Non-governmental organisations and the regulation of harmful commodity industries: navigating global governance to change corporate practices

Lauber et al. Globalization and Health (2026) 22:40 https://doi.org/10.1186/s12992-026-01200-4 Globalization and Health Open Access RESEARCH Non-governmental organisations and the regulation of harmful commodity industries: navigating global governance to change corporate practices Kathrin Lauber1, Belinda Townsend2, Liz Arnanz3, Fran Baum4, Katherine Cullerton5, Sharon Friel2, Rodney Holmes6, Jane Martin7, Rob Ralston1 and Jeff Collin1* Abstract Background The crucial role of non-governmental organisations (NGOs) in advancing effective regulation of health-harming corporate practices is widely accepted, yet how precisely they shape global health governance is not well-understood. While a vast literature has grappled with corporate power and its political, market, and technological dimensions, less attention has been paid to strategic efforts to counter the influence of corporate actors. Drawing on international relations and political economy scholarship, we seek to understand NGO strategies aimed at achieving greater regulation of the ultra-processed food (UPF) and alcohol industries in global fora, and examine the considerations and constraints which inform NGO strategy choice. Methods We conducted 22 semi-structured interviews with professional advocates active in global debates on UPF and/or alcohol governance, complemented by six interviews with officials from international organisations (IOs). Coding combined inductive and deductive approaches, with the latter informed by existing models of advocacy strategy. Results Participants described ‘inside’ strategies targeting IOs and member states as the primary focus of their organisations’ global advocacy, underpinned by a sense that such approaches are more effective. More confrontational, outside approaches were seen as inappropriate particularly for targeting the World Health Organisation as a key forum. Core advocacy activities thus include participation in consultations and meetings hosted by IOs, although advocates did highlight less radical forms of ‘outside’ strategies, rooted in information provision rather than protest. The direct targeting of corporations was relatively uncommon, with monitoring and exposing of corporate practices primarily aimed at building momentum for governmental regulation. Advocates highlighted the importance of engagement beyond health governance, noting, however, that resource challenges preclude effective entry into new fora for many NGOs. *Correspondence: Jeff Collin Full list of author information is available at the end of the article © The Author(s) 2026. 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Globalization and Health (2026) 22:40 Page 2 of 12 Discussion The challenge of attaining and maintaining insider status in relevant fora introduces constraints which may explain the reliance on quieter, less confrontational strategies. We reflect critically on the potential value of a noisier approach to addressing health-harming corporate practices, and challenge the notion that a primary function of NGOs can and should be to act as a ‘watchdog’ of corporate practices, instead advancing a wider perspective on corporate accountability. Keywords Global health governance, Non-governmental organizations, Advocacy, Commercial determinants of health, Ultra-processed food, Alcohol Introduction The global production, distribution, and marketing of health-harming commodities poses a central challenge for public health. A growing body of research on the commercial determinants of health has examined the ways in which corporate actors have sought to influence policy and regulation [1, 2]. This includes the global level, where concerted efforts by companies and industry associations to obstruct the adoption of strong guidance, commitments, and binding instruments have been documented [3–5]. Yet, despite frequent appeals to the role civil society can and should play in counteracting such obstruction [6], advocacy strategies have received limited attention within research on the commercial determinants. Much like organisations representing corporate actors, non-governmental organisation (NGOs) make tactical choices about the strategies which best serve their interests [7]. In this article, we seek to illuminate the strategies NGOs employ when they act through global governance to influence government regulation and corporate practices. To understand this, and the decisions which underpin strategy choice, we draw on areas of scholarship with a more established focus on advocacy. Literatures on interest group behaviour, international relations, and political economy provide a rich conceptual background to understand the strategies available to health NGOs as well as the trade-offs underpinning strategic decisions. Empirically, we focus on accounts of the strategic behaviour of NGOs who engage in global governance fora with a view to promoting the regulation of health-harming industries (HHIs). We ask, firstly, how NGOs seek to influence regulation of ultra-processed food (UPF) and alcohol through global governance and, secondly, how this is shaped by the institutional context NGOs operate within. We address these questions through interviews with professional advocates from NGOs that we identified through their participation in relevant consultations and UN-led fora. In the sections which follow, we first situate our study within existing scholarship on NGO strategy, introducing the inside-outside heuristic from interest group studies and discussing contributions on global civil society from other literatures. We then consider studies of NGO activity in the specific context of global HHI regulation, before turning to an examination of the governance architecture which NGOs navigate when seeking to shape the regulation of these industries. NGO strategy and the regulation of health-harming industry behaviours The literature on interest groups is concerned with why and how interests organise to influence decision-making, as well as the strategies they employ and their impacts [8, 9]. A central heuristic within this area of scholarship is the inside-outside dichotomy. Traditionally (...truncated)