Commercial determinants of health: an approach for strengthening One Health interventions

The One Health approach recognizes the interconnectedness of human, animal, and environmental health, yet its implementation has largely focused on biomedical issues such as zoonoses and antimicrobial resistance (AMR). This biomedical focus often overlooks the social and economic drivers that shape these challenges. In this article, we argue that applying a commercial determinants of health (CDoH) lens can enhance the analytical and policy relevance of One Health as CDoH defines how non-public actors, activities and incentives support as well as undermine health. Specifically, the CDoH framework enables a systematic analysis of the diverse actors, interests and market dynamics that shape intensified animal production, which creates trade-offs between positive (e.g., economic growth, poverty reduction, food security) and negative (e.g., increased zoonotic risk, AMR, environmental degradation) outcomes. Moreover, it supports engagement with sectors beyond health, helping to identify governance strategies that balance economic, social, and ecological objectives. By integrating CDoH into One Health research and policy, we propose a more context-specific and politically informed approach to managing health risks in a globalized and rapidly changing world.