Community pharmacists are medicines use experts, work in highly accessible settings, and have increasingly been suggested as a workforce that can be deployed to address inequitable healthcare access in Australia. Critical examination of commercial interests and industry influence in the pharmacy sector is important considering: 1) the expansion of practice scope into more complex clinical activities (e.g. prescribing, screening) which may foster new opportunities for commercial interests to promote their products; and 2) ongoing discussions and reform of pharmacists’ remuneration from state/federal governments, private revenue, and/or ‘kickbacks’ from industry.

To explore these concepts, we analysed pharmaceutical patient support programs, which are often framed as supporting quality use of medicines and better patient adherence to medicines use.

An example is Amgen’s APPOINT program, part of the company’s osteoporosis awareness campaign. Pharmacies receive a $10 “professional service payment” per patient for identifying patients that have not had their osteoporosis medication supplied in over a month, assessing them for fracture risk, and referring them to their physicians to discuss medication options. For every patient returning with a prescription for Amgen’s 6-monthly osteoporosis treatment, pharmacies receive an additional $20 payment to supply the medication, enrol them in an SMS reminder service, and counsel/provide them with branded consumer information.

However, osteoporosis has been identified as a disease prone to overdiagnosis/overtreatment facilitated by industry promotion, resulting in unnecessary harm for patients, and this program appears to be a tool for the sponsor to increase product prescribing. Pharmacists’ involvement with these programs may conflict with evidence-based and appropriate care. The community pharmacy sector may have an inherent familiarity and understanding of the benefits of integrating commerce and health, which may render it more amenable to interactions with medical-related industries. Further research should explore governance and regulatory mechanisms to ensure accountability in pharmacy practice and improve healthcare delivery.

Background: There are concerns that nutrient-poor foods, particularly snacks, are being marketed as suitable for children under 36 months. The current study aimed to document the texture, level of processing and nutritional composition of snack foods marketed for young children in Australia.
Methods: A sub-set of data was used from an audit of foods for children under 36 months conducted in September/October 2022. Eligible products were those classified as ‘confectionery’ or ‘dry finger foods or snacks’ (snacks) under WHO Europe’s Nutrient and Promotion Profile Model (NPPM). These snack products were categorised according to their texture and assessed to identify any ingredient markers under the NOVA food classification system and levels of risk nutrients and energy density, with reference to international recommendations. An assessment of whether these snacks provide servings of any of the five food groups recommended in the Australian Dietary Guidelines was also undertaken.

Results: Thirty-five percent of all foods on the market for children under 36 months were classified as snacks, of which nearly three-quarters (73%) were assessed to have a sweet taste profile. Sixty-three percent of snacks were ultra-processed and 71% had a dissolvable texture. A significantly higher proportion of sweet snacks were classified as ultra-processed compared to savoury snacks (74% vs. 27%). All savoury snacks were found to be dissolvable, compared to 63% of sweet snacks. Only 17% of sweet snacks and 31% of savoury snacks met all proposed nutrient composition standards under the NPPMs.

Conclusions: Snack foods make up a significant portion of the market for young children. These foods are largely sweet and non-compliant with international recommendations for key nutrients. They are often ultra-processed and dissolvable and do not provide a good source of any of the five food groups. Regulation is needed improve the nutritional quality of these foods in Australia.

Background: Limited studies have investigated the association between alcohol outlet density and assault rates, with existing research predominantly relying on cross-sectional data. To address this gap, this study aims to assess the relationship between alcohol outlet density and assault rates in New South Wales (NSW) using spatial panel data from November 2015 to November 2019.
Method: Local Government Areas (LGAs) were utilised as the geographic unit of analysis, and data were collected from various sources. Four outcome variables were assessed: the rate of domestic assault, non-domestic assault, alcohol-related domestic assault, and alcohol-related non-domestic assault. The primary exposure variable was alcohol outlet density per LGA. Geo-Spatial Weighted Panel models were employed to examine the relationship between alcohol outlet density and assault rates across different LGAs over time.
Result: High alcohol outlet density was significantly associated with increased rates of domestic (β=0.096, p=0.001) and non-domestic assaults (β=0.050, p < 0.001), as well as alcohol-related domestic (β=0.047, p=0.002) and non-domestic assaults (β=0.037, p=0.001). This association varied based on region, socioeconomic status, and proportion of Aboriginal and Torres Strait Islander (Indigenous) peoples, with stronger associations observed in urban areas, lower socioeconomic regions, and areas with higher Indigenous Australian populations.
Conclusion: An increase in alcohol outlet density was associated with higher rates of assault, with variations observed across socioeconomic status, rurality of the region, and among the proportion of Aboriginal and Torres Strait Islander peoples. Reducing alcohol outlet density could effectively reduce domestic and non-domestic assaults in NSW. In addition, urban regions, and low socioeconomic status and higher proportions of Aboriginal and Torres Strait Island peoples magnified the effect of alcohol outlet density on the rate of assault. Public health practitioners and policy makers should engage Aboriginal and Torres Strait Islander communities to design culturally sensitive interventions and strategies to reduce impact of alcohol outlet density on rates of assault.

