Commercial determinants of health: Time for tropical medicine to look beyond the clinic

Traditionally, tropical medicine has been concerned with infectious diseases in terms of diagnosis, treatment, prevention, and control. But there is a growing dual burden of communicable and non-communicable diseases in many low- and middle-income countries due to commercial determinants of health (CDoH). The marketing and availability of tobacco, alcohol, sugared drinks, and ultra-processed foods impact on health behaviour and lead to obesity, diabetes, heart disease, cancer, and poor infection outcomes. Hence, tropical medicine needs to move beyond the clinical realm to include consideration of the commercial context of disease. This requires healthcare practitioners, universities, scientific societies, and medical publications to promote informed regulation of commercial determinants, healthy food environments, taxation policy, health literacy, and protection from harmful commercial activity. It is vital that CDoH be incorporated into research, teaching and health promotion activities as an integral part of the preventive mandate of tropical medicine.