Analyzing corporate power through networks

Health Inc Season 5, Episode 3 – Analyzing corporate power through networks

Co-hosted by the Lawrence Bloomberg Faculty of Nursing, the DLSPH's Centre for Global Health, and the WHO Collaborating Centre for Governance, Accountability, and Transparency in the Pharmaceutical Sector

Title: Mapping industry influence: Network methods for analyzing corporate power in global health systems

Speaker: Dr. Andrea Bowra

Abstract: Corporations work through networks of actors to circulate narratives that serve their interests, shaping how products are understood, regulated, and used. Studying these networks provides a powerful way to identify how corporate narratives gain legitimacy and move across scientific, policy, and public domains. Actor-network theory and visual network analysis offer useful tools for tracing these processes and making visible the relationships through which influence is exerted. As an example, this study examines Purdue Pharmaceutical’s 1996 launch of OxyContin, backed at the time by the largest marketing plan in pharmaceutical history. Drawing on document analysis and key informant interviews, I trace how Purdue advanced narratives of opioid safety and necessity, and embedded these framings through relationships with public relations firms, medical professionals, and academic institutions. These networks extended across borders, shaping media coverage, scholarship, and health practices in ways that increased opioid acceptability and delayed regulatory responses to opioid-related harms. This research demonstrates how corporations are able to mobilize transnational networks to promote products, deflect accountability, and influence health policy, with consequences that reverberate through global health systems.

Recommended readings:

Bowra, A., Perez-Brumer, A., Forman, L. & Kohler, J.C. (2025). Networked narratives: Examining how Purdue Pharmaceuticals shaped public health policy and practice. Drug Science, Policy and Law, 11:1-12.

Bowra, A., Perez-Brumer, A., Forman, L., & Kohler, J. C. (2025). Accountability in global health systems: Insights from a network analysis of Purdue Pharmaceuticals. Globalization and Health, 21(1), 45.

Bowra, A., Perez-Brumer, A., Forman, L., & Kohler, J. C. (2024). Interconnected influence: Unraveling purdue pharmaceutical's role in the global response to the opioid crisis. International Journal of Drug Policy, 133, 104604.

About the Health Inc Seminar Series

The corporation is arguably the most powerful social and economic institution globally, with unprecedented power to shape scientific evidence, public policy, and lifestyles. Corporations share practices including advertising, public relations, and lobbying that are common across industries and which impact population health and health equity. For example, non-communicable diseases (NCDs) are currently the leading cause of mortality globally and account for 71% of all deaths according to the World Health Organization (WHO).[1] The main risk factors for developing NCDs as identified by the WHO include harmful alcohol drinking, tobacco use, physical inactivity, and the consumption of unhealthy diets rich in overly processed foods.[2] The United Nations has addressed NCDs in their Sustainable Development Goal target 3.4, which is to reduce premature mortality from NCDs by a third by 2030.[3] At the same time, the medically-related industry, including pharmaceutical, medical device, infant formula, and health technology companies have pervasive influence over the production of health evidence, the dissemination of health innovations, and the development of clinical practice and health policy. Critical public health analysis of the power of the corporate sector in influencing public health outcomes informed the field referred to as the commercial determinants of health. The Lancet Global Health defines the commercial determinants of health as “strategies and approaches used by the private sector to promote products and choices that are detrimental to health”.[4] Corporate practices can thus be critically examined and strategically challenged in order to contribute to healthy, evidence-based public policy solutions.[5] In 2021, The Dalla Lana School of Public Health’s Centre for Global Health in partnership with the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto launched a seminar series entitled, “Health Inc.: Corporations, Capitalism, and the Commercial Determinants of Health.” The objective of this seminar series is to create a forum to promote conversations, research training and collaboration across sectors and disciplines regarding the impact of corporations and other commercial determinants of health.

1. World Health Organization. Non communicable diseases. World Health Organization; 2021.

2. World Health Organization. Noncommunicable diseases country profiles 2018. Geneva, Switzerland: World Health Organization; 2018.

3. NCD Countdown 2030 collaborators. (2020). NCD Countdown 2030: pathways to achieving Sustainable Development Goal target 3.4. Lancet Public Health. 396(10255): 918-934 https://doi.org/10.1016/S0140-6736(20)31761-X

4. Kickbusch, I., Allen, L., Franz, C. (2016). The commercial determinates of health. Lancet. 4(12): 895-896, https://doi.org/10.1016/S2214-109X(16)30217-0

5. Friel. S, et al. (2023). Commercial determinants of health: future directions. Lancet. 401(10383): 1229-1240. https://doi.org/10.1016/S0140-6736(23)00011-9