Taking global action to end childhood obesity

Hannah Brinsden, Head of Advocacy & Public Affairs at the World Obesity Federation, discusses childhood obesity ahead of World Obesity Day 2016

This year World Obesity Day, which takes place on 11^th October, is focusing on childhood obesity. The message is simple:  Governments need to up their game and urgently take leadership and comprehensive action to end childhood obesity.

In the last decade, childhood overweight and obesity has risen significantly around the world. Figures from 2013 show that approximately 222 million school-aged children globally are overweight or obese and our latest estimates suggest that this number is set to rise by about 20% by 2025. The impact of this is not to be underestimated. Not only does it put our children’s future health at risk but it impairs their immediate health, increasing their risk of type 2 diabetes, raised blood pressure and non-alcoholic fatty liver disease. This puts our already struggling health systems under more strain. This is preventable and the need for action is unquestionable, but what will it take for the required action to be taken?

Obesity is a chronic form of malnutrition and in many low- and middle-income countries it is often found alongside undernutrition. This means that nutrition policies that promote healthy growth, ensure household nutrition security and protect children from marketing and advertising of foods which have low nutritional quality will be an essential part of our efforts to end childhood obesity.

Arguably we’ve come a long way in nutrition policy over the last few decades. More and more countries are starting to implement marketing restrictions, school meal guidelines, interpretative nutrition labelling and sugar taxes. But it’s not nearly enough. While best practices can be found, very few countries have implemented the full package of multi-sectoral policies. This is despite extensive research and repeated recommendations for action in this area, most recently in the report of the WHO’s Commission on Ending Childhood Obesity. 

So why the resistance? Some of this will be due to a lack of capacity, in other cases a result of the prioritisation of other issues. But in most cases it comes down to an issue of political will. Not so much a lack of political will to protect the health of our children, I think you’d be hard pushed to find someone who would admit to that (!), but a lack of political will to challenge the commercial drivers of our unhealthy food environments. This leaves governments exposed to weak and voluntary policies and a leniency in favour of private interests rather than the public good. As a result, childhood obesity, and indeed adult obesity, continues to rise.

If we are to improve the global state of nutrition, strengthen national food sovereignty and reduce childhood obesity we need to consider something different and more far-reaching. If we are to have hope of change, we need to explore legally-binding frameworks to protect and support governments, particularly in regional economic areas and smaller nations. Having a legally binding mechanism would help to define minimum nutritional standards to drive commercial food markets and the operation of global food trade. Further, it would help governments to enact the policies required to end childhood obesity and would help to protect governments and citizens from commercial interests and food markets which often undermine efforts to protect health.  

So this World Obesity Day, we are calling on governments around the world to fulfil their commitments made earlier this year and to take urgent action to end childhood obesity. We must also explore the mechanisms that will be required to effectively implement such a comprehensive package of policies. A legally binding framework to protect diets isn’t about hindering governments, it’s about supporting them in taking the required steps, as difficult as they may appear, to protect the health of citizens all around the world, and to ensure a healthier future for all. 

For more information about World Obesity Day visit www.obesityday.worldobesity.org

For more information about Consumer International and World Obesity Federation’s calls for a framework to protect and promote healthy diets see here. 

Overuse of Antibiotics, the Chilean consumer perspective

Speech by Stefan Larenas, President of  Chilean CI Member ODECU at Intelligence Squared debate: The End of Antibiotics? at New York Academy of Sciences, 14th September 2016

I am happy to speak to you on the important topic of preserving the effectiveness of antibiotics. This requires reducing antibiotic use in humans AND in food animal production. And I would like to say I speak here not just for Chilean consumers but also for other Latin American consumer organizations. My organization has been working since 2005 to research products and services and raise consumer awareness in Chile.

We are very concerned that there is very high use of antibiotics in the production of poultry and salmon, both of which are exported as well as consumed within Chile.

In poultry production, according to research by a Chilean university, colistin is the main antibiotic used in pork and poultry production preventatively. In Chile, this drug has the approval of the Agriculture and Farming Service.

We are concerned, as public health officials are all over the world, about recent data showing resistance to colistin in both food animals and in sick people. Colistin is an antibiotic doctors use when everything else fails. If resistance develops to this antibiotic too, in some situations doctors will be left with nothing to treat a sick patient.

Antibiotic use in salmon production, which is a very big industry in Chile, is also extremely high, much higher than in other countries. In Chile in 2013, more than 500,000 kilograms of antimicrobials were used in salmon production.

Whereas in Norway, which produced almost 50 percent more salmon, the industry used only 972 kilograms of antimicrobials. This is a shocking difference. The Chilean industry uses more than 900 times as much antimicrobials per kilogram of salmon as Norway does. Most disturbingly, a Norwegian company operates salmon farms in Chile. Why don’t they use the same standards and practices?

Because of our concerns, the Chilean consumer organization is participating in the Consumers International campaign, called “Antibiotics Off the Menu”, to persuade global fast food chains McDonalds, Subway and KFC to eliminate antibiotics, or at least antibiotics important in human medicine, from the food they serve in their restaurants. Consumer awareness of this problem in rising globally—in March of this year 90 consumer organizations joined this campaign.

