HERA-lding More Integration in Health? Examining the Discursive Legitimation of the European Commission's New Health Emergency Preparedness and Response Authority.

CONTEXT: Since COVID-19, the European Commission (EC) has sought to expand its activities in health through the development of a 'European Health Union' and within it, the Health Emergencies Preparedness and Response Authority (HERA). METHODS: We applied a discourse analysis on documents establishing HERA to investigate how the creation of this institution was legitimated by the EC. We focused on how it framed health emergencies; how it framed the added value of HERA; and how it linked HERA to existing EU activities and priorities. FINDINGS: Our analysis demonstrates that security-based logics have been central to the EC's legitimation of HERA - in alignment with a 'securitization of health' occurring worldwide in recent decades. This legitimation can be understood as part of the EC's effort to promote future integration in health in the absence of new competencies. CONCLUSIONS: Securitization has helped the EC raise its profile in health politically, without additional competencies, thereby laying the groundwork for potential future integration. Looking at the discursive legitimation of HERA sheds light not only on whether the EC is expanding its health powers, but also how it strategizes to do so. HERA, while constrained, allows the EC to further deepen security-driven integration in health.

Reconceptualising the commercial determinants of health: bringing institutions in.

The concept of the 'commercial determinants of health' (CDOH) has been developed by public health researchers as a way to describe the political economy of corporations and the impact of their practices on health, social inequalities and climate change. In this analysis, we assess the conceptual work that has developed this field and the influence of the more established 'social determinants of health' models. We highlight the dominance of epidemiologic and biomedical concepts on understandings of structure and agency in the CDOH literature and argue that the terminology of 'risk factors', 'drivers' and 'pathways' reflects an agent-centred approach. We suggest that, as a result, there is a tendency to overlook the importance of political institutions in shaping the exercise of corporate power. Our analysis seeks to 'bring institutions in' to CDOH research, using the empirical cases of Health in All Policies and Better Regulation in the European Union to highlight how institutional contexts shape political legitimacy and accountability, and in turn the strategies of corporate actors. Institutionalist approaches, we argue, have the potential to develop and expand understandings of CDOH by opening the black box between agency and structure.

The World Health Organization, Corporate Power, and the Prevention and Management of Conflicts of Interest in Nutrition Policy Comment on "Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool".

The World Health Organization's (WHO's) draft Decision-Making Process and Tool to assist governments in preventing and managing conflicts of interest in nutrition policy marks a step-change in WHO thinking on large corporations and nutrition policy. If followed closely it stands to revolutionise business-government relations in nutrition policy. Ralston and colleagues outline how the food and beverage industry have argued against the decision-making tool. This commentary expands on their study by setting industry framing within a broader analysis of corporate power and explores the challenges in managing industry influence in nutrition policy. The commentary examines how the food and beverage industry's collaboration and partnership agenda seeks to shape how policy problems and solutions are interpreted and acted on and explores how this agenda and their efforts to define conflicts of interest effectively represent non-policy programmes. More generally, we point to the difficulties that member states will face in adopting the tool and highlight the importance of considering the central role of transnational food and beverage companies in contemporary economies to managing their influence in nutrition policy.