World Antibiotics Awareness Week: Global food brands must take Antibiotics off the Menu

Anna Glayzer, Advocacy Manager at Consumers International, outlines the need for an urgent, global response to the world's escalating antibiotic resistance crisis. 

This week is World Antibiotics Awareness Week. Given the seriousness of the public health crisis we are facing, there are few topics more in need of heightened worldwide awareness than antibiotic resistance. Many people do not realise that we are a few decades away from the end of modern medicine as we know it. By 2050 drug resistant infections will cause 10 million deaths- becoming a bigger killer than cancer is today.

Resistance to antibiotics occurs naturally with use, making it essential that we use these drugs sparingly, for the treatment of disease, where prevention and other methods of treatment have failed. Instead, the irresponsible use of antibiotics is a major driver of resistance.  Farm animals consume two thirds of the world’s antibiotics. These vital drugs are often routinely added to feed to make animals grow faster or to counter unsanitary conditions in factory farming facilities.

This week is also the one year anniversary of the publication of research showing that the threat from Colistin resistance was far greater than previously realised. Colistin is one of the antibiotics on the World Health Organization’s critically important list. It is used in human medicine as a drug of last resort- something to be prescribed when other antibiotics have failed. Colistin resistant infections in food animals and humans are spreading around the world.This is being driven by agricultural use of Colistin, which continues to rise year on year.

Our campaign #AntibioticsOffTheMenu is about calling on global food businesses to end the routine use of all antibiotics included on the World Health Organization’s list of critically important antibiotics. This week we have published an open letter to the CEOs of KFC, Subway and McDonald’s calling on them to make global commitments to end the routine use of all antibiotics included on the World Health Organization’s list of medically important antimicrobials, in all of their livestock supply chains. This means prohibiting suppliers from using these antibiotics for growth promotion or disease prevention and only using these antibiotics when there has been a diagnosis of illness.

Global food brands like KFC, Subway and McDonald’s are in a position to make an impact on the antibiotic resistance crisis, faster than legislation alone. Subway and McDonald’s have already made commitments in North America. In the USA Subway has committed to only source meat and poultry raised on no antibiotics. McDonald’s USA already serves chicken in the raised without the routine use of any of the antibiotics from the WHO list, with McDonald’s Canada soon to follow.

We welcome the progress by Subway and McDonald’s in North America but action in one country or one region is simply not enough. Antibiotic resistance does not respect national boundaries.  Our food and farming systems are more globalised now than ever. Resistant bacteria spread from the guts of farm animals via faeces, air, soil, water, contact with farm workers, contaminated meat.

The response to the antibiotic resistance crisis the world is now facing will need to be multifaceted. Prudent use in human medicine, better hygiene in health care and the development of new drugs will be needed.  We cannot escape public health disaster unless we tackle agricultural use of antibiotics.

The World Health Organization, the UN, the G20, governments, scientists, consumer and environmental advocates, academics and medical professionals all over the world are calling for urgent action to stop the threat of antibiotic resistance.  Global, consumer facing food brands should act now, and act globally.

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. 

Fears over industry influence in proposed new WHO global health forum

Dr Lida Lhotska (Regional Coordinator for the International Baby Food Action Network) has been campaigning on infant and young child nutrition for 20 years.

From 17-25 January 2011 I attended the annual World Health Organization (WHO) Executive Board (EB) meeting in Geneva on behalf of Consumers International (CI) with three other members of IBFAN’s staff, Rebecca Norton, Nahed Ismail and Patti Rundall.

We submitted statements calling for principles contained in the Global Strategy on Infant and Young Child Feeding to be observed as we were concerned about the potential expansion of the role of the baby food industry into the policy setting sphere with a new implementation plan on infant and young child nutrition being developed by WHO. 

It was with concern that we read in the report to the EB on future financing of the WHO by that organisation’s Director General (DG), Dr Margaret Chan, of the proposal for a new Global Health Forum.  The proposal was repeated in Dr Chan’s PowerPoint presentation given during a debate on future funding.  The new forum is designed to bring together Member States, global health funds, development banks, partnerships, non-governmental organisations, civil society organisations, and the private sector to address issues critical to global health.
 

The DG said that the idea for the forum had come from member states and from civil society.  I find it hard to imagine that the private sector was not a very strong advocate for the idea. As a campaigner on infant and young child nutrition, I am all too aware of the dangers of allowing the private sector a hand in shaping policy.  The potential for conflicts of interest is vast and self-evident. 

In many countries, the food industry is keen to fund education, specifically seeking out children, teenage girls and young mothers.  While some governments may welcome such assistance, they should be reminded that there is no such thing as a free lunch. ‘Education’ is all too often used by industry as a subtle and pervasive form of marketing to build trust and to promote fortified foods and supplements as well as foods high in sugar, salt and fat to children.