A new report on US fast food chains, called Chain Reaction 2, is coming out next week. I understand that in North America, McDonald's has completely eliminated all medically important antibiotics in the production of the chicken it serves in its restaurants. Why, I have to ask, have they not done this in South America? This is a double standard. If their suppliers can do this in the USA, one would think they could explain to their suppliers in Chile how to raise chicken without medically important antibiotics.

Overuse of antibiotics is a global problem. Superbugs do not know national borders. When antibiotic resistance emerges in one place it travels rapidly around the world. So while action in the US, or Norway, is vitally important, we also need action in Chile and everywhere else food animals are raised. Antibiotic use must be limited to curing sickness in animals, just as it is in humans, not used to promote growth or prevent disease in factory farming conditions. We hope the nations of the world will take action on this serious problem at the UN High Level meeting on 21st September.

Averting an antibiotic apocalypse? Time for global restaurants chains to take action

Amanda Long, Director General at Consumers International, reacts to McDonald's recent announcement that it has finished implementing its commitments on chicken in the USA.

Consumers International and its Members are calling on KFC, McDonald’s and Subway to take meat raised on antibiotics important for human medicine off their menus globally.

At the beginning of this month McDonald’s USA announced that it had achieved its goal, of serving only chicken raised without antibiotics important to human medicine, eight months ahead of schedule.  The announcement came in the run up to a UN High Level meeting on anti-microbial resistance, taking place in New York on 21^st September.

Because of overuse, resistance to existing antibiotics is rising at alarming levels, and there is a dearth of new drugs being brought to market. Without antibiotics that work, infections, small cuts and minor surgeries could once again become killers.

Left unchecked, antimicrobial resistance (the collective term for resistance to all kinds of antimicrobial drugs, of which bacterial resistance to antibiotics is the most pressing) will kill 10 million a year by 2050 – more than cancer. It is already killing 700,000 a year. We are on the brink of what Professor Dame Sally Davies, UK Chief Medical Officer has called an antibiotic apocalypse. 

Despite these dire warnings, animals destined to end up in our burgers, sausages and nuggets are being pumped full of antibiotics.  In many cases, rather than being used to treat sick animals, antibiotics are being used to make them grow faster or to prevent the cramped unsanitary conditions they are kept in from making them sick.  The more we use antibiotics, the more bacteria develop resistance to them.

There is strong consensus that measures to limit the use of antibiotics in farming should be a first port of call for the world’s decision makers. The use of antibiotics in farm animals exceeds use in humans in many countries and globally is believed to be more than 50% of use.  In the USA, more than 70% of antibiotics use is agricultural.  Furthermore the use of antibiotics in farming is set to increase by two thirds from by 2030: from 63,200 tons in 2010, to 105,600 tons in 2030.  The rise is driven by our monumental and growing global meat consumption.

So what has McDonalds actually done and will it make any difference?  McDonald’s has ended the use of antibiotics listed as critically important for human medicine by the World Health Organization in its poultry supply in the USA and has pledged to do the same in Canada. 

In taking this action, McDonald’s has gone further than some other chains in the USA.   KFC, which has a larger number of restaurants in the USA than any other chicken chain and is the second highest in sales has not gone as far.  It has said it will stop using just a handful of highest priority critically important antibiotics from the WHO list.   KFC is under increasing pressure to go further.  Pizza Hut and Taco Bell, (also subsidiaries of the Yum! Brands) have recently committed to serving chicken to its US customers raised without any of the antibiotics from the full WHO list. On 9 August, Yum! investors filed a shareholder resolution calling for KFC to follow suit.

On the other hand, there are chains in the USA that have gone further than McDonald’s.  Whereas McDonalds has only taken this action for the chicken it serves, Subway has committed to using chicken, turkey, beef, and pork raised without any antibiotics.  In a report from a coalition of consumer and environmental groups last year Chipotle, Panera and Chick-Fil-A, were given A and B grades for their antibiotic policies whereas McDonald’s was given a C.

The fact remains however, that these global chains are failing to make the same commitments outside of the USA. Whilst it is commendable that McDonald’s has acted in the USA and Canada, where around 43% of its branches are located, it has not committed to act on pork or beef and has not made the same commitment on chicken in other parts of the world.  McDonald’s in Europe has said that it will stop the use of some important antibiotics in the chicken it serves, but fails to go as far as McDonald in the USA and McDonald in Canada.   KFC and Subway have yet to make announcements anywhere outside of North America.

Of course we welcome any progress in this area and we don’t suggest that the sole power to prevent an antibiotic apocalypse rests entirely with a few fast food chains – but these are significant players and can lead the way.  When world leaders meet at the UN in September we will need strong, concerted, action on all fronts; including reducing use of antibiotics in human health and animal health and tackling the development of new drugs.

Given the scale of the global public health crisis the world is facing now due to antibiotic resistance, making partial commitments is simply not an option.  There is no plan B.

KFC, McDonald’s and Subway can and must go further. As awareness of the threat we are facing grows among consumers and politicians, they will be left with little choice. Far better to commit now, to work to set the standard for their industry globally, than be forced to catch up later.

Join us now in the call to take Antibiotics off the Menu. 

Will the Ending Childhood Obesity (ECHO) report make a difference for consumers?

