When Tax Havens Cost Lives: Why Health Professionals Should Care

According to the State of Tax Justice report, over £333 billion is lost globally every year through corporate tax abuse and private tax evasion. That’s enough to fund nearly 34 million nurses’ salaries — or one nurse’s salary, every single second!

As a nutritionist, I’ve dedicated my career to helping people improve their health — through food, education, and support. Earlier in my career, I undertook postgraduate research on sweetened beverage consumption in urban areas facing socio-economic deprivation — a project that gave me a deeper understanding of how commercial forces shape what ends up in our shopping baskets and, ultimately, our bodies.

That experience helped crystallise something I’ve felt ever since: no matter how much we do at the individual level, our health systems and the people they serve, are fighting an uphill battle when they’re being bled dry by powerful industries and commercial interests operating far beyond the reach of local clinics. This isn’t just about accountants and offshore accounts. This is about beds left unstaffed, mothers giving birth without adequate care, and children going without basic nutrition.

The hidden hand of profit: how corporate influence shapes health policy from behind the scenes.

The Hidden Hand Behind Health Inequities

We often talk about the social determinants of health — the conditions in which people are born, grow, live, work, and age. But there’s another layer that deserves far more scrutiny: the commercial determinants of health. These are the strategies corporations use to promote harmful products, influence policy in their favour and avoid accountability for the resulting health impacts.

It’s not just about unhealthy items lining our supermarket shelves. It’s about how some of the world’s most powerful industries, from food and drink to pharmaceuticals and fossil fuels, use their financial and political influence to shape policy, resist regulation, and steer public conversations in their favour.

When multinational corporations shift profits to tax havens, they actively weaken public services. The money lost could fund school meal programmes, local authority support for families, public health campaigns, community nutrition initiatives, NHS staff salaries — and so much more.

The damage doesn’t stop there. When governments are swayed by corporate lobbying, private donations, or partnerships that blur the line between public service and private profit, democratic accountability begins to erode. Policy decisions start to reflect commercial priorities instead of public needs. Regulations are watered down. Health warnings are delayed. Tax reform is stalled. And ultimately, it's the public — especially those already disadvantaged — who are left to bear the cost.

Commercial determinants don’t just affect our health —

they distort the systems meant to protect it.

When Profit Shapes Policy: UK Examples of Commercial Influence

While the concept of commercial determinants of health can feel abstract, its effects are very real and very visible right here in the UK. From sugary drinks to NHS contracts, corporate influence has repeatedly shaped, delayed, or diluted health policy decisions. The following UK-based examples illustrate how these commercial dynamics play out in practice — often at the expense of population health and policy integrity.

1. Delays to Junk Food Advertising and Promotions Ban

In 2020, the government announced plans to restrict advertising of high fat, sugar and salt foods (HFSS) before 9pm and to ban promotional offers like “buy one get one free” on unhealthy products. But following sustained industry lobbying, including arguments around economic recovery after COVID, the policy has been delayed multiple times, now set for October 2025 at the earliest. Public health experts warn this delay will come at a real cost to child health.

2. The “Sugar Tax” and Industry Resistance

The Soft Drinks Industry Levy, introduced in 2018, led to a significant reduction in sugar content in many popular beverages. But it faced years of pushback from parts of the food and drink industry, who painted it as overreach and harmful to business. It eventually passed, but only as a rare exception to the norm of corporate resistance succeeding.

3. Food Industry Involvement in Policy-Making

From front-of-pack labelling to reformulation targets, the food industry has long been involved in shaping government decisions, often from inside advisory committees. This close involvement can slow down bold action on ultra-processed foods and raises concerns about whether public health is truly the priority in those rooms.

This influence doesn’t stop at government. Across the UK, several professional and advisory organisations in the nutrition field include senior figures who hold, or have held, roles in major food companies. While collaboration between professionals and industry can offer insights, close and ongoing ties to companies producing HFSS products present a clear conflict of interest, particularly when these individuals are involved in policy advice or standard setting.

A 2023 investigation by The BMJ found that over half of the experts on the UK government’s nutrition advisory panel had links to the food industry — a stark reminder of just how deeply embedded commercial interests can be in the very bodies tasked with protecting public health.

If we’re serious about tackling the commercial determinants of health, we need to ask difficult questions about transparency, independence, and accountability — not just in government, but within our own professional institutions. Being part of a health profession means putting public wellbeing first — even when it means questioning the systems we're part of.

4. NHS Outsourcing and Private Sector Expansion

The expansion of private sector roles in delivering NHS services, often through public-private partnerships or direct outsourcing, represents another form of commercial influence. While not framed as a health harm in the traditional sense, these partnerships shift decision-making toward financial efficiency and away from transparency and public accountability, with unclear long-term effects on equity and quality of care.

As a Nutritionist, Why Do I Care?

I care because food insecurity and malnutrition aren’t random. They’re symptoms of underfunded health and social systems. And those systems are underfunded, in part, because the wealthiest corporations are not paying their fair share.

I see the effects first-hand:

• Schools unable to provide consistently nutritious meals due to rising food costs, limited funding, or eligibility gaps in free school meal provision

• Mothers who struggle to access infant feeding support — whether due to postcode, funding cuts, or lack of culturally appropriate services

• Communities without access to affordable, healthy food

• Families relying on ultra-processed products because they’re cheaper and more heavily promoted than healthier alternatives

  
  

If we want to tackle the root causes of poor nutrition, we must look beyond diet and behaviour. We must look at power and profit.

Time to Raise Our Voices

This isn’t just a problem for economists or tax lawyers to solve. It’s a public health crisis, which means every health professional has a stake in it.

So here’s what I’m asking:

• Let’s talk more openly about tax justice in our health spaces.

• Let’s call out the contradiction when companies who underpay taxes sponsor health initiatives.

• Let’s demand transparency and fairness — not as activists, but as professionals committed to human wellbeing.