An interesting example comes from Russia, where Nestlé is pushing chocolate. The company’s ‘Programme about Correct Nutrition - working notebook for school children’ has been used in thousands of schools in Russia. Among other images it shows a mother telling her child that eating chocolate rather than a sandwich before an exam will help her manage the difficult exercises. So what exactly is this Nestlé message about? -  the more chocolate you eat the cleverer you will be?Since few governments have legislation to control health and nutrition claims, the door is left wide open for these market-led strategies leading to dependence on unnecessary products and undermining of sustainable local healthy feeding practices and skills.The Global Health Forum is due to have its first trial run as a one-day meeting linked to the WHO NCD meeting in April in Moscow. A concrete proposal will be submitted to the World Health Assembly in 2011 and if approved, the mechanism could go forward for 2012. We will be watching the process very closely.

Fighting chronic non-communicable diseases

The Pan American Health Organization (PAHO) recently organised a workshop to think about setting up a multi-stakeholder forum to fight chronic non-communicable diseases. CI's Hubert Linders, Information Consultant and Project Coordinator, attended the meeting and writes from Santiago:

'On 23-24 March 2009, the Pan American Health Organization (PAHO) organised a workshop to think about how to set up a multi-stakeholder forum where governments, civil society organisations and industry should come together to fight chronic non-communicable diseases (CNDCs). Among governments and civil organisations, Consumers International was also invited.

These diseases, like diabetes type 2, hypertension, obesity, cardiovascular diseases, some types of cancer and osteoporosis, are the main causes of premature deaths, 80% of which occur in low and middle income countries. Physical inactivity, an unhealthy diet with too much sugar, salt and fat, smoking and abuse of alcohol are the main causes of CNDCs, affecting more and more the poor people.

And what is worse, these diseases can be prevented in many cases. Lowering the salt consumption with 2 to 5 grams each day and smoking less can prevent globally 13,8 million deaths in the coming 10 years[1]! With some other measures, like extra physical activities, etc. this number can be still higher.

Now to be able to achieve that, large changes are necessary which no one party, be it government, industry or civil society, can accomplish by itself. So there is a strong need to bring these parties together to fight the epidemic of CNDCs. What we, governments and NGOs, tried to envision in the two days of brainstorming and work lunches was how to involve the industry without generating conflicts of interest.

Listening to previous experiences of creating alliances and projects, one can see that there are many things going on but these are not aligned. They work locally or nationally or treat specific diseases. The new forum that PAHO is setting up should comprise all CNDCs and all countries in South and North America. A huge task but this is where the transnational companies, selling their sometimes not so healthy food in almost all the North and South American countries, come in.

There is mistrust between NGOs and large corporations. What happens if a company, willing to sponsor a PAHO project, earns money selling unhealthy products (alcohol, tobacco, unhealthy foods and drinks)? Well, the companies related to alcohol or tobacco or guns will never be allowed to do so. Industry with product or services damaging (public) health cannot either. Moreover, companies with a bad corporate social responsibility record are also not considered. PAHO has very strict rules to scrutinise companies and deciding whether they can form part of the platform. Its reputation is at stake and cannot be compromised.

On the other hand, we know that industry is very interested in participating. Maybe because this way they hope to get recognition for their self regulation programs. The food industry got together to start removing trans fats from food stuff. Something which could serve as an example for lowering levels of salt, even though from experience, we know that self regulation alone is not sufficient.

It is interesting and dramatic at the same time to see that many governments are spending their health care money on curing diseases, while they could spend it much more efficiently on preventing people from getting sick in the first place. Doctors are educated in treating patients, not really in preventing people from contracting a disease. The CNDCs will grow in such a pace that the costs involved will explode and be unsustainable soon. Changes have to be made, nationally but also internationally. Even the WHO needs to do so.

Talking about this, we agreed quite quickly and we discussed the next steps that should be taken. And now it is time to stop talking and start doing things. We need to go back to our workplaces, organisations, etc. and figure out how to move forward. In the months to come meetings will be held where industry shall be invited together with other civil organisations. Governments of all countries in the region will be invited too. The plan is to create an alliance with clear roles and criteria for all participating sectors and launch it at the end of 2009. WHO is planning to do so in other regions as well.'

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[1] The Lancet, Volume 370, Issue 9604, Pages 2044 - 2053, 15 December 2007 Chronic disease prevention: health effects and financial costs of strategies to reduce salt intake and control tobacco use Perviz Asaria MPH, Dr Dan Chisholm PhD, Colin Mathers PhD, Majid Ezzati PhD, Robert Beaglehole DSc