Justin Macmullan, Consumers International’s Head of Advocacy discusses the recent report by the Commission for Ending Childhood Obesity, endorsed by the World Health Assembly last week, and outlines what it means for consumers.

Helping consumers to choose healthy diets is a major challenge when, in many countries, the marketing of food, the food choices available and the prices of different foods all appear designed to promote an unhealthy diet high in calories, fat, sugar and salt.

With 70 million young children predicted to be overweight or obese by 2025 this is a major public health issue and one that Consumers International (CI) and our Members have campaigned on for many years, most recently for World Consumer Rights Day 2015. 

At this year’s World Health Assembly, governments and civil society had the opportunity to consider the World Health Organisation’s (WHO) latest initiative in this area, the Ending Childhood Obesity (ECHO) report  which was a personal initiative of Dr Margaret Chan the Director General of the WHO.

The report, which was developed by an appointed commission, delivered more than 30 recommendations across six areas including promoting intake of healthy foods; promoting physical activity; preconception and pregnancy care; early childhood diet and physical activity; health, nutrition and physical activity for school children; and weight management..

What’s in the report?

First of all, as the list of topics shows, this is a report about tackling obesity rather than diet-related disease. Therefore, for example, it includes recommendations on increasing physical activity as this helps to reduce obesity, but not on salt reduction as this is not directly related to obesity.

Looking specifically at the recommendations related to healthy diets, the report includes many of the issues CI and our Members have campaigned on including restricting marketing of unhealthy food to children, improved nutritional information including front of pack labelling, improving the availability of healthy food in public institutions, improving nutrition information in schools, introducing taxes of sugar sweetened beverages, promoting breast feeding. There are gaps – notably in relation to the impact of trade and investment agreements on the ability of governments to take action – but there is also much to welcome.

Another possible criticism is that it offers little that is new but, although this might be true, it does have the benefit of bringing these proposals and recommendations together in one place to create a comprehensive package, stating the proposals clearly and adding the logo of the WHO on the cover, which gives the whole exercise political status and weight.

Will it make a difference?

The challenge is what will happen next. Following a resolution agreed at this year’s World Health Assembly, the WHO is now charged with developing an implementation plan to support the report’s recommendations. If this is going to be effective it must deal with some of the issues that have frustrated previous initiatives in this area. 

CI’s Recommendations for a Global Convention to Protect and Promote Healthy Diets seeks to address these challenges by moving the discussion on from ad hoc initiatives to an international legal framework that would support action on a comprehensive set of policies at the national level. The ECHO report doesn’t include that recommendation, but their implementation plan does have the potential to go some way towards it.

To do that, the key area of accountability must be addressed. The Director General of the WHO, Dr Margaret Chan, on whose initiative this report was developed, has often used the phrase, ‘what gets counted gets done’ in relation to increasing accountability and delivering results. We hope the same maxim will apply to this important area of work.

A proposal to create a monitoring system as part of the implementation plan could signal genuine progress, but only if it is sufficiently strong, transparent and well publicised and monitors the quality and implementation of policies as well as results. Only this way can governments be held to account for their actions and a clear picture emerge of successes and challenges in implementation.

Read the statement on the ECHO that CI and 9 other NGOs gave at the WHA last week.

Why KFC, McDonald's and Subway Need to Get Antibiotics Off the Menu

To mark World Consumer Rights Day 2016, Consumers International

(CI) Director General Amanda Long outlines why antibiotic resistance is such an important issue, the role global fast food chains have in tackling it and what CI Members are doing around the world to campaign for #AntibioticsOffTheMenu.


Every week brings a fresh story about the threat to human health from growing antibiotic resistance. The World Health Organization has warned that we face a post-antibiotic era, in which we no longer have effective treatment against bacterial infections. If urgent action is not taken to tackle antibiotic resistance we could face a future where common infections and minor injuries can kill again.

Antibiotic resistance is driven by overuse of existing medicines. With over half of the world's antibiotics being consumed by animals, antibiotics in farming is a major contributing factor. Despite this, the use of antibiotics in agriculture is predicted to grow by two thirds: from 63,200 tons in 2010 to 105,600 tons in 2030.

Tuesday 15th March is World Consumer Rights Day (WCRD). Consumers International and its Members are using this day of action in order to call on KFC, McDonald's and Subway to make global, time bound commitments to stop serving meat from animals routinely given antibiotics that are classed as important for human medicine by the World Health Organization.

McDonald's has made such a commitment on chicken in USA and Canada. The commitment does not extend to other types of meat however, nor to other countries outside of North America. Subway has committed to stop serving meat from any animal given antibiotics in the USA. KFC has made no meaningful commitments anywhere.

Of course we would like to see other restaurant chains, as well as meat suppliers and retailers, make global time bound commitments to stop selling meat from animals routinely given antibiotics important for human medicine. We are focusing on these three chains because they have over 100,000 restaurants between them. It is about more than simple buying power however, these are global household names with the ability to influence markets even where they have fewer outlets.

This World Consumer Rights day is about calling for major global brands to act responsibly. Antibiotic resistance is spreading in every region of the world. Left unchecked, antimicrobial resistance will kill 10 million a year by 2050. Given the scale of the global public health crisis the world is facing due to antibiotic resistance, making partial commitments is inadequate. KFC's efforts so far have been token and McDonald's and Subway must go much further.

