Close up of medic expert using glucometer for sugar level measurements, checking the insulin levels and ensuring diabetic care in busy drugstore space. Specialist does health consultation.
Ghana is facing a rising burden of non‑communicable diseases (NCDs); 45% of deaths in Ghana are now caused by NCDs such as hypertension, heart disease, and diabetes. According to the latest reports from the WHO STEPS (STEPwise approach to NCD risk factor surveillance) and demographic health surveys, obesity and being overweight are now among the most pressing risk factors. Nearly 1 in 2 women aged 20-49 years and 2 in 10 men are overweight or obese. Childhood obesity and overweight are also on the rise; nearly one in ten children under five is overweight or obese, and overall, about 19% of Ghanaian children fall into these categories. These trends are not simply the result of individual choices but of structural forces: the marketing of sugary foods, the exploitation of weaker regulatory environments, and the embedding of unhealthy diets from early life.
Big food transnational corporations (TNCs) play a central role in the rising burden of NCDs by shaping food environments toward highly processed, energy-dense, and nutrient-poor products. Through aggressive marketing, product reformulation strategies, pricing power, influence on policy and research, and partnerships with public institutions, these corporations normalize unhealthy diets and make them more accessible and desirable. As Ghana grapples with a rising burden of NCDs, the role of TNCs in shaping health outcomes cannot be ignored.
Nestlé provides a clear example of how big food TNCs contribute to the rising burden of NCDs. As one of the world’s largest food and beverage companies, Nestlé has significant influence over what people eat through its wide portfolio of processed and ultra-processed products, many of which are high in sugar, salt, and unhealthy fats. The company has cultivated partnerships across diverse sectors, including academic institutions, regulatory agencies, community initiatives, product marketing, and supply chain programs in Ghana. Yet, when viewed through the lens of commercial determinants of health, these partnerships raise serious concerns.
“Can the same companies driving poor diets also be trusted to shape public health solutions?”
To better understand how these dynamics play out in practice, it is useful to examine Nestlé’s partnerships in Ghana more closely, looking at each engagement on its own terms. While often presented as mutually beneficial collaborations, these partnerships operate across different domains—including academia, regulation, and community development—each with distinct implications for public health. By unpacking them individually, it becomes possible to move beyond general concerns about corporate influence and instead identify the specific pathways through which interests may align, diverge, or conflict.
Academic Partnerships and Conflicts of Interest
Partnerships between multinational food corporations and academic institutions are increasingly common in Ghana, often framed as opportunities for training and research. For example, the University of Ghana and Kwame Nkrumah University of Science and Technology have both engaged with Nestlé Ghana on initiatives “to offer students practical learning opportunities to enhance their skills in the area of nutrition, science, and technology.” While such collaborations offer clear benefits, they also raise concerns about influence. Embedding companies linked to health-harming products within academic spaces risks shaping research priorities and professional norms and can fundamentally conflict with the public health mandate of promoting and protecting health.
Regulatory Partnerships and Institutional Independence
Partnerships between regulatory bodies and industry actors raise particularly important questions for public health governance. In 2019, the Ghana Standards Authority entered into a strategic partnership with Nestlé Ghana to support laboratory services, standardisation, and technical capacity. This collaboration is presented as a means to strengthen food safety systems, but it also creates closer alignment between a regulator and a major food industry actor. This proximity can generate real or perceived conflicts of interest, especially when the same institution is responsible for setting and enforcing standards for products linked to diet-related health risks. In a context of rising NCDS, maintaining regulatory independence is critical. Without clear safeguards, transparency, and accountability mechanisms, such partnerships risk blurring the line between oversight and collaboration, with potential implications for public trust and health protection.
Corporate Social Responsibility or Strategic Positioning?
Nestlé’s partnerships also extend into community and humanitarian initiatives. In 2022, Nestlé Ghana collaborated with the Ghana Red Cross Society to improve access to safe water in cocoa-growing communities. While such initiatives provide tangible benefits, they also serve strategic purposes, supporting a stable workforce, strengthening corporate legitimacy, and enhancing public image. Given longstanding concerns about labour practices in cocoa supply chains, including child labour, these initiatives may function as reputational tools that deflect attention from deeper structural issues.
