A level playing field should recognize and reward businesses that internalize these costs and contribute meaningfully to the well-being of the communities in which they operate. Clear, predictable, and fairly enforced standards can reward innovation while protecting the public.
A credible One Health agenda must engage the private sector without allowing commercial actors to define the boundaries of acceptable action. Communities affected by commercial decisions must also have a meaningful role in setting priorities, evaluating trade-offs, and holding both companies and governments accountable. Engagement should be governed by transparency, conflict-of-interest safeguards, independent evaluation, and measurable public health and environmental outcomes. Voluntary commitments may contribute, but they cannot substitute for effective regulation.
Governments should also stop treating One Health as a specialized technical program residing somewhere between health and agriculture ministries. It should inform taxation, procurement, trade, urban planning, transportation, food policy, environmental regulation, and investment decisions. Municipal governments have a particularly important role because the consequences of these decisions converge in cities and in neighborhoods where traffic pollution, food insecurity, heat exposure, substandard housing, infectious disease risks, and limited access to care frequently overlap.
The private sector, meanwhile, should be expected to demonstrate more than compliance with minimum standards. Businesses that claim alignment with environmental, social, or health goals should disclose their political activities, supply-chain impacts, emissions, labor practices, antimicrobial use, and effects on community health. Such disclosures should be standardized, independently verifiable, and accessible to the communities most directly affected. What companies advocate privately should not contradict what they promise publicly.
One Health will fail if it remains an aspirational slogan attached to conferences, declarations, and pilot projects. Its success requires confronting the policies, incentives, and power structures that determine whose health is protected, whose environment is degraded, and who pays the resulting costs. It also demands the political courage to translate evidence into action, even when doing so disrupts entrenched interests or imposes near-term costs. Commerce must be part of the solution. But partnership cannot mean exemption from scrutiny.
Achieving One Health goals will require dismantling artificial silos, resisting avoidable political obstruction, aligning commercial incentives with public value, and insisting that health and environmental costs can no longer be treated as somebody else’s problem. Human, animal, and planetary health are interconnected. Recognizing that interdependence must change not only how we describe health threats, but also how we govern, finance, and respond to them. Our systems of accountability must finally become interconnected as well.