As global brands KFC, McDonald's and Subway are in a strong position to set the standard for their industry globally and drive a decrease in agricultural use of antibiotics, faster than legislative change alone.

See what CI Members are doing to mark World Consumer Rights Day around the world on the WCRD 2016 Map.

View our #AntibioticsOffTheMenu campaign photos, taken by CI Members across the world outside their local fast food restaurants. 

Green Action Fund 2015

Consumers International's (CI) Fundraising Officer Steven Hawkes looks back on the 2015 Green Action Week campaigns and reflects on the diverse activities and results that were achieved by CI Members from across the world. 

The Green Action Fund is a collaborative project by CI and the Swedish Society for Nature Conservation (SSNC) to promote safe and sustainable food in the Global South.

Each year, CI Members are given the opportunity to apply for a small grant to carry out awareness and advocacy activities under the theme ‘safe and sustainable food for all’. Utilising their local expertise and networks, CI Members promote local, practical solutions to global consumer issues.

CI and SSNC support participants with funding (made available by SSNC), materials, research and policy support, and joint-campaign communications. Being part of a wider thematically coordinated campaign strengthens local messages, gives campaigns added credibility, and ultimately increases impact. 

In 2015 more consumer organisations took part than ever before, with 20 campaigns across 16 countries over three continents (ten in Africa, seven in Asia-Pacific and the Middle East, and three in Latin America).

Lembaga Konsumen Yogyakarta (LKY) in Indonesia reported: “This programme is very strategic for women farmer groups and consumer groups especially on increasing their quality of life. By developing and spreading it, we are convinced that food consumption patterns can be improved. Green Action Week is very important and relevant to be developed in the future.”

Highlights from GAF 2015

Increased consumer awareness

• In India, Consumer Education and Research Society (CERC) produced a guidebook to inform consumers about sustainable food and help them make healthier food choices. The guide has been shared free of charge with CERC members and supporters, the media, consumer organisations, regulatory authorities and government, NGOs, libraries and schools.

• In Kenya, Youth Education Network (YEN) educated young consumers in schools on sustainable food and health, reaching over 1,500 people. Their families showed appreciation to YEN’s efforts and reported being more confident giving money to their children as they thought they would make healthier food choices. Teachers agreed that healthy eating was integral to learning and fully supported the project. The campaign was aired on a radio news bulletin that has an audience of 3 million listeners.

• In Burundi, Association Burundaise des Consommateurs (ABUCO) carried out awareness-raising activities with consumers and farmers, including two educative interactive public theatre pieces and presentations to over 500 school students. The campaign was supported by representatives from the Ministry of Interior and Ministry of Agriculture and Livestock, and featured on the most-listened to radio station in Burundi.

• In Ecuador, Tribuna Ecuatoriana de Consumidores y Usarios held practical workshops in neighbourhoods of Quito with producers and consumers on sustainable consumption and healthy food. 310 people attended, around 80% of who were women. They also held a fair on sustainability and had stalls over five days at a location where organic products were sold (Bio Fairs), reaching over 450 people.

Commitment from government and other key stakeholders

• In Cape Verde, Associação para Defesa do Consumidor (ADECO) trained 39 customs officials to be more aware of the regulation of pesticides - this was the first time they had participated in training on this. Officials are now more knowledgeable of the regulations regarding the entry, sale and use of pesticides. Authorities at the highest level recognised the campaign and it was discussed in two meetings of the National Council for Food and Nutritional Security, chaired by the Rural Development Minister who congratulated ADECO on the initiative.

• In Pakistan, The Network for Consumer Protection focused on influencing policy-makers, government and other civil society organisations. They were successful in spreading the message that organic food was no longer just an awareness issue but a policy and regulatory matter. At the advocacy seminar, policy-makers agreed on the need to ban around 450 particularly hazardous pesticides (although concrete action is yet to be taken) and the need for a cost-effective local certification body which can be utilised by small-scale farmers.

• Yemen Association for Consumer Protection (YACP) carried out a survey of pesticides in Yemen, finding that many internationally banned substances (such as DDT) are still being sold along with many expired pesticides. Following this, YACP held a policy workshop with specialists from the Ministry of Agriculture, Agricultural Associations, and Women’s Association, to formulate recommendations for improved oversight of pesticide sales.

• In Rwanda, Rwanda Consumer’s Rights Protection Organization (ADECOR) advocated for an increase in budget allocation for organic farming and natural pest control with the Parliament and a number of government authorities. Follow-up meetings have been scheduled and ADECOR report that the Rwanda Standards Board and Ministry of Health understood the need to start testing the impact that pesticides have on health and soil degradation. ADECOR was invited to be a part of the team for inspection on quality and standards. 

CI is delighted to partner with its Members and SSNC for the Green Action Fund campaign and looks forward to further collaboration in 2016, fighting for the right to safe and sustainable food for all consumers.

