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.