We would like to acknowledge the expertise and leadership of the Aboriginal Advisory Group who provided input into the analysis and write up of this paper.

Marketing of energy-dense nutrient-poor foods constitutes a major commercial determinant of health and driver of obesity. Reducing exposure to advertising on government-owned property is emerging as a national and state priority. This study aimed to measure the volume and type of unhealthy food advertising on public transport infrastructure in two local government areas (LGAs) within the Western Public Health Unit (WPHU) catchment area.

We recorded the details of advertisements at all 14 train stations and 1,323 bus stops in one inner-suburban (Hobsons Bay) and one outer-suburban (Wyndham) LGA between November 2023 and March 2024. To reflect typical exposure for train commuters, we captured advertisements on roaming buses adjacent to train stations for 20 minutes during peak hour. We classified food and drink advertisements as less healthy (including alcohol) or more healthy, using existing guidelines. We applied the NOVA system to classify ultra-processed foods.

We identified 386 advertisements, of which 151 contained food and drink products or brands. There was a similar number of food advertisements in each LGA, but nearly half were at bus stops in Hobsons Bay (34 of 70) compared to none in Wyndham, and roaming bus advertisements were more common in Wyndham (36 versus 8). Less healthy (73%, n=110) and ultra-processed (78%, n=118) foods accounted for similar proportions of food ads in each LGA. The most common product type was sugar-sweetened beverages (n=56), which were mainly advertised on train platform vending machines (n=33).

We found a high volume of unhealthy and ultra-processed food and drink advertising on public transport infrastructure, particularly sugar-sweetened beverage advertising on vending machines. Placement of advertisements varied between LGAs, which was partially attributable to different planning regulations. These results demonstrate opportunities for government to alter exposure to unhealthy food and drink advertising.

Background: Unhealthy diets are a leading risk factor for the global burden of disease. Early childhood presents a critical opportunity to establish healthy dietary behaviours, reducing future health risks. Clear and consistent evidence demonstrates that food marketing negatively influences children’s diets. Food marketing is ubiquitous and dominated by promotions for unhealthy foods. Commercial infant and toddler foods are heavily promoted to children and parents alike. These products are often intensely sweet, highly processed, offer limited textures, and do not align with recommended infant and toddler feeding practices. Understanding the nature of marketing across different settings can facilitate design and implementation of comprehensive regulatory controls to protect and promote healthy diets for children.

Aim: Characterise the marketing techniques used by food retailers to promote commercial infant toddler foods in supermarket catalogues.

Methods: Weekly catalogues from Australia’s four major supermarket chains were collected (Aug-Oct 2023). Each catalogue page was coded for the presence of whole core food (fresh fruit, vegetables, meat); packaged core food (packaged fruit, vegetables, meat, dairy and grains); packaged discretionary food; and packaged commercial infant and toddler foods. Product type, age range and type of packaging, and the promotional techniques on the page were also recorded.

Results: Thirty-five catalogues included one or more pages promoting commercial infant and toddler foods. The most frequently advertised infant and toddler foods were fruit purees (40%), snacks (27%) and confectionary (12%); 50% of advertised products were packaged in pouches. Promotional techniques included price promotions (86%), health-related messaging (20%), images of fresh fruit, vegetables, dairy or grains (16%); and images of babies or children (8.2%).

Implications for public health policy and advocacy: The overall dietary pattern for infants and children presented in supermarket catalogues explicitly encourages purchase and consumption of commercial infant and toddler foods. Implementing comprehensive food marketing laws is necessary to promote development of healthy dietary behaviours and protect young children’s diets from commercial influence.