Photos feature the following CI Members who took part in the Green Action Fund 2015: Youth Education Network (YEN) - Kenya, Formadores de Organizaciones Juveniles de Consumidores y Consumidoras (FOJUCC) - Chile, Yogyakarta Consumer Institute - Indonesia, REDECOMA - Consumer Defence Group of Mali - Regroupement pour la défense des consommateurs du Mali and Consumer Confederation - Tamil Nadu (CONFET) - India. 

Please click here for a full list of Green Action Fund 2015 participants.

CI Member BEUC campaigns for meat origin labelling

Monique Goyens, Director General of The European Consumer Organisation (BEUC), unveils the new EU consumer campaign aiming to demystify our meat’s origin.

When food shopping in the EU, you don’t enjoy the same level of origin information when you’re buying fresh or processed meat.

If you go for a fresh beef steak, you will know the animal’s comings and goings from farm to fork.

The reason is that ‘Country-Of-Origin Labelling’ (known as 'COOL') is compulsory for fresh beef in the EU. Food makers have to indicate the country of birth, rearing and slaughter.

If you’re more of a white meat fan, as of April 2015, you will know where the chicken from your fillet was bred and slaughtered, but not where it was born. The same goes for pork, sheep and goat meat.

But if you prefer processed meat such as ham, salami or ready-made lasagne, origin labels depend on the manufacturer’s goodwill. Regrettably there are still no EU plans to make origin labelling compulsory for meat in processed in foods.

Yet we do not want to believe the EU legislator will turn a deaf ear to the 90% of European consumers who want to know where their meat comes from.

As the EU Commission has yet to propose legislation making COOL compulsory for meat used as an ingredient, we decided to step up our demands by launching an EU-wide campaign in early September.

With it, we intend to turn the tide and finally make meat origin labels the norm on sausages, ham, nuggets or ready-meals.

Recall how consumers’ trust in meat was shaken following last year’s ‘Horsegate’ scandal when horsemeat was discovered in processed beef products in several EU Member States.

We are convinced making the meat supply chain more transparent can help restore this lost confidence.

While no silver bullet in combatting fraud, compulsory origin labelling of processed meat would oblige food manufacturers to keep a tighter grip on their suppliers.

In just three weeks, over 8,000 consumers supported our campaign on social media. And it’s not over.

With this figure – which we expect to grow – we will address the future European Commissioner for Food and Health so that COOL for processed meat becomes a priority on the EU food agenda.

We believe consumers want to know more about how and where their food - and especially meat - is produced. This is a global trend not a specific EU feature.

If like us you think consumers have the right to know where their meat comes from, there are two ways you can help spread the word on social media:

Like and share our animated slideshow on Twitter, Facebook or LinkedIn (available in 12 languages).

Post pictures of COOL labels on processed meat products using #meatorigin on social media. They will end up in our album to prove COOL is possible and should be the norm.

Coca Cola’s label move is only ‘inch-by-inch’ progress

Even when fizzy drinks giant Coke improves its labelling, it only serves to underline the need for a much tougher regulatory environment,  argues CI's Head of Campaigns Justin Macmullan. 

Last week, Coca Cola announced that it would introduce traffic light nutrition labels on the products that it sells in the UK.

It’s good news for UK consumers trying to choose a healthier diet, but this inch-by-inch approach underlines the need for a global agreement to protect and promote healthy diets.

These labels use red, amber and green to clearly signal to consumers whether the product contains high, medium or low levels of salt, sugar and fat.

This development is certainly good news for the nutrition labelling scheme in the UK. Many UK retailers have signed up to the scheme and with manufacturers also joining, the UK is now moving towards one widely used and understood labelling system.

But it is obvious that more needs to be done.

Dragging their feet

Of course it isn’t the responsibility of Coke to introduce national nutrition labelling schemes, but Coke and other multinational food companies can certainly help by not dragging their feet or lobbying against their use.

The traffic light labelling scheme has been around in the UK for several years and Coke only announced their intention to join last week having shunned it in the past.

Will other countries have to go through years of campaigning for their consumers to get the same deal as UK consumers?

Read the label 

In the same week as Coke’s labelling announcement, I noticed large posters outside my local supermarket advertising one litre bottles of Coke on special offer. It's not an uncommon sight in the UK.

Similarly Coke is one of the world’s biggest spenders when it comes to marketing. Take for example their investment in the football World Cup, when they linked their high fat sugar products to one of the biggest sporting events in the world.

And just yesterday it was announced Coke will sponsor the London Eye – a major UK tourist attraction.

It is hard not to conclude that Coke and other major food companies are only making small changes when they feel there is no other option, but failing to take the action that is really needed to tackle rates of obesity around the world.

Just one can of regular Coke has 35g of sugar and exceeds recent WHO recommendations for the amount of calories that an adult of normal weight should get from sugar in a day.

According to Coca-Cola’s annual report, Great Britain consumed 200 of the company’s beverages per person in 2012.

The same figure for Mexico was 745, equal to more than two drinks per day, whilst US citizens on average consumed just over 400 beverages per year. Not all of these beverages will be regular Coke.

A global convention 

Obesity and diet related diseases such as diabetes, and heart disease are a public health disaster in many countries and tackling the causes requires a comprehensive global approach. CI is calling on governments to support our proposal for a global convention to protect and promote healthy diets.

