Commercial determinants of health (CDoH) operate through systems, practices, and pathways embedded in how markets are structured, how incentives are set, and how governance is exercised — across finance, technology, the arms industry, and beyond the traditional narrow set of "unhealthy commodity" industries. Population health outcomes are shaped not only by individual corporate behaviours, but by broader political-economic conditions — including deregulation, privatisation, financialisation, and global trade and investment rules — that determine whose interests are prioritised, how resources flow, and which business models are rewarded.

These commercial systems shape not only health outcomes but also the planetary conditions on which health depends: climate stability, clean air and water, and intact ecosystems. The political economy of commercial power is therefore directly linked to planetary health and the wellbeing of future generations.

Plenary 2 provides a system-level explanation of how upstream commercial forces translate into everyday environments and policy choices. It examines how wealth and corporate power shape policy agendas, regulatory environments, and public discourse — and how the commercial playbook of lobbying, litigation, marketing, standard-setting, and strategic narrative management travels across sectors and borders through intermediaries such as trade bodies, consultancies, and digital platforms. It also examines how commercial forces shape the institutional capacity of governments and health systems, including through conflicts of interest, the revolving door, and uneven regulatory capacity — particularly in low- and middle-income countries.

Plenary 2 moves from macro-drivers, to market pathways, to institutional capacity — providing the systems diagnosis that sets up the governance and solutions focus of PL3.