Patient groups play an important role in research, policy, and support, and a voice for consumers is increasingly recognised as key to regulatory and reimbursement policy. However, many patient groups receive pharmaceutical industry funding, and studies have shown a link between funding and positions favourable to sponsors’ interests. Recent experience with aducanumab’s fast-track US approval, which has been attributed in part to strong patient group pressure, and the drug’s subsequent withdrawal, raised additional concerns about the health and policy implications of conflicts of interest within the patient sector.
In this presentation, we describe the extent and patterns of pharmaceutical industry funding of patient groups, and examine the proportion of groups’ income derived from the industry in 2022.
Medicines Australia is the trade organisation for the prescription pharmaceutical industry in Australia, and member companies are required to disclose any financial or non-financial support provided to health consumer organisations. We downloaded the annual sponsorship reports from the Medicines Australia website over a ten-year period from 2013-2022. Data were combined into a searchable database by group and sponsor.
In total, 370 groups received funding from 41 companies, though this funding was highly skewed with the top ten groups receiving over 40% of the funding. The median funding over the 10 years was $28,764 (IQR $6,575-103,125) per group. The top 50 groups represent patients with a range of cancers, rare diseases, and chronic conditions such as arthritis and diabetes. These conditions represent important markets for pharmaceuticals, and previous studies have shown that drug companies tend to fund patient groups that focus on diseases for which they have products under patent or in development.
This kind of selective funding means that patient group advocacy is likely to be skewed towards industry friendly messaging, impairing the sector’s ability to be an unbiased voice for their communities.

Scientific evidence is a cornerstone of public health policy and informs the work of health professionals. Consequently, influencing research is a key strategy employed by industry to favourably shape public opinion and policy decisions. While industry-influenced research has been investigated in sectors like pharmaceuticals and sugar, the efforts of the meat industry have remained unscrutinised, despite Meat and Livestock Australia investing millions annually to support research projects. As the impacts of meat production and consumption on public health are increasingly apparent, the industry’s attempts to influence scientific research require examination.
The study assesses whether studies including meat industry aligned authors (via employment or funding) result in favourable conclusions for industry, and what methods are used to achieve these conclusions. A systematic search was undertaken to identify studies examining meat consumption and its human health impacts. Screening was completed and data from included papers was extracted using the following categories: funding source, conflicts of interest, author affiliations, and conclusions. Data was analysed using tests of independence and odds ratios to examine the association between industry alignment and conclusion. Further, a content analysis is currently underway. This analysis will examine which strategies are used by industry influenced research to achieve specific outcomes. The results of this content analysis will be the major content of the presentation. This study will provide vital insights for advocates and policymakers, enabling them to better understand and counteract the meat industry's practices in shaping science, a key component of the commercial determinants of health.

There has been increasing attention of menopause as an under-recognised and under-treated health condition. Half the human population experiences menopause - the cessation of a woman’s menstrual periods. Like puberty, this is an integral part of the human life cycle. Women’s experiences of the menopause vary enormously both within and across cultures. They range from no to mild symptoms to frequent and severe hot flushes and associated night sweats that can lead to sleep disturbances. Current framings of menopause are constructed by a range of powerful interest groups and stakeholders, including medical groups and organisations, commercial entities seeking to profit from menopause (such as pharmaceutical companies and a growing set of menopause "influencers"), the media, and government. These groups contribute to shaping narratives which increasingly problematise and catastrophise menopause, seek to drive product consumption, and detach women’s experiences of menopause from broader social, commercial and political contexts. For example, media reports have claimed that experiences of menopause could force more than one million women out of their jobs, and that cautious prescribing decisions are based on entrenched misogyny, including a ‘tolerance’ for women’s suffering. In this presentation we examine commercial influences on the framing of menopause as a life event, both during the last half of the 20th century and within the current “second wave” of menopause marketing. We also examine the intersection between gender discrimination and these commercial messages, and the use of feminist empowerment language to sell a range of products, from chocolates to complementary therapies to prescription medicines. We will examine the equity implications of commercial narratives that use feminist empowerment messages, and the misrepresentation of product benefits, especially hormone therapies. The presentation concludes by highlighting the important role that public health can play in exposing and combating the hijacking of gender equity messages by commercial actors.

This presentation argues that among the multiple ‘streams’, or channels of activity, that constitute the commercial determinants of health, the stream of affective practices is highly significant, notably in the case of the gambling industry. Each CDoH stream supports an aspect of the CDoH apparatus for these businesses, facilitating their establishment, continued operation, and growth. Most importantly, each stream plays a role in defending harmful commodity industries from the consequences of the harmful negative externalities arising from their activities, by preventing effective regulation, building a corporate and business ecosystem to support growth of their business, and overcoming criticism and opposition from concerned citizens, officials, and public health scientists. The streams of commercial partnership building, corporate political activity, and influence over research and evidence, have been documented to varying degrees. This paper proposes that the affective practices of harmful commodity industries require consideration. The gambling industry will be used as an example, via reviews of the literature on the marketing and advertising of gambling, and on the characteristics of gambling products. In this context, affective practices are constituted by the advertising, marketing, and promotion of gambling products via appeals to emotion and affect; and by the affective elements of gambling products, particularly those products that encourage deep immersion, such as the experience of ‘the zone’. These two aspects of the affective practices operate in tandem to attract users to the product, and, having done so, extract maximum revenue from engaged users.