Amanda Long: We must act now to stop obesity killing millions

As worldwide support for our call for tougher action on unhealthy diets shows, there is an overwhelming consensus that the obesity crisis is out of control. CI's Director General, Amanda Long, on why we need immediate action.

Last week, we launched a new set of Recommendations that call for a Global Convention to protect and promote healthy diets, drawing worldwide media coverage and support.

Developed in consultation with Members of both Consumers International and the World Obesity Federation, as well as a wider network of public health experts, our Recommendations have already received endorsement from the likes of  the UK's Association of Directors of Public Health, the US Public Health Institute, World Cancer Research Fund, European Public Health Association , and the UN's food chief Olivier De Schutter. Not to mention the support of our 250 membership orgainsations around the world.


Such strong support underlines the fact that the case for a Global Convention on healthy diet is now overwhelming. We face an unprecedented health crisis, that is largely preventable – yet action is falling far short of what is required.

Here are a few shocking statistics:

• One person every seven seconds dies of diabetes – nearly half of those deaths (44%) are attributable to overweight and obesity
• 9.4 million people die of hypertension every year – with high salt intake a major risk factor for that disease
• obesity rates have nearly doubled since 1980
• 2.3 billion people will be overweight by 2015.

This crisis is truly global – the highest rates of growth for obesity and overweight are now found in low and middle income countries.

As Margaret Chan said in her opening address to this year’s World Health Assembly:

"We see no good evidence that the prevalence of obesity and diet-related non-communicable diseases is receding anywhere. Highly processed foods and beverages loaded with sugar are ubiquitous, convenient, and cheap."

The figures are absolutely compelling. Yet our collective response is lagging far behind what is needed.

Calling for a Global Convention inevitably draws comparisons with the Framework Convention on Tobacco Control (FCTC). Of course food is not the same as tobacco – but in public health terms we are facing a similar, or even greater, crisis.

The point is about impact.

When it comes to the scale and scope of the impact, tobacco and unhealthy food are directly and very worryingly comparable. 

Smoking still kills six million people a year and rates continue to rise in many countries.  In some countries however, rates are decreasing; in large part because concerted efforts by governments to put public health ahead of the commercial interests.

The FCTC is a major part of this story. It was a ground breaking international agreement that built political will and led to co-ordinated action around the world.

The shocking truth is that, today, poor diet is the number one cause of premature death globally – more than smoking.

As we seek to tackle poor diets we need to learn from the FCTC success, without repeating the thirty years of debate that led to its adoption. We cannot afford to allow the food industry to repeat the foot-dragging strategy taken by the tobacco lobby.

How many times have we said to ourselves – if we knew then the harm caused by tobacco, we’d have done things sooner? Well we do know the damage of unhealthy diets– let’s make amends and prevent a similar catastrophe.

We believe that the global community can, and must, do better than the story of tobacco controls.  The vast majority of deaths from unhealthy eating are preventable. There is widespread agreement about the policies that will have an impact – but we are not doing enough and we are not taking action fast enough.

Of course there are some good examples. Governments that have moved on this such as Finland, or more recently Argentina, with programmes to reduce salt in food. Others such as the UK have pushed for clearer labelling. And of course the recent decision by the Mexican government to tax soda and junk food.

At the city level the excellent lead taken by Michael Bloomberg when he was Mayor of New York, introducing calorie labelling in restaurants, making the food that the city authority provided in schools and hospitals healthier.

Companies are also responding by reducing fat, sugar and salt in food, improving labelling and some efforts to reduce marketing to children.

Many of these developments have been the result of pressure from campaigners all over the globe – including CI Members.

But the response – whether from governments or the food industry - is inadequate.

Ten years ago, the WHO adopted the Global Strategy on Diet Physical Activity and Health. It marked a significant step forward but steadily rising figures for obesity and non communicable diseases show that it is clearly not enough.

Individual related WHO programmes and guidance, and Codex initiatives on labelling are all important steps, but without the political will and comprehensive approach offered by a Framework Convention they are not having the impact that is needed.

The WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases, that was adopted just last year, calls for a ‘halt’ in the rise of obesity and overweight.

Just a halt. Given the rate of increase, this was thought to be realistic. What a sad indictment. It should not be accepted. It is just not enough.

Back in 1998, then director of the WHO, Dr Gro Harlem Brundtland speaking on the FCTC said:
‘Tobacco control cannot succeed solely through the efforts of individual governments, national nongovernmental organizations and media advocates.  We need an international response to an international problem’.

The direct parallel is here.  This problem is global and systemic and requires a global, systemic response.

We need concerted action on a global scale.  In doing so governments will be truly serving their citizens. Putting them first. Acting for those they represent and sparing them the horror story from poor diet that we all saw happen as a consequence of inaction on tobacco controls.

The world cannot wait another 10 years until we find the will to take the action necessary.   And we cannot contemplate the 30 years it took to get the FCTC agreed.  We cannot let history repeat itself.

A global convention on healthy diets? Some lessons from the WHO Framework Convention on Tobacco Control

Jonathan Liberman, director of the McCabe Centre for Law and Cancer, comments on CI's and World Obesity Federation's publication Recommendations towards a Global Convention to protect and promote healthy diets. 

