The COVID-19 pandemic, alongside the growing threats of antimicrobial resistance (AMR), zoonotic spillover, and climate-sensitive infectious diseases, has exposed deep vulnerabilities in global health systems. These vulnerabilities are not only technical or biomedical; they are also shaped by the commercial determinants of health, including corporate practices, market incentives, information sharing, regulatory influence, and inequities in access to resources.

The One Health framework—recognizing the interconnectedness of human, animal, and environmental health—offers an important lens for understanding infectious disease threats. Yet disease risks and responses are increasingly shaped by commercial forces operating across sectors such as pharmaceuticals, agribusiness, food production, extractive industries, finance, and digital media. These forces influence where risks emerge, how research and surveillance priorities are set, and who has access to the tools needed to prevent and respond to outbreaks.

Key dynamics include commercial drivers of disease emergence, such as intensive livestock production, deforestation, wildlife trade, and globalized supply chains that heighten the risk of zoonotic spillover. Commercial interests also shape access to vaccines, therapeutics, and diagnostics, often reinforcing power asymmetries between high-income and low- and middle-income countries. During COVID-19, inequitable access to vaccines and other countermeasures reflected the combined effects of intellectual property regimes, pricing strategies, manufacturing concentration, and advance purchasing by wealthier states. At the same time, private-sector innovation—from mRNA vaccines and diagnostics to AI-enabled surveillance and cold-chain logistics—has become indispensable to infectious disease preparedness and response.

These benefits, however, coexist with significant governance challenges: limited transparency in data and information sharing, the amplification of misinformation through commercially driven digital platforms, accountability gaps for multinational actors operating across jurisdictions, and financial systems that can either reinforce harmful commercial practices or help drive better health, environmental, and social outcomes. Understanding how markets shape both infectious disease risks and the tools available to address them is essential to building more equitable, resilient, and effective global health systems.