Double Standards and Health Risks
One of the most striking examples of corporate influence is Nestlé’s marketing of infant foods. Nestlé’s business practices in Africa have been heavily criticized marketing baby cereals with added sugar while offering sugar‑free equivalents in the Global North. Recent analysis by the Public Eye and the International Baby Food Action Network (IBFAN) reveals that Nestlé’s products marketed in Africa (and other low-income countries) commonly contain added sugar—about 6 g per serving on average. In contrast, equivalent products in Switzerland and key European markets are sold without added sugar. The World Health Organization’s guidelines recommend no added sugar in baby foods, as exposure to sugar early in life can create a lifelong preference for sugary products and is a major risk factor for developing obesity. This practice exemplifies a commercial determinant of health—where corporate product design and market segmentation exploit weaker regulation in low- and middle-income countries, embedding health risks from the start of life. These “double standards” highlight how weaker regulatory environments may be exploited, raising serious implications for child health and nutrition in Ghana. Such double standards not only raise serious concerns for child health but also highlight global inequities in food governance, where the quality of nutrition a child receives depends less on science than on geography and regulation.
Why This Matters for Public Health
Together, these examples illustrate how corporate actors operate across multiple domains—research, regulation, and community engagement—to shape health environments and narratives. Nestlé’s partnerships illustrate the multiple pathways through which industry positions itself as a stakeholder in public health—while simultaneously contributing to the very diet-related risks driving Ghana’s NCD epidemic. Each of these collaborations is often presented as mutually beneficial, offering training, resources, or social support. Yet, when examined through the lens of commercial determinants of health, they reveal how corporate actors embed themselves in public institutions and community spaces, gaining legitimacy and influence that can shape health agendas. In this context, Nestlé’s partnerships may not simply support Ghana’s public health goals—they may actively undermine them.
This raises a critical question: should such partnerships be dismissed outright as conflicts of interest, or can they be structured in ways that truly serve public health?”
It’s important to ask whether these collaborations are inherently harmful—or whether they can sometimes deliver genuine public health benefits. Industry partnerships may provide funding, technical expertise, and infrastructure that public institutions struggle to secure on their own. At the same time, they carry risks of influence, agenda‑setting, and weakened accountability. The real challenge, then, is not simply labeling partnerships as good or bad but asking, under what conditions can they be structured to truly serve public health rather than corporate interests?
As a researcher having worked in the tobacco control space and now researching other health-harming industries, including ultra-processed foods, sugar-sweetened beverages, and alcohol, I have learned from these partnerships to look beyond individual projects and ask, “Who benefits from the structures that produce them?”
The tobacco industry once positioned itself as a development partner, funding research and community projects even as its products fuelled rising rates of cancer and cardiovascular disease. That history offers a cautionary lesson: corporate partnerships can confer legitimacy and influence that mask the harms of their core business. Nestlé’s entanglements in Ghana—through academia, regulation, and community initiatives—echo this pattern, raising urgent questions about whether such collaborations truly serve public health or entrench the very risks they claim to address. The question is no longer whether industry partnerships should exist but how they are governed—and whether public health will remain the priority. Ultimately, safeguarding Ghana’s health future will require not only stronger conflict-of-interest safeguards and greater transparency in industry engagements but also deliberate efforts to identify and manage conflicts of interest with health-harming industries. The experience of tobacco control in Ghana has shown that corporate partnerships can confer legitimacy while masking harm, and that only by setting clear boundaries can public health be protected. Building on these lessons, Ghana must ensure that food industry collaborations are scrutinised with the same rigour so that partnerships strengthen health systems rather than entrench the very risks driving the NCD epidemic.
Arti Singh
(Associate Professor of public health and epidemiology)
School of Public Health
KNUST, Kumasi
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DISCLAIMER: The Views, Comments, Opinions, Contributions and Statements made by Readers and Contributors on this platform do not necessarily represent the views or policy of Multimedia Group Limited.