On 27 February 2015, it will be ten years since the WHO Framework Convention on Tobacco Control (FCTC) entered into force. I’ve argued that the FCTC has done a number of great things, including:

• raising the global profile of tobacco control
• strengthening governments in their fight against the tobacco industry, politically and legally 
• reinforcing the view that tobacco products are not normal consumer products, contributing to the ongoing denormalisation of the tobacco industry
• catalysing the formation and deepening of transnational civil society coalitions; 
• facilitating the sharing of experiences, expertise and capacity among and between governments and nongovernmental organisations; 
• and bringing new resources — political, financial and human — into the field.

The FCTC has generated substantial interest in the use of treaties to advance global health (and development). I’ve suggested that it has made treaties the Holy Grail of global health governance. What might our next global health treaty be?

The proposal for a global convention to protect and promote healthy diets, which draws heavily on the FCTC, is an ambitious one – as it should be, given the scale of the health, social, economic and developmental consequences of unhealthy diets and the urgent need for the global community to act.

While it is easy to observe that food is not tobacco (or alcohol) - and the food industry is not the tobacco industry (or the alcohol industry) - it is much harder to articulate exactly what lessons from tobacco control (and the FCTC) are, and are not, applicable to diet.

Recommendations towards a Global Convention to protect and promote healthy diets does not shy away from the complexity of global and domestic food policy.

It offers definitions to distinguish between ‘healthy food’ and ‘unhealthy food’, which include both foods and beverages.

It covers food supply, production, price, marketing, standards and labelling, and consumer information and education.

It acknowledges that cross-agency coordination within the United Nations system is needed on health, trade, food security, environment, and economic and international development.

It recognises that the action and inaction of a large number of government departments and agencies affect diet, mentioning agriculture, regional development, social support, education, health services, defence, justice, telecommunications, transport, energy, trade, industry and finance.

Against this complexity, I offer a few suggestions as the idea is taken forward:

• Make sure the proposal is manageable in the real world. If it’s too ambitious in its scale and breadth, it’s unrealistic to expect that the many government departments that need to be engaged in a treaty negotiation will be able to come to whole-of-government positions at a meaningful level of commitment. Let alone that the 194 Member States of the World Health Assembly will be able to reach agreement over a realistic number of treaty negotiation sessions (that many States will be reluctant to fund).
• Work out whether / where you’re looking for a framework that encourages and facilitates ongoing, coordinated global action versus states agreeing to very specific detailed legal obligations (for example, on marketing unhealthy foods to children). In saying “versus”, I don’t mean to overstate the either/or quality, but trade-offs inevitably have to be made, and sometimes at the outset, rather than at the death, if the proposal is to get moving.
• Make sure that the proposal is flexible enough to have truly global application, across the very different situations in different countries in what foods are eaten, and how they are produced and sold.
• Think carefully through the relationships with other international agencies whose mandates affect diet. If WHO is to be (or to house) the treaty’s Secretariat, don’t burden it with responsibilities it is not functionally equipped to perform.
• Don’t discuss the proposal through draft legal text. Focus on concepts, and discuss text at the appropriate time. Nothing can kill off meaningful conceptual discussion quite like poring over, and suggesting amendments to, legal text.

At its most recent session, in Seoul in November 2012, the FCTC’s governing body, its Conference of the Parties, expressed “a need to examine the impact of the Convention as a tool in promoting public health in general and tobacco prevention in particular”.

Just how such an “impact assessment” might best be performed will be discussed at the upcoming session of the COP  in Moscow in October this year.

This impact assessment is bound to be an interesting exercise. It should yield valuable lessons for other areas of global health governance in general, and the use of treaties for global health in particular, including the proposed Global Convention to Protect and Promote Healthy Diets.

The time has come for a global convention to promote healthy diets

CI food expert Anna Glayzer sets out the case for targeting junk food with the kind of public health strategy used to fight smoking.

This week marks the ten year anniversary of the World Health Organization Global Strategy on Diet Physical Activity and Health.

The stated overall goal of that strategy was: "To promote and protect health by guiding the development of an enabling environment for sustainable actions at individual, community, national and global levels that, when taken together, will lead to reduced disease and death rates related to unhealthy diet and physical inactivity."

The Global Strategy on Diet Physical Activity and Health (or DPAS, as it is often abbreviated to) was a significant step forward for that time but it is now clear that much more is needed. 

Since 2004 obesity rates, along with diet related diseases like diabetes, have continued to climb steadily. In 2005 approximately 1.6 billion adults (age15+) were overweight and at least 400 million adults were obese.

By 2015, approximately 2.3 billion adults will be overweight and more than 700 million will be obese.

These rates are climbing far faster in developing countries. Diet related ill health now globally outranks tobacco as a cause of death.

In 2011, we reached the point where one person dies from diabetes every seven seconds.

Figures also show that 44% of the diabetes burden is attributable to overweight and obesity.

On 19 May,  CI published Recommendations Towards a Global Convention to Protect and Promote Healthy Diets.

The Recommendations are a joint initiative with World Obesity Federation, developed in consultation with our members and with public health experts around the world.  

We are calling on governments to make a binding commitment to introduce a raft of policy measures designed to help consumers make healthier choices and improve nutrition security for everyone.

