More prevention, less ‘modern corruption’: A call-to-action to protect public health

PHCC Briefing by Professor Boyd Swinburn and Jason Alexander

Strong prevention policies are a low-cost way of achieving major and equitable gains in health, while reducing the pressures on our over-stretched healthcare system. This Briefing summarises Health Coalition Aotearoa’s (HCA) newly launched manifesto, Prevention Brief 2026. HCA is a coalition of health, consumer and community organisations and academic leaders committed to closing the health prevention gap in Aotearoa New Zealand (NZ).

Three commercial products, tobacco, alcohol and unhealthy food, cause one-quarter of all healthy years of life lost in NZ and drive health inequities. For example, Māori life expectancy remains six years lower than for non-Māori.1 About a third of that is attributed to differences in smoking rates.2

Prevention Brief 2026 is a suite of practical policies that would fundamentally shift the health system towards prevention, improve health equity, and help reduce the current overload of services.

Commercial determinants of health must be reined in
Evidence-based, cost-effective policies that address the commercial determinants of health are readily available but have been largely ignored by successive governments – a source of frustration for public health researchers, clinicians and community providers.

HCA’s four expert panels have scoped the national and international evidence and identified the top priority areas for action in the NZ context.

Prevention Brief 2026 is HCA’s strong call to reverse the recent backsliding on prevention with powerful industries in key positions to wield extraordinary influence over public policy.

Despite wide public support for nicotine regulation, our world-leading smokefree legislation has been repealed, and youth vaping is unacceptably high. This policy U-turn in favour of the tobacco industry has seen NZ slide from second place in the Global Tobacco Industry Interference Index in 2023 to 53rd in 2025.3

Return to the tobacco endgame
Prevention Brief 2026 calls for a return to endgame policies with its top priority being to license all nicotine-product retailers, so that sinking lids can be applied to both the number of retail outlets, and the nicotine level of tobacco and vape products.

Concerns about tobacco industry influence on the Coalition Government’s policies means that Article 5.3 of the Framework Convention on Tobacco Control,4 which specifies multiple measures to prevent industry influence in public policy, needs to be codified into law.

These measures, along with greater support for cessation programmes, can return NZ to making substantive progress on reducing the enormous health, health equity, and economic burden to New Zealanders from tobacco.5

Major regulatory and fiscal policies to reduce alcohol harm
Alcohol law reform is needed to reduce the inequities in health and social harm caused by alcohol. Around 900 deaths each year are attributed to alcohol, and Māori are twice as likely as non-Māori to die from alcohol-related causes.6

The Sale and Supply of Alcohol Act 2012 needs major reform to tighten protections on availability and marketing, reduce trading hours, delay online deliveries and mandate an age check, ban all alcohol marketing, and raise the purchase age to 20. The Act needs to embed Te Tiriti o Waitangi so that the Crown’s responsibilities to Māori are upheld.

A 50 percent rise in alcohol excise tax would lift prices by around 10 percent,7 reduce consumption by about 5 percent, according to price modelling, and the revenue gained could fund more prevention and treatment programmes.

Reverse the failed experiment of inedible school lunches
Improving food security is urgent because now more than one in five children live in a household where food runs out sometimes or often.8

Children from these struggling households deserve better than a low-cost school lunch programme that serves up inedible meals, fails nutrition standards, and provides insufficient energy for growing children.9 Without adequate dietary energy, children are less likely to focus at school – so making poorer use of society’s investment in education.

An Audit Office report highlighted these performance failures as well as murky procurement processes.10 HCA supports permanent funding of the healthy school lunch programme, redesigning it to optimise nutrition and learning, and progressively expanding it to cover more schools in low-income communities.

The heavy marketing of unhealthy foods is fuelling the childhood obesity epidemic, and HCA is calling for legislation to protect children from this harmful practice.

Over 100 countries have a sugary drinks tax, and a priority policy for HCA is to implement a Sugary Drinks Industry Levy similar to the successful UK model. Revenue from this levy could help fund free dental care.

Strengthen our democracy to counter ‘modern corruption’
Multiple pro-democracy strategies are needed to counter the rising ‘modern corruption’ of commercial lobbying resulting in public policies for private profit. Health, social benefits, and environmental sustainability need to return to the forefront of public policymaking.

NZ now ranks last among 47 OECD countries for lobbying regulation,11 and only two in five New Zealanders trust the Government ‘to do the right thing’.12

Core recommendations in HCA’s ‘Level the Playing Field’ campaign include lobbying legislation, better management of commercial conflicts of interest, and reform of the 44-year-old Official Information Act 1982.

These new lobbying laws would include a public register of meetings, mandatory codes of conduct, stand-down periods before ministers can become lobbyists, and an Integrity Commission.

Prevention policies benefit all of Aotearoa
We are calling for all political parties to adopt these recommendations because they are good for Aotearoa New Zealand (more detail in the Appendix).

Prevention Brief 2026 is a blueprint for increasing health equity, and reducing preventable diseases and pressures on currently overloaded healthcare systems.

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