Governance and regulatory systems have often struggled to keep pace with the increasing complexity, scale, and influence of private-sector actors and sometime-dramatic changes in medical and health needs, as can happen due to outbreaks, climate change, demographic shifts, major migrations, and other factors. Important gaps remain in how governments can effectively govern and align commercial incentives with public health goals, and manage conflicts between profit motives and equitable access to care. Additional challenges are introduced by the vast variety of circumstances that characterize groups and individual. For example, Variation in education, economic status, employer, geography, legal status, and immigration context are all influential on the how, what, when, and where that profoundly shape access to medical and health interventions. The session will examine how commercial incentives shape which services are developed, marketed, financed, and delivered, including inequitable access to essential medicines and technologies, low-value care, irrational use of services, antimicrobial resistance, and the role of media and digital platforms in shaping expectations and demand. Also, we will explore how these market and regulatory dynamics play out for people and groups in different circumstances