The measures that we have included are not new. In developing the Recommendations, we drew on a growing body of existing policy packages such World Cancer Research Fund’s Nourishing Framework.
 
We call for:

• tighter controls on marketing of unhealthy food;
• for better provision of nutrition information to consumers;
• for healthy food to be served in public institutions;
• and for the use of economic tools to influence consumption patterns.  

Some countries have already implemented or partially implemented some of the measures we recommend.

What would be new about a global convention to protect and promote healthy diets would be the scale, ambition and level of co-ordination it would entail.

It would amount to the world taking the inpact of unhealthy diets as seriously as the impact of tobacco.

Of course we know that food is not the same as tobacco. There are however, some strong and often drawn parralels, in terms of impact and in terms of the actions of the protagonists.

Back in 1998, then director of the WHO, Dr Gro Harlem Brundtland said: ”The tobacco habit is extensively communicated!  It is communicated through the media, the entertainment industry, and most directly through the marketing and promotion of specific products.

“Global trade in tobacco has increased markedly over the last few years.  Direct foreign investment by multinationals in developing countries has also increased…Tobacco control cannot succeed solely through the efforts of individual governments, national nongovernmental organizations and media advocates.  We need an international response to an international problem.”

We recognise that the solution to the problem of unhealthy diets is complex. Our publication is not intended to offer a ready-to-wear global convention.

Hence we have called it Recommendations towards a global convention. We intend it as a conversation starter. It is however, a conversation that urgently needs to be had.  Inaction is costing millions of lives.

If the average adult reads 250 words per minute; in the time it took you to read this blog, at least 20 people will have died from diabetes. It’s time to take unhealthy diets seriously.

Africa update: The food security 'death sentence' blighting millions of lives

CI's Cathy Rutivi lifts the lid on the horrendous food shortages which many Africans face - and outlines how the consumer movement is trying to help. 

The right to basic needs is still a far cry for most consumers in Africa. Access to basic essential services like water and food is still a constant problem.

Food security is a major issue here and even food sufficiency alone does not guarantee an end to hunger. There are many factors internal or external that can affect or alter the availability, affordability, quality and safety of food in different degrees.

A number of factors like war, natural disasters like floods or even drought and famine have often displaced people and left them without food.

There are many people who rely on humanitarian relief aid just to survive especially in the Sahel and Horn of Africa regions. Access to land for farming is also a critical issue in most countries in Africa as this also addresses food security.

Most countries in Sub Saharan Africa have seen a decline in national income due to the economic and financial crises, poor governance, corruption and wars.

This has resulted in people living in very hard and harsh economic environments with high unemployment and lack of service delivery for most services.

When you picture people in these situations what they are mostly concerned about is having just a meal a day, if they can find it. Even in countries like South Africa (SA) that are considered more developed than most developing countries in Africa, 12 million people go to bed hungry each night.

According to a recent published report by the University of Cape town’s African Food Security Unit Network: “There are children whose daily food is half a white bread sandwich” (in most cases it is just half a slice with no spread on it; just dry taken with water).

The implication of this is a death sentence, says Food Bank SA. The figures on the surveyed cities in South Africa showed 77% of households were either moderately or severely food insecure. Most analysts however believe the figures to be far higher than this.

According to the Food and Agriculture Organization, of the 870 million people worldwide who are chronically undernourished, 234 million of them live in Sub Saharan Africa .

The main problem is also access to adequate nutrition, not necessarily availability of food. People are too poor to afford to buy food and accessibility is also a major issue for people in rural areas where either markets or supermarkets are located far around urban areas.

Queuing for food at a school in Eastern Cape, South Africa

Picture by Shelley Christians; Image by: The times/Shelley Christians/Gallo Images

Most school feeding programmes like the one seen above in the picture are used as an intervention to ensure children receive at least a balanced meal of corn maize and bean soup.

Towards the end of last year in October 2013, I attended a food safety workshop on Early Warning Rapid Alert (EWRA) systems hosted by FAO in Rome, Italy.

It was a platform to share knowledge and experiences on early warning, rapid alert and horizon scanning systems.

It also served to generate concrete ideas on how FAO - in collaboration with other key partners  - could assist countries and regions to build early warning and rapid alert capacities in food safety and to benefit from global/regional horizon scanning as well as creating opportunities for collaboration.

The workshop discussions sought to answer critical questions that, given the many competing national priorities, to what extend are the EWRA systems in food safety a realistic priority for low to medium income countries, and, if not, how do we make them a priority?

A lot of food in these countries is lost in post-harvest activities from the farm before it reaches the markets. This results in food losses which also has a big impact on food security.

Over the years, consumer organisations in Africa have participated in national, regional and international food security programmes aimed at reducing poverty and hunger as well as collaborating with research NGOs/institutions and other global CI Members to establish the fundamental issues of the whole food chain (accessibility, affordability, availability and safety).

CI Africa will soon be working on a paper on Food Security, Nutrition and Safety in Africa to define a CI Africa agenda on the issue, including recommendations for consumer policy positions.

We would like to hear from our Members in Africa about their current country experiences regarding food security, nutrition and safety. Please share with us on our African Consumers International Facebook group or via Twitter.