Planetary health equity - the equitable enjoyment of good health and Earth – is in crisis (Friel, Arthur, and Frank, 2022). At its core lies the global consumptogenic system, a complex web of institutions, policies, and commercial activities rewarding the production and consumption of fossil fuels-based goods, despite their negative impact on health and the environment (Friel, 2019). Foods are a major part of this through the production, promotion, and consumption of ultra-processed foods (UPFs) (Russell et al., 2024; Parker and Johnson, 2019; Swinburn et al., 2019). UPFs are highly profitable (low-cost ingredients, long shelf-life). Their convenience, hyper-palatability, and ownership by multinational corporations (MNCs) help them stimulate consumption (Monteiro et al., 2019; Watt et al., 2023; Mozaffarian, 2016; Hawkes, 2009).
This is concerning due to the health and environmental implications of UPFs. As green-minded consumers are willing to pay more for “green” foods (perceived as less harmful to the environment), the UPFs are catering to them using marketing, and not politics, to address climate change (Pearse, 2014). But green claims are often vague or untrue, with UPFs facing scrutiny due to “greenwashing’ practices” (de Freitas Netto et al., 2020). 
Greenwashing is the deception or false communication of environmental efforts by companies to persuade the public that products and/or practices are environmentally sound (Delmas and Burbano, 2011). It emerged in the 1980s alongside increased globalization and environmental concerns about production (Rosen, 1995), with the financialization of industry and the proliferation of green standards further commodifying sustainability and creating incentives to greenwash (IMPAKTER, 2023; Perez, 2011). Greenwashing undermines the market for green products (disincentivises innovation, punishes just efforts to produce genuine green aliments, and confuses/deceits consumers) (Yang et al., 2020; Lyon and Montgomery, 2015; Laufer, 2003).
This presentation recognises the complexity of achieving health and environmental equity in foods. It explores the power dynamics contributing to greenwashing in UPFs (the case of Nestlé) by investigating the application of Steven Lukes’ and John Gaventa's power theories (Harris et al., 2020; Haugaard, 2012; Dowding, 2006). The two reveal how MNCs like Nestlé can exploit regulatory gaps and instil greenwashing in the green market.

The global arms trade and the increasingly widespread distribution of conventional and non-conventional weapons is a major global public health issue with far-reaching implications for international security, stability, and humanitarian outcomes. The movement and distribution of weapons within and across borders have both direct and indirect implications for health by fuelling conflict, exacerbating violence, and hindering global peace and security initiatives. While the historical, socio-political and economic determinants of the arms trade are well-recognised, there is limited research into the commercial practices perpetuating the proliferation of weaponry on a global scale. This study aims to comprehensively assess the extent and type of evidence surrounding the commercial practices that underpin and drive the global proliferation of weapons by undertaking a scoping review of peer-reviewed and grey literature. The review will identify documents that examine the seven key commercial practices (political, scientific, marketing, supply chain and waste, labour and employment, financial and reputational and management practices) of arms manufacturers and how these influence the spread of weapons globally to drive increasingly poor health and inequity.
The scoping review is being conducted in accordance with the JBI PRISMA-ScR guidelines for scoping reviews. Five electronic social science, biomedical and business databases have been searched using predefined search terms related to the global arms trade, weapons and key practices. Google Advanced Search has been used to source grey literature. Documents will be screened and data from included documents will be extracted and coded. Content analysis will be used to analyse the data. The results from this study will be presented, offering comprehensive insight into the commercial practices and actors involved in the global arms trade.

For many years the tactics employed by commercial actors have been studied by public health researchers. However, the methods used to study these tactics often rely on publicly available data or interviews with current or former executives. Both of these data sources can be difficult to access and may often provide an incomplete picture of reality, or may not be representative. To gain primary data on the tactics of the commercial sector, undertaking covert research is a valuable research method. However, it can be difficult to undertake. In this presentation we will outline the barriers and enablers to conducting covert research to study the commercial determinants of health. This will include overcoming challenges around ethics applications, interacting with industry actors while undertaking the research, ensuring research integrity, and overcoming challenges related to publication.